scholarly journals Sequential ACTH and catecholamine secretion in a phaeochromocytoma

2002 ◽  
pp. 201-206 ◽  
Author(s):  
PS van Dam ◽  
A van Gils ◽  
MR Canninga-van Dijk ◽  
EJ de Koning ◽  
LJ Hofland ◽  
...  
Keyword(s):  
Severe Hypertension ◽  
Catecholamine Secretion ◽  
Surgical Removal ◽  
Ectopic Acth ◽  
Hyperintense Signal ◽  
Ectopic Acth Production ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
T2 Weighted Images

OBJECTIVE: We describe a patient with an ACTH-producing phaeochromocytoma who initially presented with hypercortisolism and normal catecholamine concentrations, followed by near-normalisation of ACTH secretion and massive catecholamine secretion. In vitro studies were carried out on the tumour to evaluate the interaction between the tumour cells and normal adrenal cortex. METHODS AND RESULTS: A 30-year-old man initially presented with severe hypercortisolism, biochemical evidence of ectopic ACTH production, a tumour in the right adrenal gland without a hyperintense signal on the T2-weighted images at magnetic resonance imaging (MRI) scanning, and normal urinary metanephrine concentrations. After 6 months, ACTH production had almost completely resolved, but the patient developed severe hypertension and excess catecholamines. At repeated MRI-scanning, the T2-weighted images showed a hyperintense signal, in agreement with the diagnosis of phaeochromocytoma. Although the initial T1-weighted images suggested bleeding in the adrenal tumour, no signs of bleeding were observed after surgical removal. The diagnosis of ACTH-producing phaeochromocytoma was histologically and immunohistochemically confirmed. Cultured cell suspensions of the tumour secreted ACTH, which stimulated cortisol production in the ipsilateral adrenocortical cells. CONCLUSION: This case demonstrates that the biological activity of an ACTH-producing phaeochromocytoma can vary significantly in time, which may be the consequence of different stages of tumour differentiation.

Adrenocorticotropin Production by a Mammary Carcinoma

1977 ◽  
Vol 35 ◽  
pp. 462-463
Author(s):  
K.S. McCarty ◽  
N.R. Wallace ◽  
W. Litaker ◽  
S. Wells ◽  
G. Eisenbarth
Keyword(s):  
Adrenocorticotropic Hormone ◽  
Small Cell ◽  
Hormone Production ◽  
Carcinoma Of The Breast ◽  
Ectopic Acth ◽  
Ultrastructural Studies ◽  
Subcutaneous Metastases ◽  
Ectopic Acth Production ◽  
The Right ◽  
Pituitary Carcinomas

The production of adrenocorticotropic hormone by non-pituitary carcinomas has been documented in several tumors, most frequently small cell carcinoma of the lung, islet cell carcinomas of the pancreas, thymomas and carcinoids. Electron microscopy of these tumors reveals typical membrane-limited "neurosecretory" granules. Confirmation of the granules as adrenocorticotropin (ACTH) requires the use of OsO4 as a primary fixative to give the characteristic cored granule appearance in conjunction with immunohistochemical demonstration of the hormone peptide. Because of the rarity of ectopic ACTH production by mammary carcinomas and the absence of appropriate ultrastructural studies in the two examples of such ectopic hormone production in the literature of which we are aware (1,2), we present biochemical and ultrastructural data from a carcinoma of the breast with apparent ACTH production.The patient had her primary tumor in the right breast in 1969. The tumor recurred as visceral and subcutaneous metastases in 1976 and again in 1977.

Ectopic ACTH production by a bronchial carcinoid tumour responsive to desmopressin in vivo and in vitro

1997 ◽  
Vol 47 (5) ◽  
pp. 623-627 ◽  
Author(s):  
W. Arlt ◽  
P.L.M. Dahia ◽  
F. Callies ◽  
J.P. Nordmeyer ◽  
B. Allolio ◽  
...  
Keyword(s):  
Carcinoid Tumour ◽  
Bronchial Carcinoid ◽  
Ectopic Acth ◽  
Ectopic Acth Production

scholarly journals A rare case of Cushing syndrome by cyclic ectopic-ACTH

2012 ◽  
Vol 56 (5) ◽  
pp. 324-330 ◽  
Author(s):  
Mariana Farage ◽  
Mario Alberto da Dantas Loures Costa ◽  
Amélio Fernando Godoy-Matos
Keyword(s):  
Primary Tumor ◽  
Rare Case ◽  
Glomus Tumor ◽  
Cushing Syndrome ◽  
Severe Hypertension ◽  
Abdominal Fat ◽  
Ectopic Acth ◽  
Mood Changes ◽  
Ectopic Acth Production

ACTH-dependent Cushing syndrome (CS) due to ectopic ACTH production is most times difficult to manage. The identification of the source of ACTH may take many years. Surgery or chemotherapy for the primary tumor is not always possible. Control of Cushing symptoms is many times achieved using medication, or bilateral adrenalectomy in refractory cases. This case presents a Brazilian male who showed severe hypertension, mood changes, muscle weakness, darkening of skin, and increased abdominal fat. An investigation for Cushing syndrome was carried out and, after a four-year follow-up, a carotid glomus tumor (chemodectoma) was confirmed, a rare ectopic ACTH-producing tumor. Besides, the patient presented cyclic Cushing syndrome that was exacerbated by diverticulitis episodes. This case presents interesting pitfalls on diagnosis and management of ACTH-dependent CS. This is the only report of a chemodectoma that produced ACTH in the literature.

scholarly journals Wallerian-Like Degeneration After Ischemic Stroke Revealed by Diffusion - Weighted Imaging

2007 ◽  
Vol 34 (2) ◽  
pp. 243-244 ◽  
Author(s):  
P. N. Sylaja ◽  
M. Goyal ◽  
T. Watson ◽  
M. D. Hill
Keyword(s):  
Cerebral Artery ◽  
Diffusion Weighted Imaging ◽  
Acute Onset ◽  
Cerebral Peduncle ◽  
Diffusion Weighted ◽  
Intravenous Tissue Plasminogen Activator ◽  
Hyperintense Signal ◽  
Apparent Diffusion ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

A 22-year-old female was seen in the emergency within one hour of acute onset of right sided headache followed by weakness of the left side of body. On neurological examination, she was mildly drowsy, had forced right gaze deviation, dysarthria, left hemiplegia and left hemisensory loss. Computed tomography (CT) scan revealed early ischemic changes in the right middle cerebral artery (MCA) territory. The CT angiography done showed evidence of dissection of the supraclinoid segment of the right internal carotid artery with reduced flow distally into the MCA, which was confirmed by a conventional angiogram. In view of the intracranial carotid dissection, the patient was not treated with intravenous tissue plasminogen activator. Magnetic resonance imaging (MRI) of the brain done on the next day revealed evidence of acute ischemic lesions in the right MCA and anterior cerebral artery territory on diffusion-weighted imaging (DWI), with normal brainstem. [Figure 1] A repeat MRI performed 13 days after ictus showed hyperintense signal on DWI in the right cerebral peduncle which was hypointense on apparent diffusion coefficient (ADC) map suggestive of Wallerian-like degeneration. [Figure 2] The signal changes were less conspicuous on T2-weighted images. She had antigravity strength in the left leg but remained weak in her left arm at one month.

scholarly journals Cushing's syndrome due to ectopic ACTH production by a nasal paraganglioma

2013 ◽  
Vol 2013 ◽  
Author(s):  
F Serra ◽  
S Duarte ◽  
S Abreu ◽  
C Marques ◽  
J Cassis ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Microscopic Analysis ◽  
Cushing's Syndrome ◽  
Ectopic Acth Syndrome ◽  
List Type ◽  
Rare Tumour ◽  
Ectopic Acth ◽  
Ectopic Acth Production ◽  
The Right

Summary Ectopic secretion of ACTH is an infrequent cause of Cushing's syndrome. We report a case of ectopic ACTH syndrome caused by a nasal paraganglioma, a 68-year-old female with clinical features of Cushing's syndrome, serious hypokalaemia and a right paranasal sinus' lesion. Cranial magnetic resonance image showed a 46-mm mass on the right paranasal sinuses. Endocrinological investigation confirmed the diagnosis of ectopic ACTH production. Resection of the tumour normalised ACTH and cortisol secretion. The tumour was found to be a paraganglioma through microscopic analysis. On follow-up 3 months later, the patient showed nearly complete clinical recovery. Ectopic ACTH syndrome due to nasal paraganglioma is extremely uncommon, as only two other cases have been discussed in the literature. Learning points Ectopic Cushing's syndrome accounts for 10% of Cushing's syndrome etiologies. Most paraganglioma of the head and neck are not hormonally active. Nasal paraganglioma, especially ACTH producing, is a very rare tumour.

Trigeminal Cave Brain Metastasis from Prostate Adenocarcinoma: Case Report and Review of the Literature

2018 ◽  
Vol 37 (04) ◽  
pp. 330-333
Author(s):  
João Zanatta ◽  
Laisa Zanella ◽  
Guilherme Kurtz ◽  
Bárbara Gabardo ◽  
Alex Roman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Brain Metastases ◽  
Prostate Specific Antigen ◽  
Cranial Nerve ◽  
Specific Antigen ◽  
Prostate Adenocarcinoma ◽  
Brain Parenchyma ◽  
Surgical Removal ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

The present study presents the case of a 66-year-old patient diagnosed with prostate adenocarcinoma 4 years earlier and treated with prostatectomy, radiotherapy, chemotherapy and hormone therapy but still displaying high prostate-specific antigen (PSA) levels. The patient complaints were double vision and headaches. Upon physical examination, he displayed 6th cranial nerve paresis and 5th cranial nerve paresthesia. A magnetic resonance imaging (MRI) exam was performed, which revealed a mass on the right trigeminal cave. The patient underwent surgical removal of the tumor, and the pathological analysis of the specimen established metastatic prostate cancer as the diagnosis.Brain metastases from prostate cancer are extremely rare and mark advanced disease, with immune system failure and blood-brain barrier breach. Prostate-specific antigen levels do not correlate with the possibility of metastatic disease. Prostate adenocarcinoma is the histologic type most commonly associated with brain metastases, with the meninges being more frequently affected, followed by the brain parenchyma. The neurological symptoms more often displayed are non-focal, such as headaches and mental confusion. Surgery associated with radiotherapy is the most validated treatment.

scholarly journals Intracranial Mature Teratoma in an Adult Patient: A Case Report

2019 ◽  
Vol 80 (01) ◽  
pp. e14-e17
Author(s):  
Dominik Romić ◽  
Marina Raguž ◽  
Petar Marčinković ◽  
Patricija Sesar ◽  
Martina Špero ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Radical Resection ◽  
Brain Parenchyma ◽  
Surgical Removal ◽  
Histopathological Analysis ◽  
Intracranial Teratoma ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Introduction: Primary intracranial teratoma is a subtype of germ cell tumors, classified into three subtypes. They occur very rarely, with only several reported individual cases in adults. Case Description We present a patient with an intermittent headache in the right frontal region. Magnetic resonance imaging (MRI) revealed a right sided high frontal parasagittal mass that compressed the falx, the right lateral ventricle, as well as the brain parenchyma. Patient underwent surgical treatment. Histopathological analysis described mature teratoma. Four months after the surgical treatment there were no signs of residual intracranial mass or relapse. Discussion Primary intracranial teratoma in adults has a nonspecific clinical presentation. MRI reveals a solitary irregular mass with multilocularity and mixed signals derived from different tissues. The patients age, biochemical markers, and patohistological analysis are necessary to confirm the diagnosis. Conclusion Teratoma treatment strategy still remains controversial. It includes radical resection whenever possible. Since the residual portion of mature teratoma may contain part of immature or malignant tissue, tumor recurrence after surgical removal is possible. Also, new tumor mass could occur at other sites intracranial after the initial one was removed. Thus, although patients usually recover, they should be followed-up for a long period of time.

scholarly journals Giant Posttraumatic Angiolipoma of the Forearm: A Case Report and Review of the Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Athanasios Fotiadis ◽  
Petros Ioannidis ◽  
Ioannis Skandalos ◽  
Stergios Papastergiou ◽  
Aristeidis Vrettakos ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Tumor ◽  
Histological Evaluation ◽  
Surgical Removal ◽  
Vascular Proliferation ◽  
Soft Tissue Masses ◽  
Benign Soft Tissue Tumor ◽  
General Surgeons ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Angiolipoma is a type of lipoma, a benign soft tissue tumor. It is distinguished by the excessive degree of vascular proliferation and the presence of mature adipocytes. It occurs commonly on the trunk and extremities. Angiolipomas larger than 4 cm are classified as “giant,” and due to their size, histological evaluation is necessary to exclude malignancy. We report a case of a male patient who suffered from a giant noninfiltrating intramuscular angiolipoma which formed after venipuncture in the antecubital fossa. Clinical examination showed a palpable painless soft mass. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a giant angiolipoma on the right forearm. Surgical removal of the mass was performed, and the biopsy was negative for malignancy. To the best of our knowledge, this is the first report in the literature of posttraumatic intramuscular angiolipoma. Physicians and orthopedic/general surgeons should be aware of the possibility of soft tissue masses in a posttrauma situation.

scholarly journals Intraventricular tuberculosis abscess in an immunocompromised patient: clinical vignette

2021 ◽  
Vol 15 (6) ◽  
pp. 293-297
Author(s):  
Mohamad Hanafiah ◽  
Shahizon A Mohamed Mukhari ◽  
Aida M Mustapha ◽  
Nazimah Ab Mumin
Keyword(s):  
Polymerase Chain Reaction Analysis ◽  
External Ventricular Drainage ◽  
Tuberculous Infection ◽  
High Grade Fever ◽  
Hyperintense Signal ◽  
Tuberculous Abscess ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
Hypointense Signal ◽  
The Right

Abstract Tuberculosis is caused by Mycobacterium tuberculosis. Tuberculosis of the central nervous system is common and manifestations include meningeal and intraparenchymal diseases. However, intraventricular tuberculous abscess is a rare manifestation of intracranial tuberculous infection. We present a case of an immunocompromised female patient with high-grade fever and signs of meningism. The computed tomography and magnetic resonance imaging (MRI) of the brain showed hydrocephalus with rim-enhancing lesion in the right lateral ventricle. The MRI demonstrated a hypointense signal on T1-weighted imaging, hyperintense signal on T2-weighted imaging, and mild restricted diffusion in diffusion-weighted imaging. She underwent emergency external ventricular drainage and frank pus was drained. Diagnosis of tuberculosis was made via polymerase chain reaction analysis and culture. Understanding the intracranial manifestation of neurotuberculosis is imperative to arrive at the diagnosis correctly and ensure prompt treatment.

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