Mixed Corticomedullary Carcinoma of the Adrenal Gland: A Case Report

Turk, Andrew T.; Asad, Haider; Trapasso, Joseph; Perilli, Gretchen; LiVolsi, Virginia A.

doi:10.4158/ep11222.cr

Cited by 15 publications

(31 citation statements)

References 12 publications

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“…A corticomedullary mixed tumour is defined as a single adrenal tumour mass containing an intimately admixed population of both adrenal cortical cells and pheochromocytes [ 1 ]. Corticomedullary mixed tumours are likely to occur in female [ 16 ], and most of them are benign with a favourable prognosis. However, some malignant tumours with a poor prognosis have been reported [ 16 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Corticomedullary mixed tumour resembling a small adrenal gland-involvement of cancer stem cells: case report

Duan

Fang

et al. 2017

BMC Endocr Disord

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BackgroundAdrenal corticomedullary mixed tumours are very rare. Its mechanism is rarely reported. Here we report the first case of a corticomedullary mixed tumour resembling a “small adrenal gland” with distinct arrangement of the cortical and medullary layers. We further hypothesize regarding the tumorigenic mechanism of this tumour.Case presentationA 58-year man had been diagnosed with diabetes and hypertension for 3 years. His 24-h urine vanillylmandelic acid (VMA) levels were slightly elevated. An abnormal circadian cortisol rhythm was noted, and his cortisol levels were not suppressed by dexamethasone. Abdominal computed tomography (CT) revealed a right adrenal gland lesion (diameter, 30 × 38 mm), while an enhanced CT showed enhancement and hypervascularization. The tumour was positive for adrenocorticotropic hormone, chromogranin A (CGA), and steroidogenic factor-1 (SF-1) on the tumour surface. Acetaldehyde dehydrogenase 1(ALDH1), CD44, CD133, Nestin, Nerve growth factor receptor (NGFR), and Sex determining region y-box 9(SOX9) staining were positive. Although administration of medications for diabetes and hypertension was stopped until surgery was performed, the blood sugar level and blood pressure were maintained after surgery.ConclusionsThis is the first report about a possible mechanism by which cancer stem cells induce adrenal corticomedullary tumours.

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Section: Discussionmentioning

confidence: 99%

Corticomedullary mixed tumour resembling a small adrenal gland-involvement of cancer stem cells: case report

Duan

Fang

et al. 2017

BMC Endocr Disord

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“…Two cases of malignant MCMT, or mixed corticomedullary carcinoma (MCMC), have recently been reported 14–15. When evaluating these mixed tumours histologically, features concerning for malignancy include tumour necrosis, atypical mitotic activity, nuclear pleomorphism, lymphovascular invasion and a high Ki-67 proliferative index 14. Both patients with MCMC reported in the literature were treated with adjuvant etoposide and platinum-based chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Adrenal Cushing syndrome with detectable ACTH from an unexpected source

et al. 2016

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Mixed corticomedullary adrenal tumours (MCMT) are rare. We describe the second reported case of a male patient presenting with hypertension and Cushing syndrome with MCMT. A man aged 48 years presented with hypertension and signs of Cushing syndrome. 24-hour urine cortisol was elevated, with detectable adrenocorticotropic hormone (ACTH). A high-dose dexamethasone suppression test indicated an adrenal or ectopic Cushing syndrome. Plasma metanephrines were normal. A 3 cm left adrenal mass was identified without potential ectopic sources of ACTH on imaging. After induction of anaesthesia for laparoscopic adrenalectomy, the patient developed resistant hypertension with stress-dose hydrocortisone administration. Surgery was cancelled and repeat testing revealed elevated plasma metanephrines. α-Blockade was administered for a presumed coexisting pheochromocytoma, and the patient underwent adrenalectomy. Pathology revealed an MCMT. This case highlights the importance of a thorough biochemical evaluation in patients with adrenal masses to rule out multiple hormone producing tumours.

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“…Ganglionöroma, bizim olgumuzda olduğu gibi literatürdeki KAMT olgularının neredeyse %70'inde non-feokromositoma komponentini oluşturmaktadır (5). Hormonal yönden aktif olan feokromasitoma komponenti tanı öncesi klinik bulgulara çarpıntı, başağrısı, hipertansiyon gibi şikayetlerle neden olabilen komponenttir (1,4). Bu nedenle KAMT olguları feokromositoma ön tanısı ile ameliyat edilirler ve ancak histopatolojik incelemede saptanabilirler (5).…”

Section: Olguunclassified

“…Bununla beraber feokromositoma komponentinin nöroblastom ve schwannoma ile, ayrıca adrenal kortikal kanserler ve bazı endokrin sendromlar ile birlikteliği gösterilmiştir (3). Hastalar genel olarak artmış katekolamin deşarjına bağlı semptomlar ile başvururlar (4). Kliniğimize hipertansiyon, karın ağrısı ve sık idrara çıkma şikayetleri ile başvuran ve tetkiklerinde saptanan adrenal kitlenin ameliyatı sonrası KAMT teşhisi konulan hastamıza ait klinik ve histopatolojik bulguları paylaşmayı amaçladık.…”

Section: Introductionunclassified

Composite Adrenal Medullary Tumor: A Case Report

Dural¹,

Kabuli²,

Ünsal³

et al. 2018

İstanbul Tıp Fakültesi Dergisi

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Birden fazla hücre tipinden oluşan ve karışık histolojik görünüm içeren adrenal neoplaziler nadir görünürler. 57 yaşında, kadın hastanın bulantı, idrar yapma sıklığında artış, karın ağrısı ve hipertansiyon hikayesi mevcuttu. Laboratuar sonuçlarından 24 saatlik idrar tetkikinde artmış idrar dopamin ve metanefrin atılımı saptandı. Bilgisayarlı tomografide 50 mm, sağ suprarenal kitle saptandı, manyetik rezonans görüntülemede T2 ağırlıklı görüntülerde hiperintens, T1 ağırlıklı görüntülerde heterojen izointens görünüm mevcuttu. Hastaya laparoskopik sağ adrenalektomi yapıldı. Perioperatif dönemde herhangi bir sorun olmadı. Histopatolojik ve immünhistokimyasal incelemede feokromositoma ve ganglionöromaya ait karışık medüller histolojik özellikler izlendi. Kapsüler ve periadrenal yağ dokusu invazyonu da izlenmesine rağmen hasta semptomsuz ve hastalıksız olarak beşinci yılındadır. Kompozit adrenal medüller tümörler benign özellikli olup nadir görülür ancak bir olguda uzak metastaz bildirilmiştir. Bizim olgumuz da kapsüler ve periadrenal yağ doku invazyonu olması nedeniyle malign davranış potansiyeline sahiptir. Bu tür hastalarda ömür boyu klinik ve biyokimyasal takip önerilmelidir

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Mixed Corticomedullary Carcinoma of the Adrenal Gland: A Case Report

Cited by 15 publications

References 12 publications

Corticomedullary mixed tumour resembling a small adrenal gland-involvement of cancer stem cells: case report

Corticomedullary mixed tumour resembling a small adrenal gland-involvement of cancer stem cells: case report

Adrenal Cushing syndrome with detectable ACTH from an unexpected source

Composite Adrenal Medullary Tumor: A Case Report

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