This report describes the case of a 48-year-old woman found to have a leiomyoma of the left adrenal gland after presenting with anemia and hypertension. An upper gastrointestinal series revealed a mass in the posterior region of the body that distorted the stomach. A computed tomography (CT) scan showed a well-circumscribed mass with a high-density outline in the left adrenal gland, and magnetic resonance imaging (MRI) revealed a homogeneous mass. Multiple catheter samplings of vena cava blood revealed a slight elevation of epinephrine and norepinephrine in the left adrenal vein and the left renal vein. Thus, asymptomatic pheochromocytoma of the left adrenal gland was highly suspected as a preoperative diagnosis and a left adrenalectomy was performed. However, histologic examination subsequently revealed findings suggestive of leiomyoma of the adrenal gland, which was confirmed by electron microscopy. The patient's postoperative course was uneventful and she has remained free from any further symptoms.
An eighty-year-old woman with spontaneous rupture of the left iliac vein is described as the first case reported in Japan. The 12 cases previously reported are also reviewed, and clinical and possible etiologic findings are discussed.
This study was conducted to assess the efficacy of portal vein reconstruction with an expanded polytetrafluoroethylene (e-PTFE) graft. Five patients underwent interposition of the portal vein with e-PTFE graft following en bloc resection of the entire pancreas and the portal vein for advanced pancreatic cancer. The length of the excised vein ranged from 5 to 7 cm and that of the implanted graft (8 or 10 mm in diameter), 3 to 7.5 cm. In 4 of the 5 cases, the graft was patent at five to eighteen months following implantation. One patient died of respiratory failure two months after operation, and partial occlusion of the graft was noted at autopsy. Four patients died of recurrence of the original disease five to eighteen months after operation. The implanted graft taken at autopsy eighteen months after operation was covered uniformly with thin neointima on the internal surface. Microscopic examination showed endothelial cells covering the surface of the neointima, and capillary vessels had developed in the neointimal layer. Experimentally, five grafts, 0.8 cm in diameter and 2.5 cm in length with external ring support, were interposed in the portal vein in pigs. All grafts were patent during a four-month follow-up period. The authors conclude that the e-PTFE graft is a suitable prosthesis for replacement of the portal vein following its resection.
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.