Myelolipoma is an uncommon benign tumor of unknown etiology and adrenal myelolipoma is rarely associated with endocrine disorders. We report a 67-year-old woman with Cushing's syndrome due to left adrenal adenoma associated with myelolipoma. The patient underwent laparoscopic left adrenalectomy and pathological examination revealed an adrenocortical adenoma associated with myelolipoma. To the best of our knowledge, 25 cases of endocrine dysfunction associated with myelolipoma have been reported in the English and Japanese literature. We review and discuss the pathogenesis of adrenal myelolipoma.
The proliferation of peritubular endothelial cells during compensatory renal growth (CRG) following unilateral nephrectomy in mice was investigated using a labeling index. The labeling index of peritubular endothelial cells increased 6 h after uninephrectomy and decreased to the normal level within 72 h. Immunohistochemical study revealed that c-myc protein was expressed in the nuclei of both cortical tubular cells and peritubular endothelial cells. Furthermore, intravenous injection of anti-basic fibroblast growth factor (bFGF) neutralizing antibody just after uninephrectomy led to significant inhibition of proliferation of peritubular endothelial cells, but not tubular cells. These results indicate that peritubular endothelial cells proliferate transiently during CRG and that bFGF plays an important role for the growth regulation of that cell in the kidney.
We report a case of mucinous adenocarcinoma of the renal pelvis associated with bladder carcinoma in situ (CIS). Transitional cell carcinoma (TCC) of the renal pelvis and CIS were also observed adjacent to the adenocarcinoma. Immunohistochemical assessment of the pelvic adenocarcinoma revealed positive expressions for mucin, epithelial membrane antigen, cytokeratin 7, cytokeratin 19 and carcinoembryonal antigen, but not vimentin or chromogranin. Based on the histopathological examinations, the adenocarcinoma of the renal pelvis in the present case may have a similar biological nature to conventional TCC and probably originated by development of pre-existing TCC of the renal pelvis.
A 79-year-old woman was referred for evaluation of episodic weakness of all four limbs, associated with marked hypokalaemia and hypertension. CT showed a heterogeneous mass in the left suprarenal area (Fig. 1a). Endocrinological studies showed hyperaldosteronism (Table 1) and she underwent transabdominal left adrenalectomy. The hormone studies showed elevated aldosterone and low plasma renin activity. Basal levels of cortisol and adrenocorticotropic hormone (ACTH) were normal, although the urinary excretion of 17-hydroxycorticosteroid (17-OHCS) was slightly elevated, and the urinary excretion of 17-ketosteroid (17-KS) was normal. The histopathological diagnosis was adrenocortical carcinoma (Fig. 1b). Her BP, serum potassium and plasma aldosterone levels became normal after surgery. Unfortunately, evidence of metastatic spread to the lung and liver was detected 3 months after surgery. Repeat endocrinological investigations revealed a markedly elevated cortisol level and a suppressed ACTH; aldosterone was at normal levels whilst the plasma renin activity was slightly high. Despite the oral administration of mitotane, her condition deteriorated and she died 1 month later.
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