scholarly journals Mixed corticomedullary tumor accompanied by unilateral aldosterone-producing adrenocortical micronodules: A case report

2021 ◽  
Author(s):  
Sawa Yoshida ◽  
Naru Babaya ◽  
Hiroyuki Ito ◽  
Yoshihisa Hiromine ◽  
Yasunori Taketomo ◽  
...  
Keyword(s):  
Case Report ◽  
Tumor Cells ◽  
Adrenocorticotropic Hormone ◽  
Adrenal Tumor ◽  
Histopathological Examination ◽  
Clinical Findings ◽  
Subclinical Cushing’S Syndrome ◽  
Cortical Cells ◽  
Hybrid Tumor ◽  
Ectopic Production

Abstract Mixed corticomedullary tumors (MCMTs) are rare and comprise of medullary and cortical cells in a single adrenal tumor. The mechanisms underlying its development have not been fully elucidated. Here, we report a case of MCMT in a 42-year-old woman. Based on the preoperative clinical findings, the patient was diagnosed as having a pheochromocytoma with subclinical Cushing's syndrome. Postoperative pathological diagnosis revealed that the tumor demonstrated morphologically distinct medullary and cortical components, which produced catecholamines and cortisol, respectively. Hybrid tumor cells producing both catecholamines and cortisol were not detected. Adrenocorticotropic hormone (ACTH)-positive tumor cells were identified to be present in the pheochromocytoma. This ectopic production of ACTH can contribute to an autonomous cortisol production in a paracrine manner. In addition, micronodules producing aldosterone were detected in the adrenal tissue adjacent to the tumor. The simultaneous development of these two lesions may not be correlated with each other; however, this case confirms the importance of a detailed histopathological examination of the adrenal lesions harboring complicated hormonal abnormalities by providing pivotal and indispensable information on their pathogenesis and the possible interaction of the hormones produced in the adrenal gland.

scholarly journals Tuberous sclerosis complex diagnosed from oral lesions

2013 ◽  
Vol 131 (5) ◽  
pp. 351-355 ◽  
Author(s):  
Leonardo de Jesus Araujo ◽  
Guilherme Braga Muniz ◽  
Edmilson Santos ◽  
Joao Paulo Versiani Ladeia ◽  
Hercilio Martelli Junior ◽  
...  
Keyword(s):  
Case Report ◽  
Tuberous Sclerosis ◽  
Tuberous Sclerosis Complex ◽  
Histopathological Examination ◽  
Dental Enamel ◽  
Clinical Findings ◽  
Subependymal Giant Cell Astrocytoma ◽  
Abdominal Ultrasonography ◽  
Nasolabial Folds ◽  
Expansive Process

CONTEXT: Tuberous sclerosis complex (TSC) is a genetic disease in the group known as neurocutaneous syndromes, with dominant autosomal inheritance. It is characterized by skin and adnexal lesions and central and peripheral nervous system tumors, with neurological and psychiatric findings. It may affect the heart, kidneys, eyes, face, bones, lungs, stomach and dentition. CASE REPORT: We present the case of a 66-year-old man with dermatological signs that included hypopigmented maculae, confetti-like lesions, shagreen plaque, angiofibromas on nasolabial folds, neck and back, nail dystrophy and periungual fibromas on fingers and toes. An electroencephalogram produced normal results, but magnetic resonance imaging showed a nodular image measuring 1.2 x 1.0 cm close to the Monro foramen, which was similar to cerebral parenchyma and compatible with a subependymal giant-cell astrocytoma. A conservative approach was taken, through control imaging examinations on the lesion for seven years, with absence of any expansive process or neurological symptoms. Abdominal ultrasonography revealed a solid, heterogenic and echogenic mass with a calcified focus, measuring 4.6 x 3.4 cm, in the rightkidney, compatible with angiomyolipoma. The patient was treated by means of complete nephrectomy because of malignant areas seen on histopathological examination and died one month after the procedure. This case report illustrates the importance of oral clinical findings such as dental enamel pits and angiofibromas in making an early diagnosis of TSC, with subsequent screening examinations, treatment and genetic counseling.

scholarly journals Subungual Onycholemmal Cysts: A Case Report

2021 ◽  
pp. 394-398
Author(s):  
Erika Lydrup ◽  
Anette Pedersen Pilt ◽  
Volker-Jürgen Schmidt ◽  
Hannah Trøstrup
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Clinical Findings ◽  
Differential Diagnoses ◽  
Nail Bed ◽  
Histological Features

Subungual onycholemmal cysts (SOCs) are rare nail abnormalities. The clinical findings vary and include onychodystrophy, ridging, nail bed pigmentation, and thickening, but most often SOCs do not cause any symptoms and are accidental findings. In this case report, we present a case of a woman with pigmentation of the toenail, suspect for melanoma. Surprisingly, the histopathological examination showed SOCs. We discuss the histological features of SOCs, etiology, and differential diagnoses.

scholarly journals The role of microfilaments in the response of adrenal tumor cells to adrenocorticotropic hormone.

1979 ◽  
Vol 254 (18) ◽  
pp. 9080-9084 ◽  
Author(s):  
P.F. Hall ◽  
C. Charpponnier ◽  
M. Nakamura ◽  
G. Gabbiani
Keyword(s):  
Tumor Cells ◽  
Adrenocorticotropic Hormone ◽  
Adrenal Tumor

scholarly journals Case of BRAF mutant Erdheim-Chester disease presenting with multisystem involvement: A case report

2021 ◽  
Vol 8 (2) ◽  
pp. 136-139
Author(s):  
Nang Hseng Kyio ◽  
Tugce Kıran ◽  
Ali Eser ◽  
Guven Cetin ◽  
Cumali Karatoprak
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Endocrine System ◽  
Clinical Findings ◽  
Unknown Etiology ◽  
Erdheim Chester Disease ◽  
Multisystem Involvement ◽  
Imaging Results ◽  
Erdheim Chester ◽  
Chester Disease

Objective: Erdheim-Chester disease is a rare form of non-Langerhans cell histiocytosis of unknown etiology. It is a multisystemic disease that can involve bones, skin, brain, retroperitoneum, cardiovascular system, endocrine system, and lungs. Diagnosis is made by clinical findings, imaging results, and histopathological examination. BRAFV600E (B-rapidly accelerated fibrosarcoma gene) mutation is found in more than half of the cases. When Erdheim-Chester disease is not considered the differential diagnosis, it is not possible to diagnose and treat. In this case report, an Erdheim-Chester case with symptomatic, multisystem involvement, BRAFV600E mutation, and initiated vemurafenib treatment is presented in the light of literature data.

scholarly journals Mixed Corticomedullary Tumors of the Adrenal Gland Harboring Both Medullary and Cortical Properties

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A143-A143
Author(s):  
Aiko Inoue ◽  
Sachika Inoue ◽  
Rui Sawai ◽  
Keita Hamamatsu ◽  
Kyoko Okazaki ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Tumor Cells ◽  
Adrenal Cortex ◽  
Chromogranin A ◽  
Adrenal Tumor ◽  
Uterine Fibroids ◽  
Plasma Renin ◽  
Clinical Findings ◽  
Plasma Adrenaline ◽  
First Case

Abstract Adrenal cortex and medulla are derived from mesoderm and ectoderm, respectively. Mixed corticomedullary tumors (MCMTs), comprising an intimately admixed population of both adrenal cortical cells and pheochromocytes in a single adrenal tumor, are extremely rare and its pathogenesis has remained unknown. Here, we report a case of MCMT whose cells co-expressed cortical and medullary antigens in the same tumor cells.[Case description]A 40-year-old woman was referred to our hospital for investigating Takotsubo cardiomyopathy following resection of uterine fibroids. An abdominal CT scan depicted a 24 mm tumor on her left adrenal gland. Her basal serum ACTH, cortisol levels and urinary cortisol were 13.8 pg/mL, 9.5 μg/dL, and 26.5 μg/day respectively. The cortisol level was normally suppressed by an administration of 1 mg dexamethasone (1.4 μg/dL). Plasma renin activity, aldosterone levels and urinary aldosterone were 15.0 ng/mL/h, 122 pg/mL, and 5.0 μg/day, respectively (with administration history of azosemide). On the other hand, her plasma adrenaline and noradrenaline levels were elevated as high as 177 pg/mL and 536 pg/mL, and urinary metanephrine and normetanephrine were 2.12 mg/day and 1.10 mg/day. A 123I-metaiodobenzylguanidine scan revealed high uptake in the tumor. After adequate adrenergic α-receptor blockage, left adrenalectomy was performed. Her postoperative endocrine and clinical findings were normalized without any further complications.[Pathology] Immunohistochemistry (IHC) revealed the presence of MCMT. Cells morphologically consistent with pheochromocytoma and adrenocortical cells were confirmed by immunostaining of chromogranin A and SF-1, respectively. Chromogranin A-positive medullary-derived and SF-1-positive cortical-derived tumor cells were intermixed in the chimeric fashion. In addition, some tumor cells were positive for both proteins, indicating hybrid nature of the cells. Tumor cells of cortical origin expressed CYP11β1, 3β-HSD, p450c21, and p450c17, but not CYP11β2. Non neoplastic adrenal cortex were atrophic, whereas the glomerulosa was hyperplastic positive for CYP11β2, consistent with diffuse hyperplasia and adrenal medullar unremarkable. [Conclusions:]The adrenal tumor was clinically diagnosed as pheochromocytoma, but the pathological findings did reveal cortisol production in the tumor and aldosterone overproduction in the accompanying cortex. This is the first case of MCMT co-expressing adrenal medullary and cortical antigens in the same tumor cells as hybrid cells.

scholarly journals Orofacial Crohn’s disease: a Case Report

2017 ◽  
Vol 21 (2) ◽  
pp. 123-126
Author(s):  
Damla Tuncer Budanur ◽  
Merve Şirin ◽  
Elif Sepet ◽  
Meral Ünür ◽  
Mine Güllüoğlu ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Case Report ◽  
Crohn's Disease ◽  
Histopathological Examination ◽  
Abdominal Ultrasound ◽  
Punch Biopsy ◽  
Clinical Findings ◽  
Ulcer Formation ◽  
Lower Lip ◽  
Exclusive Enteral Nutrition

Summary Background: Crohn’s disease (CD) and ulcerative colitis (UC) are the two major relapsing conditions of inflammatory bowel diseases. Case Report: A case of Crohn’s disease with orofacial manifestations in a 10 year old girl is described. She had suffered from fever, dysphagia, arthralgia, painful recurrent ulcers of the oral mucosa and swelling of the lower lip lasting over 6 weeks. Clinical examination and the punch biopsy from the buccal mucosa revealed major recurrent aphthous ulcerations. A partial regression and significant relief of lesions were achieved two weeks after the treatment, but the patient suffered from abdominal pain, irregular bowel movements, arthritis, multiple hyperplastic and swollen mucosal folds, after 3 months. The patient was referred to a pediatric gastroenterologist. Esophagogastroduodenoscopy showed pyloric ulcer formation. Abdominal ultrasound showed increased thickening of the ileal wall with multiple enlarged lympadenopathies in the periileal region. Colonoscopy images showed deep ulcers with surrounding erythema. The histopathological examination of biopsies from the terminal ileum and the colon showed basal plasmacytosis, minimal crypt distortions and aphthous ulcerations. The diagnosis of Orofacial Crohn’s disease was made. Exclusive enteral nutrition for 8 weeks, followed by azathiopurine treatment was started with an excellent clinical response on abdominal and oral symptoms. Conclusion: Diagnosis of the disease by dentists and other clinicians through the evaluation of oral clinical findings is very rare. Mucocutaneous and granulomatous lesions of the oral cavity should alert the clinician to pursue an underlying systemic cause. Early communication with a gastroenterologist can help early diagnosis of Crohn’s disease for better patient management and prognosis.

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

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