Left Adrenal Carcinoma Research Articles

Neoadjuvant chemotherapy and salvage surgery for an aldosterone-producing adrenal carcinoma with inferior vena cava thrombus: Case report and literature review

Inferior vena cava (IVC) thrombus is a rare presentation of adrenal carcinoma. Hyperladosteronism is rarely associated with it. We report a case of an aldosterone-producing left adrenal carcinoma with IVC thrombus and invasion of multiple organs, treated with neoadjuvant chemotherapy and salvage surgery. The patient is alive and asymptomatic after 46 months. Surgical aspects and therapeutic options are discussed and compared with the current medical literature. This is believed to be the first report of multiple organ resection combined with IVC thrombus removal for a functioning adrenal carcinoma.

Primary hepatocellular carcinoma in ectopic liver masquerading as left adrenal carcinoma: a rare occurrence

We report a unique case of primary hepatocellular carcinoma in an ectopic liver rest in the left renal hilum masquerading as a left adrenal tumor. Adrenal tumors have been reported within adrenal rests inside the liver but hepatocellular carcinoma in ectopic liver rests in the adrenal area is an extremely rare entity. To the best of our knowledge, this is the first case report from the Indian subcontinent to describe this event in the English literature.Our patient, a sixty-year-old, non-diabetic, non-hypertensive male, presented with a history of left flank pain for the past six months. He was a chronic smoker and also consumed excessive amounts of alcohol. He had chronic obstructive pulmonary disease and was hepatitis B surface antigen positive. A contrast enhanced computer tomography scan of the abdomen showed an 8×8×8 cm, well-defined, heterogeneously enhancing mass with central necrosis, in the left suprarenal region. The provisional diagnosis of an adrenal tumor was made and open transperitoneal excision of the tumor along with two enlarged lymph nodes was done. Immunohistochemistry staining of the specimen revealed it to be a primary hepato cellular carcinoma. The patient died within six months of surgery owing to extensive metastases. We concluded that chronic hepatitis B infection and chronic and excessive alcohol consumption and/or chronic smoking may have been the predisposing factors for the occurrence of primary hepatocellular carcin oma in the liver rest in our patient. The prognosis appears to be poor despite surgical management.

The Safety and Efficacy of Laparoscopic Adrenalectomy in Children—Invited Critique

Hypothesis: Laparoscopic adrenalectomy (LA) has become standard therapy for benign adrenal masses in adults. The utility of LA in children with adrenal masses is less well defined because of the infrequency and pathologic variability of pediatric adrenal masses, and body size and instrumentation considerations that exist in small children. Evaluation of a case series of children undergoing lateral, transperitoneal LA will reflect the safety and efficacy of this procedure in pediatric patients and identify preferred patient selection criteria. Design: A combined case series including patients treated between March 1999 and November 2004. Setting: Urban tertiary referral pediatric teaching hospitals. Patients and Interventions: All children with pathologic adrenal masses undergoing LA were included. Main Outcome Measures: The primary study outcome measures included operative duration, conversions to open adrenalectomy, complications, length of hospital stay, and freedom from recurrence of the original pathologic adrenal mass. Results: A total of 21 LAs (including a staged, bilateral LA) were performed in 20 patients (13 girls, 7 boys) with a mean age of 6.4 years (range, 14 months to 18 years). Nine patients (43%) had neuroblastic tumors. Operative duration averaged mean±SD 101±48 minutes, and there was a single conversion to open adrenalectomy in a patient with a left adrenal carcinoma and tumor thrombus extending into the renal vein. There were no peri-operative complications, and no patients required blood transfusions. The postoperative hospital stay averaged 1.5 days (range, 1-4.5 days). At a mean±SD follow-up of 31±17 months, all patients remained clinically (radiologically and/or biochemically) free of their original adrenal disease. Conclusion: Laparoscopic adrenalectomy can be used to safely treat suspected benign and selected malignant adrenal masses in children.

The Safety and Efficacy of Laparoscopic Adrenalectomy in Children

Laparoscopic adrenalectomy (LA) has become standard therapy for benign adrenal masses in adults. The utility of LA in children with adrenal masses is less well defined because of the infrequency and pathologic variability of pediatric adrenal masses, and body size and instrumentation considerations that exist in small children. Evaluation of a case series of children undergoing lateral, transperitoneal LA will reflect the safety and efficacy of this procedure in pediatric patients and identify preferred patient selection criteria. A combined case series including patients treated between March 1999 and November 2004. Urban tertiary referral pediatric teaching hospitals. All children with pathologic adrenal masses undergoing LA were included. The primary study outcome measures included operative duration, conversions to open adrenalectomy, complications, length of hospital stay, and freedom from recurrence of the original pathologic adrenal mass. A total of 21 LAs (including a staged, bilateral LA) were performed in 20 patients (13 girls, 7 boys) with a mean age of 6.4 years (range, 14 months to 18 years). Nine patients (43%) had neuroblastic tumors. Operative duration averaged mean +/- SD 101 +/- 48 minutes, and there was a single conversion to open adrenalectomy in a patient with a left adrenal carcinoma and tumor thrombus extending into the renal vein. There were no perioperative complications, and no patients required blood transfusions. The postoperative hospital stay averaged 1.5 days (range, 1-4.5 days). At a mean +/- SD follow-up of 31 +/- 17 months, all patients remained clinically (radiologically and/or biochemically) free of their original adrenal disease. Laparoscopic adrenalectomy can be used to safely treat suspected benign and selected malignant adrenal masses in children.

Carcinoma suprarrenal: supervivenvia a 7 años libre de enfermedades tras resección completa del tumor primario y resecciones repetidas de recidivas locorregional y a distancia: Revisión a raíz de un caso con una pobre esperanza de vida inicial

We report the case of a female patient with adrenal carcinoma who had undergone surgery and presented with local-regional and distant recurrences, emphasizing the importance of the aggressive surgical treatment to achieve long-term survival which is unexpected sometimes. Currently, it represents the gold standard and all cases should be reported to stimulate other groups to work in this line. We report the case of a 29-year-old female patient who consulted for left flank pain, being diagnosed of an adrenal tumor by radiological tests; she underwent surgical excision of a left adrenal carcinoma (stage II). Later on she presented with local-regional recurrences (2 times) and distant metastases (liver) undergoing excision in three procedures. Currently, the patient is alive and free of disease 7 years after diagnosis. Adrenal cancer recurrences have been considered lethal in the short-term. Nevertheless, an aggressive surgical approach of local recurrences and metastasic disease may significantly prolong patient's survival and, sometimes, leave the patient disease free several years after the diagnosis of the primary tumor.

Obstructive jaundice due to radiation-induced hepatic duct stricture

A case of obstructive jaundice due to radiation-induced hepatic duct stricture is reported. The patient received postoperative radiation for left adrenal carcinoma, seven years prior to this admission. The sequelae of hepatobiliary radiation and their management are discussed briefly.

Metastatic Adrenal Cortical Carcinoma: Biochemical Changes Accompanying Clinical Regression During Therapy with o,p'-DDD

Abstract A 7-year-old girl with a six-month history of increasing virilism, growth, and acne excreted supranormal amounts of urinary 17-ketosteroids (87.6 mg/24 h). ACTH stimulation and dexamethasone suppression studies indicated adrenal tumor. A large left adrenal carcinoma was removed. Metastases were not observed. Postoperatively, 24-h urinary ketosteroids remained supranormal (16 mg). Sudden fever, cough, and hemoptysis precipitated hospitalization 42 months later. Bilateral lung metastases, a mass in the right upper quadrant, virilism, advanced bone age, and supranormal 24-h urinary ketosteroids (166 mg) and hydroxysteroids (16 mg) were found. The patient received 240 g of o,p'-dichlorodiphenyl-dichloroethane (o,p'-DDD), whereupon the abdominal mass and lung lesions regressed and 24-h urinary ketosteroids and hydroxysteroids decreased. Since this treatment (which ended April, 1968) the patient has been maintained at home on 7.5 g o,p'-DDD/day and replacement therapy with 9-α-fluorohydrocortisone and cortisone acetate. Almost all signs and symptoms have disappeared and urinary steroids are normal.