Ectopic hepatocellular carcinoma of the right adrenal gland: a case description.
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ABSTRACT:
SUBMITTER: Gan L
PROVIDER: S-EPMC9929416 | biostudies-literature | 2023 Feb
REPOSITORIES: biostudies-literature
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Ectopic hepatocellular carcinoma of the right adrenal gland: a case description.
Gan Leijuan L Ren Shaohua S Lang Mengran M Fang Feng F Chen Lu L Song Tianqiang T
Quantitative imaging in medicine and surgery 20230102 2
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Project description:RationaleHepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related deaths and the sixth most commonly diagnosed cancer globally. Interdisciplinary and multimodal treatment strategies are essential for a successful therapy in HCC. Established therapies for HCC treatment include surgical resection, liver transplantation, local ablative therapies, transarterial chemoembolization (TACE), tyrosine kinase inhibitors (TKIs), immunotherapy, and radiotherapy (RT).Patient concernsA 52-year-old male patient did an ultrasound scan and found a large mass within the right lobe of the liver and gallstones in December 2018. He had a history of chronic hepatitis C virus infection (30 years) and was treated with sofosbuvir (400 mg, q.d.) for 1 year. The patient never had any symptoms of gallstones. Enhanced abdominal computed tomography of this patient showed a heterogeneous irregular mass with the largest measurement of up to 13.7 × 11.1 cm in size in the right lobe of the liver, meanwhile also had inferior vena cava (IVC) tumor thrombus, right atrial (RA) tumor thrombus, and left adrenal gland metastasis. The laboratory test data revealed that the serum tumor marker α-fetoprotein was 2.63 ng/mL, cancer antigen 19-9 (CA 19-9) was 34.40 U/mL, and protein induced by Vitamin K absence was 391.94 mAU/mL.DiagnosisHCC with IVC tumor thrombus, RA tumor thrombus, and left adrenal gland metastasis, and gallstones.InterventionsHe was hospitalized and received TACE treatment, oral TKIs, intravenous drip programmed cell death-1 (PD-1) inhibitor and RT.OutcomesThe patient showed a favorable response after consecutive treatment with TACE, TKIs, PD-1 inhibitor, and RT. Until now, the patient has survived 34 months since the diagnosis of the disease.LessonsOur case suggests that TACE combined with TKIs, PD-1 inhibitor, and RT may be a suitable treatment option for advanced HCC patients with IVC tumor thrombus and/or RA tumor thrombus, and/or adrenal gland metastasis.
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Project description:BackgroundEctopic thyroid carcinoma in the mandible is extraordinarily rare; few histologically proven cases have been reported in the literature. Embryologically, cases of ectopic thyroid occur with a developmental abnormality during the migration of the thyroid gland from the floor of the primitive foregut to its final position in the neck. Ectopic thyroid tissue can be found around the course of the thyroglossal duct or laterally in the neck, and even in the mediastinum or below the diaphragm. Since 90% of ectopic thyroid tissues are located at tongue bases, the mandible ectopic thyroid gland is extremely rare. Theoretically, ectopic thyroid glands in the mandible are unlikely to become cancerous. Clinically, follicular carcinoma is less common than papillary carcinoma in both the ectopic thyroid regions and the eutopic anterior neck position. This case is the first to report a cancerous ectopic thyroid in the mandibular bone with eutopic thyroid follicular adenoma and adenomatous goiter.Case descriptionHere, we report a case of mandible follicular thyroid cancer (MFTC). A 72-year-old male was presented with a chief complaint of pain and discomfort in the lower right back tooth that had persisted for over 3 months, with cone-beam computed tomography (CBCT) revealing a mass in the right mandible. The patient's mandible mass was removed via right hemimandibulectomy, and reconstruction was simultaneously performed using free autogenous rib grafts. The postoperative pathology diagnosis revealed follicular thyroid carcinoma. In addition, this patient underwent a total thyroidectomy at another hospital 3 years ago for benign thyroid lesions.ConclusionsIn conclusion, we present a rare case of ectopic follicular thyroid carcinoma located in the right mandible, accompanied by benign eutopic thyroid lesions. Effective management of such cases necessitates a multidisciplinary approach, and surgical resection is recommended for ectopic follicular thyroid carcinoma.
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Project description:IntroductionWe report a case of laparoscopic adrenalectomy in a salvage setting after multiple chemotherapies for neuroendocrine carcinoma.Case presentationA 49-year-old man was diagnosed with unknown primary carcinoma with single brain metastasis, and right supraclavicular and mediastinal lymph node metastases. After stereotactic radiotherapy of the brain metastasis and systemic chemotherapy, lymphadanectomy was performed. The pathologic diagnosis was neuroendocrine carcinoma. At 11 months after surgery, computed tomography revealed right adrenal metastasis. Local radiotherapy initially resulted in complete remission. However, adrenal recurrence was noted 10 months later. Laparoscopic adrenalectomy was performed with curative intent. The patient is currently alive without recurrence at 20 months after the operation.ConclusionAdrenalectomy can become a treatment option if other metastases are well-controlled with systemic therapy. Surgical elimination of oligometastases can offer long-term disease control in selected patients as part of a multimodal approach.
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Project description:Ectopic adrenal gland is an atypical medical condition with a prevalence of less than 1%. It occurs due to an abnormal gland development during embryonic life and can be found in different parts of the body. Rarely, these ectopic glands can be hormonally active and present as bulky masses. Herein we report a case of a patient who underwent laparoscopic surgery for a large myelolipoma associated with an androgen producing adenoma in an ectopic adrenal gland.
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Project description:We present a case report of a patient with a rare high-grade transformation of an acinic cell carcinoma (ACC) of the parotid gland, who developed Cushing's syndrome (CS) as a result of ectopic secretion of adrenocorticotropic hormone by the tumour. The hypercortisolism was successfully treated with metyrapone, and the ACC was treated with local radiotherapy and a combined six cycles of gemcitabine and cisplatin, having achieved a partial response to the tumour. A multidisciplinary approach and combined medical treatment with radiotherapy and were essential for disease control and CS management. ACC should be considered in the differential diagnosis of ectopic CS.
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Project description:Ectopic thymic carcinoma is extremely rare. We present a case of a 73-year-old male patient with ectopic right parietal pleural thymic carcinoma and performed a literature review. Computed tomography (CT) of the chest demonstrated a sharp-edged soft tissue mass with intense enhancement measuring 47 mm × 29 mm with a broader base adjacent to the right axillary chest wall at the level of the 5th rib. There was no hilar or mediastinal lymphadenopathy or evidence of a mediastinal tumor or pleural nodules. A totally extra-pleural tumor resection and partial right lung resection was performed. Histological examination demonstrated infiltrative growth typical of carcinoma cells with a nest-like distribution locally invading the surface of the lung tissue. Immunohistochemical examination confirmed the diagnosis of thymic squamous carcinoma positive for CD5. Mediastinal radical radiotherapy (60 Gy) was performed postoperatively. The patient was followed for 17 months without any evidence of recurrence or metastasis.
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Project description:The sharp line of demarcation between zona glomerulosa (ZG) and zona fasciculata (ZF) has been recently challenged suggesting that this interface is no longer a compartment boundary. We have used immunohistochemical analyses to study the steroid 11β-hydroxylase (CYP11B1) and aldosterone synthase (CYP11B2) pattern of expression and investigate the remodeling of the adrenal cortex in relation to aging. We analyzed human adrenal glands prepared from 47 kidney donors. No aldosterone-producing micronodules (APMs) were detectable in the younger donors aged between 22-39 but the functional ZG depicted by positive CYP11B2 staining demonstrated a lack of continuity. In contrast, the development of APMs was found in samples from individuals aged 40-70. Importantly, the progressive replacement of CYP11B2-expressing cells in the histological ZG by CYP11B1-expressing cells highlights the remodeling capacity of the adrenal cortex. In 70% of our samples, immunofluorescence studies revealed the presence of isolated or clusters of CYP11B2 positive cells in the ZF and zona reticularis. Our data emphasize that mineralocorticoid- and glucocorticoid-producing cells are distributed throughout the cortex and the medulla making the determination of the functional status of a cell or group of cells a unique tool in deciphering the changes occurring in adrenal gland particularly during aging. They also suggest that, in humans, steroidogenic cell phenotype defined by function is a stable feature and thus, the functional zonation might be not solely maintained by cell lineage conversion/migration.
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Project description: Not available
| S-EPMC10498195 | biostudies-literature
Project description:Ectopic hepatocellular carcinoma (HCC) can be defined as an HCC arising from hepatic parenchyma located in an extrahepatic organ or tissue. Fewer than 100 cases of ectopic liver have been reported. In 30 of these cases, HCC was detected in ectopic tissue. The author describes a case of ectopic HCC mimicking subepithelial tumor (SET) of the stomach successfully treated by laparoscopic resection. This case report also provides a pertinent review of the literature. A 61-year-old male was referred to our department for the management of an intra-abdominal mass found on abdominal computed tomography performed at a local medical center due to a 2-month history of vague abdominal pain. Abdominal magnetic resonance imaging and computed tomography showed a 7.2-cm sized heterogenous mass over the left subphrenic space adjacent to the stomach. Esophagogastroduodenoscopy showed a huge subepithelial mass at the fundus of the stomach. Based on the above findings, the diagnosis of SET of the stomach such as gastrointestinal stromal tumor or leiomyoma was suspected. Laparoscopic surgery was performed for definite diagnosis and treatment of the huge SET of the stomach. Histologic diagnosis was ectopic HCC of the trabecular type. Its histologic grade was consistent with Edmondson grade II. Although ectopic HCC is quite rare tumor of the stomach, it should be considered in the differential diagnosis of other abdominal mass-like lesions. Currently, with advances of laparoscopic surgery, laparoscopic resection for complete excision of ectopic HCC is possible with acceptable results.
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Project description:BackgroundTeratomas are unusual tumors derived from multiple germ layers but they usually arise from all three germ layers. Knowledge of this disease is still very limited because of its low incidence. Retroperitoneal teratomas are extremely rare neoplasms, especially adrenal teratomas, which frequently found to be large, cystic or cyst-solid lesions. Adrenal teratomas are easily confused with various benign or malignant tumors, such as myelolipomas, adenomas, and hamartomas.Case descriptionIn this case presentation, we report a rare case in which an adrenal gland mass without apparent discomfort was detected by abdominal computed tomography (CT) for 6 months in a 59-year-old female. Results from the patient's adrenal hormonal evaluation were normal. An abdominal enhanced CT scan revealed a heterogeneous mass in the right adrenal gland. The patient then underwent a laparoscopic right adrenalectomy and the lesion was diagnosed as mature teratoma through histopathological examination. The patient recovered well without any complications.ConclusionsBased on our knowledge, surgical resection is the first-choice intervention for the diagnosis and treatment of mature teratoma. Open surgery is the preferred method for the large tumors, while the laparoscopic adrenalectomy can be a better option in the small one. The patient's prognosis is usually good after complete resection, but close follow-up is also recommended.
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