Asymptomatic and Biochemically Silent Pheochromocytoma with Characteristic Findings on Imaging

Liposarcomas are common malignant soft-tissue tumors, which come from primitive mesenchymal cells and differentiate into adipose tissue. These tumors are more commonly found in lower limbs and retroperitoneal region but also reported in pharynx, lung, liver, digestive tract, diaphragm, as well as in the spermatic cord. We reported a case of primary orbital myxoid liposarcoma in a 20-year-old female patient presented with a painless proptosis of the right eye. The mass was pathologically diagnosed as a myxoid liposarcoma. The tumor recurred in 9 months after surgical intervention. The second surgery was performed and followed by postoperative local radiotherapy. No recurrence has been reported after one year of follow-up. We highlighted the role of CT and MRI findings in the tumor diagnosis and the importance of local radiotherapy after surgery. Asian Journal of Medical Science, Volume-4 (2013), Pages 28-32 DOI: http://dx.doi.org/10.3126/ajms.v4i4.8311

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Intraoperative Anesthetic Management in an Asymptomatic and Biochemically Silent Pheochromocytoma

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i10/1227 ◽

2021 ◽

Vol 6 (10) ◽

pp. 716-719

Author(s):

Omar N. ◽

Shahid M. ◽

M. Bashir ◽

Imran S. ◽

Vipin K. ◽

...

Keyword(s):

Adrenal Mass ◽

Intraoperative Complications ◽

Anesthetic Management ◽

Preoperative Evaluation ◽

Hypertensive Crisis ◽

Surgical Techniques ◽

Surgical Removal ◽

Asymptomatic Patients ◽

Laparoscopic Techniques ◽

Chromaffin Tissue

Pheochromocytomas are tumors that originate from the chromaffin tissue of the adrenal medulla and commonly produce catecholamines. The diagnosis is typically established by the measurement of catecholamines or their metabolites in urine or plasma and tumors are localized with the use of radiographic and scintigraphic studies. Pheochromocytomas can occur in asymptomatic patients and the preferred treatment is surgical removal of the tumor. These chromaffin tissue tumors are not uncommon in anesthetic practice and have varied manifestations. The perioperative management of these tumors has improved remarkably over the yearsin conjunction with the evolution of surgical techniques (laparotomy to laparoscopic techniques and now to robotic approaches.). Majority of the patients present with normal clinical and biochemical parameters in the preoperative period, the incidence of hypertension being only 50 %. Even though patients may be clinically asymptomatic, surveillance and proper preoperative evaluation is important, as surgery for associated tumors may precipitate a hypertensive crisis and result in severe complications. We report an intraoperative anesthetic management of 32-year-old female with a left adrenal mass (pheochromocytoma) and left ovarian cyst. Throughout her entire course of treatment she was asymptomatic with normal blood pressure readings. Her biochemical screening was unremarkable. She underwent open surgical resection of the adrenal mass with confirmation of pheochromocytoma on histology. Pheochromocytoma represents very significant challenges to the anesthesiologist’s especially when undiagnosed. This case illustrates how paucity of literature on perioperative preparation of clinically and biochemically silent Pheochromocytomas led to serious intraoperative complications even in an asymptomatic, biochemically negative patient.

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Successful Conservative Management of a Dislocated IUD

Case Reports in Obstetrics and Gynecology ◽

10.1155/2015/130528 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3

Author(s):

Hasan Ali Inal ◽

Zeynep Ozturk Inal ◽

Ender Alkan

Keyword(s):

Conservative Management ◽

Low Cost ◽

Rare Complication ◽

Abdominal Cavity ◽

Surgical Removal ◽

Uterine Perforation ◽

Contraceptive Devices ◽

Asymptomatic Patients ◽

Intrauterine Contraceptive

Background. Intrauterine contraceptive devices (IUDs) are widely utilized all over the world owing to their low cost and high efficacy. Uterine perforation is a rare complication that may occur at IUD insertion resulting in extrauterine location of the IUD. Traditionally, surgical removal of dislocated IUDs has been recommended.Case. A 68-year-old patient who had an IUD (Lippes loop) inserted 32 years ago and whose routine examination incidentally revealed a dislocated IUD in the abdominal cavity. The patient remained asymptomatic during three years of follow-up and the IUD was left in place.Conclusion. Asymptomatic patients, whose vaginal examinations and ultrasonography or X-ray results reveal a dislocated IUD, may benefit from conservative management.

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A rare case of fetus in fetu in the sacrococcygeal region: CT and MRI findings

BMC Pediatrics ◽

10.1186/s12887-021-03063-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tao Lu ◽

Junmei Ma ◽

Xudan Yang

Keyword(s):

Tethered Cord ◽

Axial Skeleton ◽

The Body ◽

Pathological Examination ◽

Surgical Removal ◽

Mri Findings ◽

Fetus In Fetu ◽

Common Location ◽

Sacrococcygeal Region ◽

Ct And Mri

Abstract Background Fetus in fetu is a rare condition in which a malformed fetus is found in the body of a living twin. The retroperitoneum is the most common location of this condition. However, the sacrococcygeal region is a rare site of the disease. The presence of vertebral bodies and limbs differentiates FIF from teratoma. Imaging modalities are important for diagnosing FIF. Case presentation A 12-months old boy was hospitalized because of a mass in the sacrococcygeal region. CT showed a large, complex mass with bony structure resembling sacrococcygeal bone, hip bone and the femur in the sacrococcygeal region of the boy. The blood supply of the mass was from the aorta of the host. MRI revealed the mass was connected with the dilated sacral canal of the host, which resulted in tethered cord. A preoperative diagnosis of FIF was made and surgery was performed to remove the mass. Surgical removal and subsequent pathological examination revealed the anencephalic fetus had limb buds and a sacrum but no axial skeleton, which supported the diagnosis of FIF. Conclusions CT and MRI played important roles in diagnosing FIF based on the location of the lesion.

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Presentation and management of pheochromocytomas and paragangliomas: about 40 cases

African Journal of Urology ◽

10.1186/s12301-021-00265-4 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Faten Hadj kacem ◽

Ameni Salah ◽

Bilel Fathallah ◽

Khouloud Boujelben ◽

Nadia Charfi ◽

...

Keyword(s):

Genetic Diseases ◽

Adrenal Incidentaloma ◽

Population Based ◽

Clinical Aspects ◽

Magnetic Resonance Imaging Scan ◽

Spss Software ◽

Plasma Free Metanephrines ◽

Evolutionary Aspects ◽

Chromaffin Tissue

Abstract Background Pheochromocytoma and paraganglioma are rare neuroendocrine tumors of the chromaffin tissue, which may produce catecholamines. The aim of our study was to analyze the clinical and para-clinical aspects as well as the therapeutic and evolutionary aspects of pheocromocytomas and paragangliomas based on a series of 40 cases. Methods Our retrospective population-based research study includes 40 patients. Then, a statistical analysis was carried out using the SPSS software (version21). Results Our study involves 40 patients, including 23 women (57, 5%) and 17 men (42,5%). The mean age at the time of the diagnosis was 43.8 ± 16.8 years. The circumstances of the discovery were mainly characterized by adrenal incidentaloma and hypertension. The biological diagnosis was based on the dosage of urinary metanephrines and plasma-free metanephrines in, respectively, 61.5% and 18% of cases. A computerized tomography scan and/or a magnetic resonance imaging scan could help to locate the tumor in 100% of cases. Our series includes 3 cases of bilateral pheochromocytoma, 3 cases of paragangliomas and 1 case of malignant pheochromocytoma, while a hereditary form was retained in 3 patients. In fact, thirty-two patients were operated; cure was clinically labeled in 100% and biologically in 87.5% of patients. Conclusions The main points for improvement that our study has revealed are; a patient follow-up after surgery, which was not always regular, and an insufficient screening for genetic diseases associated with pheochromocytomas and paragangliomas.

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An incidental radiographic finding of an inverted mesiodens — A case report with a comprehensive review

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4553 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 2768-2776

Author(s):

Rakhi Issrani ◽

Hessah Alfrhan ◽

Arunpriya Srinivasan ◽

Namdeo Prabhu

Keyword(s):

Developmental Disorders ◽

Treatment Options ◽

Radiographic Finding ◽

Radiographic Examination ◽

Surgical Removal ◽

Supernumerary Teeth ◽

Asymptomatic Patients ◽

Nasal Floor ◽

Exact Position

Supernumerary teeth (ST) are uncommon developmental disorders that can be seen in either of the dental arches. Mesiodens is the most common type of ST. The experience of observing one such case is reported along with a literature review. This article describes a clinical case of a 46-year-old female patient with an impacted inverted mesiodens that was diagnosed accidentally during the routine radiographic examination. The mesiodens was very close to the nasal floor. Advanced radiographic investigations (CBCT) was advised for locating the exact position of mesiodens. The patient was counselled regarding the potential complications of ST and was advised for the surgical removal of the mesiodens, but the patient denied the treatment as ST was not causing any immediate problem. Therefore, the patient is under the continuous follow-up to avoid any complications with the mesiodens. The present case focuses on the importance of careful clinical and radiographic assessment in the diagnosis of ST, especially when they are asymptomatic. Patients should be educated regarding the same with proper explanations of all the treatment options.

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