We report 2 cases of adrenal myelolipoma. The diagnosis was suspected preoperatively in the first case on the basis of radiographic findings, ultrasonography and computerized tomography, and was confirmed by an operation. In the second case the diagnosis was established by fine needle biopsy. Computerized tomography and ultrasonography help in the preoperative diagnosis of myelolipoma but only fine needle biopsy can differentiate this lesion from a malignant neoplasm and avoid an operation.
A series of 13 patients with incidental adrenal mass discovered by computed tomography or/and ultrasound is reported. In 5 cases endocrine evaluation and radiological criteria suggested the diagnosis of the mass. In 8 cases we carried out fine needle biopsy (FNB) under ultrasound guidance. FNB confirmed in two cases the presence of metastatic diseases, in one case adrenal adenoma, in other two cases myelolipoma and in one case lymphoma. Surgical exploration was avoided in all cases. In two cases the presence of an asymptomatic adrenal carcinoma and of a giant adenoma, potentially malignant, was demonstrated by FNB. None of the patients underwent surgical exploration as a final diagnostic measure. In conclusion, FNB may represent a useful tool to select the best modalities of treatment.
Objectives: In spite of a great amount of data, the hormonal treatment of advanced prostatic carcinoma (CaP) still remains controversial. As a relevant amount of dihydrotestosterone is present within the prostate tissue after castration, complete androgen blockade (CAB), with inhibition of the activity of both testicular and adrenal androgens, has been advocated as up-front treatment of advanced CaP. However, many controlled studies have failed to demonstrate a benefit for CAB in comparison with simple surgical or chemical castration. The present study was performed to bring additional data for a worldwide meta-analysis of all phase III trials comparing castration and CAB. Methods: This is a centrally controlled phase III study in which chemical castration with leuprorelin acetate depot was compared with leuprorelin plus flutamide in stage C and D CaP. Two hundred and forty-one eligible and evaluable patients with histologically proven CaP were recruited for the study (120 treated with castration and 121 with CAB). The diagnostic and staging workup consisted of blood chemistry, general condition assessment, prostate-specific antigen (PSA), abdominal sonography and computed tomography scan, and whole-body isotopic bone scan. End points of the study were survival, time to treatment failure, and time to progression. The patients were followed every 6 months with PSA and sonography. Results: At a cut-off analysis performed in December 1996, when the mean follow-up period was 43.7 ± (SD) 24.1 months, no statistical differences in terms of time to treatment failure, time to progression, and death rate could be detected. Also considering the common risk factors, such as basal PSA, haemoglobin, alkaline phosphatase, and Gleason score, the outcome did not show any clear advantage for CAB. Conclusions: This study appears to confirm that the advantages of first-line CAB in CaP are at best marginal. The final analysis will be performed when the follow-up period has reached 5 years, but it seems unlikely that the present results will change.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.