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Sample records for adenomas

  1. Parathyroid adenoma

    ... page: //medlineplus.gov/ency/article/001188.htm Parathyroid adenoma To use the sharing features on this page, please enable JavaScript. A parathyroid adenoma is a noncancerous (benign) tumor of the parathyroid ...

  2. Adenoma

    Well circumscribed areas consisting of cuboidal to columnar cells lining alveoli. The size is usually less than 5 mm in diameter. These lesions retain preexisting alveolar structure and tend to be multiple in existing mouse models. Absence of pronounced fibrovascular stroma, as well as more "plump" shape of epithelial cells, may be the reason for different appearance of mouse adenomas, as compared to their human counterparts. Differentiation between a small adenoma and focal hyperplasia can be very difficult. At the same time, no absolute criteria exist for distinguishing a large adenoma from a well-differentiated adenocarcinoma. Among features indicating benign character are a small size, and absence of vascular invasion. Well delineated demarcation and absence of lepidic growth are considered by some as indicators of a benign character. Bland character of nuclei is a main feature of human adenomas. By this criterion many mouse adenomas could be assigned to adenocarcinomas. However, unlike in humans, mouse tumors rarely metastasize during the time of their observation.

  3. Nipple adenoma in infancy.

    Clune, James E; Kozakewich, Harry P; VanBeek, Christine A; Labow, Brian I; Greene, Arin K

    2009-11-01

    We report the first patient with a nipple adenoma presenting in infancy. Nipple adenoma is a benign lesion typically affecting women between 45 and 55 years of age. This lesion can occur in the pediatric population and should be included in the differential diagnosis of an infantile breast lesion. Management of children with nipple adenoma requires consideration for breast development; excision before maturity may cause nipple-areola deformity or injury to the breast bud. PMID:19944237

  4. Pituitary Adenoma Segmentation

    Egger, Jan; Kuhnt, Daniela; Freisleben, Bernd; Nimsky, Christopher

    2011-01-01

    Sellar tumors are approximately 10-15% among all intracranial neoplasms. The most common sellar lesion is the pituitary adenoma. Manual segmentation is a time-consuming process that can be shortened by using adequate algorithms. In this contribution, we present a segmentation method for pituitary adenoma. The method is based on an algorithm we developed recently in previous work where the novel segmentation scheme was successfully used for segmentation of glioblastoma multiforme and provided an average Dice Similarity Coefficient (DSC) of 77%. This scheme is used for automatic adenoma segmentation. In our experimental evaluation, neurosurgeons with strong experiences in the treatment of pituitary adenoma performed manual slice-by-slice segmentation of 10 magnetic resonance imaging (MRI) cases. Afterwards, the segmentations were compared with the segmentation results of the proposed method via the DSC. The average DSC for all data sets was 77.49% +/- 4.52%. Compared with a manual segmentation that took, on the...

  5. Adenoma metanéfrico Metanephric adenoma

    Ana Sayuri Ota

    2005-12-01

    Full Text Available Metanephric adenoma is a recently described, rare and benign renal tumor that generally occurs in adults and has an excellent prognosis. Pain, hematuria and palpable mass are the most commonly presented signs. We report the case of a 49-year old female with a 14-cm solitary right renal tumor. Radiological features of the tumor were non-specific and histopathological examination was essential to establish a definitive diagnosis.

  6. Double pituitary adenomas.

    Iacovazzo, D; Bianchi, A; Lugli, F; Milardi, D; Giampietro, A; Lucci-Cordisco, E; Doglietto, F; Lauriola, L; De Marinis, L

    2013-04-01

    Double pituitary adenomas represent up to 2.6 % of pituitary adenomas in large surgical series and up to 3.3 % of patients with Cushing's disease have been found to have double or multiple pituitary adenomas. We report the case of a 60-year-old male patient whose medical history began in 2002 with erectile dysfunction; hyperprolactinemia was found and MRI showed a 6-mm area of delayed enhancement in the lateral portion of the right pituitary lobe. Treatment with cabergoline was started with normalization of prolactin levels; the following MRI, performed in 2005 and 2008, showed shrinkage of the pituitary lesion. In 2005, the patient began to manifest weight gain, hypertension, and facial plethora, but no further evaluations were done. In January 2010, the patient came to our attention and underwent multiple tests that suggested Cushing's disease. A new MRI was negative. Bilateral inferior petrosal sinus sampling showed significant pituitary-to-peripheral ratio and, in May 2010, the patient underwent exploratory pituitary surgery with evidence of a 1-2-mm white-coloured midline area compatible with pituitary adenoma that was surgically removed. Post-operatively, the patient's clinical conditions improved with onset of secondary hypoadrenalism. The histologic examination confirmed a pituitary adenoma (immunostaining was found to be positive for ACTH and negative for prolactin). We report the case of an ACTH-producing microadenoma metachronous to a prolactin secreting microadenoma although not confirmed histologically, shrunk by medical treatment. A review of data in the literature regarding double or multiple pituitary adenomas has also been done. PMID:23325364

  7. Pregnancy and pituitary adenomas.

    Glezer, Andrea; Jallad, Raquel S; Machado, Marcio C; Fragoso, Maria C; Bronstein, Marcello D

    2016-09-01

    Infertility is frequent in patients harboring pituitary adenomas. The mechanisms involved include hypogonadism secondary to hormonal hypersecretion (prolactin, growth hormone and cortisol), stalk disconnection and pituitary damage. With the improvement of clinical and surgical treatment, pregnancy in women harboring pituitary adenomas turned into a reality. Pituitary hormonal hyper- and hyposecretion influences pregnancy outcomes, as well as pregnancy can interfere on pituitary tumors, especially in prolactinomas. We review literature about specific follow-up and management in pregnant women harboring prolactinomas, acromegaly, or Cushings disease and the impact of clinical and surgical treatment on each condition. PMID:26977888

  8. Lacrimal Gland Pleomorphic Adenoma and Carcinoma ex Pleomorphic Adenoma

    von Holstein, Sarah L; Fehr, André; Persson, Marta;

    2014-01-01

    To study genetic alterations in lacrimal gland pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (Ca-ex-PA) with focus on copy number changes and expression patterns of the translocation target genes PLAG1, HMGA2, and CRTC1-MAML2 in relation to clinical data.......To study genetic alterations in lacrimal gland pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (Ca-ex-PA) with focus on copy number changes and expression patterns of the translocation target genes PLAG1, HMGA2, and CRTC1-MAML2 in relation to clinical data....

  9. Parathyroid adenoma Localization

    Nasiri, Shirzad; Soroush, Ahmadreza; Hashemi, Amir Pejman; Hedayat, Anushiravan; Donboli, Kianoush; Mehrkhani, Farhad

    2012-01-01

    Background Bilateral neck exploration is the gold standard for parathyroid adenoma localization in primary hyperparathyroidism. But surgeons do not have adequate experience for accurate surgical exploration and new methods are developed for surgery like unilateral exploration and minimally invasive surgery, thus, preoperative localization could reduces time and stress in surgical performance. Method 80 patients with documented primary hyperparathyroidism and with raised serum calcium and para...

  10. [Treatment of pituitary adenomas].

    Mezosi, Emese; Nemes, Orsolya

    2009-09-27

    According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are "incidentalomas". The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, hypophysis apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3-5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing's disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors. PMID:19758960

  11. The Spectrum of Pituitary Adenoma Hemorrhage

    Hickstein, Dennis D.; Marshall, John C.; Chandler, William F.

    1986-01-01

    In 34 cases of pituitary adenoma hemorrhage at one institution, the clinical manifestations of adenoma hemorrhage depended upon the size of the adenoma, the presence of suprasellar extension, the amount of hemorrhage and the extent of pituitary glandular destruction. Recognition of the spectrum of acute, subacute and chronic pituitary adenoma hemorrhage should expedite diagnosis and treatment.

  12. Imaging of giant pituitary adenomas

    We present five proven giant pituitary adenomas studied by CT and MRI, and review the clinical and imaging findings. Our aim was to examine the radiologic appearances and to search for criteria useful in distinguishing these tumors from other sellar and suprasellar tumours, mainly craniopharyngioma. The main differences from small adenomas were high prevalence of macrocysts, a more invasive behaviour and a clinical picture dominated by mass effect rather than endocrine disturbance. Factors supporting the diagnosis of pituitary adenoma in a giant intra- and suprasellar mass include: infrasellar extension, absence of calcification and presence of low-signal cysts on T1-weighted images. (orig.) (orig.)

  13. Intrasellar schwannoma mimicking pituitary adenoma

    Sai Sudarsan Puduru

    2013-01-01

    Intrasellar location of schwannoma is extremely uncommon and 18 cases are documented in the literature till now. This report describes intrasellar schwannoma in a patient in whom the neuroimaging features were suggestive of a pituitary adenoma.

  14. Long-term risk of colorectal cancer in patients with sessile serrated adenomas, traditional serrated adenomas, and hyperplastic polyps

    Baron, John A; Erichsen, Rune; Hamilton-Dutoit, Stephen Jacques;

    Long-term risk of colorectal cancer in patients with sessile serrated adenomas, traditional serrated adenomas, and hyperplastic polyps......Long-term risk of colorectal cancer in patients with sessile serrated adenomas, traditional serrated adenomas, and hyperplastic polyps...

  15. Radiosurgery of pituitary adenomas

    The efficacy and role of gamma knife (GK) in the treatment of various pituitary adenomas are described on author's experience and discussed with literature. GK subjects are 328 patients (M 126/F 202, av. age of 47.8 y) in author's hospital, and satisfactory follow-up (32-44 mo) for evaluation has been possible in 253 cases, who had tumors non-functional (129 cases), producing ACTH (23), HGH (70) and PRL (31). Stereotactic GK radiosurgery is done with navigation by Gamma Plan based on enhanced MRI images at various doses, and evaluation in the follow-up period is performed by hormonal levels and MRI which give efficacy of complete response (CR), partial response (PR), MR and standard deviation (SD)/ progressive disease (PD) on the tumor size. The overall tumor control rate is found to be 95-100%. Effectiveness (CR and PR) is found as high as 77.4% in PRL-producing tumor (marginal dose 14-32 Gy), 65% in non-functioning (15-25 Gy), 61% in ACTH (19-30 Gy) and 60% in GH (19-31 Gy), of which tendency is similar to that in literature. Even in ACTH-producing tumor, low ACTH and cortisol levels persisted with tendency of improved obese and hypertensive symptoms. GK radiosurgery has limitations in the tissue size and distance between the tumor and optic nerve/chiasm, but for the enough small tumor, it gives satisfactorily long term efficacy. (R.T.)

  16. Radiosurgery for pituitary adenomas; Radiocirurgia nos adenomas hipofisarios

    Castro, Douglas Guedes de; Salvajoli, Joao Victor; Canteras, Miguel Montes; Cecilio, Soraya A. Jorge [Instituto de Radiocirurgia Neurologica, Sao Paulo, SP (Brazil)]. E-mail: dougguedes@uol.com.br

    2006-12-15

    Pituitary adenomas represent nearly 15% of all intracranial tumors. Multimodal treatment includes microsurgery, medical management and radiotherapy. Microsurgery is the primary recommendation for nonfunctioning and most of functioning adenomas, except for prolactinomas that are usually managed with dopamine agonist drugs. However, about 30% of patients require additional treatment after microsurgery for recurrent or residual tumors. In these cases, fractionated radiation therapy has been the traditional treatment. More recently, radiosurgery has been established as a treatment option. Radiosurgery allows the delivery of prescribed dose with high precision strictly to the target and spares the surrounding tissues. Therefore, the risks of hypopituitarism, visual damage and vasculopathy are significantly lower. Furthermore, the latency of the radiation response after radiosurgery is substantially shorter than that of fractionated radiotherapy. The goal of this review is to define the efficacy, safety and role of radiosurgery for treatment of pituitary adenomas and to present the preliminary results of our institution. (author)

  17. Villous Adenoma of Papilla of Vater

    1990-01-01

    Biliary obstruction due to a benign villous adenoma of the ampulla of Vater treated by transduodenal local excision and sphincteroplasty is reported. Local surgical resection enabled a submucosal resection of the adenoma.

  18. Pleomorphic adenoma of the soft palate

    Singh, Sourav; Shivamurthy, D. M.; Agarwal, Rohit

    2010-01-01

    Pleomorphic adenoma is the commonest benign salivary gland tumour, accounting for almost three fourths of all such tumours. Pleomorphic adenoma most commonly occurs in the parotid gland; however it is also encountered in the submandibular, sublingual and minor salivary glands.

  19. Ectopic Mediastinal Parathyroid Adenoma: A Case Report

    Umut Mousa; Dalokay Kılıç; Yahya Ekici

    2012-01-01

    Parathyroid adenomas comprise the majority of cases of primary hyperparathyroidism. Most of these adenomas are located near the lower poles of the thyroid glands, however, mediastinal, intrathyroidal, retroesophageal and intrathymic localizations have been reported. Preoperative imaging is very important for localization of the parathyroid adenomas. The most effective imaging method in localizing ectopic parathyroid adenomas is Technetium-99m sestamibi scintigraphy. Even when localized by sci...

  20. Recurrence of adrenal aldosterone-producing adenoma

    Calvo-Romero, J. M.; Ramos-Salado, J. L.

    2000-01-01

    Conn's syndrome (adrenal aldosterone-producing adenoma) and bilateral adrenal hyperplasia are the most common causes of primary aldosteronism. The treatment of choice for patients with aldosterone-producing adenoma is unilateral total adrenalectomy. Recurrence after adequate surgery is exceptional. We present a patient with recurrence of an aldosterone-producing adenoma in the right adrenal gland 9 years after adenomectomy of a aldosterone-producing adenoma in the same adrenal gland. We concl...

  1. Pleomorphic adenoma of the nasal septum

    Saxena, Sunil Kumar; Gopalakrishnan, S

    2003-01-01

    Despite the common occurrence of pleomorphic adenoma of major salivary glands, intranasal pleomorphic adenoma are rare. We present a ease of pleomorphic adenoma of the nasal septum along with a brief review of literature. The histological nature of this lesion in comparison to other salivary gland tumours and the importance of an accurate diagnosis has been stressed.

  2. Hepatic adenomas: comprehensive imaging diagnosis

    Objective: To describe the US, CT and MR imaging findings and diagnosis of hepatic adenomas. Methods: The comprehensive imaging features in 6 patients with 6 hepatic adenomas confirmed pathologically were reviewed retrospectively and correlated with pathologic findings. Results: One case was diagnosed correctly, four cases were mistaken for hepatocellular carcinomas (HCC), and one case was mistaken for focal nodular hyperplasia. US: six lesions were hypoechoic with hypo-halo in four lesions, and there was low velocity arterial and venous flow within the six lesions. CT: six lesions were hypodense with pseudo capsule in four lesions, and the four lesions showed slight enhancement during arterial and portal venous phases, and one lesion showed moderate enhancement during arterial phase and slight enhancement during portal venous phase. MRI: six lesions had heterogeneously high signal intensity on T1WI and T2WI, and the high intensity on T1WI remained unchanged after using fat saturation. Two lesions showed strong enhancement during arterial phase and slight enhancement during portal venous and delayed phases, and three lesions showed slight enhancement during arterial, portal venous, and delayed phases. Pseudo capsule detected in six lesions showed slight enhancement on portal venous or delayed phases. Conclusion: The comprehensive imaging findings of hepatic adenomas were nonspecific. The presence of pseudo capsule, heterogeneous high signal intensity on T1WI, and the high intensity remained unchanged after using fat saturation may help make a correct diagnosis of hepatic adenoma

  3. Lactating Adenoma of the Breast.

    Barco Nebreda, Israel; Vidal, M Carmen; Fraile, Manel; Canales, Lydia; González, Clarisa; Giménez, Nuria; García-Fernández, Antonio

    2016-08-01

    Lactating adenoma is an uncommon breast palpable lesion occurring in pregnancy or lactation. Although it is a benign condition, it often requires core biopsy or even surgery to exclude malignancy. As with other solid lesions in pregnancy and lactation, lactating adenoma needs an accurate evaluation in order to ensure its benign nature. Work-up must include both imaging and histologic findings. Ultrasound evaluation remains the first step in assessing the features of the lesion. Some authors consider magnetic resonance imaging as a useful tool in cases of inconclusive evaluation after ultrasound and histologic exam in an attempt to avoid surgery. Most lactating adenomas resolve spontaneously, whereas others persist or even increase in size and must be removed. The authors present a case of a 35-year-old woman at 6 months postpartum with a lactating adenoma in her right breast. After surgical removal, breastfeeding was perfectly continued within the next 24 hours, which highlights the fact that breast surgery is most often compatible with breastfeeding. PMID:27197575

  4. Computed tomography of adrenal Cushing's adenoma

    CT findings of 22 patients with surgically confirmed adrenal Cushing's adenomas were compared with pathologic findings. The cut surfaces of the adenomas showed mixture of yellow and brown areas in various proportions and were classified into three patterns; speckled brown areas in yellow background, geometrically brown areas in yellow background, totally brown or black surface. The maximum diameters of the cut surfaces were measured. The CT appearances of Cushing's adenomas after intravenous contrast administration have various patterns of enhancement and classified into three patterns; speckled, geometrical, and homoenous. The maximum diameters of the adenomas in CT images were also measured. Correlation between the CT and gross appearances of the specimens showed that while brown areas in adenomas were strongly enhanced, yellow areas were poorly enhanced. Histologically, brown areas in adenomas consist of compact-like cells with rich intercellular space and yellow areas consist of clear-like cells with poor intercellular space. The patterns of contrast enhancement some to depend on the cell types of adenomas. Difference in the intercellular space between compact and clear-like cells may have altered the patterns of contrast enhancement. The study also revealed that predominantly brownish adenomas were smaller in size than predominantly yellowish ones. As compact-like cells which make up the brown areas in Cushing's adenoma are thought to be more active in producing and secreting steroid hormones than clear-like cells, this result suggests that clinical symptoms may appear earlier in predominantly brownish adenomas than in predominantly yellowish ones. (author)

  5. Ectopic Mediastinal Parathyroid Adenoma: A Case Report

    Umut Mousa

    2012-06-01

    Full Text Available Parathyroid adenomas comprise the majority of cases of primary hyperparathyroidism. Most of these adenomas are located near the lower poles of the thyroid glands, however, mediastinal, intrathyroidal, retroesophageal and intrathymic localizations have been reported. Preoperative imaging is very important for localization of the parathyroid adenomas. The most effective imaging method in localizing ectopic parathyroid adenomas is Technetium-99m sestamibi scintigraphy. Even when localized by scintigraphy, surgical exploration may be unsuccessful in adenomas less than 2 cm in size. In our case, we have obtained a successful parathyroid imaging which guided the chest surgeons and general surgeons to perform a successful parathyroidectomy via sternotomy. The attendance of a general surgeon experienced in parathyroid surgery has provided benefit in surgical exploration of the ectopic parathyroid adenoma. Turk Jem 2012; 16: 46-8

  6. MRI of pituitary adenomas in acromegaly

    Adenomas causing acromegaly represent at least a quarter of pituitary adenomas. We studied 12 patients presenting with active acromegaly due to a pituitary adenoma with a 1.5 T superconductive MRI unit. All had T1-weighted sagittal and coronal sections before and after Gd-DTPA; six had coronal T2-weighted images. Surgical correlation was obtained in seven patients. Histologically, there were eight growth hormone (GH)-secreting and three mixed [GH and prolactin (PRL) secreting[ adenomas, and one secreting GH, PRL and follicle-stimulating hormone. Macroadenomas (10) were more frequent than microadenomas (2). No correlation was found between serum GH and tumour size. There were nine adenomas in the lateral part of the pituitary gland; seven showed lateral or infrasellar invasion. Homogeneous, isointense signal on T1-and T2-weighted images was observed in six cases. Heterogeneous adenomas had cystic or necrotic components. (orig.). With 5 figs., 3 tabs

  7. Tuberous sclerosis and parathyroid adenoma.

    Mortensen, L. S.; Rungby, J

    1991-01-01

    Very little is known about the pathogenesis of tuberous sclerosis. Over the past 10 years, however, increasing numbers of reports on adenomatous diseases in association with tuberous sclerosis have been published. A case of hypercalcaemia and parathyroid adenoma in association with tuberous sclerosis is presented, of which there has been one such report published previously. This association might be another manifestation of this complex disease: it is therefore recommended that plasma calciu...

  8. Solid serous adenoma of pancreas

    Yasmin Altaf Momin

    2014-04-01

    Full Text Available Solid serous adenoma (SSA is a rare variant of serous cystic neoplasm of pancreas. We present a case of pancreatic SSA in a 73 - year - old female, who underwent Whipple’s surgery. Histopathological study supplemented by histochemical and immuno - histochemical study was performed which supported the diagnosis. Recognition of this variant is important as solid pancreatic tumors, although benign, behave in a malignant fashion

  9. Gut Microbiome and Colorectal Adenomas

    Dulal, Santosh; Keku, Temitope O.

    2014-01-01

    The trillions of bacteria that naturally reside in the human gut collectively constitute the complex system known the gut microbiome, a vital player for the host’s homeostasis and health. However, there is mounting evidence that dysbiosis, a state of pathological imbalance in the gut microbiome is present in many disease states. In this review, we present recent insights concerning the gut microbiome’s contribution to the development of colorectal adenomas and the subsequent progression to co...

  10. Genomic Landscape of Colorectal Mucosa and Adenomas.

    Borras, Ester; San Lucas, F Anthony; Chang, Kyle; Zhou, Ruoji; Masand, Gita; Fowler, Jerry; Mork, Maureen E; You, Y Nancy; Taggart, Melissa W; McAllister, Florencia; Jones, David A; Davies, Gareth E; Edelmann, Winfried; Ehli, Erik A; Lynch, Patrick M; Hawk, Ernest T; Capella, Gabriel; Scheet, Paul; Vilar, Eduardo

    2016-06-01

    The molecular basis of the adenoma-to-carcinoma transition has been deduced using comparative analysis of genetic alterations observed through the sequential steps of intestinal carcinogenesis. However, comprehensive genomic analyses of adenomas and at-risk mucosa are still lacking. Therefore, our aim was to characterize the genomic landscape of colonic at-risk mucosa and adenomas. We analyzed the mutation profile and copy number changes of 25 adenomas and adjacent mucosa from 12 familial adenomatous polyposis patients using whole-exome sequencing and validated allelic imbalances (AI) in 37 adenomas using SNP arrays. We assessed for evidence of clonality and performed estimations on the proportions of driver and passenger mutations using a systems biology approach. Adenomas had lower mutational rates than did colorectal cancers and showed recurrent alterations in known cancer driver genes (APC, KRAS, FBXW7, TCF7L2) and AIs in chromosomes 5, 7, and 13. Moreover, 80% of adenomas had somatic alterations in WNT pathway genes. Adenomas displayed evidence of multiclonality similar to stage I carcinomas. Strong correlations between mutational rate and patient age were observed in at-risk mucosa and adenomas. Our data indicate that at least 23% of somatic mutations are present in at-risk mucosa prior to adenoma initiation. The genomic profiles of at-risk mucosa and adenomas illustrate the evolution from normal tissue to carcinoma via greater resolution of molecular changes at the inflection point of premalignant lesions. Furthermore, substantial genomic variation exists in at-risk mucosa before adenoma formation, and deregulation of the WNT pathway is required to foster carcinogenesis. Cancer Prev Res; 9(6); 417-27. ©2016 AACR. PMID:27221540

  11. Adenoma Malignum Detected on a Trauma CT

    McEachern, James; Butcher, Matthew; Burbridge, Brent; Zhu, Yu

    2013-01-01

    Adenoma malignum is a rare subtype of cervical adenocarcinoma. Clinical presentation is variable with watery vaginal discharge being the most commonly associated finding. We report a case of adenoma malignum incidentally detected on pelvic computed tomography (CT) performed for a trauma patient. The cervical mass was further characterized by magnetic resonance (MR) imaging and remained compatible with adenoma malignum. Local cervical biopsy was suggestive of the diagnosis which was subsequent...

  12. Pleomorphic Adenoma of the Upper Lip

    Ülkü KÜÇÜK

    2011-01-01

    Full Text Available Pleomorphic adenoma is the most common neoplasm of the salivary glands and is most commonly located in the parotis followed by the submandibular glands. Its localization in the minor salivary glands is mostly reported in the palate. Few publications report pleomorphic adenoma cases located in the lip.We present a 35-year-old male patient with a pleomorphic adenoma located in the upper lip.

  13. Sessile serrated adenoma: from identification to resection.

    Bordaçahar, Benoît; Barret, Maximilien; Terris, Benoît; Dhooge, Marion; Dreanic, Johann; Prat, Frédéric; Coriat, Romain; Chaussade, Stanislas

    2015-02-01

    Until the past two decades, almost all colorectal polyps were divided into two main groups: hyperplastic polyps and adenomas. Sessile serrated adenomas presented endoscopic, pathological and molecular profiles distinct from others polyps. Previously under-diagnosed, physicians now identified sessile serrated adenomas. The serrated neoplastic pathway is accounting for up to one-third of all sporadic colorectal cancers and sessile serrated adenomas have been identified as the main precursor lesions in serrated carcinogenesis. By analogy with the adenoma-adenocarcinoma sequence, the sessile serrated adenomas-adenocarcinoma sequence, has been identified. The development of endoscopic resection techniques permits the consideration of a non-surgical approach as the first option regardless of the size of the lesion. Sessile serrated adenoma warrants the watchfulness of physicians and requires an optimal quality of the colonoscopy procedure, a thorough evaluation of the lesion, an adequate endoscopic resection and follow-up colonoscopies in accordance with sessile serrated adenomas guidelines. We herein present a review on sessile serrated adenomas focusing on their pathological specificities, epidemiology, treatment modalities and follow-up. PMID:25445408

  14. Sequels after radiotherapy of adenoma of adenohypophysis

    14 years before his death, iridium seeds were implanted in the adenohypophysis of a 69-year-old patient with a STH producing adenoma of the adenohypophysis and acromegaly. 5 years after recurrence, transsphenoidal hypophysectomy was done. The patient died of central dysregulation due to cerebral insults. At autopsy, a recurrence of the undifferentiated acidophilic adenoma was found within the sphenoidal bone corpus. Immunohistochemistry was positive for STH, prolactin, TSH, LH, and FSH. Besides the adenoma, a mucoepidermoid carcinoma was found within the sphenoid cavity. This carcinoma may be a consequence of the radiotherapy of the adenoma of the adenohypophysis. (orig.)

  15. Piecemeal Versus En Bloc Resection of Large Rectal Adenomas

    2016-05-10

    Colorectal Adenoma With Mild Dysplasia; Colorectal Adenoma With Severe Dysplasia; Colorectal Adenomatous Polyp; Colorectal Low Grade Intraepithelial Neoplasia; Colorectal High Grade Intraepithelial Neoplasia

  16. Microfollicular thyroid adenoma and congenital goitrous hypothyroidism.

    Alabbasy, A J; Delbridge, L.; Eckstein, R; Cowell, C.; Silink, M

    1992-01-01

    Three patients with congenital goitrous hypothyroidism are reported. They were treated with adequate thyroxine replacement and developed well defined microfollicular thyroid adenomas despite being euthyroid clinically and biochemically throughout their clinical course. Patients with congenital goitrous hypothyroidism appear to be at increased risk of developing thyroid adenoma in childhood despite the use of replacement thyroxine treatment in physiological doses.

  17. Concomitant pituitary adenoma and Rathke's cleft cyst

    We reviewed the clinical, radiological and surgical findings in patients with both pituitary adenoma and Rathke's cleft cyst. We retrospectively selected patients with both lesions from the 374 patients in whom a sellar/juxtasellar lesion was detected on MRI at 1.5 tesla. All patients received intravenous contrast medium. Concomitant pituitary adenoma and Rathke's cleft cyst were found in eight patients (2.1 %). The frequency of the combination was 3.5 % of pituitary adenomas and 11 % of Rathke's cleft cysts. Symptoms were always due to the adenoma, secreting adrenocorticotrophin in two patients and growth hormone in six. The adenoma was larger in five patients, and the cyst in three. The cysts gave variable signal. The adenoma was adjacent to the cyst in seven patients, and enclosed it in the other patient. As a result of experience with MRI, concomitant pituitary adenoma and Rathke's cleft cyst are now known not to be as rare as thought previously. When a nonenhancing cyst-like structure is demonstrated in a patient with pituitary adenoma, the possibility of a coexisting Rathke's cleft cyst should be considered. (orig.)

  18. Magnetic resonance imaging of pituitary adenomas

    Bonneville, Jean-Francois; Bonneville, Fabrice; Cattin, Francoise [University Hospital, Department of Neuroradiology, Besancon (France)

    2005-03-01

    Today, MR is the only method needed for the morphological investigation of endocrine-active pituitary adenomas. In acromegaly and Cushing's syndrome, the therapeutic attitude is directly dictated by MR data. We present the MR aspect of pituitary adenomas according to size, sex, age, endocrine activity and a few particular conditions such as hemorrhagic pituitary adenomas, pituitary adenomas during pregnancy, cavernous sinus invasion and postsurgical changes. When an intrasellar mass extending out of the sella turcica is detected, the goal of the MR examination is to indicate precisely the origin of the tumor, its extension in relation to the various surrounding structures, its structure and its enhancement in order to help in the differential diagnosis. Demonstration of very small pituitary adenomas remains a challenge. When SE T1- and Turbo SE T2-weighted sequences are non-diagnostic, enhanced imaging becomes mandatory; half-dose gadolinium injection, delayed sequence, dynamic imaging can be of some help. (orig.)

  19. PAROTIDEKTOMI SUPERFISIAL PADA ADENOMA PLEOMORFIK PAROTIS

    Kertanadi N

    2015-01-01

    Full Text Available Adenoma pleomorfik parotis adalah tumor jinak pada kelenjar ludah parotis. Hampir semua asimtomatik sehingga terdeteksi secara kebetulan saat dilakukan pemeriksaan rutin atau setelahpenderita mengeluh benjolan di daerah parotis. Adenoma pleomorfik dapat berubah menjadi suatu keganasan bila tidak diobati. Standar pengobatan adenoma pleomorfik adalah eksisi komplit tumormelalui total atau superfisial parotidektomi dengan margin yang adekuat untuk menghindari kekambuhan. Komplikasi operasi dapat berupa kelumpuhan saraf fasialis dan Frey’s syndrome. Kamimelaporkan satu kasus perempuan usia 52 tahun dengan adenoma pleomorfik parotis yang datang dengan keluhan benjolan kecil pada bagian depan telinga kiri sejak 3 bulan sebelumnya. Penanganantelah dilakukan dengan parotidektomi superfisial. Diagnosis adenoma pleomorfik parotis dikonfirmasi dengan pemeriksaan histopatologis. Penderita tidak mengalami komplikasi kelumpuhan saraf fasialisataupun Frey’s syndrome, dan tidak ada kekambuhan setelah operasi. [MEDICINA 2014;45:43-46

  20. Octreotide Uptake in Parathyroid Adenoma

    Seyhan Karaçavuş

    2012-08-01

    Full Text Available The patient with a history of bone pain and muscle weakness, was thought to have oncogenic osteomalacia as a result of biochemical investigations and directed to Nuclear Medicine Department for a whole-body bone scintigraphy and 111In-octreotide scintigraphy. There was no focal pathologic tracer uptake, but generalized marked increase in skeletal uptake on bone scintigraphy. Octreotide scintigraphy showed accumulation of octreotide in the region of the left lobe of the thyroid gland in the neck. Thereafter, parathyroid scintigraphy was performed with technetium-99m labeled metroxy-isobutyl-isonitryl (99mTc-MIB and MIBI scan demonstrated radiotracer uptake at the same location with octreotide scintigraphy. The patient underwent left inferior parathyroidectomy and histopathology confirmed a parathyroid adenoma. Somatostatin receptor positive parathyroid adenoma may show octreotide uptake. Octreotide scintigraphy may be promising and indicate a possibility of using somatostatin analogues for the medical treatment of somatostatin receptor positive parathyroid tumors. (MIRT 2012;21:77-79

  1. Giant Parotid Pleomorphic Adenoma Involving Parapharyngeal Space

    Sukri Rahman

    2013-09-01

    Full Text Available AbstrakLatar belakang: Pleomorfik adenoma parotis merupakan tumor jinak kelenjar liur yang paling sering ditemukan, namun pleomorfik adenoma parotis yang sangat besar sehingga melibatkan ruang parafaring (RPF sangat jarang. Diagnosis ini sulit ditegakkan karena gejala klinisnya tidak khas. Penatalaksanaanya harus hati-hati mengingat banyak struktur vital yang beresiko mengalami trauma. Tujuan: Bagaimana menegakkan diagnosis dan penatalaksanaan pleomorfik adenoma parotis yang melibatkan RPF. Kasus: Seorang pasien perempuan 27 tahun ditegakkan diagnosis pleomorfik adenoma parotis kanan dengan melibatkan RPF. Terdapat pembengkakan pada leher yang bersifat asimtomatis dan gejala pendorongan faring dan laring yang menyebabkan disfonia, disfagia, dan defisit saraf kranial IX,X,XII. Penatalaksanaan: Pasien telah dilakukan operasi parotidektomi pendekatan transervikal–transparotid dengan preservasi arteri karotis eksterna dan saraf fasialis. Kesimpulan: Biopsi Aspirasi Jarum Halus (BAJAH dan radiologi merupakan pemeriksaan yang penting untuk menegakkan diagnosis. Penatalaksanaan pleomorfik adenoma parotis yang melibatkan RPF adalah bedah ekstirpasi komplit dengan beberapa pendekatan. .Kata kunci: tumor jinak kelenjar liur, pleomorfik adenoma, ruang parafaringAbstractBackground: Parotid pleomorphic adenoma is the most common benign salivary gland tumor, while giant parotid pleomorphic adenoma involving the parapharyngeal space (PPS is rare. It was difficult to diagnose because the clinical presentation of this tumor can be subtle. The management must be performed carefully due to anatomy relation to complex vital structure lead to traumatic injury highrisk. Purposes: How to make diagnosis and management parotid pleomorphic adenoma involving PPS. Case: A female 27 years old with diagnosis was giant parotid pleomorphic adenoma involving PPS. There was asymptomatic swelling of the neck and presence of pushing the pharynx and larynx medially causes

  2. MR of pituitary micro-adenomas

    Most of the time, rationales to look for pituitary micro-adenomas are based on endocrinal disorder. MRI is often helpful to confirm diagnosis. It gives information about micro-adenomas size and localisation. If conventional sequence are inadequate, a dynamic sequence has then to be performed after Gadolinium injection. Any disorder observed from the pituitary gland must be correlated with the clinical observation and results from biochemistry analysis. False positive happens quite open because of gland morphological variation, incidentalomas and partial volumes. MRI offers the possibility to follow-up treated micro-adenomas evolution especially to detect recurrence. (author)

  3. A Case of Mediastinal Parathyroid Adenoma

    Erkan Akar

    2015-12-01

    Full Text Available Parathyroid adenomas are the most important cause of primary hyperparathyroidism. The diagnosis of primary hyperparathyroidism is established based on the combination of elevated serum calcium and parathyroid hormone levels. Parathyroid adenomas are rarely found in the mediastinum. The definitive treatment of primary hyperparathyroidism is parathyroidectomy. The parathyroid hormone and serum calcium levels were determined high in a fifty-seven-year-old female patient with a history of bone and abdominal pain, fatigue, and kidney stones. Anterior mediastinal ectopic parathyroid adenoma was detected with Technetium-99m (Tc-99m methoxy isobutyl isonitrile scintigraphy. Adenoma was removed surgically with partial median sternotomy. Serum calcium and parathyroid hormone levels returned to normal on the 3rd postoperative day. The patient was discharged with healing.

  4. Mediastinal Parathyroid Adenoma and Brown Tumors

    Bernal, P.; Ucros, G.; Mejia, A

    2012-01-01

    In this report, we describe a rare case of brown tumor and mediastinal parathyroid adenoma. This report emphasizes the value of radionuclide scintigraphy in the setting of persistent disease following parathyroid surgery.

  5. Gamma knife radiosurgery for pituitary adenomas.

    Ježková, Jana; Marek, Josef

    2016-09-01

    Pituitary adenomas are frequently occurring intracranial neoplasms. The aim of the treatment of pituitary adenomas is to normalize hormonal hypersecretion, to preserve the normal pituitary function, to reserve or treat impaired pituitary function and to control tumor growth and its mechanical effects on the surrounding structures. Treatment modalities include surgical, medical and radiation therapy. Radiosurgery is mainly used as a secondary line treatment after surgery for residual or recurrent tumors. The antiproliferative effect is achieved by LKG irradiation in more than 90% of patients. Regarding the functioning pituitary adenomas, the manifestation of the treatment effect is slow and depends mainly on the type of adenoma. Gamma knife irradiation is safe when the maximal doses to pituitary and infundibulum are respected. PMID:26899535

  6. Pituitary prolactin adenoma with Toxoplasma gondii infection

    张晓晖; 李青; 程虹; 阎庆国; 黄高昇

    2003-01-01

    Objective: To report two recent cases of pituitary adenoma associated with Toxoplasma gondii (T.Gondii) infection.Methods: Histological changes were observed in H & E and PAS staining sections microscopically.Immunohistochemistry was performed to classify the pituitary tumors and to confirm the diagnosis of T.gondii.Results: The cases were 43- and 19-year-old females, in which the latter one was a recurring case, and radiology examination showed that tumors existed in sellar region.Microscopically, the tumors consisted of small homogenous polygonal or round cells with abundant eosinophilic granular cytoplasm.Immunohistochemistry revealed they were prolactin-producing adenomas.Interestingly, we found toxoplasma infection in the tumor tissues, being confirmed by T.gondii sepicific antibody immunohistochemistry.Conclusion: The association of pituitary adenoma with toxoplasma raises the possibility that T.gondii may be involved in the development of certain cases of pituitary adenoma.

  7. Metastases from a pituitary adenoma: MRI

    Few cases of pituitary adenoma with metastases have been reported. We report a case with histologically benign intracranial and cauda equina metastases. We compare it to the others in the literature. (orig.)

  8. Metastases from a pituitary adenoma: MRI

    Boucaud, L. de; Dousset, V.; Viaud, B.; Caille, J.M. [Service de Neuroradiologie, CHU Pellegrin, Bordeaux (France); Caillaud, P.; Guerin, J. [Service de Neurochirurgie, CHU Pellegrin, Bordeaux (France)

    1999-10-01

    Few cases of pituitary adenoma with metastases have been reported. We report a case with histologically benign intracranial and cauda equina metastases. We compare it to the others in the literature. (orig.)

  9. A Case of Mediastinal Parathyroid Adenoma

    Erkan Akar

    2015-01-01

    Parathyroid adenomas are the most important cause of primary hyperparathyroidism. The diagnosis of primary hyperparathyroidism is established based on the combination of elevated serum calcium and parathyroid hormone levels. Parathyroid adenomas are rarely found in the mediastinum. The definitive treatment of primary hyperparathyroidism is parathyroidectomy. The parathyroid hormone and serum calcium levels were determined high in a fifty-seven-year-old female patient with a history of bone an...

  10. Parathyroid Adenoma: is Sestamibi scintigraphy mandatory?

    Chandrasekar Maharajan; Sucharitha Vedachalam

    2013-01-01

    Localization of parathyroid adenoma using 99mTc scintigraphy is the standard of care. However, of late, ultrasound has been employed to this end with increasing frequency.1, 2, 3 The employment of intra-operative PTH estimation (IOPTH) has further augmented the cure rate of hyperparathyroidism due to parathyroid adenomas.4 While ultrasound is widely available, scintigraphy is available only in tertiary health-care centres. With this background, a prospective study was conducted in the ...

  11. Myxoid adrenocortical adenoma: a case report

    ZHU Yu; WU Yu-xuan; ZHANG Chong-yu; ZHAO Ju-ping; RUI Wen-bin; HE Hong-chao; SHEN Zhou-jun

    2008-01-01

    @@ Myxoid adrenocorticfal adenomas are extremely rare with only 24 cases reported.1-12 The first case was reported by Tang et al1 in 1979 which was diagnosed as a myxoid adrenocortical carcinoma. Nearly all the reports were of single case except Browen et al3 who described a group of 14 cases. We report here an additional case of myxoid adrenocortical adenoma with an immunohistochemical study of the tumor and discuss the diagnosis with reference to the current literature.

  12. Pleomorphic adenoma of the hard palate

    Kaur S

    2003-03-01

    Full Text Available Pleomorphic adenoma is a benign tumor of the salivary glands that has elements of both epithelial and mesenchymal tissues. The tumor most commonly arises in the parotid or submandibular glands. Infrequently, it may arise from the minor salivary glands and present as an intraoral mass over the palate or lip. We report a patient with pleomorphic adenoma over the hard palate, which resembled common intraoral diseases like condyloma acuminata, oral papilloma and squamous cell carcinoma.

  13. Diagnosis of pituitary adenoma with dynamic MRI

    Seventeen patients with pituitary adenomas topographically diagnosed by dynamic MRI between 1990 and 1995 are analyzed in this study. All patients were treated surgically and diagnosed pathologically. In all eight cases of macroadenomas, not only the normal glands, but also the adenomas were enhanced by Gd-DTPA (gadolinium diethylenetriamine pentaacetic acid). In three of eight cases, the normal glands could not be delineated, even by dynamic MRI. In five cases, the normal gland was recognized as an early enhancing area. In four of nine cases of microadenomas, the tumor was identified as a well-defined round area that enhanced later than normal tissue. In four other cases, a delayed enhancing area was vaguely dectable and proved to be the adenoma by histopathology. One of these cases was an ACTH producing adenoma. In the remaining case, three dynamic MRI study was performed, but no tumor was recognized preoperatively. This tumor was also an ACTH producing adenoma. These results suggest that, even by the dynamic MRI, sometimes the normal gland is not distinguishable from macroadenomas and furthermore, ACTH producing adenomas are still difficulty to diagnose preoperatively. (author)

  14. Giant serous microcystic pancreas adenoma

    Mustafa Kerem

    2012-10-01

    Full Text Available Serous cystadenomas are rare tumors comprising 1-2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females. Non-specific symptoms, such as abdominal pain or symptoms due to mass affect, are usually seen. A 64-year old female patient was investigated for abdominal pain. Physical and laboratory findings were normal. Abdomen ultrasonography confirmed an 11x9.5 cm solid cystic lesion and abdomen computed tomography scan confirmed a 12x11 cm lobulated cystic solid lesion which had central cystic necrotic areas extending from liver hilus inferiorly. Fine needle biopsy confirmed benign cytology and trucut biopsy of the pan creatic mass reported chronic inflamation. Nevertheless, this mass could have malignant contents and transformation potential. A laparatomy was decided due to patient’s symptoms and mass effect. Due to vascular invasion of the tumor, Whipple procedure was performed. The pathology report confirmed serous microcystic adenoma. These rare tumors are usually benign but pre-operative malignity criterias are not identified. There are few differential diagnostic tools for excluding malignity. We suggest surgical resection as best treatment approach for selected cases.

  15. Heterogeneity of secretory granules of silent pituitary adenomas

    Holck, S; Wewer, U M; Albrechtsen, R

    1988-01-01

    Silent pituitary adenomas were compared with hormonally active tumors taking into account the size, number, and ultrastructural characteristics of secretory granules (SG). The study group (a total of 79 primary pituitary adenomas) comprised 27 silent, 21 growth hormone (GH)-producing-, 16 prolactin...... (PRL)-producing-, 5 GH-PRL-producing- and 10 adrenocorticotropic hormone (ACTH)-producing adenomas. The SG of silent adenomas were significantly smaller than SG in endocrine active adenomas. All hormonally inactive tumors also contained small (mean, 94 nm) specific cytoplasmic granules, designated...... "silent adenoma granules" (SIG). The fine structural features of the SIG included: a flocculent, granular material occupying an eccentric position in a larger vesicle limited by a double membrane. In the silent adenomas this particular granule was present in up to 90% of the adenoma cells and constituted...

  16. Radiotherapy for pituitary adenomas: an endocrinologist`s perspective

    O`Halloran, D.J.; Shalet, S.M. [Christie Hospital and Holt Radium Inst., Manchester (United Kingdom)

    1996-10-01

    A brief review is given of the clinical management of patients with pituitary adenomas such as prolactinomas, adenomasin acromegoly and Leushin`s disease, and non-functioning pituitary adenomas. In particular the complications of radiotherapy are explored. (UK).

  17. HYPONATREMIA AFTER TRANSSPHENIODAL SURGERY OF PITUITARY ADENOMA

    陶蔚; 任祖渊; 苏长保; 王任直; 杨义; 马文斌

    2003-01-01

    Objective. To clarify the frequency, presentation, associated factors, treatment and outcome of hy-ponatremia after transsphenoidal surgery of pituitary adenomas.Methods. Retrospectively reviewed the database of 183 patients who underwent transsphenoidal surgeryof pituitary adenomas between January 1999 and June 2000 in our department.Result.s. 38.8% (71/183) had postoperative hyponatremia. Among them, 59.2% (42/71) appeared onthe 4th to 7th day postoperatively. 59.2% (42/71) presented with nausea, vomiting, headache, dizzi-ness, confusion and weakness. Hyponatremia was related to age, tumor size and adenoma type, but notrelated to sex and degree of resection. Treatment consisted of salt replacement and mild fluid restrictionin 4 patients and salt and fluid replacement in 67 patients. Hyponatremia resolved within 16 days in allthe patients.Conclusions. Hyponatremia often appeared about 7 days after transsphenoidal surgery of pituitary ade-nomas, especially in elderly and patients with macroadenomas and huge pituitary adenomas. The principleof treatment was salt and fluid replacement.

  18. Primary hyperparathyroidism: adenoma or hyperplasia

    Betancourt-Piñeres Aiken Felipe

    2012-12-01

    Full Text Available Introduction: primary hyperparathyroidism (PH is a symptomatic or asymptomaticclinical entity, characterized by the autonomous production of parathyroid hormone (PTH. Its classical presentation exhibits an increase of the serum calcium andparathyroid hormone levels. Parathyroid scintigrafy, among other imaging modalities,is frequently used to detect the hyperfunctioning glands.Clinical case: number 1. Female, 69 years old, asymptomatic, hypertension of recentonset, osteopenia, increased intact PTHi level and serum calcium concentration, andlow phosphate level, multinodular goiter (ultrasound, and focal increased uptake inthe inferolateral aspect of thyroid right lobe (parathyroid scintigraphy consistent withparathyroid adenoma, confirmed by surgery and histopathology examination. Number2. Female, 69 years old, with history of chronic hypertension, nephrolithiasis andpartial thyroidectomy, actually with chronic diarrhea and headaches, erosive chronicduodenitis (endoscopy, increase of PTHi and serum calcium levels, changes in contrastneck CT scan and US consistent with thyroidectomy, and parathyroid scintigraphy withthree areas of focal increased isonitrile uptake consistent with parathyroid hyperplasia,confirmed by surgery and histopathologic findings.Conclusion: the parathyroid Scintigraphy (planar and Spect, double phase and doubletracer done in combination, have good sensibility, specificity and diagnostic accuracyof parathyroid adenomas and hyperplasia, improving surgical procedures, with minimalincision or invasion, ad quality of life of hyperparathyroidism patients. Rev.cienc.biomed. 2012;3(2:350-354RESUMEN:Introducción: el hiperparatiroidismo primario (HP es una entidad clínica sintomáticao asintomática, caracterizada por la producción autónoma de parathormona (PTH.Se presenta elevación del calcio sérico y de la parathormona (PTH, aunque estaúltima puede permanecer dentro en los rangos normales altos. La gammagraf

  19. Status and advances in imaging diagnosis of hepatic adenoma

    Hepatic adenoma is a rare benign tumor, which is quite easily misdiagnosed for its nonspecific appearance. The great advances in imaging technology have led an increase in the detection rate of hepatic adenoma. This article reviews the recent advances at home and abroad in imaging diagnostic characteristic of hepatic adenoma, in order to raise awareness of clinicians and make accurate judgment. (authors)

  20. Recurrent oculomotor palsy due to haemorrhage in pituitary adenoma.

    Mohanty, S.

    1980-01-01

    Haemorrhage in pituitary adenoma is an unusual cause of recurrent oculomotor palsy. Three episodes of right oculomotor palsy are reported from a patient having haemorrhage in pituitary adenoma. Early operation and decompression of haemorrhagic pituitary adenoma should be performed so that vision may be preserved and recovery of oculomotor palsy be assured.

  1. The first case of pediatric bile duct adenoma

    Zhi Li; Xiaoyi Sun; Jiexiong Feng

    2015-01-01

    Intrahepatic bile duct adenoma (BDA) is a rare benign epithelial liver tumor derived from bile duct cells. We report the first case of pediatric bile duct adenoma in the world. Furthermore, we review the diagnosis, pathology, treatment and prognosis of bile duct adenoma.

  2. Relationship Between Histopathology and Clinical Prognosis of Invasive Pituitary Adenoma

    LIYong; SHUKai; DONGFangyong; WANFeng; LEITing; LILing

    2005-01-01

    Objective: To study the relationship between histopathology and clinical prognosis of invasive pituitary adenoma subjected to transsphenoidal surgery. Methods: The enrolled were 82 patients with invasive pituitary adenomas undergoing transsphenoidal surgery during Jan. 2000 May 2003 in our department with full MR imaging findings, pathology data and follow-up information. The follow-up duration was 5-30 months. Results: MR imaging findings of invasive pituitary adenoma included: depression of the sellar floor, involvement of sphenoid sinus and cavernous sinus, breakthrough of diaphragma sellae,encasement of internal carotid artery, etc. Pathological examination revealed that the invasion rate of dura in sella turcica was the highest among the structures around tumor. Pituitary adenoma apoplexy was found in 20 cases (24.4%). The total removal rate for PRL-secreting adenomas was significantly lower than that for non-secreting adenomas (P<0.01), but non-, GH-, ACTH-secreting adenomas had no significant differences. The recurrence rate of PRL-secreting adenornas was higher than that of non- and GH-secreting adenomas (P<0.05). Conclusion: Among invasive pituitary adenomas, the therapeutic effects of nonand GH-secreting pituitary adenomas are better than that of PRL-secreting adenomas. Invasive biological behaviors of invasive pituitary adenomas result in radical operation failure and postoperative recurrence.

  3. Advanced methods of treatment of hypophysis adenoma

    Kan Ya.A.

    2011-03-01

    Full Text Available Hypophysis adenomas are mostly spread in the chiasmatic cellular area. They account 18% of all new brain formations, the structure of pituitary adenomas includes prolactinomas in a large number of cases which are manifested by the syndrome of hyperprolactinemia and hormone inactive hypophysis tumours (35%. Somatotropins (13-15% are lower in frequency, the main clinical feature is acromegalia. One can rarely reveal corticotropins (8-10%, gonadotro-pins (7-9% and thyrotropins (1% and their mixed forms. Transsphenoidal surgical interventions are considered to be methods of choice treatment of hypophysis adenomas and other formations in the chiasmatic cellular area. Alternative methods of treatment are conservative. They can be as an addition to microsurgery (radiotherapy

  4. PARATHYROID ADENOMA: IS SESTAMIBI SCINTIGRAPHY MANDATORY?

    Chandrasekar Maharajan

    2013-01-01

    Full Text Available Localization of parathyroid adenoma using 99mTc scintigraphy is the standard of care. However, of late, ultrasound has been employed to this end with increasing frequency.1, 2, 3 The employment of intra-operative PTH estimation (IOPTH has further augmented the cure rate of hyperparathyroidism due to parathyroid adenomas.4 While ultrasound is widely available, scintigraphy is available only in tertiary health-care centres.With this background, a prospective study was conducted in the department of endocrine surgery of a tertiary care hospital to analyse the efficacy of surgeon-performed ultrasound (SPUS in comparison to that of 99mTc Sestamibi scintigraphy in the localization of parathyroid adenomas.

  5. Light bodies in human pituitary adenomas

    Holck, S; Wewer, U M; Albrechtsen, R

    1987-01-01

    Light bodies are large cytoplasmic granules originally described in the gonadotrophic cells of the rat pituitary gland. In order to determine whether similar bodies occur in the human anterior pituitary gland, 89 pituitary adenomas and periadenomatous tissue from 20 cases were examined by...... cells in periadenomatous tissue from 20 cases. These results show that some human pituitary adenomas may contain light bodies identical to those seen in gonadotrophs of rat pituitary....... transmission electron microscopy. Double membrane bound bodies with filamentous internal structure identical to rodent light bodies were identified in 10 hormone-producing adenomas: 5 PRL, 1 PRL-GH, 2 GH, and 2 ACTH-producing tumours. No light bodies were found in the remaining 79 tumours nor in the pituitary...

  6. Preoperative volume determination for pituitary adenoma

    Zukic, Dženan; Egger, Jan; Bauer, Miriam H. A.; Kuhnt, Daniela; Carl, Barbara; Freisleben, Bernd; Kolb, Andreas; Nimsky, Christopher

    2011-03-01

    The most common sellar lesion is the pituitary adenoma, and sellar tumors are approximately 10-15% of all intracranial neoplasms. Manual slice-by-slice segmentation takes quite some time that can be reduced by using the appropriate algorithms. In this contribution, we present a segmentation method for pituitary adenoma. The method is based on an algorithm that we have applied recently to segmenting glioblastoma multiforme. A modification of this scheme is used for adenoma segmentation that is much harder to perform, due to lack of contrast-enhanced boundaries. In our experimental evaluation, neurosurgeons performed manual slice-by-slice segmentation of ten magnetic resonance imaging (MRI) cases. The segmentations were compared to the segmentation results of the proposed method using the Dice Similarity Coefficient (DSC). The average DSC for all datasets was 75.92%+/-7.24%. A manual segmentation took about four minutes and our algorithm required about one second.

  7. Comparison of the Blood and Lymphatic Microvessel Density of Pleomorphic Adenoma and Basal Cell Adenoma

    Andresa Borges Soares; Albina Altemani; Thais Ribeiro de Oliveira; Felipe de Oliveira Fonseca Rodrigues; Alfredo Ribeiro-Silva; Danilo Figueiredo Soave; Fabricio Passador-Santos; Suellen Trentin Brum; Marcelo Henrique Napimoga; Vera Cavalcanti de Araújo

    2015-01-01

    BACKGROUND Pleomorphic adenoma (PA) is the most common tumor of the salivary gland, while basal cell adenoma (BCA) is an uncommon neoplasm. Blood and lymphatic vessels are crucial for tumor metabolism. The aim of this study was to compare the blood and lymphatic vascular density and vascular and endothelial growth factor (VEGF) expression in PA and BCA tumors. In addition, cell proliferation was evaluated in these tumors. METHODS Blood and lymphatic vessel content, VEGF expression, and cell p...

  8. Immunohistochemical Expression of p53 in Pleomorphic Adenoma and Carcinoma Ex Pleomorphic Adenoma

    Bassel Tarakji; Omar Kujan; Nassani, Mohammad Z.

    2010-01-01

    Context. Immunohistochemical stains for p53 are used as a diagnostic marker associated with malignancy in several histologic types of salivary gland tumors. This marker may be useful in differentiating pleomorphic adenoma (PA) from carcinoma ex pleomorphic adenoma (CPA), as these tumors are often difficult to distinguish on the basis of morphology alone. Objective. to evaluate whatever inactivation of tumor suppressor gene (p53) increases with the tumor progression from normal salivary tissue...

  9. Etiology and management of recurrent parotid pleomorphic adenoma.

    Witt, Robert L; Eisele, David W; Morton, Randall P; Nicolai, Piero; Poorten, Vincent Vander; Zbären, Peter

    2015-04-01

    The objective of this review study was to encompass the relevant literature and current best practice options for this challenging, sometimes incurable problem. The source of the data was Ovid MEDLINE from 1946 to 2014. Review methods consisted of articles with clinical correlates. The most important cause of recurrence is enucleation with rupture and incomplete tumor excision at operation. Incomplete pseudocapsule, extracapsular extension, pseudopods of pleomorphic adenoma tissue, and satellite pleomorphic beyond the pseudocapsule are also likely linked to recurrent pleomorphic adenoma. Most recurrent pleomorphic adenoma are multinodular. Magnetic resonance imaging is the imaging study of choice for recurrent pleomorphic adenoma. Nerve integrity monitoring may reduce morbidity for recurrent pleomorphic adenoma. Treatment of recurrent pleomorphic adenoma must be individualized. Total parotidectomy, given the multicentricity of recurrent pleomorphic adenoma, is appropriate in many patients, but may be inadequate to control recurrent pleomorphic. There is accumulating evidence from retrospective series that postoperative radiation therapy results in significantly better local control. PMID:25289881

  10. Angioscan exploration of morphology of pituitary adenoma

    Tabarin, A.; David, J.P.; Drouillard, J. and others

    1987-01-01

    Considerable progress has been made in the morphologic study of pituitary due to the availability of angioscan programs. An exceptional case is presented of a persistent intrasellar trigeminal artery associated with prolactinoma. Based on technological progress in CT scan imaging the place of angiographic explorations in the investigation of pituitary adenoma is reconsidered.

  11. Parathyroid adenoma imaging-preoperative localization

    Ghemigian Adina

    2015-08-01

    Full Text Available Primary hyperparathyroidism (PHPT is a frequent endocrine disorder that can only be cured by a surgical procedure that is parathyroidectomy. The main causes are usually solitary benign adenoma (80-85%, diffuse or nodular hyperplasia (10-15%, or parathyroid carcinoma (<1%. Out of the known localization techniques, ultrasonography, nuclear scintigraphy and computer tomography (CT scan are most commonly used [1].

  12. Parathyroid adenoma imaging-preoperative localization

    Ghemigian Adina; Buruiana Andra; Olaru Maria; Dumitru Nicoleta; Goldstein A.; Hortopan D.; Ioachim D.; Ghemigian M.; Boanta Roxana; Caragheorgheopol Andra; Eugenia Petrova

    2015-01-01

    Primary hyperparathyroidism (PHPT) is a frequent endocrine disorder that can only be cured by a surgical procedure that is parathyroidectomy. The main causes are usually solitary benign adenoma (80-85%), diffuse or nodular hyperplasia (10-15%), or parathyroid carcinoma (

  13. Genotype phenotype classification of hepatocellular adenoma

    Paulette Bioulac-Sage; Jean Frédéric Blanc; Sandra Rebouissou; Charles Balabaud; Jessica Zucman-Rossi

    2007-01-01

    Studies that compare tumor genotype with phenotype have provided the basis of a new histological/molecular classification of hepatocellular adenomas. Based on two molecular criteria (presence of a TCF1/HNF1α or β-catenin mutation), and an additional histological criterion (presence or absence of an inflammatory infiltrate), subgroups of hepatocellular adenoma can be defined and distinguished from focal nodular hyperplasia. Analysis of 96 hepatocellular adenomas performed by a French collaborative network showed that they can be divided into four broad subgroups: the first one is defined by the presence of mutations in TCF1 gene inactivating the hepatocyte nuclear factor 1 (HNF1α); the second by the presence of β-catenin activating mutations; the category without mutations of HNF1α or β-catenin is further divided into 2 subgroups depending on the presence or absence of inflammation. Therefore, the approach to the diagnosis of problematic benign hepatocytic nodules may be entering a new era directed by new molecular information. It is hoped that immunohistological tools will improve significantly diagnosis of liver biopsy in our ability to distinguish hepatocellular adenoma from focal nodular hyperplasia (FNH), and to delineate clinically meaningful entities within each group to define the best clinical management. The optimal care of patients with a liver nodule will benefit from the recent knowledge coming from molecular biology and the combined expertise of hepatologists, pathologists, radiologists, and surgeons.

  14. Nephrogenic adenoma. Reports of two cases

    Osther, P J; Starklint, H

    1989-01-01

    Nephrogenic adenoma is a rare lesion of the urinary tract. Two cases in the urinary bladder are described. Histologically the tumor consists of cystic and tubular structures resembling the distal part of the nephron. The etiology and pathogenesis are discussed and a new etiologic theory is...

  15. URINARY MUTAGENICITY AND COLORECTAL ADENOMA RISK

    AbstractWe investigated urinary mutagenicity and colorectal adenoma risk in a clinic-based, case-control study of currently nonsmoking cases (n = 143) and controls (n = 156). Urinary organics were extracted by C18/methanol from 12-h overnight urine samples, and mutagenici...

  16. Thyroid Adenomas After Solid Cancer in Childhood

    Purpose: Very few childhood cancer survivor studies have been devoted to thyroid adenomas. We assessed the role of chemotherapy and the radiation dose to the thyroid in the risk of thyroid adenoma after childhood cancer. Methods and Materials: A cohort of 3254 2-year survivors of a solid childhood cancer treated in 5 French centers before 1986 was established. The dose received by the isthmus and the 2 lobes of the thyroid gland during each course of radiation therapy was estimated after reconstruction of the actual radiation therapy conditions in which each child was treated as well as the dose received at other anatomical sites of interest. Results: After a median follow-up of 25 years, 71 patients had developed a thyroid adenoma. The risk strongly increased with the radiation dose to the thyroid up to a few Gray, plateaued, and declined for high doses. Chemotherapy slightly increased the risk when administered alone but also lowered the slope of the dose-response curve for the radiation dose to the thyroid. Overall, for doses up to a few Gray, the excess relative risk of thyroid adenoma per Gray was 2.8 (90% CI: 1.2-6.9), but it was 5.5 (90% CI: 1.9-25.9) in patients who had not received chemotherapy or who had received only 1 drug, and 1.1 (90% CI: 0.4-3.4) in the children who had received more than 1 drug (P=.06, for the difference). The excess relative risk per Gray was also higher for younger children at the time of radiation therapy than for their older counterparts and was higher before attaining 40 years of age than subsequently. Conclusions: The overall pattern of thyroid adenoma after radiation therapy for a childhood cancer appears to be similar to that observed for thyroid carcinoma.

  17. Thyroid Adenomas After Solid Cancer in Childhood

    Haddy, Nadia; El-Fayech, Chiraz; Guibout, Catherine; Adjadj, Elisabeth [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Thomas-Teinturier, Cecile [Radiation Epidemiology Group, INSERM, Villejuif (France); Hopital Bicetre, Bicetre (France); Oberlin, Odile [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Veres, Cristina [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Pacquement, Helene [Institut Curie, Paris (France); Jackson, Angela [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Munzer, Martine; N' Guyen, Tan Dat [Institut Jean Godinot, Reims (France); Bondiau, Pierre-Yves [Centre Antoine Lacassagne, Nice (France); Berchery, Delphine; Laprie, Anne [Centre Claudius Regaud, Toulouse (France); Bridier, Andre; Lefkopoulos, Dimitri [Institut Gustave Roussy, Villejuif (France); Schlumberger, Martin [Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Rubino, Carole; Diallo, Ibrahima [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Vathaire, Florent de, E-mail: florent.devathaire@igr.fr [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France)

    2012-10-01

    Purpose: Very few childhood cancer survivor studies have been devoted to thyroid adenomas. We assessed the role of chemotherapy and the radiation dose to the thyroid in the risk of thyroid adenoma after childhood cancer. Methods and Materials: A cohort of 3254 2-year survivors of a solid childhood cancer treated in 5 French centers before 1986 was established. The dose received by the isthmus and the 2 lobes of the thyroid gland during each course of radiation therapy was estimated after reconstruction of the actual radiation therapy conditions in which each child was treated as well as the dose received at other anatomical sites of interest. Results: After a median follow-up of 25 years, 71 patients had developed a thyroid adenoma. The risk strongly increased with the radiation dose to the thyroid up to a few Gray, plateaued, and declined for high doses. Chemotherapy slightly increased the risk when administered alone but also lowered the slope of the dose-response curve for the radiation dose to the thyroid. Overall, for doses up to a few Gray, the excess relative risk of thyroid adenoma per Gray was 2.8 (90% CI: 1.2-6.9), but it was 5.5 (90% CI: 1.9-25.9) in patients who had not received chemotherapy or who had received only 1 drug, and 1.1 (90% CI: 0.4-3.4) in the children who had received more than 1 drug (P=.06, for the difference). The excess relative risk per Gray was also higher for younger children at the time of radiation therapy than for their older counterparts and was higher before attaining 40 years of age than subsequently. Conclusions: The overall pattern of thyroid adenoma after radiation therapy for a childhood cancer appears to be similar to that observed for thyroid carcinoma.

  18. Silent pituitary adenomas: review and clinical cases

    Anna Konstantinovna Lipatenkova

    2015-06-01

    Full Text Available Silent, or clinically nonfunctioning adenomas are morphologically heterogeneous group, characterized by positive immunoreactivity for one or more hormones classically secreted by normal pituitary cells but without clinical expression. Although in some occasions enhanced or changed secretory activity can develop over time. According to immunoreactivity they are divided into "silent" gonado-, cortico-, somato -, mammo – and thyrotropinomas, oncocytomas, «zero-cell» tumors. All types of "silent" adenomas have different biological activity, secretory capacity and outcomes in the postoperative period. This series of clinical cases shows more «aggressiveness», a higher risk of relapse for "silent" cortico- and somatotropinomas. Immunohistochemical analysis of residual tissue can be used to identify patients with high risk of recurrence, to develop optimal treatment and follow-up.

  19. Pleomorphic Adenomas of the Parapharyngeal Space

    İstemihan Akın

    2014-01-01

    Full Text Available Background. Parapharyngeal space is one of potential facial planes for neoplasms and infections and represents less than 1% of all head and neck tumours. Occurrence of the pleomorphic adenoma in the parapharyngeal space is a rarity. Case Presentation. Here, three giant pleomorphic adenomas of different sizes occupying the parapharyngeal space in three patients are reported. Extensive preoperative diagnostic workup was done in order to verify the nature and size of the tumour and the proximity to the large vessels. Review of the literature, clinical features, pathology, radiological findings, and treatment of these tumours are discussed. Conclusion. The excision of the tumor through submandibular transcervical approach, without cutting the mandible, turned out to be a safe and radical approach in all three cases.

  20. [One case of laryngeal pleomorphic adenoma].

    An, Huiqin; Bu, Guiqing; Guo, Mingli

    2013-05-01

    A male patient, 55 years old, suffered from intermittent sound,voice depression and shortness of breath for one year,and from dysphagia for 3-4 months. Through fiber laryngoscopy,we could see tumor in the left posterior aryepiglottic fold. The tumor's surface was smooth. A portion of the tumor protruded to the laryngeal cavity and the aryepiglottic fold external,it also covered most of the glottis. Bilateral vocal cord were smooth and had good mobility. Throat CT demonstrated an irregular soft tissue mass on the left side of the aryepiglottic fold in supraglottic area with obscure normal boundary from adjacent structure. The left side of pyriform sinus became shallow without obvious bone destruction. The pathological report showed pleomorphic adenoma. The diagnosis was laryngeal pleomorphic adenoma. PMID:23898619

  1. Pleomorphic adenoma of the parotid gland 1985-2010

    Andreasen, Simon; Therkildsen, Marianne H; Bjørndal, Kristine;

    2015-01-01

    BACKGROUND: Pleomorphic adenoma is the most frequent salivary gland tumor and is known for its tendency to recur and for its ability to transform to carcinoma ex pleomorphic adenoma (Ca-ex-PA). Along with pleomorphic adenoma demographics, we present the first nationwide study with long-term follow......-up on these topics. METHODS: The Danish Pathology Data Bank was searched for parotid pleomorphic adenoma and Ca-ex-PA in the period 1985 to 2010 and all pathology descriptions were reviewed. Ca-ex-PA specimens were reviewed by a pathologist. RESULTS: A total of 5.497 patients were identified and 2.......86% had at least one recurrence. An incidence of 4.29/100,000/year was found. The rate of malignant transformation in recurrent pleomorphic adenoma was 3.3%. CONCLUSION: We report an up-to-date assessment of the epidemiology of pleomorphic adenoma. We found an increasing incidence and low recurrence rate...

  2. Metanephric Adenoma: clinical, imaging, and histological findings

    Torricelli, Fabio Cesar Miranda; Marchini, Giovanni Scala, E-mail: fabio_torri@yahoo.com.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Urologica; Campos, Rodrigo Sousa Madeira [Hospital do Servidor Publico Estadual, Sao Paulo, SP (Brazil). Dept. de Urologia; Gil, Antonio Otero [Instituto Dante Pazanezzi, Sao Paulo, SP (Brazil)

    2011-07-01

    Metanephric adenoma (MA), also designated nephrogenic nephroma or renal epithelial tumor resembling immature nephron, has just been recently recognized as a special type of benign renal epithelial tumor. Only few reports are found in the literature regarding this rare renal tumor. The purpose of this paper is to describe our clinical, imaging and histological / immunohistochemical observations of MA diagnosed in two patients and compare these data to previous information reported in medical databases (author)

  3. Metanephric Adenoma: clinical, imaging, and histological findings

    Metanephric adenoma (MA), also designated nephrogenic nephroma or renal epithelial tumor resembling immature nephron, has just been recently recognized as a special type of benign renal epithelial tumor. Only few reports are found in the literature regarding this rare renal tumor. The purpose of this paper is to describe our clinical, imaging and histological / immunohistochemical observations of MA diagnosed in two patients and compare these data to previous information reported in medical databases (author)

  4. The result of radiotherapy for pituitary adenoma

    To evaluate the prognostic factors for disease-free survival and long-term results of radiotherapy for pituitary adenoma. The study involved a retrospective review of outcome in a series of 27 patients with pituitary adenoma, between 1984 and 1995 at Paik hospital. The study included 20 patients treated with surgery and postoperative radiotherapy and 7 with radiotherapy alone. The patients were followed for 12-146 months (median: 97 months). Seventeen were men and 10 were women. The numbers of functioning and non-functioning pituitary adenoma were 22 and 5 respectively and those of microadenoma and macroadenoma were 4 and 23 respectively. The radiation doses of 5040-5580cGy(median: 5040cGy) were delivered over 5-7 weeks, using 4MV LINAC. The prognostic factors were analyzed by log-rank test. For radiation therapy alone, the 5 YSR was 100% and progression free survival rate was 85.8%. The tumor was controlled in 6/7 (85.8%). For surgery and postoperative radiotherapy , the 5YSR, progression free survival rate and local control rate were 95%, 84.8%, and 89.5% respectively. The parameters of tumor size, hormone secretion, radiation dose, radiotherapy field size were evaluated in a uni- and multivariate analysis and all the factors were not statistically significant (P>0.05). Eleven of 12 (92%) with visual field defect experienced normalization or improvement, and 5 for 7 evaluable patients with hyperprolactinoma achieved normalization in 4 and decrement in 5 patients. Only 2 patients developed mild degree of panhypopituitarism. The radiotherapy appears to be effective in controlling clinical symptoms and signs resulting from pituitary adenoma. Local control rate with radiotherapy alone or with surgery and postoperative radiotherapy was comparable. There was a trend toward high recurrence rate in patients with nonfunctioning or prolactin secreting tumor and larger radiation field sizes. (author)

  5. File list: Pol.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Pol.Dig.05.AllAg.Intestinal_adenoma mm9 RNA polymerase Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Pol.Dig.05.AllAg.Intestinal_adenoma.bed ...

  6. File list: His.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available His.Dig.20.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.20.AllAg.Intestinal_adenoma.bed ...

  7. File list: Pol.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Pol.Dig.20.AllAg.Intestinal_adenoma mm9 RNA polymerase Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Pol.Dig.20.AllAg.Intestinal_adenoma.bed ...

  8. File list: His.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available His.Dig.10.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.10.AllAg.Intestinal_adenoma.bed ...

  9. File list: His.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available His.Dig.50.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.50.AllAg.Intestinal_adenoma.bed ...

  10. File list: His.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available His.Dig.05.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.05.AllAg.Intestinal_adenoma.bed ...

  11. File list: Pol.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Pol.Dig.50.AllAg.Intestinal_adenoma mm9 RNA polymerase Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Pol.Dig.50.AllAg.Intestinal_adenoma.bed ...

  12. Alcohol Drinking Increased the Risk of Advanced Colorectal Adenomas

    Song, Yoon Kyung; Park, Young Sook; Seon, Choon Sik; Lim, Hye Jin; Son, Byung Kwan; Ahn, Sang Bong; Jo, Young Kwan; Kim, Seong Hwan; Jo, Yun Ju; Lee, Ji Hyun; Kim, Seung Chan

    2015-01-01

    Background/Aims Age, sex, gene and life style are modulating risks for colon cancer. Although alcohol intake may impact on colorectal adenoma, clear association has not been established yet. We aimed to investigate effects of alcohol consumption on the characteristics of colorectal adenoma. Methods Patients who underwent colonoscopic polypectomy of colorectal adenoma in the department of gastroenterology of Eulji hospital through 2005 to 2012, having both blood tests and ultrasound or abdomin...

  13. Pulmonary Pleomorphic Adenoma : Report of a Rare Case

    Jin, Heung-Yong; Park, Tae-Sun

    2007-01-01

    Primary pleomorphic adenoma of the lung is a type of pulmonary adenoma that is extremely rare, and it predominantly occurs in the proximal airway. We recently experienced a case of a peripheral solitary pulmonary nodule that was discovered on the CT scans. We performed wedge resection with video-assisted thoracoscopic surgery and we firmly diagnosed this lesion as pulmonary pleomorphic adenoma according to the histology. We report here on a rare benign tumor that was diagnosed as a primary pl...

  14. Bile Duct Adenoma with Oncocytic Features

    E. J. Johannesen

    2014-01-01

    Full Text Available Bile duct adenomas are benign bile duct proliferations usually encountered as an incidental finding. Oncocytic bile duct neoplasms are rare and the majority are malignant. A 61-year-old male with a diagnosis of colorectal adenocarcinoma was undergoing surgery when a small white nodule was discovered on the surface of the right lobe of his liver. This lesion was composed of cytologically bland cells arranged in tightly packed glands. These cells were immunopositive for cytokeratin 7, negative for Hep Par 1, contained mucin, and had a Ki67 proliferation index of 8%. The morphology, immunophenotype, presence of mucin, and normal appearing bile ducts, as well as the increased Ki67 proliferation rate, were consistent with a bile duct adenoma with oxyphilic (oncocytic change. Oncocytic tumors in the liver are rare; the first described in 1992. Only two bile duct adenomas with oncocytic change have been reported and neither of them had reported mucin production or the presence of normal appearing bile ducts within the lesion.

  15. Laparoscopic ampullectomy for an ampullarian adenoma.

    Borie, Frédéric; Zarzavadjian Le Bian, Alban

    2013-11-01

    Lesions involving the ampulla of Vater are rare entities (0.1-0.2 %) with high malignant potential (90 %) [1]. As a treatment, the surgical procedure known as duodenopancreatectomy was the main option, whatever the tumor's stage or nature. Yet with improvements of endoscopic diagnostic and therapeutic techniques, management of these lesions has been modified, enabling endoscopic removal of adenoma and adenocarcinoma-in situ. Thus, when endoscopic treatment is not possible, surgical ampullectomy is still an alternative option to duodenopancreatectomy [1, 2]. The continuous improvements in surgical techniques and instruments now allow the safe realization of laparoscopic ampullectomy, despite the few cases described in the literature [3, 4]. Here we present a surgical technique in a 52-year-old patient with an ampulloma. The ampulloma was discovered during a gastroscopy for abdominal pain. The endoscopic ultrasound with biopsy revealed a 15-mm adenoma with moderate-grade dysplasia. The thoracoabdominal CT scan was normal. The procedure was performed as shown. The tumor histology showed a R0 resection (5-mm surgical margin) of an adenoma with focal high-grade dysplasia. At 3-year follow-up, outcomes were unremarkable, without any complications. PMID:23836126

  16. Risk of colorectal cancer in patients with sessile serrated adenomas/polyps is the same magnitude or even higher than in patients with conventinal adenomas

    Erichsen, Rune; Baron, John A; Snover, Dale;

    2014-01-01

    Risk of colorectal cancer in patients with sessile serrated adenomas/polyps is the same magnitude or even higher than in patients with conventinal adenomas......Risk of colorectal cancer in patients with sessile serrated adenomas/polyps is the same magnitude or even higher than in patients with conventinal adenomas...

  17. Combined parathyroid adenoma and an occult papillary carcinoma

    Although the pathological association of thyroid and parathyroid disease is common, the association of both parathyroid adenoma and thyroid cancer is rare. We report here a case of a 45-year-old saudi women who diagnosed to have primary hyperparathyrodism due to single parathyroid adenoma as confirmed biochemically and radiologically. At operation, the adenoma was found to be an intrathyroid and therefore a thyroid lobectomy was performed. Histology of the excised lobe revealed in addition to the intrathyroid parathyroid adenoma a concurrent occult thyroid papillary carcinoma. The interesting association is discussed based on a literature review. (author)

  18. Sequels after radiotherapy of adenoma of adenohypophysis. Folgen einer Hypophysenadenombestrahlung

    Knuepffer, J.; Helpap, B. (Staedtisches Krankenhaus, Singen (Germany). Inst. fuer Pathologie); Saeger, W. (Marienkrankenhaus, Hamburg (Germany). Abt. fuer Pathologie)

    1991-10-01

    14 years before his death, iridium seeds were implanted in the adenohypophysis of a 69-year-old patient with a STH producing adenoma of the adenohypophysis and acromegaly. 5 years after recurrence, transsphenoidal hypophysectomy was done. The patient died of central dysregulation due to cerebral insults. At autopsy, a recurrence of the undifferentiated acidophilic adenoma was found within the sphenoidal bone corpus. Immunohistochemistry was positive for STH, prolactin, TSH, LH, and FSH. Besides the adenoma, a mucoepidermoid carcinoma was found within the sphenoid cavity. This carcinoma may be a consequence of the radiotherapy of the adenoma of the adenohypophysis. (orig.).

  19. A parathyroid adenoma case study: Protocol review

    Full text: Technetium-99m (99mTc) Sestamibi as opposed to Thallous-201 Chloride and 99mTc Sodium Pertechnetate subtraction, has become the radiopharmaceutical of choice for detection of parathyroid adenomas. A 17-year-old female patient presented to the department for a parathyroid 99mTc Sestamibi scan to evaluate possible parathyroid adenoma/s. She was initially admitted with increasing serum Calcium levels, polyuria, abdominal pain and general malaise. The patient was injected with 900MBq of 99mTc Sestamibi, and a pinhole dynamic at a distance of 10 cm from the neck was acquired followed by a 5-minute static image at 7 cm. Single Photon Emission Computed Tomography (SPECT) was then performed on a dual-head gamma camera followed by an anterior and posterior 10-minute static image. At 3 and 5 hours post injection the 10-minute static image was repeated. This study was reported as normal with uniform uptake and washout of the tracer over the 5-hour period. An ultrasound study was performed, and it showed a lesion believed to be a parathyroid adenoma measuring 2.2 x 0.8 x 0.4 cm in size in the right upper lobe of the thyroid. A subsequent thyroid scan was performed to confirm that it was non-functioning thyroid tissue. The patient was injected with 250MBq of 99mTc Sodium Pertechnetate and scanned with a pinhole collimator at a distance of 7 cm. When the 99mTc Sestamibi and 99mTc Sodium Pertechnetate scan were viewed together, it was clear that there was excess 99mTc Sestamibi distribution on the right upper lobe of the thyroid, which washed out over time. This corresponded to the ultrasound findings and was confirmed at surgery to be a parathyroid adenoma. A 99mTc Sodium Pertechnetate scan and an ultrasound are now also routinely performed on patients presenting for 99mTc Sestamibi parathyroid scans

  20. Gene expression profiling analysis of MENX-associated rat pituitary adenomas contributes to understand molecular mechanisms of human pituitary adenomas

    ZHANG, HONGZHI; XU, CHUAN; SUN, NINGYANG; ZHOU, YINTING; Yu, Xiaofei; Yan, Xue; ZHANG, QIUJUAN

    2015-01-01

    The present study aimed to screen potential genes associated with pituitary adenomas to obtain further understanding with regard to the pathogenesis of pituitary adenomas. The microarray GSE23207 dataset, containing 16 pituitary adenoma samples from multiple endocrine neoplasia syndrome-associated rats and 5 normal pituitary tissue samples, was downloaded from Gene Expression Omnibus. The Linear Models for Microarray Data package was used to identify the differentially-expressed genes (DEGs) ...

  1. Paneth Cell in Adenomas of the Distal Colorectum Is Inversely Associated with Synchronous Advanced Adenoma and Carcinoma.

    Mahon, Megan; Xu, Jie; Yi, Xianghua; Liu, Xiuli; Gao, Nan; Zhang, Lanjing

    2016-01-01

    Recent studies have linked appearance of Paneth cells in colorectal adenomas to adenoma burden and male gender. However, the clinical importance of Paneth cells' associations with synchronous advanced adenoma (AA) and colorectal carcinoma (CRC) is currently unclear. We performed a comprehensive case-control study using 1,900 colorectal adenomas including 785 from females, and 1,115 from males. We prospectively reviewed and recorded Paneth cell status in the colorectal adenomas consecutively collected between February 2014 and June 2015. Multivariable logistic regression analyses revealed that, in contrast to the adenomas without Paneth cells, the Paneth cell-containing adenomas at distal colorectum were inversely associated with presence of a synchronous AA or CRC (odds ratio [OR] 0.39, P = 0.046), whereas no statistical significance was reached for Paneth cell-containing proximal colorectal adenomas (P = 0.33). Synchronous AA and CRC were significantly associated with older age (60 + versus <60 years, OR 1.60, P = 0.002), male gender (OR 1.42, P = 0.021), and a history of AA or CRC (OR 2.31, P < 0.001). However, synchronous CRC was not associated with Paneth cell status, or a history of AA or CRC. Paneth cell presence in the adenomas of distal colorectum may be a negative indicator for synchronous AA and CRC, and seems to warrant further studies. PMID:27188450

  2. Characteristics and outcomes of endoscopically resected colorectal cancers that arose from sessile serrated adenomas and traditional serrated adenomas

    Seo, Ji Yeon; Choi, Seung Ho; Chun, Jaeyoung; Choi, Ji Min; Jin, Eun Hyo; Hwang, Sung Wook; Im, Jong Pil; Kim, Sang Gyun; Kim, Joo Sung

    2016-01-01

    Background/Aims The efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps. Methods Among patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed. Results Overall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, Padenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period. Conclusions Cautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy. PMID:27433150

  3. Expression of PI3Kp110α and PI3Kp110β in the colorectal conventional adenoma, serrated lesions and adenoma with canceration and their significance

    Wu, Shuhua; Li, Tangyue; Mu, Qinghai; Li, Yangyang; Gao, Xiangqian; He, Shuang; Sun, Chenbo

    2015-01-01

    Aims: To evaluate the expression and clinical significance of PI3Kp110α and PI3Kp110β in colorectal conventional adenoma, serrated lesions and adenoma with canceration. Methods and results: Immunohistochemistry and Western blot analysis were conducted to detect the expression of p110α and p110β in normal colorectal tissues, conventional adenoma, serrated lesions and adenoma canceration. Results revealed that the expression of P110α and P110β in the adenoma canceration was significantly higher...

  4. DNA aneuploidy in colorectal adenomas: Role in the adenoma-carcinoma sequence Aneuploidía del ADN en adenomas colónicos: Papel en la secuencia adenoma-carcinoma

    M. Alcántara Torres

    2005-01-01

    Full Text Available Introduction: aneuploidy has been observed in 6-27% of lesions known to be precursors of colorectal cancer, such as adenomas or ulcerative colitis. It has been suggested that aneuploidy may predispose to malignancy in these cases. However, its role in the adenoma-carcinoma sequence has not been definitely established. The objective of this study was to assess the incidence of aneuploidy in colon adenomas, as well as to study its possible role in the adenoma-carcinoma sequence. Material and methods: the study was performed on a series of 57 large bowel adenomas measuring 10 mm or more, collected from 54 consecutive patients. All specimens were obtained either by endoscopic or by surgical resection. There were 49 adenomas with low-grade dysplasia, two with high-grade dysplasia, two intramucous carcinomas, and four microinvasive carcinomas. A flow cytometric DNA analysis was performed in fresh specimens following Vindelov´s method. Results: aneuploid DNA was detected in five out of 49 low-grade dysplasia adenomas (10%, in all four high-grade dysplasia adenomas or intramucous carcinomas (100%, and in three out of four microinvasive carcinomas (75%. The association between aneuploidy and high-grade dysplasia adenomas, intramucous, or microinvasive carcinoma was statistically significant (p Introducción: en patología benigna de intestino grueso precursora del cáncer colorrectal, como adenomas o colitis ulcerosa, se ha observado aneuploidía en el 6-27% de los casos y se ha sugerido que su presencia predispone al desarrollo de malignidad. Sin embargo, su papel en la secuencia adenoma-carcinoma no se ha demostrado de forma concluyente. El objetivo de nuestro trabajo fue valorar la incidencia de aneuploidía en adenomas colónicos, con y sin signos de malignidad, y estudiar su posible papel en la secuencia adenoma-carcinoma. Material y métodos: el estudio se realizó en una serie de 57 adenomas de intestino grueso, de 10 o más mil

  5. Contemporary issues in the evaluation and management of pituitary adenomas.

    Pekic, S; Stojanovic, M; Popovic, V

    2015-12-01

    Pituitary adenomas are common benign monoclonal neoplasms accounting for about 15% of intracranial neoplasms. Data from postmortem studies and imaging studies suggest that 1 of 5 individuals in the general population may have pituitary adenoma. Some pituitary adenomas (mainly microadenomas which have a diameter of less than 1 cm) are exceedingly common and are incidentally diagnosed on magnetic resonance imaging (MRI) performed for an unrelated reason (headache, vertigo, head trauma). Most microadenomas remain clinically occult and stable in size, without an increase in tumor cells and without local mass effects. However, some pituitary adenomas grow slowly, enlarge by expansion and become demarcated from normal pituitary (macroadenomas have a diameter greater than 1 cm). They may be clinically silent or secrete anterior pituitary hormones in excess such as prolactin, growth hormone (GH), or adrenocorticotropic hormone (ACTH) causing diseases like prolactinoma, acromegaly, Cushing's disease or rarely thyroid-stimulating hormone (TSH) or gonadotropins (LH, FSH). The incidence of the various subtypes of pituitary adenoma varies but the most common is prolactinoma. Clinically non-functioning pituitary adenomas (NFPAs), which do not secrete hormones often cause local mass symptoms and represent one-third of pituitary adenomas. Given the high prevalence of pituitary adenomas and their heterogeneity (different tumor subtypes), it is critical that clinicians have a thorough understanding of the potential abnormalities in pituitary function and prognostic factors for behavior of pituitary adenomas in order to timely implement specific treatment modalities. Regarding pathogenesis of these tumors genetics, epigenetics and signaling pathways are the focus of current research yet our understanding of pituitary tumorigenesis remains incomplete. Although several genes and signaling pathways have been identified as important factors in the development of pituitary tumors, current

  6. Adenoma detection in patients undergoing a comprehensive colonoscopy screening

    Measures shown to improve the adenoma detection during colonoscopy (excellent bowel preparation, cecal intubation, cap fitted colonoscope to examine behind folds, patient position change to optimize colon distention, trained endoscopy team focusing on detection of subtle flat lesions, and incorporation of optimum endoscopic examination with adequate withdrawal time) are applicable to clinical practice and, if incorporated are projected to facilitate comprehensive colonoscopy screening program for colon cancer prevention. To determine adenoma and serrated polyp detection rate under conditions designed to optimize quality parameters for comprehensive screening colonoscopy. Retrospective analysis of data obtained from a comprehensive colon cancer screening program designed to optimize quality parameters. Academic medical center. Three hundred and forty-three patients between the ages of 50 years and 75 years who underwent first screening colonoscopy between 2009 and 2011 among 535 consecutive patients undergoing colonoscopy. Comprehensive colonoscopy screening program was utilized to screen all patients. Cecal intubation was successful in 98.8% of patients. The Boston Bowel Preparation Scale for quality of colonoscopy was 8.97 (95% confidence interval [CI]; 8.94, 9.00). The rate of adenoma detection was 60% and serrated lesion (defined as serrated adenomas or hyperplastic polyps proximal to the splenic flexure) detection was 23%. The rate of precancerous lesion detection (adenomas and serrated lesions) was 66%. The mean number of adenomas per screening procedure was 1.4 (1.2, 1.6) and the mean number of precancerous lesions (adenomas or serrated lesions) per screening procedure was 1.6 (1.4, 1.8). Retrospective study and single endoscopist experience. A comprehensive colonoscopy screening program results in high-quality screening with high detection of adenomas, advanced adenomas, serrated adenomas, and multiple adenomas

  7. Contrast-enhanced ultrasound in diagnosis of gallbladder adenoma

    Hai-Xia Yuan; Jia-Ying Cao; Wen-Tao Kong; Han-Sheng Xia; Xi Wang; Wen-Ping Wang

    2015-01-01

    BACKGROUND:Gallbladder adenoma is a pre-cancerous neoplasm and needs surgical resection. It is dififcult to differ-entiate adenoma from other gallbladder polyps using imaging examinations. The study aimed to illustrate characteristics of contrast-enhanced ultrasound (CEUS) and its diagnostic value in gallbladder adenoma. METHODS:Thirty-seven patients with 39 gallbladder adenoma-toid lesions (maximal diameter≥10 mm and without metastasis) were enrolled in this study. Lesion appearances in conventional ultrasound and CEUS were documented. The imaging features were compared individually among gallbladder cholesterol polyp, gallbladder adenoma and malignant lesion. RESULTS:Adenoma lesions showed iso-echogenicity in ul-trasound, and an eccentric enhancement pattern, "fast-in and synchronous-out" contrast enhancement pattern and homo-geneous at peak-time enhancement in CEUS. The homogenic-ity at peak-time enhancement showed the highest diagnostic ability in differentiating gallbladder adenoma from cholesterol polyps. The sensitivity, speciifcity, positive predictive value, negative predictive value, accuracy and Youden index were 100%, 90.9%, 92.9%, 100%, 95.8% and 0.91, respectively. The characteristic of continuous gallbladder wall shown by CEUS had the highest diagnostic ability in differentiating adenoma from malignant lesion (100%, 86.7%, 86.7%, 100%, 92.9% and 0.87, respectively). The characteristic of the eccentric enhance-ment pattern had the highest diagnostic ability in differenti-ating adenoma from cholesterol polyp and malignant lesion, with corresponding indices of 69.2%, 88.5%, 75.0%, 85.2%, 82.1% and 0.58, respectively. CONCLUSIONS:CEUS is valuable in differentiating gallbladder adenoma from other gallbladder polyps (≥10 mm in diameter). Homogeneous echogenicity on peak-time enhancement, a con-tinuous gallbladder wall, and the eccentric enhancement pat-tern are important indicators of gallbladder adenoma on CEUS.

  8. Heterogeneity of colorectal adenomas, the serrated adenoma, and implications for screening and surveillance

    Hugh James Freeman

    2008-01-01

    Current algorithms for screening and surveillance for colon cancer are valuable, but may be limited by the underlying nature of the targeted neoplastic lesions. Although part of the success of adenoma removal relates to interruption of so-called "adenoma-carcinoma sequence", an alternate serrated pathway to colon cancer may pose difficulties with the ultimate results achieved by traditional colonoscopic methods. The endpoint carcinoma in this unique pathway may be derived from a dysplastic serrated adenoma. These tend to be located primarily in the right colon, especially in females, and are frequently associated with coexistent colon cancer. Unfortunately, however, there are few, if any, other identifiable risk factors, including age or family history of colon polyps or colon cancer. Moreover, this alternate serrated pathway may itself also be quite biologically heterogeneous as reflected in sessile serrated adenomas (SSA) with virtually exclusive molecular signatures defined by the presence of either BRAF or KRAS mutations. Screening algorithms in the future may need to be modified and individualized, depending on new information that likely will emerge on the natural history of these biologically heterogeneous lesions that differs from traditional adenomatous polyps.

  9. [Acute complications after endoscopic resection of duodenal adenomas].

    König, J; Kaiser, A; Opfermann, P; Manner, H; Pohl, J; Ell, C; May, A D

    2014-02-01

    With the increasing technological development of endoscopy in recent years the diagnosis of and endoscopic therapy for duodenal adenomas has gained in importance. Due to its potentially malignant transformation an effective and safe therapy is necessary. The endoscopic resection has been shown to be safe and effective, even in cases of resection of large duodenal adenomas. Several studies have supported this thesis but are based on relatively small numbers of patients. In our clinic we have performed endoscopic resections of 178 duodenal adenomas over a period of 14 years, including sporadic duodenal adenomas as well as adenomas in familial polyposis syndromes. The aim of this retrospective analysis was to determine the acute complications associated with this technique. The rate of severe complications such as major bleeding or perforations was 9%. Further complications were minor bleeding (15.7%), pain needing treatment with analgesia (6.7%), fever (2.8%) and pancreatitis (0.6%). Summing up our experience with the endoscopic resection of adenomas of the small bowel we also consider the endoscopic resection of duodenal adenomas in most cases as a safe and effective alternative to surgical therapy. Because of the potential complications and their management especially in the resection of large adenomas with a size more than 2 cm, the endoscopic resection should be performed on an inpatient basis in experienced centres. PMID:24526403

  10. Large Brunner's gland adenoma: Case report and literature review

    Alba Rocco; Pasquale Borriello; Debora Compare; Patrizia De Colibus; Loredana Pica; Alessandro Iacono; Gerardo Nardone

    2006-01-01

    Brunner's gland adenoma (BGA) is a very rare benign tumour of the duodenum, which is usually asymptomatic and discovered incidentally at endoscopy. Occasionally,this lesion may be large, causing upper gastrointestinal haemorrhage or intestinal obstruction. The case had a large Brunner's gland adenoma, presenting melena that was managed by endoscopic excision.

  11. Cytogenetic analysis of colorectal adenomas: karyotypic comparisons of synchronous tumors

    Bomme, L; Bardi, G; Pandis, N;

    1998-01-01

    the colon, no karyotypic similarity between the lesions was found. Our findings indicate that whereas close, but macroscopically distinct, synchronous colorectal adenomas usually have a common pathway of progression, perhaps even the same clonal origin, large bowel adenomas at a considerable distance...

  12. Ductal adenoma of the breast: a case report

    Kim, Eun Kyung; Oh, Ki Keun; Lee, Kyong Sik; Lee, Hyun Hee [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-11-01

    Ductal adenoma of the breast is an uncommon benign tumor consisting of an adenomatous nodule within the ductal lumen; on both clinical and histologic examination, it may simulate malignancy. We report a case of ductal adenoma of the breast, and the related mammographic and sonographic findings.

  13. Combined transcervical and thoracoscopic mediastinal parathyroid adenoma resection.

    Siddiqi, Mohammad Salman; Al Badai, Yahya; Al Kemyani, Nasser A; Al Kindi, Adil H

    2016-07-01

    The routine approach for excision of a parathyroid adenoma is transcervical, but this approach is inadequate when the gland is located in the mediastinum. Traditionally, these cases have required a sternotomy or thoracotomy. We used a combined transcervical and video-assisted thoracoscopic surgery approach to resect a parathyroid adenoma that extended to the middle mediastinum. PMID:27206778

  14. Multiple Pituitary Adenomas: A Systematic Review

    Budan, Renata M.; Georgescu, Carmen E.

    2016-01-01

    PubMed, Scopus, and Web of Science Core Collection databases were systematically searched for studies reporting synchronous double or multiple pituitary adenomas (MPA), a rare clinical condition, with a vague pathogenesis. Multiple adenomas of the pituitary gland are referred to as morphologically and/or immunocytochemically distinct tumors that are frequently small-sized and hormonally non-functional, to account for the low detection rate. There is no general agreement on how to classify MPA, various criteria, such as tumor contiguity, immunoreactivity, and clonality analysis are being used. Among the component tumors, prolactin (PRL)-immunopositive adenomas are highly prevalent, albeit mute in the majority of cases. The most frequent clinical presentation of MPA is Cushing’s syndrome, given the fact that in more than 50% of reported cases at least one lesion stains for adrenocorticotrophic hormone (ACTH). Plurihormonal hyperactivity may be diagnosed in a patient with MPA when more than one tumor is clinically active (e.g., ACTH and PRL) or in cases with at least one composite tumor (e.g., GH and PRL), to complicate the clinical scenario. Specific challenges associated with MPA include high surgical failure rates, enforcing second-look surgery in certain cases, and difficult preoperative neuroradiological imaging evaluation, with an overall sensitivity of only 25% for magnetic resonance imaging to detect distinct multiple tumors. Alternatively, minor pituitary imaging abnormalities may raise suspicion, as these are not uncommon. Postoperative immunohistochemistry is mandatory and in conjunction to electron microscopy scanning and testing for transcription factors (i.e., Pit-1, T-pit, and SF-1) accurately define and classify the distinct cytodifferentiation of MPA. PMID:26869991

  15. Immunostains Used to Subtype Hepatic Adenomas Do Not Distinguish Hepatic Adenomas From Hepatocellular Carcinomas.

    Liu, Liping; Shah, Sejal S; Naini, Bita V; French, Samuel; Wu, Tsung-Teh; Torbenson, Michael S; Chandan, Vishal S

    2016-08-01

    Immunostains are used to subtype hepatic adenomas to stratify for the risk of malignant transformation. The most common panel of immunostains used for this purpose includes liver fatty acid-binding protein (LFABP), serum amyloid A (SAA) protein, C-reactive protein (CRP), and glutamine synthetase (GS). Importantly, some pathologists use these stains in an attempt to distinguish hepatocellular carcinomas (HCC) from hepatic adenomas. However, there are limited data on the performance of these stains in HCCs. To investigate the staining characteristics of HCCs, we studied 159 HCCs (92 well-differentiated, 67 moderately differentiated, and 7 poorly differentiated) and 7 fibrolamellar carcinomas for the expression of LFABP, SAA, CRP, and GS. All of the stains were positive in at least a subset of HCCs: SAA was positive in 27 of 159 (17%), CRP in 86 of 159 (54%), and GS in 23 of 47 (49%) cases; LFABP showed loss of staining in 36 of 159 (23%) cases. Fibrolamellar carcinomas were consistently CRP positive (7 of 7 cases) and frequently showed loss of LFABP (4 of 7 cases). There was no association between expression of SAA, CRP, and GS as well as loss of LFABP expression and other clinicopathologic features. HCCs with loss of LFABP were more frequently associated with negative GS expression (11 of 14 cases, P=0.02). These data show that immunostains used to subtype hepatic adenomas are not useful for distinguishing HCCs from hepatic adenomas and should be used only after a diagnosis of hepatic adenoma has been made using other criteria. PMID:26927891

  16. Expression of Neuropeptide Y in Human Pituitary Adenoma

    Laizhao Chen; Jingjian Ma; Anchao Zheng; Honggang Zheng

    2006-01-01

    OBJECTIVE Neuropeptid e Y (NPY) acts as a neuroendocrine modulator in the anterior pituitary, and NPY mRNA and NPY-immunoreactivity have been detected in normal human anterior pituitaries. However, only a few studies of NPY expression in human pituitary adenomas have been published. Our study was conducted to determine whether or not adenomatous cells express NPY, to investigate the relationship between NPY expression and the subtypes of pituitary adenoma and to explore the clinical significance of NPY.METHODS The study included tissues from 58 patients with pituitary adenomas who underwent surgery because of their clinical diagnosis.Using a highly specific anti-NPY polyclonal antibody, immunohistochemical analysis was performed on the surgically removed pituitary adenomas. Six fresh specimens also were examined using immuno-electron microscopy. NPY was labeled with colloidal gold in order to study the distribution of NPY at the subcellular level.RESULTS The NPY expression level was significantly different among subgroups of pituitary adenomas (P<0.05). NPY was immuno-detected in 58.6% of all adenomas, in 91.7% of gonadotrophic adenomas and in 14.3% of prolactinomas. NPY expression was slightly lower in invasive pituitary adenomas compared to noninvasive adenomas, but the difference was not significant (t=1.81, P>0.05). Of particular interest was the finding that vascular endothelial cells showed positive NPY expression in some pituitary adenomas. Parts of strongly positive tumor cells were seen in channels formed without endothelial cells, but which contained some red blood cells in a formation similar to so-called vasculogenic mimicry. Immuno-electron microscopy demonstrated that 4 of the 6 fresh specimens displayed positive NPY staining with a high density of gold particles located mainly in the secretory granulas. In addition, gold particles were sparsely detected in the rough endoplasmic reticulum and cell matrix.CONCLUSION NPY exists in pituitary adenomas

  17. Inverted cystic tubulovillous adenoma involving Brunner's glands of duodenum

    Ji Hoon Kim; Jong-Jae Park; Jung Woo Choi; Yeon Seok Seo; Beom Jae Lee; Jong Fun Yeon; Jae Seon Kim; Kwan Soo Byun; Young-Tae Bak; Insun Kim

    2007-01-01

    Benign neoplasia of the duodenum are very rare.Moreover, duodenal tubulovillous adenomas are more uncommon lesions. The microscopic structure of tubulovillous adenoma has frond-like projection of mucosa with branching papillary structure and generally upward growth into the lumen. We describe a 72-year-old man who showed aduodenal tubulovillous adenoma with unusual inverted cystic growth pattern.Interestingly, this tubulovillous adenomatous lesion was interrupted by gastric metaplasia in the deep portion of the cyst and was closely surrounded by Brunner's glands. Although histogenesis of gastric metaplasia of duodenum is not fully understood, Brunner's glands has been suggested as a precursor for gastric metaplasia.Therefore, these findings argued that this adenoma arises from Brunner's glands through gastric metaplasia.This is the first case of inverted cystic tubulovillous adenoma involving Brunner's glands of duodenum with gastric metaplasia.

  18. Research Advances in Pituitary Adenoma and DNA Methylation.

    Wei, Zhen-Qing; Li, Yang; Li, Wei-Hua; Lou, Jia-Cheng; Zhang, Bo

    2016-08-01

    DNA methylation is closely related to the genesis and development of pituitary adenoma. Studies have shown that high methylation in the promoter region of potassium voltage-gated chanel,shaker related subfamily,beta member 2,O-6-methylguanine-DNA methyltransferase,echinoderm microtubule associated protein like 2 ,ras homolog family member D ,homeobox B1 ,NNAT, and P16 inhibits the expression of these genes and regulates of the proliferation of pituitary adenoma. DNA methylation is also closely related to invasive pituitary adenoma. Therefore,further study on molecular mechanism of DNA methylation of pituitary adenoma will offer a new strategy for the diagnosis and treatment of pituitary adenoma. PMID:27594164

  19. Ectopic pituitary adenoma presenting as midline nasopharyngeal mass.

    Ali, R

    2012-02-01

    INTRODUCTION: Ectopic pituitary adenomas are extremely rare. We report a case of ectopic pituitary adenoma in the midline of the nasopharynx. This adenoma probably arose from the pharyngeal remnant of Rathke\\'s pouch. METHODS: We discuss a case of a lady who presented to our unit with 2 months history of dryness and sensation of lump in her throat and a long standing history of hypothyroidism. Examination of nasopharynx revealed a smooth and fluctuant midline mass. CT scan of nose and paranasal sinuses confirmed the midline mass with small defect communicating with the sphenoid sinus. An initial diagnosis of Thornwaldt\\'s cyst was made and she underwent upper aerodigestive tract endoscopy and marsupialization of the mass. Histopathological examination revealed ectopic pituitary adenoma. CONCLUSION: Ectopic pituitary adenoma is an important differential diagnosis for a midline nasopharyngeal mass. It is recommended that prior to surgical resection of midline nasopharyngeal mass biopsy is taken and MRI is performed.

  20. Intrathyroidal parathyroid adenoma presenting with neuromuscular manifestation

    Zhu Xiaodong

    2009-01-01

    Full Text Available Primary hyperparathyroidism (PHPT is not an uncommon endocrine disorder. We describe a patient with PHPT who presented with progressive proximal limbs weakness and dystrophic changes of leg muscles. Serum calcium, alkaline phosphatase, and parathyroid hormone were elevated and serum phosphorus was low. Neck computerized tomography scan showed a parenchymatous tumor in the right lobe of the thyroid. The tumor presented as a ′cold nodule′ in the dual-phase single-agent Tc-99m MIBI scan. The right lobectomy examination confirmed the diagnosis of an intrathyroidal parathyroid adenoma of the right gland.

  1. Radiosurgery for infundibulum adenoma: stalk dose implications.

    Sokolowski, Jennifer D; Cohen-Inbar, Or; Sheehan, Jason P

    2016-09-01

    Treating pituitary adenomas in the infundibulum with stereotactic radiosurgery (SRS), achieving tumor volume control while preserving pituitary endocrine function and visual function, is challenging. We present a case of a recurrent remnant infundibular lesion treated with Gamma Knife surgery (GKS). The mass was treated with microsurgical resection twice, and the residual stalk lesion was treated with single-session SRS employing a margin dose of 15 Gy to the infundibulum. Five years after GKS, tumor regression persists without visual dysfunction or hypopituitarism. Radiosurgical doses of 30 Gy to the pituitary stalk may be tolerated by patients while maintaining endocrine function. PMID:27435739

  2. Adenoma incidence decreases under the effect of polypectomy

    Isadora Rosa; Carlos N Leit(a)o; Paulo Fidalgo; José Soares; Susana Vinga; Carla Oliveira; Jo(a)o P Silva; Susana M Ferro; Paula Chaves; António G Oliveira

    2012-01-01

    AIM:To investigate whether,under the influence of polypectomy,the incidence of adenoma decreases with age.METHODS:Consecutive patients with colonic adenomas identified at index colonoscopy were retrospectively selected if they had undergone three or more complete colonoscopies,at least 24 mo apart.Patients who had any first-degree relative with colorectal cancer were excluded.Data regarding number of adenomas at each colonoscopy,their location,size and histological classification were recorded.The monthly incidence density of adenomas after the index examination was estimated for the study population,by using the person-years method.Baseline adenomas were excluded from incidence calculations but their characteristics were correlated with recurrence at follow-up,using the x2 test.RESULTS:One hundred and fifty-six patients were included (109 male,mean age at index colonoscopy 56.8 ± 10.3 years),with follow-up that ranged from 48 to 232 mo.No significant correlations were observed between the number,the presence of villous component,or the size of adenomas at index colonoscopy and the presence of adenomas at subsequent colonoscopies (P =0.49,0.12 and 0.78,respectively).The incidence of colonic adenomas was observed to decay from 1.4%person-months at the beginning of the study to values close to 0%,at 12 years after index colonoscopy.CONCLUSION:Our results suggest the sporadic formation of adenomas occurs within a discrete period and that,when these adenomas are removed,all neoplasia-prone clones may be extinguished.

  3. Treatment of chromophobe adenomas with megavoltage irradiation

    From 1956 to 1972, 62 previously untreated patients with chromophobe adenomas received high-dose (average equivalent dose: 5700 rads in 6 weeks) megavoltage (4 to 4.8 MeV) irradiation at Stanford, 33 postoperatively and 29 as the only intended treatment. Initial treatment failure rates were 18 percent and 41 percent, respectively; however, overall control was 85 percent and 90 percent, despite 2 uncontrolled invasive adenomas in each group. Nine of the 12 failures in the group treated by irradiation alone had cystic tumors, and 9 of the 12 failed in less than 3 months. Despite a considerably greater degree of abnormal vision initially in the postoperative irradiation group, improvement of vision with treatment in that group was 83 percent (39 percent returned to normal) compared to 46 percent (only 8 percent to normal) in the irradiation alone group. Based upon an evaluation of the extent of findings at diagnosis and our results, we recommend surgical decompression followed by 5000 rads in 5 weeks for patients with any one or more of the following findings: (1) more than minimal depression of peripheral visual fields; (2) corrected visual actuity of less than 20/30 in either eye; or (3) more than 1-cm suprasellar extension of tumor. (U.S.)

  4. Cystic Change in Pleomorphic Adenoma: A Rare Finding and a Diagnostic Dilemma.

    Khetrapal, Shaan; Jetley, Sujata; Hassan, Mohd Jaseem; Jairajpuri, Zeeba

    2015-11-01

    Pleomorphic adenoma forms the majority of salivary gland neoplasms. Cystic change in pleomorphic adenomas is a diagnostic dilemma and can mimic mucoepidermoid carcinoma, mucocele or carcinoma ex pleomorphic adenoma and squamous cell carcinoma. Hereby we report this interesting and rare case of cystic pleomorphic adenoma in a 32-year-old male. PMID:26675071

  5. Diagnosis and Surgical Treatment of Parathyroid Adenoma (24 Case Report)

    Wei Zhang; Junchu Zhang; Daqiao Zhu; Zhiqian Hu; Qiang Wang

    2005-01-01

    OBJECTIVE To summarize the experience in diagnosing and treating parathyroid adenoma.METHODS Twenty-four patients were diagnosed with parathyroid adenoma and received parathyroidectomy in our hospital. Sixteen of them presented with hyperparathyroidism. The patients received ultrasounography, CT or 99mTc-MIBI to locate the tumor site. Serum concentrations of PTH and calcium were checked before the operation. All operations were performed under general anesthesia. The adenomas were resected and the four glands explored.RESULTS All of the patients were cured and there was no mortality in our group. The symptoms of hyperparathyroidism remitted to various degrees after the operation. PTH dropped to the normal range 2 days after operation.Serum calcium concentrations declined to different levels from the first day after operation. Seven patients developed hypocalcemia post-operation but recovered by injection of calcium gluconate. Only one of the patients with parathyroid adenoma recurred 2 years after the operation and was found to have malignancy of the parathyroid adenoma.CONCLUSION Not all the patients with parathyroid adenoma had clinical manifestations. The CT and 99mTc-MIBI were more accurate than ultrasounography in locating the adenoma. The four glands should be explored during the operation. Protecting the recurrent laryngeal nerve from being injuried and maintaning secure hemastasis were most important.

  6. Reg Ⅳ, a differentially expressed gene in colorectal adenoma

    张宇伟; 来茂德; 谷雪梅; 罗敏捷; 邵丽娜

    2003-01-01

    ObjectiveTo discover and identify differentially expressed genes associated with colorectal adenoma formation and the role of RegⅣ in colorectal adenoma differentiation.MethodsA subtracted cDNA library was constructed with cDNAs that were isolated from either the normal mucosa or adenoma tissue of a single patient. Suppressive subtractive hybridization (SSH) combined with virtual northern blotting was used to characterize differentially expressed genes and contigs were assembled by electronic cloning (in silico cloning) with the EST database. Semi-quantitative RT-PCR was performed in 9 colorectal adenomas.ResultsThe amino acid sequence was determined with open reading frame (ORF) prediction software and was found to be 100% homologous to the protein product of RegⅣ (a novel gene isolated from a large inflammatory bowel disease library). RegⅣ was found to be highly expressed in all of the adenoma samples (9/9) compared with the normal mucosa samples, while 5/6 cases showed RegⅣ to be more strongly expressed in adenocarcinoma.Conclusion RegⅣ may play an important role in the initiation of colorectal adenoma differentiation, and its detection may be useful in the early diagnosis of colorectal adenoma formation.

  7. Follicle stimulating hormone secreting pituitary adenoma: a challenging diagnosis

    Madhuri Alap Mehendale

    2015-04-01

    Full Text Available FSH secreting pituitary adenomas are relatively uncommon brain tumours and usually non-functioning. But in rare cases they produce ovarian hyperstimulation. We report a case of a 32 year old female P2L2, with amenorrhoea of 1 year, pain in abdomen and galactorrhoea since 6 months. Initially thought to be a simple prolactinoma with multicystic ovaries, but after thorough investigations to our surprise diagnosed to be a rare case of gonadotropin secreting pituitary adenoma. Patient was successfully managed by excision of the pituitary adenoma. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 493-496

  8. Myxoid Adrenocortical Adenoma: Magnetic resonance imaging and pathology correlation

    We report a case of a 74-year-old female with myxoid adrenocortical adenoma which showed different magnetic resonance imaging findings compared to those of a typical adrenocortical adenoma. The myxoid change in the adrenocortical adenoma is a rare form of degeneration. It presents a considerable diagnostic challenge to both radiologists and clinicians because it can mimic other adrenal tumor types on imaging. The MRI findings of the presented case included a high signal intensity on T2-weighted images similar to that of fluid and delayed progressive enhancement.

  9. Myxoid Adrenocortical Adenoma: Magnetic resonance imaging and pathology correlation

    Kim, Tae Un [Dept. of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of); Kim, Suk; Lee, Jun Woo; Lee, Nam Kyung; Ha, Hong Koo; Park, Won Young [Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of)

    2014-04-15

    We report a case of a 74-year-old female with myxoid adrenocortical adenoma which showed different magnetic resonance imaging findings compared to those of a typical adrenocortical adenoma. The myxoid change in the adrenocortical adenoma is a rare form of degeneration. It presents a considerable diagnostic challenge to both radiologists and clinicians because it can mimic other adrenal tumor types on imaging. The MRI findings of the presented case included a high signal intensity on T2-weighted images similar to that of fluid and delayed progressive enhancement.

  10. Metachronous tubulovillous and tubular adenomas of the anal canal

    NOZAWA, HIROAKI; ISHIHARA, SOICHIRO; Morikawa, Teppei; Tanaka, Junichiro; YASUDA, KOJI; Ohtani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Kawai, Kazushige; Hata, Keisuke; Kazama, Shinsuke; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji

    2015-01-01

    Anal canal adenoma is an extremely rare disease that has the potential to transform into a malignant tumor. We herein presented a rare case of metachronous multiple adenomas of the anal canal. A 48-year-old woman underwent total colonoscopy following a positive fecal blood test. A 9-mm villous polyp arising from the posterior wall of the anal canal was removed by snare polypectomy. Histologically, the tumor was tubulovillous adenoma with high-grade dysplasia and the cut end was negative for t...

  11. Immunohistochemical Expression of p16 in Pleomorphic Salivary Adenoma

    Hanouneh, Salah; Darwish, Shorouk; Baroudi, Kusai; Sakka, Salah; Tarakji, Bassel

    2013-01-01

    Objective: This study aimed to characterize alteration in the immunohistochemical expression of p16 in normal tissue of the salivary gland surrounding pleomorphic adenoma, and the tumor cells of pleomorphic adenomas.Material and Method: A selected series of 120 cases of pleomorphic adenomas were examined.Results: The results showed that p16 expression in non tumor duct cells was strong positive nuclear staining in 98 (81.6%) cases out of 120, while there were 20 (16.6%) with moderate staining...

  12. Hiperparatiroidismo primario por adenoma paratiroideo mediastinal

    Jeffry Solís-Torres; Esteban Mora-Segura

    2015-01-01

    El hiperparatiroidismo primario cursa con un aumento de la secreción de hormona paratiroidea, generalmente debido a un adenoma, e hipercalcemia. Su presentación clásica se diagnostica con la determinación de calcio sérico y de hormona paratiroidea, asociada con estudios de imágenes. Su tratamiento es quirúrgico y tiene altas tasas de éxito. Se analiza el caso de una paciente hipertensa, de 63 años, con historia de pérdida de apetito y debilidad de un año y medio de evolución, por lo que se le...

  13. Clonal karyotypic abnormalities in colorectal adenomas: clues to the early genetic events in the adenoma-carcinoma sequence

    Bomme, L; Bardi, G; Pandis, N;

    1994-01-01

    together with other numerical changes in another. A +7 was also present in one case with structural aberrations. Other recurrent numerical aberrations were -14 and -18, both found in 2 adenomas with structural karyotypic changes; in addition, one chromosome 14 was lost in one of the tumors with only...... normal karyotype. All adenomas with a tubulovillous or villous architecture had structural rearrangements. Our findings confirm that a subset of colorectal adenomas exists that have only numerical chromosome aberrations. They also support our previous conclusion that loss of material from distal 1p is an...

  14. Focal nodular hyperplasia and hepatocellular adenoma

    Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are liver lesions of hepatocellular origin. The FNH is a commonly occurring hepatic lesion whereas HCA is very rare. Non-invasive differentiation between HCA subtypes and atypical FNH may pose a diagnostic challenge as both entities predominantly occur in middle-aged female patients. The conventional imaging modalities include ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). Distinguishing FNH from HCA is of great importance clinically as FNH is considered to be a benign lesion and needs no further management. In contrast HCA is considered to be a borderline tumor due to the risk of hemorrhage, growth and even malignant transformation and requires individualized management. The abovementioned radiological procedures usually enable an accurate and certain diagnosis of a typical FNH to be achieved. In cases of atypical FNH, particularly in patients with a clinical history of malignancy, these imaging modalities are insufficient to establish a clear diagnosis. In this scenario, the use of modern hepatobiliary contrast-enhanced MRI will enable a differentiation between FNH and metastasis with a high sensitivity and specificity. Furthermore, it allows a differentiation of FNH from 90 % of adenoma subtypes. This article describes the histopathological and radiological features of these lesions and explains the advantages and limitations of various imaging modalities used for the diagnosis and differentiation of these entities. The new classification of HCAs according to phenotype and genotype and their imaging features, as well as different enhancement patterns, are described. The correlation between HCA subtypes and their individual management are also discussed. (orig.)

  15. Hiperparatiroidismo primario por adenoma paratiroideo mediastinal

    Jeffry Solís-Torres

    2015-06-01

    Full Text Available El hiperparatiroidismo primario cursa con un aumento de la secreción de hormona paratiroidea, generalmente debido a un adenoma, e hipercalcemia. Su presentación clásica se diagnostica con la determinación de calcio sérico y de hormona paratiroidea, asociada con estudios de imágenes. Su tratamiento es quirúrgico y tiene altas tasas de éxito. Se analiza el caso de una paciente hipertensa, de 63 años, con historia de pérdida de apetito y debilidad de un año y medio de evolución, por lo que se le realizaron exámenes de laboratorio que revelaron hipercalcemia y elevación de la hormona paratiroidea. Se le indicó entonces una gamagrafía con Tecnecio 99, que evidenció un nódulo de 18mm de diámetro, ubicado 2 centímetros caudal al lóbulo tiroideo derecho. Se le efectuó una exploración cervical sin encontrarse la lesión, por lo que requirió una esternotomía media superior, que permitió encontrar un adenoma en el mediastino superior, detrás de la vena braquiocefálica derecha, de manera que se procedió a su extracción. Los controles de calcio y de hormona paratiroidea a las 24 horas estaban entre los límites normales, y se egresó.

  16. Metanephric adenoma: Management in a 7-year-old child

    Katharine Caldwell

    2015-12-01

    Full Text Available We report the case of a 7-year-old girl in whom a left renal mass was incidentally discovered on computerized tomography (CT scan during evaluation for acute perforated appendicitis. The presence of polycythemia and the radiographic characteristics of the mass suggested a metanephric adenoma but a Wilm's tumor could not be excluded with preoperative studies. Gross inspection and intra-operative ultrasound of the tumor supported the suspicion of a metanephric adenoma and a partial nephrectomy was performed. Frozen section and permanent pathologic analysis confirmed a benign metanephric adenoma. At current date, patient is recovering well and polycythemia has resolved. A review of the management of metanephric adenoma in the child is presented.

  17. Growth hormone receptor expression and function in pituitary adenomas

    Clausen, Lene R; Kristiansen, Mikkel T; Rasmussen, Lars M;

    2004-01-01

    OBJECTIVE AND DESIGN: Hypopituitarism, in particular GH deficiency, is prevalent in patients with clinically nonfunctioning pituitary adenomas (NFPAs) both before and after surgery. The factors regulating the growth of pituitary adenomas in general and residual tumour tissue in particular are not...... transcription 5) phosphorylation was measured by Western blot analysis as an index of GHR signalling; cell proliferation was evaluated by [H3]-thymidine incorporation and glycoprotein hormone production analysed by radioimmunoassay (RIA). RESULTS: All adenomas investigated expressed the GHR, but there was no...... detection of STAT5 phosphorylation. Overall, GH and IGF-I administration did not significantly stimulate cell proliferation in vitro, although some individual adenomas exhibited a proliferative response to various extents. GH also did not significantly influence glycoprotein hormone secretion in vitro...

  18. Bilateral SMAS rhytidectomy in parotid recurrent pleomorphic adenoma

    A. Baj; BELTRAMINI, G.A.; Demarchi, M; V.A. Combi; A. Giannì

    2011-01-01

    SUMMARY A case is presented of a young female with parotid recurrent pleomorphic adenoma and skin infiltration treated with subtotal parotidectomy combined with a bilateral superficial muscular aponeurotic system rhytidectomy.

  19. Growth hormone secreting pituitary adenoma with admixed gangliocytoma and ganglioglioma.

    Jukes, Alistair; Allan, Rodney; Rawson, Robert; Buckland, Michael E

    2016-09-01

    Pituitary adenomas are the most common tumours found in the sellar region and, when both functioning and non-functioning adenomas are combined, account for 7-15% of primary brain tumours in adults. Rarely, admixed or discrete groups of cells comprising two or more tumour subtypes are seen; the so-called 'collision tumour'. We present a case of a 54-year-old-woman with a growth hormone-secreting pituitary adenoma admixed with both ganglioglioma and gangliocytoma. The possible mechanisms by which this may occur include a pre-existing gangliocytoma promoting the development of pituitary adenoma by hypersecretion of releasing hormones or aberrant migration of hypothalamic neurons in early embryogenesis. PMID:27068013

  20. Molecular screening of pituitary adenomas for gene mutations and rearrangements

    Herman, V.; Drazin, N.Z.; Gonskey, R.; Melmed, S. (Cedars-Sinai Medical Center, Los Angeles, CA (United States))

    1993-07-01

    Although pituitary tumors arise as benign monoclonal neoplasms, genetic alterations have not readily been identified in these adenomas. The authors studied restriction fragment abnormalities involving the GH gene locus, and mutations in the p53 and H-, K-, and N-ras genes in 22 human GH cell adenomas. Twenty two nonsecretory adenomas were also examined for p53 and ras gene mutations. Seven prolactinoma DNA samples were tested for deletions in the multiple endocrine neoplasia-1 (MEN-1) locus, as well as for rearrangements in the hst gene, a member of the fibroblast growth factor family. In DNA from GH-cell adenomas, identical GH restriction patterns were detected in both pituitary and lymphocyte DNA in all patients and in one patient with a mixed GH-TSH cell adenoma. Using polymerase chain reaction (PCR)-single stranded conformation polymorphism analysis, no mutations were detected in exons 5, 6, 7 and 8 of the p53 gene in GH cell adenomas nor in 22 nonsecretory adenomas. Codons 12/13 and 61 of H-ras, K-ras, and N-ras genes were also intact on GH cell adenomas and in nonsecretory adenomas. Site-specific probes for chromosome 11q13 including, PYGM, D11S146, and INT2 were used in 7 sporadic PRL-secreting adenomas to detect deletions of the MEN-1 locus on chromosome 11. One patient was identified with a loss of 11p, and the remaining 6 patients did not demonstrate loss of heterozygosity in the pituitary 11q13 locus, compared to lymphocyte DNA. None of these patients demonstrated hst gene rearrangements which also maps to this locus. These results show that p53 and ras gene mutations are not common events in the pathogenesis of acromegaly and nonsecretory tumors. Although hst gene rearrangements and deletions of 11q13 are not associated with sporadic PRl-cell adenoma formation, a single patient was detected with a partial loss of chromosome 11, including the putative MEN-1 site. 31 refs., 5 figs., 2 tabs.

  1. On the question whether to irradiate TSH secreting hypophyseal adenomas

    Hypophyseal adenomas secreting TSH are very rare. In dependence on local symptoms, internal-endocrinological, neurosurgical, or radiotherapeutical treatment approaches are applied alone or in combination. A case of radiotherapy alone is presented which was performed successfully in a patient with TSH secreting hypophyseal adenoma. This case is compared with the rates of success of other therapy modalities by means of a detailed literature survey. (orig.)

  2. Role of radionuclide scintigraphy in the detection of parathyroid adenoma

    Singh N; Krishna B

    2007-01-01

    Background: Preoperative detection of parathyroid adenoma is a diagnostic challenge. The sonography and computerized tomography (CT) scan demonstrate high sensitivity but low specificity. The advent of radionuclide scanning technique has enhanced the specificity in this context. Aim: We undertook a study to assess the role of radionuclide scanning in suspected cases of parathyroid adenomas. Materials And Methods: Totally 28 cases were incorporated in the study. The suspicion was raised e...

  3. Parathyroid adenoma on the ipsilateral side of thyroid hemiagenesis

    Kroeker, Teresa R.; Stancoven, Kevin M.; Preskitt, John T.

    2011-01-01

    We present a case of a parathyroid adenoma on the ipsilateral side of thyroid hemiagenesis—which, to our knowledge, is the third reported case of this entity. A 41-year-old man with nephrolithiasis was found to have elevated calcium and intact parathyroid hormone levels. Both ultrasound and technetium sestamibi scintigraphy with single photon emission computed tomography confirmed left thyroid hemiagenesis and an adenoma in the left inferior thyroid bed. The patient underwent left neck explor...

  4. Pancreatitis complicating mucin-hypersecreting common bile duct adenoma

    Panagiotis Katsinelos; George Basdanis; Grigorios Chatzimavroudis; Giorgia Karagiannoulou; Taxiarchis Katsinelos; George Paroutoglou; Basilios Papaziogas; George Paraskevas

    2006-01-01

    Villous adenomas of the bile ducts are extremely uncommon. We describe a 58-year-old man presenting with clinical signs and laboratory findings of acute pancreatitis and obstructive jaundice. Preoperative investigation demonstrated a dilated papillary orifice with mucus exiting (fish-mouth sign) and a filling defect in the distal common bile duct. He underwent a modified Whipple operation and histological examination of the surgical specimen showed villous adenoma with rich secretion of mucus.

  5. Association between measures of obesity and colorectal adenoma

    KIM You Joung; LEE Kang-moon; CHUNG Woo Chul; PAIK Chang Nyol; JUNG Sung Hoon

    2011-01-01

    Background Few studies have used body mass index (BMI),waist-to-hip ratio (WHR) and waist circumference (WC) at the same time to investigate the association between obesity and colorectal adenoma.This study examined the strength of association between colorectal adenoma and obesity using not only BMI,but also WHR and WC.Methods Subjects of this study included 1322 asymptomatic patients who underwent colonoscopy for cancer screening from January 2006 to June 2008.Anthropometric measurements,blood test results,and a self-administered questionnaire from each subject were analyzed.Results Four hundred and fourteen adenoma cases were identified in 1322 subjects.Using univariate analysis,the prevalence of adenoma was associated with BMI and WHR and was higher among the abdominal obesity group using WC guidelines of the Korean Society for the Study of Obesity,but not using WC guidelines of the International Diabetes Federation.In multiple Logistic regression analysis,general obesity (BMI >25 kg/m2) increased the risk of colorectal adenoma (odds ratio (OR),1.43; 95% confidence interval (CI),1.05-1.94).Also,abdominal obesity by the WC cutoffs and the highest WHR percentile group (WHR >0.95) were significantly associated with adenoma.Among three measures of obesity,however,only BMI had a persistent association with adenoma after adjusting reciprocally for BMI,WC,and WHR (OR,1.30; 95% CI,1.02-1.80; and 1.49; 1.06-2.10,adjusted for WC and WHR,respectively).Conclusion The data suggest that general obesity is associated with an increased risk of colorectal adenoma.

  6. Bilateral Adrenal Adenoma Presented As Multiple Metatarsal And Phalangeal Fractures

    LiYeung, L L; Lui, T.H.

    2015-01-01

    Introduction: Symptomatic adrenal adenoma usually presents with systemic symptoms. Depending on the function of the adenoma, the patient can present with pheochromocytoma-like symptoms; primary hyperaldosteronism and Cushing syndrome (weight gain, weakness, depression, and bruising). Case report: A 41 year-old lady presented with multiple metatarsal and phalangeal fractures of the both feet without significant injury. DEXA scan showed evidence of osteoporosis. Investigations showed that the p...

  7. Nephrogenic adenoma arising from the urinary bladder: a case report

    Chung, Sun Hee; Lee, Sun Wha; Han, Woon Seup [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-03-01

    Nephrogenic adenoma is a benign metaplastic lesion of the urinary tract occurring most frequently at the urinary bladder. It is very rare, especially in children. We describe the US, CT and MRI findings of nephrogenic adenoma arising from the urinary bladder in an 8-year-old girl who suffered rupture of the bladder, urethra and vagina after a traffic accident and whose condition was complicated by urethral stricture and vesicoureteral reflux.

  8. Technetium-99m pentavalent dimercaptosuccinic acid imaging for pituitary adenomas

    The authors performed scintigraphy using 99mTc(V)-DMSA (Technetium-99m pentavalent dimercaptosuccinic acid) on patients with pituitary adenomas. Three non-functioning (100%), 2 GH-secreting (67%), 4 PRL-secreting (80%), and zero ACTH-secreting (0%) adenomas concentrated the 99mTc(V)-DMSA, but all 5 of the non-adenomatous lesions and 1 normal pituitary gland did not. There was no significant relationship between tumor-to-background ratios and tumor sizes, or the serum hormone level. The 99mTc(V)-DMSA scintigraphy showed an overall sensitivity of 69% (9/13) in detecting pituitary adenomas, which increased to 82% for non-functioning, GH-secreting and PRL-secreting adenomas. In conclusions, 99mTc(V)-DMSA was found to be a suitable radiotracer for detecting pituitary adenomas. But further studies are necessary to define the processes that concentrate 99mTc(V)-DMSA and their role in pituitary adenomas. (author)

  9. Nipple adenoma arising from axillary accessory breast: a case report

    Shioi Yoshihiro

    2012-11-01

    Full Text Available Abstract Nipple adenoma is a relatively rare benign breast neoplasm, and cases of the disease arising from the axillary accessory breast have very seldom been reported in the English literature. We report a case of nipple adenoma arising from axillary accessory breast including clinical and pathological findings. An 82-year-old woman presented with the complaint of a small painful mass in the right axilla. Physical examination confirmed a well-defined eczematous crusted mass that was 8 mm in size. The diagnosis of nipple adenoma was made from an excisional specimen on the basis of characteristic histological findings. Microscopic structural features included a compact proliferation of small tubules lined by epithelial and myoepithelial cells, and the merging of glandular epithelial cells of the adenoma into squamous epithelial cells in the superficial epidermal layer. Because clinically nipple adenoma may resemble Paget’s disease and pathologically can be misinterpreted as tubular carcinoma, the correct identification of nipple adenoma is an important factor in the differential diagnosis for axillary tumor neoplasms. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1186821489769063

  10. Renal Adenomas: Pathological Differential Diagnosis with Malignant Tumors

    F. Algaba

    2008-10-01

    Full Text Available The renal adenomas can be confused by imaging diagnosis with malignant renal tumors, but there are also real biological dilemmas to determine their behavior. The consensus decisions are the following. (1 The adenoma of clear cells is not accepted, instead it is considered that all the clear-cell tumors are carcinomas, with greater or lesser aggressiveness. (2 Among the papillary neoplasms the WHO 2004 renal cell tumors classification are considered as papillary adenomas tumors with a maximum diameter of 5 mm and may represent a continuum biological process to papillary renal cell carcinoma. The papillary adenomas associated with End-kidney and/or acquired cystic disease may have a different pathogenesis. (3 To consider a tumor as an oncocytoma the size is not important, only the cytological features, microscopic, ultrastructural, and immunohistochemically can help, but some chromosomal observations introduce some questions about its relation with the chromophobe renal cell carcinoma. (4 Finally, the metanephric adenoma, a tumor with some morphological similarity with the nephroblastoma must be considered in the renal adenomas diagnosis.

  11. Hiperparatiroidismo secundario a adenoma paratiroideo mediastinal Hyperparathyroidism due to mediastinal parathyroid adenoma

    C Agostinis

    2012-03-01

    Full Text Available Las glándulas paratiroides se localizan en el cuello, en la cara posterior de la glándula tiroides. Tienen como función secretar PTH, la cual está regulada por la concentración extracelular de calcio. Se define como hiperparatiroidismo a la producción excesiva de PTH por las glándulas paratiroideas, siendo el 85 % aproximadamente de los casos producto de un adenoma; un 12 % debido a hiperplasia y menos del 1 % por carcinomas. El hiperparatiroidismo primario ectápico se presenta en el 10 % de los pacientes, de los cuales del 1 al 2 % corresponde a la localización mediastinal(1. Presentamos una paciente de 38 años, internada en nuestra institución por hipercalcemia sintomática, comprobándose niveles plasmáticos elevados de PTH. Se le realizá una gammagrafía con tecnecio 99 MIBI que evidenció una imagen hipercaptante a nivel de mediastino anterior. Fue intervenida quirúrgicamente, obteniendo como resultado de la anatomía patolágica un adenoma paratiroideo.The parathyroid glands are located in the neck, on the back of the thyroid gland. Their function is to secrete PTH, which is regulated by extracellular calcium concentration. Hyperparathyroidism is defined as the excessive production of PTH by the parathyroid glands; approximately 85 % of the cases are caused by an adenoma, 12 % due to hyperplasia and less than 1 % by carcinomas. Ectopic Primary hyperparathyroidism occurs in 10 % of the patients, of which from 1 to 2 % are of mediastinal location(1. We report the case of a 38-year-old patient hospitalized in our institution for symptomatic hypercalcemia. During her hospitalization elevated plasma levéis of PTH were found with image MIBI technetium 99 high uptake in the anterior mediastinum. She underwent surgery, and the pathology report showed parathyroid adenoma.

  12. Hiperparatiroidismo secundario a adenoma paratiroideo mediastinal Hyperparathyroidism due to mediastinal parathyroid adenoma

    Agostinis, C; S Batistelli; S Suárez Ayala; J Lápez; C Pietrangelo

    2012-01-01

    Las glándulas paratiroides se localizan en el cuello, en la cara posterior de la glándula tiroides. Tienen como función secretar PTH, la cual está regulada por la concentración extracelular de calcio. Se define como hiperparatiroidismo a la producción excesiva de PTH por las glándulas paratiroideas, siendo el 85 % aproximadamente de los casos producto de un adenoma; un 12 % debido a hiperplasia y menos del 1 % por carcinomas. El hiperparatiroidismo primario ectápico se presenta en el 10 % de ...

  13. Disturbed temporal lobe circulation due to compression by pituitary adenoma

    The objective of this study was to clarify the pathophysiology of temporal lobe-related symptoms in pituitary adenoma by investigating temporal lobe circulation in pituitary adenoma with single photon emission computed tomography (SPECT). The subjects were 37 patients with pituitary adenoma (74 regions in the bilateral temporal lobes) who underwent 123I-iofetamine (IMP) SPECT before treatment. Using imaging analysis software 3D-SSP, the temporal lobes were evaluated in the bottom view on SPECT using the following method. Regions of interest (ROI) were established in the anteromedial (AM), posteromedial (PM), anterolateral (AL), and posterolateral (PL) regions of the temporal lobe, and the activity ratio (AR) of the counts/pixel in each ROI to those throughout the entire brain was determined. The AR in the 37 patients was compared with that in 37 healthy volunteers. Furthermore, the temporal lobes in patients with pituitary adenoma were classified according to the presence or absence of compression caused by the tumor, pituitary apoplexy, and hormone production, and evaluated. The AR in the AM and AL was significantly lower in the pituitary adenoma than in the healthy group (both, p<0.001). In the pituitary adenoma group, the AR in the AM, AL, and PL was significantly lower in the compression than in the non-compression group (p<0.05, p<0.05, and p<0.01, respectively). Classification based on the presence or absence of pituitary apoplexy or hormone production did not significantly differ with the AR values. We conclude that pituitary adenoma causes hypoperfusion in the temporal lobe at a high frequency, and direct compression by the tumor is a cause of regional cerebral blood flow (rCBF) reduction. (author)

  14. The Spectrum of Hormone Immunoreactivity in Typical and Atypical Pituitary Adenomas

    Yeşim ERTAN

    2009-09-01

    Full Text Available Objective: We aimed to assess the spectrum of hormone immunoreactivity in our pituitary adenoma cases and discuss the diagnostic parameters of atypical pituitary adenomas.Material and Methods: A total of 166 pituitary adenoma cases diagnosed from 2005 to 2008 in our department were included in the present study. Hematoxylin-eosin stained and immunohistochemistry performed slides (ACTH, PRL, GH, TSH, FSH, LH, Ki-67, and p53 were evaluated. Cases having more than two mitoses on 10 high power fields besides more than 3% Ki-67 index were accepted in the atypical group.Results: Histologically, 159 cases were typical pituitary adenoma and 7 were atypical pituitary adenoma. Of the atypical pituitary adenoma cases, one case was ACTH, one GH and one both GH and prolactin hormone immunoreactive pituitary adenomas. Four cases were hormone immunonegative adenomas. Of the typical pituitary adenoma cases, 39 cases were GH, 19 ACTH, 17 prolactin, 10 FSH, 8 LH and one TSH immunreactive pituitary adenomas. Fourty-seven cases were hormone immunonegative adenomas.Twenty-two of the all pitutary adenoma cases had recurrence. Of these cases, 18 were typical adenoma and four were atypical adenoma.Conclusion: The ratio of prolactin immunoreactive pituitary adenoma cases in the surgical material of neuropathology is decreasing due to medical therapy. Atypical pituitary adenomas are not the sole factor affecting the recurrence mechanism but these tumors have higher recurrence rate compared with typical pituitary adenomas and we think the proliferation index might be the principal approach in the diagnosis of these lesions.

  15. Pediatric adrenocortical neoplasms: can imaging reliably discriminate adenomas from carcinomas?

    Flynt, Kelsey A.; Dillman, Jonathan R.; Smith, Ethan A.; Strouse, Peter J. [University of Michigan Health System, Section of Pediatric Radiology, C. S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Davenport, Matthew S.; Caoili, Elaine M. [University of Michigan Health System, Division of Abdominal Imaging, Department of Radiology, Ann Arbor, MI (United States); Else, Tobias [University of Michigan Health System, Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, Ann Arbor, MI (United States)

    2015-08-15

    There is a paucity of literature describing and comparing the imaging features of adrenocortical adenomas and carcinomas in children and adolescents. To document the CT and MRI features of adrenocortical neoplasms in a pediatric population and to determine whether imaging findings (other than metastatic disease) can distinguish adenomas from carcinomas. We searched institutional medical records to identify pediatric patients with adrenocortical neoplasms. Pre-treatment CT and MRI examinations were reviewed by two radiologists in consensus, and pertinent imaging findings were documented. We also recorded relevant histopathological, demographic, clinical follow-up and survival data. We used the Student's t-test and Wilcoxon rank sum test to compare parametric and nonparametric continuous data, and the Fisher exact test to compare proportions. We used receiver operating characteristic (ROC) curve analyses to evaluate the diagnostic performances of tumor diameter and volume for discriminating carcinoma from adenoma. A P-value ≤0.05 was considered statistically significant. Among the adrenocortical lesions, 9 were adenomas, 15 were carcinomas, and 1 was of uncertain malignant potential. There were no differences in mean age, gender or sidedness between adenomas and carcinomas. Carcinomas were significantly larger than adenomas based on mean estimated volume (581 ml, range 16-2,101 vs. 54 ml, range 3-197 ml; P-value = 0.003; ROC area under the curve = 0.92) and mean maximum transverse plane diameter (9.9 cm, range 3.0-14.9 vs. 4.4 cm, range 1.9-8.2 cm; P-value = 0.0001; ROC area under the curve = 0.92). Carcinomas also were more heterogeneous than adenomas on post-contrast imaging (13/14 vs. 2/9; odds ratio [OR] = 45.5; P-value = 0.001). Six of 13 carcinomas and 1 of 8 adenomas contained calcification at CT (OR = 6.0; P-value = 0.17). Seven of 15 children with carcinomas exhibited metastatic disease at diagnosis, and three had inferior vena cava invasion. Median

  16. Signaling pathway networks mined from human pituitary adenoma proteomics data

    Zhan Xianquan

    2010-04-01

    Full Text Available Abstract Background We obtained a series of pituitary adenoma proteomic expression data, including protein-mapping data (111 proteins, comparative proteomic data (56 differentially expressed proteins, and nitroproteomic data (17 nitroproteins. There is a pressing need to clarify the significant signaling pathway networks that derive from those proteins in order to clarify and to better understand the molecular basis of pituitary adenoma pathogenesis and to discover biomarkers. Here, we describe the significant signaling pathway networks that were mined from human pituitary adenoma proteomic data with the Ingenuity pathway analysis system. Methods The Ingenuity pathway analysis system was used to analyze signal pathway networks and canonical pathways from protein-mapping data, comparative proteomic data, adenoma nitroproteomic data, and control nitroproteomic data. A Fisher's exact test was used to test the statistical significance with a significance level of 0.05. Statistical significant results were rationalized within the pituitary adenoma biological system with literature-based bioinformatics analyses. Results For the protein-mapping data, the top pathway networks were related to cancer, cell death, and lipid metabolism; the top canonical toxicity pathways included acute-phase response, oxidative-stress response, oxidative stress, and cell-cycle G2/M transition regulation. For the comparative proteomic data, top pathway networks were related to cancer, endocrine system development and function, and lipid metabolism; the top canonical toxicity pathways included mitochondrial dysfunction, oxidative phosphorylation, oxidative-stress response, and ERK/MAPK signaling. The nitroproteomic data from a pituitary adenoma were related to cancer, cell death, lipid metabolism, and reproductive system disease, and the top canonical toxicity pathways mainly related to p38 MAPK signaling and cell-cycle G2/M transition regulation. Nitroproteins from a

  17. Pediatric adrenocortical neoplasms: can imaging reliably discriminate adenomas from carcinomas?

    There is a paucity of literature describing and comparing the imaging features of adrenocortical adenomas and carcinomas in children and adolescents. To document the CT and MRI features of adrenocortical neoplasms in a pediatric population and to determine whether imaging findings (other than metastatic disease) can distinguish adenomas from carcinomas. We searched institutional medical records to identify pediatric patients with adrenocortical neoplasms. Pre-treatment CT and MRI examinations were reviewed by two radiologists in consensus, and pertinent imaging findings were documented. We also recorded relevant histopathological, demographic, clinical follow-up and survival data. We used the Student's t-test and Wilcoxon rank sum test to compare parametric and nonparametric continuous data, and the Fisher exact test to compare proportions. We used receiver operating characteristic (ROC) curve analyses to evaluate the diagnostic performances of tumor diameter and volume for discriminating carcinoma from adenoma. A P-value ≤0.05 was considered statistically significant. Among the adrenocortical lesions, 9 were adenomas, 15 were carcinomas, and 1 was of uncertain malignant potential. There were no differences in mean age, gender or sidedness between adenomas and carcinomas. Carcinomas were significantly larger than adenomas based on mean estimated volume (581 ml, range 16-2,101 vs. 54 ml, range 3-197 ml; P-value = 0.003; ROC area under the curve = 0.92) and mean maximum transverse plane diameter (9.9 cm, range 3.0-14.9 vs. 4.4 cm, range 1.9-8.2 cm; P-value = 0.0001; ROC area under the curve = 0.92). Carcinomas also were more heterogeneous than adenomas on post-contrast imaging (13/14 vs. 2/9; odds ratio [OR] = 45.5; P-value = 0.001). Six of 13 carcinomas and 1 of 8 adenomas contained calcification at CT (OR = 6.0; P-value = 0.17). Seven of 15 children with carcinomas exhibited metastatic disease at diagnosis, and three had inferior vena cava invasion. Median

  18. Adenoma pleomórfico de septo nasal: relato de caso Pleomorphic adenoma of the nasal septum: a case report

    Mauren P. Rocha

    2004-06-01

    Full Text Available As neoplasias nasais são bastante raras. Os tumores mais observados na cavidade nasal são papilomas epiteliais, angiomas, carcinoma de células transicionais, carcinoma pavimentoso e adenocarcinoma. O adenoma pleomórfico pertence ao grupo de tumores que aparecem com menor freqüência na fossa nasal, e é o tumor benigno glandular mais comum originado na cabeça e pescoço. A apresentação clínica típica dos pacientes com adenoma pleomórfico do septo nasal é de obstrução nasal unilateral, epistaxe e massa indolor na cavidade nasal. Em vista da raridade da apresentação clínica do adenoma pleomórfico nesta localização, os autores descrevem um caso de adenoma pleomórfico nasal em um paciente do sexo masculino, com 69 anos de idade, onde relatam os achados clínicos, critérios diagnósticos, tratamento, prognóstico e revisão da literatura.Nasal tumours are very rare. The neoplasms most frequently seen in the nasal cavity are epithelial papillomas, angiomas, transitional cells carcinoma, pavement carcinoma and adenocarcinoma. The pleomorphic adenoma belongs to the group of tumours less commonly observed in the nasal cavity, and is the most common head and neck benign glandular tumour. The typical clinical presentation of the nasal pleomorphic adenoma is of unilateral nasal obstruction, epistaxis and a painless mass in the nasal cavity. The authors reported an adenoma pleomorphic case that highlights itself by its unusual nasal presentation in the nasal septum of a 45-year-old male patient who was submitted to surgical treatment, and discuss the clinical findings, diagnostic criteria, treatment, prognosis and literature review.

  19. CT scan diagnosis of hepatic adenoma in a case of von Gierke disease

    Daga, Bipin Valchandji; Shah, Vaibhav R; More, Rahul B

    2012-01-01

    Hepatic adenoma is a well-defined, benign, solitary tumor of the liver. In individuals with glycogen storage disease I, adenoma tends to occur at a relatively younger age and can be multiple (adenomatosis). Imaging plays a pivotal role in diagnosing hepatic adenoma and in differentiating adenoma from other focal hepatic lesions. Especially in patients with von Gierke disease, in addition to the associated hepatomegaly caused by steatohepatitis and the diffusely reduced attenuation of the liver parenchyma seen on CT, there may be more than one hepatic adenoma in up to 40% of patients. Malignant degeneration of hepatic adenoma into hepatocellular carcinoma can occur and hence imaging is important for prompt diagnosis of adenoma and its complications. In this case report, we present a case of liver adenoma diagnosed by CT scan in a patient with von Gierke disease. PMID:22623817

  20. CT scan diagnosis of hepatic adenoma in a case of von Gierke disease

    Bipin Valchandji Daga

    2012-01-01

    Full Text Available Hepatic adenoma is a well-defined, benign, solitary tumor of the liver. In individuals with glycogen storage disease I, adenoma tends to occur at a relatively younger age and can be multiple (adenomatosis. Imaging plays a pivotal role in diagnosing hepatic adenoma and in differentiating adenoma from other focal hepatic lesions. Especially in patients with von Gierke disease, in addition to the associated hepatomegaly caused by steatohepatitis and the diffusely reduced attenuation of the liver parenchyma seen on CT, there may be more than one hepatic adenoma in up to 40% of patients. Malignant degeneration of hepatic adenoma into hepatocellular carcinoma can occur and hence imaging is important for prompt diagnosis of adenoma and its complications. In this case report, we present a case of liver adenoma diagnosed by CT scan in a patient with von Gierke disease.

  1. Mitochondrial DNA mutations in oxyphilic and chief cell parathyroid adenomas

    Roth Sanford I

    2007-10-01

    Full Text Available Abstract Background The potential pathogenetic significance of mitochondrial DNA (mtDNA mutations in tumorigenesis is controversial. We hypothesized that benign tumorigenesis of a slowly replicating tissue like the human parathyroid might constitute an especially fertile ground on which a selective advantage conferred by mtDNA mutation could be manifested and might contribute to the oxyphilic phenotype observed in a subset of parathyroid tumors. Methods We sought acquired mitochondrial DNA mutations by sequencing the entire 16.6 kb mitochondrial genome of each of thirty sporadic parathyroid adenomas (18 chief cell and 12 oxyphil cell, eight independent, polyclonal, parathyroid primary chief cell hyperplasias plus corresponding normal control samples, five normal parathyroid glands, and one normal thyroid gland. Results Twenty-seven somatic mutations were identified in 15 of 30 (9 of 12 oxyphil adenomas, 6 of 18 chief cell parathyroid adenomas studied. No somatic mutations were observed in the hyperplastic parathyroid glands. Conclusion Features of the somatic mutations suggest that they may confer a selective advantage and contribute to the molecular pathogenesis of parathyroid adenomas. Importantly, the statistically significant differences in mutation prevalence in oxyphil vs. chief cell adenomas also suggest that mtDNA mutations may contribute to the oxyphil phenotype.

  2. A rare case of giant parathyroid adenoma presenting with recurrent episodes of pancreatitis

    Krishnamurthy, Arvind; Raghunandan, Gorantlu Chowdappa; Ramshankar, Vijayalakshmi

    2016-01-01

    Parathyroid adenomas are usually small in size; (weighing 70 mg–1 g) those weighing more than 2–3 g are classified as giant parathyroid adenomas. Giant parathyroid adenomas are in fact rarely encountered among patients with primary hyperparathyroidism. They are believed to have distinct clinical and biochemical features related to specific genomic alterations. We chanced to manage a unique and possibly the first case of giant parathyroid adenoma (6 cm diameter and weighing 20 g) presenting wi...

  3. CT scan diagnosis of hepatic adenoma in a case of von Gierke disease

    Bipin Valchandji Daga; Shah, Vaibhav R; More, Rahul B

    2012-01-01

    Hepatic adenoma is a well-defined, benign, solitary tumor of the liver. In individuals with glycogen storage disease I, adenoma tends to occur at a relatively younger age and can be multiple (adenomatosis). Imaging plays a pivotal role in diagnosing hepatic adenoma and in differentiating adenoma from other focal hepatic lesions. Especially in patients with von Gierke disease, in addition to the associated hepatomegaly caused by steatohepatitis and the diffusely reduced attenuation of the live...

  4. Adrenal imaging for adenoma characterization: imaging features, diagnostic accuracies and differential diagnoses.

    Park, Jung Jae; Park, Byung Kwan; Kim, Chan Kyo

    2016-06-01

    Adrenocortical adenoma is the most common adrenal tumour. This lesion is frequently encountered on cross-sectional imaging that has been performed for unrelated reasons. Adrenal adenoma manifests various imaging features on CT, MRI and positron emission tomography/CT. The learning objectives of this review are to describe the imaging findings of adrenocortical adenoma, to compare the sensitivities of different imaging modalities for adenoma characterization and to introduce differential diagnoses. PMID:26867466

  5. Matrix metalloproteinase-13 expression in the progression of colorectal adenoma to carcinoma : Matrix metalloproteinase-13 expression in the colorectal adenoma and carcinoma.

    Foda, Abd Al-Rahman Mohammad; El-Hawary, Amira K; Abdel-Aziz, Azza

    2014-06-01

    Most colorectal carcinomas (CRCs) are considered to arise from conventional adenoma based on the concept of the adenoma-carcinoma sequence. Matrix metalloproteinases (MMPs) are known to be overexpressed as normal mucosa progresses to adenomas and carcinomas. There has been little previous investigation about MMP-13 expression in adenoma-carcinoma sequence. In this study, we aimed to investigate the immunohistochemical expression of MMP-13 in colorectal adenoma and CRC specimens using tissue microarray (TMA) technique. A total of 40 cases of CRC associated with adenoma were collected from files of the Pathology laboratory at Mansoura Gastroenterology Center between January 2007 and January 2012. Sections from TMA blocks were prepared and stained for MMP-13. Immunoreactivity to MMP-13 staining was localized to the cytoplasm of mildly, moderately, and severely dysplatic cells of adenomas and CRC tumor cells that were either homogenous or heterogeneous. There was no significant difference in MMP-13 expression between adenomas and CRCs either non-mucinous or mucinous. Adenomas with high MMP-13 expression were significantly associated with moderate to marked degree of inflammatory cellular infiltrate and presence of familial adenomatous polyps. In conclusion, MMP-13 may be a potential biological marker of early tumorigenesis in the adenoma-carcinoma sequence. PMID:24563279

  6. Hepatocellular adenoma: what is new in 2008.

    Bioulac-Sage, Paulette; Laumonier, Hervé; Laurent, Christophe; Zucman-Rossi, Jessica; Balabaud, Charles

    2008-09-01

    Patients (85%) with hepatocellular adenoma (HCA) are women taking oral contraceptives. They can be divided into four subgroups according to their genotype/phenotype features. (1) Hepatocyte nuclear factor 1alpha (HNF1alpha) biallelic somatic mutations are observed in 35% of the HCA cases. It occurs in almost all cases in women. HNF1alpha-mutated HCA are most of the time, highly steatotic, with a lack of expression of liver fatty acid binding protein (LFABP) in immunohistochemistry analyses. Adenomatosis is frequently detected in this context. An HNF1alpha germline mutation is observed in less than 5% of HCA cases and can be associated with MODY 3 diabetes. (2) An activating beta-catenin mutation was found in 10% of HCA. These beta-catenin activated HCAs are observed in men and women, and specific risk factors, such as male hormone administration or glycogenosis, are associated with their development. Immunohistochemistry studies show that these HCAs overexpress beta-catenin (nuclear and cytoplasmic) and glutamine synthetase. This group of tumours has a higher risk of malignant transformation into hepatocellular carcinoma. (3) Inflammatory HCAs are observed in 40% of the cases, and they are most frequent in women but are also found in men. Lesions are characterised by inflammatory infiltrates, dystrophic arteries, sinusoidal dilatation and ductular reaction. They express serum amyloid A and C-reactive protein. In this group, GGT is frequently elevated, with a biological inflammatory syndrome present. Also, there are more overweight patients in this group. An additional 10% of inflammatory HCAs express beta-catenin, and are also at risk of malignant transformation. (4) Currently, less than 10% of HCAs are unclassified. It is hoped that in the near future it will be possible with clinical, biological and imaging data to predict in which of the 2 major groups (HNF1alpha-mutated HCA and inflammatory HCA) the patient belongs and to propose better guidelines in terms of

  7. File list: Unc.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Unc.Dig.10.AllAg.Intestinal_adenoma mm9 Unclassified Digestive tract Intestinal ade...noma SRX648717 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Dig.10.AllAg.Intestinal_adenoma.bed ...

  8. Chromosome number distribution and cellular DNA content in colorectal adenomas from polyposis and nonpolyposis patients

    Petersen, S E; Madsen, A L; Bak, Martin

    1991-01-01

    Ploidy analyses of colorectal adenomas were performed by combined flow cytometric DNA analysis of unfixed isolated nuclei and direct chromosome preparation after Colcemid incubation for 9-20 hours. Ten of 18 adenomas from nonpolyposis patients and 4 of 13 adenomas from patients with familial aden...

  9. File list: Pol.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Pol.Dig.10.AllAg.Intestinal_adenoma mm9 RNA polymerase Digestive tract Intestinal a...denoma http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Pol.Dig.10.AllAg.Intestinal_adenoma.bed ...

  10. File list: Oth.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Oth.Dig.50.AllAg.Intestinal_adenoma mm9 TFs and others Digestive tract Intestinal a...denoma SRX648718 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Dig.50.AllAg.Intestinal_adenoma.bed ...

  11. File list: InP.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available InP.Dig.20.AllAg.Intestinal_adenoma mm9 Input control Digestive tract Intestinal ad...enoma http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Dig.20.AllAg.Intestinal_adenoma.bed ...

  12. File list: DNS.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available DNS.Dig.10.AllAg.Intestinal_adenoma mm9 DNase-seq Digestive tract Intestinal adenom...a http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Dig.10.AllAg.Intestinal_adenoma.bed ...

  13. File list: DNS.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available DNS.Dig.50.AllAg.Intestinal_adenoma mm9 DNase-seq Digestive tract Intestinal adenom...a http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Dig.50.AllAg.Intestinal_adenoma.bed ...

  14. File list: NoD.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available NoD.Dig.50.AllAg.Intestinal_adenoma mm9 No description Digestive tract Intestinal a...denoma http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Dig.50.AllAg.Intestinal_adenoma.bed ...

  15. File list: Oth.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Oth.Dig.10.AllAg.Intestinal_adenoma mm9 TFs and others Digestive tract Intestinal a...denoma SRX648718 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Dig.10.AllAg.Intestinal_adenoma.bed ...

  16. File list: Unc.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Unc.Dig.20.AllAg.Intestinal_adenoma mm9 Unclassified Digestive tract Intestinal adenoma... SRX648717 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Dig.20.AllAg.Intestinal_adenoma.bed ...

  17. File list: ALL.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available ALL.Dig.05.AllAg.Intestinal_adenoma mm9 All antigens Digestive tract Intestinal adenoma... SRX648718,SRX648717 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Dig.05.AllAg.Intestinal_adenoma.bed ...

  18. File list: InP.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available InP.Dig.10.AllAg.Intestinal_adenoma mm9 Input control Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Dig.10.AllAg.Intestinal_adenoma.bed ...

  19. File list: NoD.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available NoD.Dig.05.AllAg.Intestinal_adenoma mm9 No description Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Dig.05.AllAg.Intestinal_adenoma.bed ...

  20. File list: ALL.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available ALL.Dig.20.AllAg.Intestinal_adenoma mm9 All antigens Digestive tract Intestinal adenoma... SRX648718,SRX648717 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Dig.20.AllAg.Intestinal_adenoma.bed ...

  1. File list: ALL.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available ALL.Dig.50.AllAg.Intestinal_adenoma mm9 All antigens Digestive tract Intestinal adenoma... SRX648718,SRX648717 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Dig.50.AllAg.Intestinal_adenoma.bed ...

  2. File list: NoD.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available NoD.Dig.10.AllAg.Intestinal_adenoma mm9 No description Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Dig.10.AllAg.Intestinal_adenoma.bed ...

  3. File list: InP.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available InP.Dig.05.AllAg.Intestinal_adenoma mm9 Input control Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Dig.05.AllAg.Intestinal_adenoma.bed ...

  4. File list: InP.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available InP.Dig.50.AllAg.Intestinal_adenoma mm9 Input control Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Dig.50.AllAg.Intestinal_adenoma.bed ...

  5. File list: Oth.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Oth.Dig.05.AllAg.Intestinal_adenoma mm9 TFs and others Digestive tract Intestinal adenoma... SRX648718 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Dig.05.AllAg.Intestinal_adenoma.bed ...

  6. File list: DNS.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available DNS.Dig.05.AllAg.Intestinal_adenoma mm9 DNase-seq Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Dig.05.AllAg.Intestinal_adenoma.bed ...

  7. File list: Unc.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Unc.Dig.50.AllAg.Intestinal_adenoma mm9 Unclassified Digestive tract Intestinal adenoma... SRX648717 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Dig.50.AllAg.Intestinal_adenoma.bed ...

  8. File list: NoD.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available NoD.Dig.20.AllAg.Intestinal_adenoma mm9 No description Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Dig.20.AllAg.Intestinal_adenoma.bed ...

  9. File list: DNS.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available DNS.Dig.20.AllAg.Intestinal_adenoma mm9 DNase-seq Digestive tract Intestinal adenoma... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Dig.20.AllAg.Intestinal_adenoma.bed ...

  10. File list: ALL.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available ALL.Dig.10.AllAg.Intestinal_adenoma mm9 All antigens Digestive tract Intestinal adenoma... SRX648718,SRX648717 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Dig.10.AllAg.Intestinal_adenoma.bed ...

  11. Transsphenoidal approach to pituitary adenoma: surgical technique of the Peking Union Medical College Hospital

    LI Yong-Ning; WANG Ren-zhi; LI Gui-lin

    2009-01-01

    @@ Although presented over one hundred years ago, the transsphenoidal approach to pituitary adenoma is still the most suitable and safe route to pituitary adenoma, with a series of significant evolutional steps. The transsphenoidal approach to pituitary adenoma is still a non-universal approach used in different centers of different areas in our country.

  12. File list: Unc.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Unc.Dig.05.AllAg.Intestinal_adenoma mm9 Unclassified Digestive tract Intestinal adenoma... SRX648717 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Dig.05.AllAg.Intestinal_adenoma.bed ...

  13. File list: Oth.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Oth.Dig.20.AllAg.Intestinal_adenoma mm9 TFs and others Digestive tract Intestinal adenoma... SRX648718 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Dig.20.AllAg.Intestinal_adenoma.bed ...

  14. Coexisting intracranial tumors with pituitary adenomas: Genetic association or coincidence?

    Furtado Sunil

    2010-01-01

    Full Text Available The co-occurrence of two or more brain tumors with different histological features is rare. The authors report three rare cases of intracranial tumors associated with pituitary adenomas. Two of the pituitary tumors were functioning adenomas: a prolactinoma and a thyrotropin secreting adenoma. Two of the associated intracranial neoplasms were gliomas and one was a meningioma. Radiological and clinical examination for syndromal association was negative in all cases. We briefly discuss the presentation and treatment options of these cases and review the 19 previous publications in the literature of pituitary tumors occurring in association with other neoplasms and explore the possible links underlying these co-occurring neoplasms. Our three cases represent 0.86% of all pituitary tumors operated at our institute over a 9-year period.

  15. Parathyroid Adenoma Presenting as a Brown Tumour of the Mandible

    Kavit Amin

    2012-01-01

    Full Text Available Background. Parathyroid adenoma is the commonest cause of primary hypercalcaemia and usually presents with symptoms/signs of hypercalcaemia. This paper highlights an unusual presentation. Case Report. A 27-year-old female presented with a painful left mandibular swelling, suspicious of neoplasia. A computed tomography (CT guided biopsy was performed. Based on the histology result, serum calcium was carried out, confirming hypercalcaemia. A left inferior parathyroid adenoma was subsequently removed. CT mandible showed extensive erosive lesions at the left 2nd/3rd inferior molar roots with protrusion to adjacent soft tissues. USS revealed a hypoechoic lesion on the left inferior parathyroid gland. Sestamibi scan showed a focus of MIBI uptake and retention at the inferior aspect of the left thyroid lobe. Conclusion. This case highlights the importance of a thorough history and examination. Clinicians should always bear in mind atypical presentations of parathyroid adenomas, with the need to exclude this differential in the presence of hypercalcaemia.

  16. Pictures of focal nodular hyperplasia and hepatocellular adenomas

    Christine; Sempoux; Charles; Balabaud; Paulette; Bioulac-Sage

    2014-01-01

    This practical atlas aims to help liver and non liver pa-thologists to recognize benign hepatocellular nodules on resected specimen. Macroscopic and microscopic views together with immunohistochemical stains illustrate typical and atypical aspects of focal nodular hyperplasia and of hepatocellular adenoma, including hepatocel-lular adenomas subtypes with references to clinical and imaging data. Each step is important to make a correct diagnosis. The specimen including the nodule and the non-tumoral liver should be sliced, photographed and all different looking areas adequately sampled for par-affin inclusion. Routine histology includes HE, trichrome and cytokeratin 7. Immunohistochemistry includes glu-tamine synthase and according to the above results ad-ditional markers such as liver fatty acid binding protein, C reactive protein and beta catenin may be realized to differentiate focal nodular hyperplasia from hepatocel-lular adenoma subtypes. Clues for differential diagnosis and pitfalls are explained and illustrated.

  17. Tubulovillous adenoma of anal canal: A case report

    Bhupinder S Anand; Gordana Verstovsek; George Cole

    2006-01-01

    Tumors arising from the anal canal are usually of epithelial origin and are mostly squamous cell carcinoma or basal cell carcinoma. We present a case of benign anal adenomas arising from the anus, an extremely rare diagnosis. A 78-year-old white man presented with rectal bleeding of several months duration. Examination revealed a 4 cm friable mass attached to the anus by a stalk. At surgery, the mass was grasped with a Babcock forceps and was resected using electrocautery.Microscopic examination revealed a tubulovillus adenoma with no areas of high grade dysplasia or malignant transformation. The squamocolumnar junction was visible at the edges of the lesion confirming the anal origin of the tumor. We believe the tubulovillus adenoma arose from either an anal gland or its duct that opens into the anus. Although seen rarely, it is important to recognize and treat these tumors at an early stage because of their potential to transform into adenocarcinoma.

  18. No association between mitochondrial DNA copy number and colorectal adenomas.

    Thyagarajan, Bharat; Guan, Weihua; Fedirko, Veronika; Barcelo, Helene; Tu, Huakang; Gross, Myron; Goodman, Michael; Bostick, Roberd M

    2016-08-01

    Despite previously reported associations between peripheral blood mtDNA copy number and colorectal cancer, it remains unclear whether altered mtDNA copy number in peripheral blood is a risk factor for colorectal cancer or a biomarker for undiagnosed colorectal cancer. Though colorectal adenomas are well-recognized precursor lesions to colorectal cancer, no study has evaluated an association between mtDNA copy number and colorectal adenoma risk. Hence, we investigated an association between peripheral blood mtDNA copy number and incident, sporadic colorectal adenoma in 412 colorectal adenoma cases and 526 cancer-free controls pooled from three colonoscopy-based case-control studies that used identical methods for case ascertainment, risk factor determination, and biospecimen collection. We also evaluated associations between relative mtDNA copy number and markers of oxidative stress, including circulating F2 -isoprostanes, carotenoids, and fluorescent oxidation products. We measured mtDNA copy number using a quantitative real time polymerase chain reaction (PCR). We used unconditional logistic regression to analyze the association between mtDNA copy number and colorectal adenoma risk after multivariable adjustment. We found no association between logarithmically transformed relative mtDNA copy number, analyzed as a continuous variable, and colorectal adenoma risk (odds ratio = 1.02, 95%CI: 0.82-1.27; P = 0.86). There were no statistically significant associations between relative mtDNA copy number and other markers of oxidative stress. Our findings, taken together with those from previous studies, suggest that relative mtDNA copy number in peripheral blood may more likely be a marker of early colorectal cancer than of risk for the disease or of in vivo oxidative stress. © 2015 Wiley Periodicals, Inc. PMID:26258394

  19. Resection of a large ectopic parathyroid adenoma: A case report

    Sato, Seijiro; Kitahara, Akihiko; Koike, Terumoto; Hashimoto, Takehisa; Ohashi, Riuko; Motoi, Noriko; Tsuchida, Masanori

    2016-01-01

    Introduction Parathyroid adenomas are the most common cause of primary hyperparathyroidism. However, cases of parathyroid adenomas greater than 4 cm with osteitis fibrosa cystica are extremely rare. Herein, we report a case of resection of a large ectopic mediastinal parathyroid adenoma. Case presentations A 46-year-old female with chief complaints of bone pain and gait disturbance was referred to our hospital. Physical examination revealed many mobile teeth in her oral cavity, distortion of the vertebral body, and bowlegs. Laboratory tests showed hypercalcemia, hypophosphatemia, and elevated serum levels of intact parathyroid hormone. Chest CT revealed a 42-mm well–defined, enhancing mass in front of the left-sided tracheal bifurcation. Her findings were diagnosed as primary hyperparathyroidism due to an ectopic mediastinal parathyroid tumor. We performed a median sternotomy and resected the tumor. The tumor was a solid, yellowish-brown mass measuring 42 × 42 mm. Pathologically, the tumor consisted mainly of chief cells with some oxyphil cells; there were no necrotic areas or nuclear atypia, and few mitotic figures. We diagnosed the tumor as an ectopic mediastinal parathyroid adenoma. Eight months after the resection, her serum calcium, phosphorus, and intact PTH levels were normal. Discussion and conclusions Parathyroid adenomas and parathyroid carcinomas have disparate natural histories, but they can be difficult to differentiate on the basis of preoperative clinical characteristics. We believe that long-term follow-up of these cases is required because there have been few reports on the postoperative natural history of large parathyroid adenomas. PMID:27078868

  20. Large hepatic adenoma in a 21-year-old male

    Martinez-Mier, Gustavo; Enriquez De los Santos, Horacio; Grube-Pagola, Peter

    2013-01-01

    Hepatic adenoma is an uncommon benign lesion of the liver that occurs more frequently in women in their third and fourth decades. The female/male ratio is up to 11:1. Hepatic adenomas may be single or multiple occasionally reaching sizes up to 20 cm. They are non-cancerous lesions, however they can become malignant. We present a 21-year-old male patient with no medical history who presented with abdominal pain, a palpable abdominal mass, abnormal liver function tests and a 14 kg weight loss i...

  1. Neuroendocrine Adenoma of the Middle Ear: A Rare Histopathological Diagnosis

    McGinness, Sam; Coleman, Hedley; Varikatt, Winny; da Cruz, Melville

    2016-01-01

    Neuroendocrine tumours occur throughout the body but are rare in the head and neck region and particularly rare in the middle ear. Clinical findings are often nonspecific and therefore pose a diagnostic challenge. Furthermore, the nomenclature of neuroendocrine tumours of the middle ear is historically controversial. Herein a case is presented of a middle ear adenoma in a 33-year-old patient who presented with otalgia, hearing loss, and facial nerve palsy. A brief discussion is included regarding the histopathological features of middle ear adenomas and seeks to clarify the correct nomenclature for these tumours. PMID:27429819

  2. Two cases of giant parathyroid adenoma in atomic bomb survivors

    In a study of parathyroid tumor among autopsy cases at RERF in Hiroshima, 16 cases of parathyroid adenoma were detected among 4,136 autopsies during 1961-77. Of these, two cases were giant adenoma (5 cm in diameter) accompanied by hyperparathyroidism. Both cases were atomic bomb survivors from Hiroshima. One was exposed to 55 rad at age 51 and died at age 71, and the other was exposed to 28 rad at age 45 and died at age 71. These two cases will be reported together with a review of the literature on parathyroid tumors developed following irradiation on the head and neck. (author)

  3. Análisis de un registro de adenomas pituitarios Analysis of a pituitary adenoma registry

    Carolina Albiero

    2010-10-01

    Full Text Available Dada la complejidad que reviste el enfoque diagnóstico y terapéutico de los tumores pituitarios, el registro y análisis de la experiencia clínica acumulada es de gran ayuda en la toma de decisiones. En este trabajo se informan datos clínico-terapéuticos, extraídos de un registro computarizado, sobre 519 de un total de 670 pacientes con adenomas pituitarios. Trescientos cuarenta y cinco fueron mujeres (66% y 174 varones (34%, de 14 a 80 años de edad. El diagnóstico final fue: acromegalia en 176, enfermedad de Cushing en 153, prolactinoma en 101 y adenoma clínicamente no-funcionante (ANF en 89. La edad media al momento del diagnóstico de acromegalia fue 43.9 ± 13.5 (16-80, para enfermedad de Cushing 35.7 ± 12.9 (14-72, para prolactinomas 30.0 ± 13.4 (15-79 y para ANF 52.1 ± 15.2 (17-79 años. La creación de un registro institucional de tumores de hipófisis es un instrumento de gran utilidad para el análisis de la experiencia adquirida y constituye una herramienta valiosa para mejorar la estrategia terapéutica, optimizar la relación costo/beneficio y mejorar el cuidado del paciente. Contribuye a la docencia médica, tanto en el pre como en el posgrado y da base a la realización de trabajos de investigación clínica, aportando a la difusión y transferencia de conocimientos.Collection and analysis of data obtained during the clinical treatment of pituitary tumours are of great utility in the decision making process, when facing clinical situations. We report here data on 519 from 670 patients with pituitary adenomas obtained from a computerized registry. Three hundred and forty five were females (66% and 174 males (34%, aged 14-80. Final diagnosis was acromegaly in 176, Cushing's disease in 153, prolactinoma in 101 and clinically non-functioning adenoma in 89. Mean age at diagnosis was 43.9 ± 13.5 (16-80 for acromegalics, 35.7 ± 12.9 (14-72 for Cushing's, 30.0 ± 13.4 (15-79 for prolactinoma and 52.1 ± 15.2 (17-79, for non

  4. IN VITRO CELL CULTURE AND HORMONE RADIOIMMUNOASSAY OF HUAMAN PITUITARY ADENOMAS

    陆汉魁; 林祥通; 等

    1994-01-01

    Tissues from 30 human pituitary adenomas are monolayer-cell-cultured in vitro.Hormone secretion of GH,PRL,TSH,LH and FSH by cells into medium is detected by radioimmunoassay .The pattern and amount of hormone(s0 in the medium are used to determine the nature of the cells and thus to establish functional classification of pituitary adenomas.The results show that cell culture technique provides and easy and suitable mode for investigating the nature of pituitary adenomas.Hormone radioimmunoassay of culture medium is precise and reliable and represents the whole adenoma tissue.Further studies can lead to clearer understandngs of the pathology of pituitary adenomas.

  5. Cyclooxygenase-2 overexpression is common in serrated and non-serrated colorectal adenoma, but uncommon in hyperplastic polyp and sessile serrated polyp/adenoma

    Kirkner Gregory J

    2008-01-01

    Full Text Available Abstract Background Cyclooxygenase-2 (COX-2, PTGS2 plays an important role in colorectal carcinogenesis. COX-2 overexpression in colorectal cancer is inversely associated with microsatellite instability (MSI and the CpG island methylator phenotype (CIMP. Evidence suggests that MSI/CIMP+ colorectal cancer may arise through the serrated tumorigenic pathway through various forms of serrated neoplasias. Therefore, we hypothesized that COX-2 may play a less important role in the serrated pathway. Methods By immunohistochemistry, we assessed COX-2 expression in 24 hyperplastic polyps, 7 sessile serrated polyp/adenomas (SSA, 5 mixed polyps with SSA and adenoma, 27 traditional serrated adenomas, 515 non-serrated adenomas (tubular adenoma, tubulovillous adenoma and villous adenoma, 33 adenomas with intramucosal carcinomas, 96 adenocarcinomas with serration (corkscrew gland and 111 adenocarcinomas without serration. Results Strong (2+ COX-2 overexpression was more common in non-serrated adenomas (28% = 143/515 than in hyperplastic polyps (4.2% = 1/24, p = 0.008 and serrated polyps (7 SSAs and 5 mixed polyps (0% = 0/12, p = 0.04. Furthermore, any (1+/2+ COX-2 overexpression was more frequent in non-serrated adenomas (60% = 307/515 than in hyperplastic polyps (13% = 3/24, p Conclusion COX-2 overexpression is infrequent in hyperplastic polyp, SSA and mixed polyp with SSA and adenoma, compared to non-serrated and serrated adenoma. COX-2 overexpression becomes more frequent as tumors progress to higher grade neoplasias. Our observations suggest that COX-2 may play a less significant role in the serrated pathway of tumorigenesis; however, COX-2 may still play a role in later stage of the serrated pathway.

  6. CLINICOPATHOLOGICAL ANALYSIS OF 50 RECTAL CANCER CASES DIAGNOSED AS ADENOMA IN BIOPSY

    BU Zhao-de; LI Zi-yu; XIE Yu-quan; JI Jia-fu; SU Xiang-qian

    2005-01-01

    Objective: To evaluate the clinicopathological characteristics of rectal cancer diagnosed as adenoma in biopsy. Methods: 50 rectal cancer cases diagnosed as adenoma in biopsy were analyzed retrospectively in this study by comparing the biopsy and postoperative pathology. Results: Among these 50 patients, biopsy pathology showed 26% (13/50) adenoma with mild dysplasia, 30% (15/50) adenoma with moderate dysplasia, and 44% (22/50) adenoma with severe dysplasia. In 8 cases, the adenomas were smaller than 2cm. On postoperatively surgical pathology, only 10 cases were carcinoma-in-situ, while 40 cases were invasive cancer. Conclusion: Special emphasis should be taken to biopsy-negative rectal adenomas and those smaller than 2cm.

  7. Endorectal ultrasonography, strain elastography and MRI differentiation of rectal adenomas and adenocarcinomas

    Waage, Jo Erling Riise; Leh, Sabine; Røsler, Cornelia;

    2015-01-01

    AIM: Strain elastography is a method for recording tissue hardness. Strain in different areas may be compared using strain ratio (SR). The aims of this study were to validate a previously proposed SR cut-off value of 1.25 for differentiating adenocarcinomas from adenomas and to compare the...... adenomas from adenocarcinomas. ERUS and MRI were performed according to standard routine at the institution, defining T0 as adenomas and T1-4 as adenocarcinomas. Subsequent histopathology was used as reference standard. RESULTS: Histopathological evaluation revealed 21 adenomas and 99 adenocarcinomas...... confirms that the elastography SR assessment accurately differentiates sessile adenomas from adenocarcinomas. SR assessment has a superior ability to differentiate adenomas and adenocarcinomas when compared with ERUS and MRI. MRI examination seems unable to recognize adenomas, and should be interpreted...

  8. Emerging Histopathological and Genetic Parameters of Pituitary Adenomas: Clinical Impact and Recommendation for Future WHO Classification.

    Saeger, W; Petersenn, S; Schöfl, C; Knappe, U J; Theodoropoulou, M; Buslei, R; Honegger, J

    2016-06-01

    The review assesses immunohistochemical findings of somatostatin receptors and of metalloproteinases in different pituitary adenoma types and the significance of molecular genetic data. Current evidence does not support routine immunohistochemical assessment of somatostatin or dopamine receptor subtype expression on hormone-secreting or nonfunctioning pituitary adenomas. Further prospective studies are needed to define its role for clinical decision making. Until then we suggest to restrict membrane receptor profiling to individual cases or for study purposes. The problems of adenoma expansion and invasion are discussed. Despite partially contradictory publications, proteases clearly play a major role in permission of infiltrative growth of pituitary adenomas. Therefore, detection of at least MMP-2, MMP-9, TIMP-2, and uPA seems to be justified. Molecular characterization is important for familial adenomas, adenomas in MEN, Carney complex, and McCune-Albright syndrome and can gain insight into pathogenesis of sporadic adenomas. PMID:26874696

  9. cAMP signaling in cortisol-producing adrenal adenoma.

    Calebiro, Davide; Di Dalmazi, Guido; Bathon, Kerstin; Ronchi, Cristina L; Beuschlein, Felix

    2015-10-01

    The cAMP signaling pathway is one of the major players in the regulation of growth and hormonal secretion in adrenocortical cells. Although its role in the pathogenesis of adrenocortical hyperplasia associated with Cushing's syndrome has been clarified, a clear involvement of the cAMP signaling pathway and of one of its major downstream effectors, the protein kinase A (PKA), in sporadic adrenocortical adenomas remained elusive until recently. During the last year, a report by our group and three additional independent groups showed that somatic mutations of PRKACA, the gene coding for the catalytic subunit α of PKA, are a common genetic alteration in patients with Cushing's syndrome due to adrenal adenomas, occurring in 35-65% of the patients. In vitro studies revealed that those mutations are able to disrupt the association between catalytic and regulatory subunits of PKA, leading to a cAMP-independent activity of the enzyme. Despite somatic PRKACA mutations being a common finding in patients with clinically manifest Cushing's syndrome, the pathogenesis of adrenocortical adenomas associated with subclinical hypercortisolism seems to rely on a different molecular background. In this review, the role of cAMP/PKA signaling in the regulation of adrenocortical cell function and its alterations in cortisol-producing adrenocortical adenomas will be summarized, with particular focus on recent developments. PMID:26139209

  10. Role of radionuclide scintigraphy in the detection of parathyroid adenoma

    Singh N

    2007-01-01

    Full Text Available Background: Preoperative detection of parathyroid adenoma is a diagnostic challenge. The sonography and computerized tomography (CT scan demonstrate high sensitivity but low specificity. The advent of radionuclide scanning technique has enhanced the specificity in this context. Aim: We undertook a study to assess the role of radionuclide scanning in suspected cases of parathyroid adenomas. Materials And Methods: Totally 28 cases were incorporated in the study. The suspicion was raised either due to raised PTH levels or recurrent calcinosis. Most of these patients had estimation of calcium done as a routine or specific investigation. The parathyroid scan was performed using either of the two techniques - Dual isotope subtraction or Sestamibi washout technique. We also used the recent approach of fusion imaging (CT + tomographic nuclear images in selected cases. Results: There were 16 true positive, 10 true negative, 1 false negative and 1 equivocal scan findings. The findings were compared with sonography, CT Scan and PTH values. The true positive yield in our study was 57%, true negative 35% and the overall sensitivity and specificity was found to be 94% and 100% respectively. Conclusion: We conclude that parathyroid scintigraphy is a reliable and sensitive technique in the preoperative detection of parathyroid adenomas and should be the first choice of imaging modality in suspicion of parathyroid adenoma.

  11. The prevalence of human papillomavirus in colorectal adenomas and adenocarcinomas

    Baandrup, Louise; Thomsen, Louise T; Olesen, Tina Bech;

    2014-01-01

    The role of human papillomavirus (HPV) in colorectal cancer has been widely studied with conflicting results. We performed a systematic review and a meta-analysis to estimate the prevalence of HPV in colorectal adenocarcinomas and adenomas, and test the potential association....

  12. Treatment and Prognosis of Pituitary Adenomas in Children

    2006-01-01

    In order to explore the treatments and prognosis of pituitary adenomas in children, the experience in the treatment of 15 children with pituitary adenomas was summed up. The clinical data of 15 children with pituitary adenomas in Tongji Hospital were retrospectively analyzed from Jan.1997 to Aug. 2004, including 9 males and 6 females with the age ranging from 9-15 years old (mean 12.8). The disease duration was 3 months to 5 years (mean 2 years). Fourteen cases were subjected to the microsurgical operation through oral tanssphenoidal approach and one case to medical treatment. All cases were followed up from 1 to 5 years by imaging studies and endocrine investigation. The results showed that 13 cases obtained total removal of the tumor and one subtotal removal of tumor. No severe complications and operation death occurred. It was concluded that the tanssphenoidal approach was the optimal treatment for children with pituitary adenomas. Regular and long-term follow-up is of great importance.

  13. Pleomorphic Adenoma Of Parotid Gland: A Case Report

    Manjunath B Chaluvaiah

    2012-01-01

    Full Text Available Salivary gland tumours are rare, comprising less than 3 % of all neoplasia of head and neck region. Pleomorphic adenoma is the most common salivary gland tumour, accounts for 60- 80% of benign tumours of salivary glands. Usually they are found as solitary unilateral, firm and mobile, painless, slow growing mass. Management involves surgical resection by superficial or total parotidectomy.

  14. Pathobiology and oncogenesis of pituitary corticotroph adenomas in dogs

    Hanson, J.M.

    2007-01-01

    Pituitary-dependent hyperadrenocorticism (PDH) or Cushing's disease is a common endocrinopathy in the elderly dog caused by a pituitary adrenocorticotrophic hormone (ACTH) producing tumor (corticotroph adenoma) of unknown pathogenesis. Surgical removal of the pituitary tumor is applied as routine tr

  15. Fractionated stereotactic radiotherapy in the treatment of pituitary adenomas

    Kopp, C.; Theodorou, M.; Poullos, N.; Astner, S.T.; Geinitz, H.; Molls, M. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie; Stalla, G.K. [Max-Planck-Institut fuer Psychiatrie, Muenchen (Germany). Klinische Neuroendokrinologie; Meyer, B. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Neurochirurgische Klinik und Poliklinik; Nieder, C. [Nordland Hospital, Bodoe (Norway). Dept. of Oncology and Palliative Medicine; Tromsoe Univ. (Norway). Inst. of Clinical Medicine; Grosu, A.L [Freiburg Univ. (Germany). Klinik fuer Strahlenheilkunde

    2013-11-15

    Purpose: The purpose of this work was to evaluate tumor control and side effects associated with fractionated stereotactic radiotherapy (FSRT) in the management of residual or recurrent pituitary adenomas. Patients and methods: We report on 37 consecutive patients with pituitary adenomas treated with FSRT at our department. All patients had previously undergone surgery. Twenty-nine patients had nonfunctioning, 8 had hormone-producing adenoma. The mean total dose delivered by a linear accelerator was 49.4 Gy (range 45-52.2 Gy), 5 x 1.8 Gy weekly. The mean PTV was 22.8 ccm (range 2.0-78.3 ccm). Evaluation included serial imaging tests, endocrinologic and ophthalmologic examination. Results: Tumor control was 91.9 % for a median follow-up time of 57 months (range 2-111 months). Before FSRT partial hypopituitarism was present in 41 % of patients, while 35 % had anterior panhypopituitarism. After FSRT pituitary function remained normal in 22 %, 43 % had partial pituitary dysfunction, and 35 % had anterior panhypopituitarism. Visual acuity was stable in 76 % of patients, improved in 19 %, and deteriorated in 5 %. Visual fields remained stable in 35 patients (95 %), improved in one and worsened in 1 patient (2.7 %). Conclusion: FSRT is an effective and safe treatment for recurrent or residual pituitary adenoma. Good local tumor control and preservation of adjacent structures can be reached, even for large tumors. (orig.)

  16. Gamma-knife surgery for secreting pituitary adenomas

    We report our preliminary results concerning 25 patients with secreting pituitary adenomas treated with stereotactic radiosurgery after partial transsphenoidal surgery and followed over a 6-36 month-period. Among the 15 acromegalic patients, a decrease of 65% in mean GH levels was achieved after 6 months and of 77% at 12 months after radiosurgery. Presently, only 3 patients (20%) are considered as in remission (mean GH and IGF1 level into the normal range). A decrease of 46% and 64% was observed at 6 and 12 months after radiosurgery in 4 patients with prolactinomas although no normalization of PRL levels occurred. Presently, 3/4 patients have individual PRL levels slightly above the normal range. A normalization of Urinary Free Cortisol (UFC) was noticed in 4/6 (66%) patients with Cushing's disease within 6-12 months. No pituitary deficiency was noticed in this series with the exception of 4/25 patients (16%) who received subtotal or total pituitary irradiation for post-operative remnants of secreting adenomas poorly defined on MRI. One woman, who had undergone previously a conventional irradiation and presenting with a cavernous sinus adenoma reaching the optic nerve, developed an optic neuropathy. A second woman, with a cavernous sinus remnant, presented a cranial nerve palsy (VI) after the irradiation. We can conclude that radiosurgery using the Cobalt-60 Gamma-unit is, at least, as effective as conventional radiotherapy in the control of pituitary hormone hypersecretion from postoperative adenomas remnants with less adverse effects. (author)

  17. Fractionated stereotactic radiotherapy in the treatment of pituitary adenomas

    Purpose: The purpose of this work was to evaluate tumor control and side effects associated with fractionated stereotactic radiotherapy (FSRT) in the management of residual or recurrent pituitary adenomas. Patients and methods: We report on 37 consecutive patients with pituitary adenomas treated with FSRT at our department. All patients had previously undergone surgery. Twenty-nine patients had nonfunctioning, 8 had hormone-producing adenoma. The mean total dose delivered by a linear accelerator was 49.4 Gy (range 45-52.2 Gy), 5 x 1.8 Gy weekly. The mean PTV was 22.8 ccm (range 2.0-78.3 ccm). Evaluation included serial imaging tests, endocrinologic and ophthalmologic examination. Results: Tumor control was 91.9 % for a median follow-up time of 57 months (range 2-111 months). Before FSRT partial hypopituitarism was present in 41 % of patients, while 35 % had anterior panhypopituitarism. After FSRT pituitary function remained normal in 22 %, 43 % had partial pituitary dysfunction, and 35 % had anterior panhypopituitarism. Visual acuity was stable in 76 % of patients, improved in 19 %, and deteriorated in 5 %. Visual fields remained stable in 35 patients (95 %), improved in one and worsened in 1 patient (2.7 %). Conclusion: FSRT is an effective and safe treatment for recurrent or residual pituitary adenoma. Good local tumor control and preservation of adjacent structures can be reached, even for large tumors. (orig.)

  18. Clinico-pathological aspects of colorectal serrated adenomas

    Ashish Chandra; Adnan A Sheikh; Anton Cerar; Ian C Talbot

    2006-01-01

    AIM: To study the association of colorectal serrated adenomas (SAs) with invasive carcinoma, local recurrence, synchronicity and metachronicity of lesions.METHODS: A total of 4536 polyps from 1096patients over an eight-year period (1987-1995) were retrospectively examined. Adenomas showing at least 50% of serrated architecture were called SAs by three reviewing pathologists.RESULTS: Ninety-one (2%) of all polyps were called SAs, which were found in 46 patients. Invasive carcinomas were seen in 3 out of 46 (6.4%) patients, of whom one was a case of familial adenomatous polyposis (FAP). A male preponderance was noted and features of a mild degree of dysplasia were seen in majority (n=75,83%) of serrated adenomas. Follow-up ranged 1-12years with a mean time of 5.75 years. Recurrences of SAs were seen in 3 (6.4%) cases, synchronous SAs in 16 (34.8%) cases and metachronous SAs in 9 (19.6%)cases.CONCLUSION: Invasive carcinoma arising in serrated adenoma is rare, accounting for 2 (4.3%) cases studied in this series.

  19. Evaluation of pituitary adenomas by multidirectional multislice dynamic CT

    Purpose: Multidetector-row CT is a new technology with a short scanning time. Multislice dynamic CT (MSDCT) in various directions can be obtained using the multidetector-row CT with multiplanar reformatting (MPR) technique. Material and Methods: We evaluated the initial results of sagittal and coronal MSDCT images reconstructed by MPR (MSDCT-MPR) in 3 pituitary adenoma patients with a pacemaker. Results: In a patient with microadenoma, the maximum contrast between the normal anterior pituitary gland and the adenoma occurred approximately 50 s after the start of the contrast medium injection. A microadenoma was depicted as a less enhanced area relative to normal pituitary tissue. The macroadenomas were depicted as a less enhanced mass with cavernous sinus invasion in 1 patient and as a non-uniformly enhanced mass in another patient. Bone destruction and incomplete opening of the sellar floor during previous surgery were clearly detected in 2 patients with macroadenomas. These pituitary adenomas were removed via the transnasal route based on information from the MSDCT-MPR images only. The findings were verified surgically. Conclusion: The MSDCT-MPR provided the information needed for surgery with good image quality in the 3 patients with pacemakers. MSDCT-MPR appears to be a useful technique for patients with a pituitary adenoma in whom MR imaging is not available. This is the first report, to our knowledge, of the MSDCT-MPR technique being used to demonstrate pituitary disorders

  20. Adrenal myelolipoma within myxoid cortical adenoma associated with Conn's syndrome

    Hong-sheng LU; Mei-fu GAN; Han-song CHEN; Shan-qiang HUANG

    2008-01-01

    The coexistence of myelolipoma within adrenal cortical adenoma is extremely rare, for both tumors present usually as separate entities. There are only 16 such cases reported worldwide. To the best of our knowledge, the case we reported here is the first one of myxoid adrenal cortical adenoma associated with myelolipoma reported. A 32-year-old Chinese woman with 4-year history of hypertension was presented in our study. Computed tomography (CT) of the abdomen showed a large heterogeneously-enhancing mass (4.5cm in diameter) in the left suprarenal region. Clinical history and laboratory results suggest a metabolic disorder as Conn's syndrome. The patient underwent a left adrenalectomy, and a histopathological study confirmed the mass to be a myxoid adrenal cortical adenoma containing myelolipoma. The patient was postoperatively well and discharged uneventfully. In the present case report, we also discuss the etiology of simultaneous myelolipoma and adrenal adenoma associated with Conn's syndrome, and the methods of the diagnosis and differential diagnosis.

  1. Ampullary Adenoma Treated by Endoscopic Double-Snare Retracting Papillectomy.

    Soma, Hiromitsu; Miyata, Naoteru; Hozawa, Shigenari; Higuchi, Hajime; Yamagishi, Yoshiyuki; Nakamura, Yuji; Saeki, Keita; Kameyama, Kaori; Masugi, Yohei; Yahagi, Naohisa; Kanai, Takanori

    2015-09-23

    We report herein improved methods for the safe and successful completion of endoscopic papillectomy (EP). Between January 2008 and November 2011, 12 patients underwent double-snare retracting papillectomy for the treatment of lesions of the major duodenal papilla. The main outcomes were en bloc resection rates, pathological findings, and adverse events. All of the patients (mean age, 60.1 years; range, 38 to 80 years) were diagnosed with ampullary adenoma by endoscopic forceps biopsies prior to endoscopic snare papillectomy. En bloc resection by double-snare retracting papillectomy was successfully performed for all lesions (median size, 12.3 mm), comprising six tubular adenomas, one tubulovillous adenoma, three cases of epithelial atypia, one hamartomatous polyp, and one case of duodenitis with regenerative change. Significant hemorrhage and pancreatitis were observed in one case after EP. Adenoma recurrence occurred in three patients during follow-up (median, 28.5 months) at a mean interval of 2 months postoperatively (range, 1 to 3 months). No serious adverse events were observed. Double-snare retracting papillectomy is effective and feasible for treating lesions of the major duodenal papilla. Further treatment experience, including a single-arm phase II study, needs to be accumulated before conducting a randomized controlled study. PMID:26087781

  2. Functional Characteristics of Multipotent Mesenchymal Stromal Cells from Pituitary Adenomas.

    Megnis, Kaspars; Mandrika, Ilona; Petrovska, Ramona; Stukens, Janis; Rovite, Vita; Balcere, Inga; Jansone, Laima Sabine; Peculis, Raitis; Pirags, Valdis; Klovins, Janis

    2016-01-01

    Pituitary adenomas are one of the most common endocrine and intracranial neoplasms. Although they are theoretically monoclonal in origin, several studies have shown that they contain different multipotent cell types that are thought to play an important role in tumor initiation, maintenance, and recurrence after therapy. In the present study, we isolated and characterized cell populations from seven pituitary somatotroph, nonhormonal, and lactotroph adenomas. The obtained cells showed characteristics of multipotent mesenchymal stromal cells as observed by cell morphology, cell surface marker CD90, CD105, CD44, and vimentin expression, as well as differentiation to osteogenic and adipogenic lineages. They are capable of growth and passaging under standard laboratory cell culture conditions and do not manifest any hormonal cell characteristics. Multipotent mesenchymal stromal cells are present in pituitary adenomas regardless of their clinical manifestation and show no considerable expression of somatostatin 1-5 and dopamine 2 receptors. Most likely obtained cells are a part of tissue-supportive cells in pituitary adenoma microenvironment. PMID:27340409

  3. Metachronous tubulovillous and tubular adenomas of the anal canal.

    Nozawa, Hiroaki; Ishihara, Soichiro; Morikawa, Teppei; Tanaka, Junichiro; Yasuda, Koji; Ohtani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Kawai, Kazushige; Hata, Keisuke; Kazama, Shinsuke; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji; Fukayama, Masashi; Watanabe, Toshiaki

    2015-01-01

    Anal canal adenoma is an extremely rare disease that has the potential to transform into a malignant tumor. We herein presented a rare case of metachronous multiple adenomas of the anal canal. A 48-year-old woman underwent total colonoscopy following a positive fecal blood test. A 9-mm villous polyp arising from the posterior wall of the anal canal was removed by snare polypectomy. Histologically, the tumor was tubulovillous adenoma with high-grade dysplasia and the cut end was negative for tumor cells. Six years later, an elevated lesion, macroscopically five millimeters in size, was detected in the left wall of the anal canal in a follow-up colonoscopy. Local excision of the tumor was performed, and the lesion was pathologically confirmed to be tubular adenoma with high-grade dysplasia limited to the mucosa. The patient is currently alive without any evidence of recurrence for six months after surgery. Although she had a past history of cervical cancer, the multiple tumors arising in the anal canal were unlikely to be related to human papilloma virus infection. Our case report underscores the importance of careful observations throughout colonoscopy to detect precancerous lesions, particularly in anatomically narrow segments. PMID:26249723

  4. Outcomes following Purely Endoscopic Endonasal Resection of Pituitary adenomas

    Rezaul Amin

    2013-01-01

    Full Text Available Background: The use of endoscope for the management of pituitary adenoma is not new. The better magnification and illumination provided by the endoscope gives better outcome than microscopic pituitary surgery. Objective: To find out the benefits of endoscope in relation to microscopic surgery. Materials and Methods: We performed 45 cases of pituitary adenoma surgery by endoscopic endonasal approach from July 2008 to July 2010. Results: Forty five cases underwent endoscopic transsphenoidal approach. Gross total removal was done in 35 cases and subtotal removal was done in 10 cases. Residual tumours were seen in 10 cases (22% in postoperative follow-up MRI scan. Visual improvement was satisfactory, and hormonal improvement of functional adenoma was nice. Postoperative visual acuity and visual field were improved in 75% cases. There were 37% cases of temporary diabetes insipidus and about 4.5% cases of permanent diabetes insipidus. The average duration of follow-up was 20 months. One patient required reexploration to correct visual deterioration in the immediate postoperative period. There were 4.5% cases of CSF leak and 6.6% mortality. Mortality was due to electrolyte imbalance and improper management of infection and hydrocephalus. Conclusion: Endoscopic endonasal pituitary surgery now has become a gold standard surgery for most of the pituitary adenomas because of its better advantages in relation to microscopic surgery and less complications and less hospital stay.

  5. Evidence for colorectal sarcomatoid carcinoma arising from tubulovillous adenoma

    2008-01-01

    Sarcomatoid carcinomas of the colorectum are rare tu- mors that display both malignant epithelial and stromal components. Clinically, they are aggressive tumors with early metastasis. Due to their infrequent occurrence, the pathogenesis is poorly understood. We report a case of a 52-year-old woman who presented with a rectal mass and intermittent hematochezia. Superficial biopsies during colonoscopy revealed a tubulovillous adenoma with high-grade dysplasia. Endoscopic ultra- sonography confirmed an invasive nature of the mass, and deeper biopsies revealed the presence of neoplasm with mixed histological components. The surgically- excised specimen demonstrated the presence of poorly differentiated spindle cells underneath the tubulovillous adenoma and an intermediate stage of invasive acleno- carcinoma. Based on the histological appearance and imrnunohistochemical studies, a diagnosis of sarcoma- toid carcinoma was made. Only nine cases of sarcoma- told carcinomas of the colorectum have been reported to date. As a result, the terminology and pathogenesis of sarcomatoid carcinoma remain speculative. To the best of our knowledge, this is the first report of co- existence of sarcomatoid carcinoma and invasive ad-enocarcinoma with tubulovillous adenoma; all stagesrepres ented within the same tumor. This observation supports the "monoclonal theory" of pathogenesis with an adenoma-sarcoma progression with or without an intermediate stage of carcinoma.

  6. 11C-Methionine positron emission tomography-computed tomography in localization of methoxyisobutyl isonitrile negative ectopic parathyroid adenoma

    Seniaray, Nikhil; Sharma, Harshul; Arbind, Arpana; Jaimini, Abhinav; D’souza, Maria; Saw, Sanjeev; Hazari, Puja Panwar; Mishra, A. K.; Sharma, Rajnish; Mondal, Anupam

    2016-01-01

    Primary hyperparathyroidism is caused by parathyroid adenomas in 85% of the cases. Since parathyroid adenomas are known for their ectopic location, presurgical localization of the suspected site of adenoma is desirable. However, current imaging modalities are not always successful in localizing ectopic parathyroid adenomas. The aim of this case report is to show that 11C-methionine positron emission tomography could accurately localize ectopic parathyroid adenomas in patients in whom conventional imaging had failed or is inconclusive. PMID:26917896

  7. Expression pattern of the Hedgehog signaling pathway in pituitary adenomas.

    Yavropoulou, Maria P; Maladaki, Anna; Topouridou, Konstantina; Kotoula, Vasiliki; Poulios, Chris; Daskalaki, Emily; Foroglou, Nikolaos; Karkavelas, George; Yovos, John G

    2016-01-12

    Several studies have demonstrated the role of Wnt and Notch signaling in the pathogenesis of pituitary adenomas, but data are scarce regarding the role of Hedgehog signaling. In this study we investigated the differential expression of gene targets of the Hedgehog signaling pathway. Formalin-fixed, paraffin-embedded specimens from adult patients who underwent transphenoidal resection and normal human pituitary tissues that were obtained from autopsies were used. Clinical information and data from pre-operative MRI scan (extracellular tumor extension, tumor size, displacement of the optic chiasm) were retrieved from the Hospital's database. We used a customized RT(2) Profiler PCR Array, to investigate the expression of genes related to Notch and Hedgehog signaling pathways (PTCH1, PTCH2, GLI1, GLI3, NOTCH3, JAG1, HES1, and HIP). A total of 52 pituitary adenomas (32 non-functioning adenomas, 15 somatotropinomas and 5 prolactinomas) were used in the final analysis. In non-functioning pituitary adenomas there was a significant decrease (approximately 75%) in expression of all Hedgehog related genes that were tested, while Notch3 and Jagged-1 expression was found significantly increased, compared with normal pituitary tissue controls. In contrast, somatotropinomas demonstrated a significant increase in expression of all Hedgehog related genes and a decrease in the expression of Notch3 and Jagged-1. There was no significant difference in the expression of Hedgehog and Notch related genes between prolactinomas and healthy pituitary tissues. Hedgehog signalling appears to be activated in somatotropinomas but not in non-functioning pituitary adenomas in contrast to the expression pattern of Notch signalling pathway. PMID:26620835

  8. Prognostic model for patients treated for colorectal adenomas with regard to development of recurrent adenomas and carcinoma

    Jensen, P; Krogsgaard, M R; Christiansen, J

    1996-01-01

    -80. INTERVENTIONS: All patients were followed up by rectoscopy and double contrast barium enema. The survival data were analysed by Cox's proportional hazards model. MAIN OUTCOME MEASURES: Variables of significant prognostic importance for recurrence of adenomas and the development of cancer were identified...

  9. A study on expression of hMLH1,hMSH2 and PCNA in colorectal adenomas and malignant change type in adenomas

    ZHOU qi; YAN xiaochu; LIU fengxuan; XIN rong; DUAN guangjie; LEI de an

    2004-01-01

    To explore the effect of hMLHland hMSH2 in carcinogenesis and progression of colorectal carcinoma,and their influences on proliferation in colorectal adenoma and malignant change in adenomas. Methods we investigated the expression of mismatch repair (MMR) gene hMLH1, hMSH2 and proliferation cell nuclear antigen (PCNA)by immunohistochemistry in 63 cases colorectal adenomas,20cases malignant change in adenomas and 20cases colorectal carcinomas (CRCs).Results The positive rate of hMLH1 and hMSH2 in colorectal adenomas,malignant change in adenomas and CRCs were significantly lower than that in normal mucosa. With increasing dysplasia in adenomas, the expression rate of hMLH1 and hMSH2 protein decreased gradually;, The PCNA label index of tumors with overexpreasion hMSH2 were significantly higher than that of tumors with negative hMSH2 in colorectal malignant change type in adenomas and CRCs PCNA lable index of tumors with overexpression hMSH2 were significant higher than that of tumors with negative hMSH2 in adenomas with grade Ⅱ, Ⅲ dysplasia. The changes of PCNA label index in colorectal adenomas, malignant change type in adenomas and CRCs were not association with the expression of hMLH1. Conclusion It indicated that the MMR genes mutation and abnormal function of DNA mismatch repair maybe participate in carcinogenesis of CRCs.It is might be an early event in carcinogenesis of CRCs. It suggested that the reduction of proliferating activities in colorectal neoplasms might be related to mutation and defect of MMR gene.

  10. Silent subtype 3 pituitary adenomas are not always silent and represent poorly differentiated monomorphous plurihormonal Pit-1 lineage adenomas.

    Mete, Ozgur; Gomez-Hernandez, Karen; Kucharczyk, Walter; Ridout, Rowena; Zadeh, Gelareh; Gentili, Fred; Ezzat, Shereen; Asa, Sylvia L

    2016-02-01

    Originally classified as a variant of silent corticotroph adenoma, silent subtype 3 adenomas are a distinct histologic variant of pituitary adenoma of unknown cytogenesis. We reviewed the clinical, biochemical, radiological, immunohistochemical and ultrastructural features of 31 silent subtype 3 adenomas to clarify their cellular origin. Among 25 with clinical and/or radiological data, all were macroadenomas; there was cavernous sinus invasion in 30% of cases and involvement of the clivus in 17% of cases. Almost 90% of patients were symptomatic; 67% had mass effect symptoms, 37% were hypogonadal and 8% had secondary adrenal insufficiency. Significant hormonal excess in 29% of cases included hyperthyroidism in 17%, acromegaly in 8% and hyperprolactinemia above 150 μg/l in 4%. Two individuals with hyperprolactinemia who were younger than 30 years had multiple endocrine neoplasia type 1. Immunohistochemically, all 31 tumors were diffusely positive for the pituitary lineage-specific transcription factor Pit-1. Although three only expressed Pit-1, others revealed variable positivity for one or more hormones of Pit-1 cell lineage (growth hormone, prolactin, thyroid-stimulating hormone), as well as alpha-subunit and estrogen receptor. Most tumors exhibited perinuclear reactivity for keratins with the CAM5.2 antibody; scattered fibrous bodies were noted in five (16%) tumors. The mean MIB-1 labeling index was 4% (range, 1-9%). Fourteen cases examined by electron microscopy were composed of a monomorphous population of large polygonal or elongated cells with nuclear spheridia. Sixty-five percent of patients had residual disease after surgery; after a mean follow-up of 48.4 months (median 41.5; range=2-171) disease progression was documented in 53% of those cases. These data identify silent subtype 3 adenomas as aggressive monomorphous plurihormonal adenomas of Pit-1 lineage that may be associated with hyperthyroidism, acromegaly or galactorrhea and amenorrhea. Our

  11. Adenomas colorretais: fatores de risco associados à displasia de alto grau Colorectal adenomas: risk factors for high-grade dysplasia

    Julia Schmidt Silva

    2009-06-01

    Full Text Available FUNDAMENTOS: O estudo dos pólipos, em especial os adenomatosos, é relevante devido à correlação direta com o carcinoma colorretal. Objetivo: Analisar quais são os fatores de risco para uma displasia de alto grau do pólipo adenomatoso retirados endoscopicamente. MÉTODOS: Avaliamos todas as colonoscopias realizadas pelo Serviço de Coloproctologia no período de janeiro de 2003 a dezembro de 2006. Foram incluídos os pacientes com diagnóstico de pólipos adenomatosos. Analisamos a existência da relação entre adenomas com displasia de alto grau e os fatores associados dos pacientes e pólipos. RESULTADOS: Foram realizados 1821 exames e encontramos 208 pacientes com 326 adenomas. 51,4% do sexo masculino e 69,2% tinham um único adenoma. Foram encontrados 28 pacientes (13,5% com, ao total, 34 adenomas (10,4%, com displasia de alto grau. Entre os adenomas com displasia de alto grau, 64,7% eram = 1cm, 61,8% eram sésseis, 29,4% vilosos e 70,6% estavam localizados no cólon esquerdo. Comparando as características do grupo dos adenomas com displasia de baixo grau com o de alto grau, foi estatisticamente significativo o tamanho = 1cm e o componente viloso (P BACKGROUND: The study of polyps, especially adenomatous, is justified because of the straight correlation among them with the incidence of CRC. Objective: To analyze the risk factors for high-grade dysplasia of adenomatous polyps removed endoscopically. METHODS: All consecutive colonoscopies performed by the Colorectal Department of the Hospital Nossa Senhora da Conceição, in Porto Alegre/RS, from January 2003 to December 2006, were evaluated. Patients diagnosed with adenomatous polyps were included. The relationship among tumors with high-grade dysplasia and the features of the patients and polyps were analyzed. RESULTS: Among the 1,821 exams, 326 adenomas were detected in 208 patients. 51.4% of the patients were male; 69,2% had only one adenoma. A total of 28 patients (13,5% with 34

  12. Promoter methylation of Wnt-antagonists in polypoid and nonpolypoid colorectal adenomas

    Nonpolypoid adenomas are a subgroup of colorectal adenomas that have been associated with a more aggressive clinical behaviour compared to their polypoid counterparts. A substantial proportion of nonpolypoid and polypoid adenomas lack APC mutations, APC methylation or chromosomal loss of the APC locus on chromosome 5q, suggesting the involvement of other Wnt-pathway genes. The present study investigated promoter methylation of several Wnt-pathway antagonists in both nonpolypoid and polypoid adenomas. Quantitative methylation-specific PCR (qMSP) was used to evaluate methylation of four Wnt-antagonists, SFRP2, WIF-1, DKK3 and SOX17 in 18 normal colorectal mucosa samples, 9 colorectal cancer cell lines, 18 carcinomas, 44 nonpolypoid and 44 polypoid adenomas. Results were integrated with previously obtained data on APC mutation, methylation and chromosome 5q status from the same samples. Increased methylation of all genes was found in the majority of cell lines, adenomas and carcinomas compared to normal controls. WIF-1 and DKK3 showed a significantly lower level of methylation in nonpolypoid compared to polypoid adenomas (p < 0.01). Combining both adenoma types, a positive trend between APC mutation and both WIF-1 and DKK3 methylation was observed (p < 0.05). Methylation of Wnt-pathway antagonists represents an additional mechanism of constitutive Wnt-pathway activation in colorectal adenomas. Current results further substantiate the existence of partially alternative Wnt-pathway disruption mechanisms in nonpolypoid compared to polypoid adenomas, in line with previous observations

  13. Mutational Profiles Reveal an Aberrant TGF-β-CEA Regulated Pathway in Colon Adenomas

    Jogunoori, Wilma; Menon, Vipin; Majumdar, Avijit; Chen, Jiun-Sheng; Gi, Young Jin; Jeong, Yun Seong; Phan, Liem; Belkin, Mitchell; Gu, Shoujun; Kundra, Suchin; Mistry, Nipun A.; Zhang, Jianping; Su, Xiaoping; Li, Shulin; Lin, Sue-Hwa; Javle, Milind; McMurray, John S.; Rahlfs, Thomas F.; Mishra, Bibhuti; White, Jon; Rashid, Asif; Beauchemin, Nicole; Weston, Brian R.; Shafi, Mehnaz A.; Stroehlein, John R.; Davila, Marta; Akbani, Rehan; Weinstein, John N.; Wu, Xifeng; Mishra, Lopa

    2016-01-01

    Mutational processes and signatures that drive early tumorigenesis are centrally important for early cancer prevention. Yet, to date, biomarkers and risk factors for polyps (adenomas) that inordinately and rapidly develop into colon cancer remain poorly defined. Here, we describe surprisingly high mutational profiles through whole-genome sequence (WGS) analysis in 2 of 4 pairs of benign colorectal adenoma tissue samples. Unsupervised hierarchical clustered transcriptomic analysis of a further 7 pairs of adenomas reveals distinct mutational signatures regardless of adenoma size. Transitional single nucleotide substitutions of C:G>T:A predominate in the adenoma mutational spectrum. Strikingly, we observe mutations in the TGF-β pathway and CEA-associated genes in 4 out of 11 adenomas, overlapping with the Wnt pathway. Immunohistochemical labeling reveals a nearly 5-fold increase in CEA levels in 23% of adenoma samples with a concomitant loss of TGF-β signaling. We also define a functional role by which the CEA B3 domain interacts with TGFBR1, potentially inactivating the tumor suppressor function of TGF-β signaling. Our study uncovers diverse mutational processes underlying the transition from early adenoma to cancer. This has broad implications for biomarker-driven targeting of CEA/TGF-β in high-risk adenomas and may lead to early detection of aggressive adenoma to CRC progression. PMID:27100181

  14. A clinical feature and therapeutic strategy in pituitary adenomas associated with intracranial aneurysms

    We studied the clinical feature and treatment strategy of pituitary adenomas associated with intracranial aneurysms. Among 102 pituitary adenoma patients (mean age: 54.8 years old) who received MR angiography and/or 3D-CT angiography,seven patients (6.9%) had intracranial aneurysms. The association of an aneurysm was more common in large size adenomas (p<0.05). According to the location of the aneurysms,five patients had these in the paraclinoid portion or cavernous portion of the internal carotid artery. Using MR images,we classified the aneurysms associated with pituitary adenomas as non-adjacent,adjacent,and intra-adenoma types. In non-adjacent types,an aneurysm is located apart from the adenoma,and has less chance of exposure during transsphenoidal surgery. In adjacent types,an aneurysm is located adjacent to the adenoma,and could be exposed during transsphenoidal surgery. In intra-adenoma types,an aneurysm is encased in the adenoma. In non-adjacent type aneurysms,a resection of the pituitary adenoma can be carried out before aneurysm treatment due to the low risk of rupture during surgery. In adjacent types,a tumor resection can precede aneurysm treatment in cases of low rupture risk aneurysms and untreatable aneurysms. In intra-adenoma types,adenoma resection should come after treatment of the aneurysms. Neurosurgeons should be careful about not only the presence of aneurysms in preoperative images during transsphenoidal surgery planning,but also their locations and proximity to adenomas. Such information may be crucial in deciding the order of treatment. (author)

  15. Radiosurgery for pituitary adenomas: evaluation of its efficacy and safety

    Canteras Miguel M

    2010-11-01

    Full Text Available Abstract Object To assess the effects of radiosurgery (RS on the radiological and hormonal control and its toxicity in the treatment of pituitary adenomas. Methods Retrospective analysis of 42 patients out of the first 48 consecutive patients with pituitary adenomas treated with RS between 1999 and 2008 with a 6 months minimum follow-up. RS was delivered with Gamma Knife as a primary or adjuvant treatment. There were 14 patients with non-secretory adenomas and, among functioning adenomas, 9 were prolactinomas, 9 were adrenocorticotropic hormone-secreting and 10 were growth hormone-secreting tumors. Hormonal control was defined as hormonal response (decline of more than 50% from the pre-RS levels and hormonal normalization. Radiological control was defined as stasis or shrinkage of the tumor. Hypopituitarism and visual deficit were the morbidity outcomes. Hypopituitarism was defined as the initiation of any hormone replacement therapy and visual deficit as loss of visual acuity or visual field after RS. Results The median follow-up was 42 months (6-109 months. The median dose was 12,5 Gy (9 - 15 Gy and 20 Gy (12 - 28 Gy for non-secretory and secretory adenomas, respectively. Tumor growth was controlled in 98% (41 in 42 of the cases and tumor shrinkage ocurred in 10% (4 in 42 of the cases. The 3-year actuarial rate of hormonal control and normalization were 62,4% and 37,6%, respectively, and the 5-year actuarial rate were 81,2% and 55,4%, respectively. The median latency period for hormonal control and normalization was, respectively, 15 and 18 months. On univariate analysis, there were no relationships between median dose or tumoral volume and hormonal control or normalization. There were no patients with visual deficit and 1 patient had hypopituitarism after RS. Conclusions RS is an effective and safe therapeutic option in the management of selected patients with pituitary adenomas. The short latency of the radiation response, the highly

  16. Radiosurgery for pituitary adenomas: evaluation of its efficacy and safety

    To assess the effects of radiosurgery (RS) on the radiological and hormonal control and its toxicity in the treatment of pituitary adenomas. Retrospective analysis of 42 patients out of the first 48 consecutive patients with pituitary adenomas treated with RS between 1999 and 2008 with a 6 months minimum follow-up. RS was delivered with Gamma Knife as a primary or adjuvant treatment. There were 14 patients with non-secretory adenomas and, among functioning adenomas, 9 were prolactinomas, 9 were adrenocorticotropic hormone-secreting and 10 were growth hormone-secreting tumors. Hormonal control was defined as hormonal response (decline of more than 50% from the pre-RS levels) and hormonal normalization. Radiological control was defined as stasis or shrinkage of the tumor. Hypopituitarism and visual deficit were the morbidity outcomes. Hypopituitarism was defined as the initiation of any hormone replacement therapy and visual deficit as loss of visual acuity or visual field after RS. The median follow-up was 42 months (6-109 months). The median dose was 12,5 Gy (9 - 15 Gy) and 20 Gy (12 - 28 Gy) for non-secretory and secretory adenomas, respectively. Tumor growth was controlled in 98% (41 in 42) of the cases and tumor shrinkage ocurred in 10% (4 in 42) of the cases. The 3-year actuarial rate of hormonal control and normalization were 62,4% and 37,6%, respectively, and the 5-year actuarial rate were 81,2% and 55,4%, respectively. The median latency period for hormonal control and normalization was, respectively, 15 and 18 months. On univariate analysis, there were no relationships between median dose or tumoral volume and hormonal control or normalization. There were no patients with visual deficit and 1 patient had hypopituitarism after RS. RS is an effective and safe therapeutic option in the management of selected patients with pituitary adenomas. The short latency of the radiation response, the highly acceptable radiological and hormonal control and absence of

  17. Anabolic steroid abuse causing recurrent hepatic adenomas and hemorrhage

    Nlicole M Martin; Barham K Abu Dayyeh; Raymond T Chung

    2008-01-01

    Anabolic steroid abuse is common among athletes and is associated with a number of medical complications. We describe a case of a 27-year-old male bodybuilder with multiple hepatic adenomas induced by anabolic steroids. He initially presented with tumor hemorrhage and was treated with left lateral hepatic segmentectomy. Regression of the remaining tumors was observed with cessation of steroid use. However, 3 years and a half alter his initial hepatic segmentectomy, he presented with recurrent tumor enlargement and intraperitoneal hemorrhage in the setting of steroid abuse relapse. Given his limited hepatic reserve, he was conservatively managed with embolization of the right accessory hepatic artery.This is the first reported case of hepatic adenoma re-growth with recidivistic steroid abuse, complicated by life-threatening hemorrhage. While athletes and bodybuilders are often aware of the legal and social ramifications of steroid abuse, they should continue to be counseled about its serious medical risks.

  18. Pure Androgen-Secreting Adrenal Adenoma Associated with Resistant Hypertension

    René Rodríguez-Gutiérrez

    2013-01-01

    Full Text Available Pure androgen-secreting adrenal adenoma is very rare, and its diagnosis remains a clinical challenge. Its association with resistant hypertension is uncommon and not well understood. We present an 18-year-old female with a 10-year history of hirsutism that was accidentally diagnosed with an adrenal mass during the evaluation of a hypertensive crisis. She had a long-standing history of hirsutism, clitorimegaly, deepening of the voice, and primary amenorrhea. She was phenotypically and socially a male. FSH, LH, prolactin, estradiol, 17-hydroxyprogesterone, and progesterone were normal. Total testosterone and DHEA-S were elevated. Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonclassic congenital adrenal hyperplasia were ruled out. She underwent adrenalectomy and pathology reported an adenoma. At 2-month followup, hirsutism and virilizing symptoms clearly improved and blood pressure normalized without antihypertensive medications, current literature of this unusual illness and it association with hypertension is presented and discussed.

  19. MR imaging of growth hormone-secreting pituitary adenomas

    Suzuki, Masayuki; Ueda, Fumiaki; Fujinaga, Yasunari [Kanazawa Univ. (Japan). School of Medicine] (and others)

    2000-11-01

    We evaluated MR imaging of 51 growth hormonesecreting pituitary adenomas. On T1WI, 22 tumors were isointense with gray matter (GM), nine isointense with GM and white matter (WM), 14 isointense with WM, and six more hyperintense than WM. On T2WI of 45 patients, only fifteen tumors showed hypointensity than WM, 10 were isointense with WM, eight isointense with GM and WM, 12 showed in part isointensity with GM, and one was more hyperintense than GM. The dynamic study demonstrated the tumor more clearly than the delayed study in 10, while the opposite was true for two patients. The dynamic study is inevitable for MR imaging of GH-secreting pituitary adenomas. (author)

  20. Immunohistochemical Characteristics of Bone Forming Cells in Pleomorphic Adenoma

    Keisuke Nakano, Takehiro Watanabe, Takako Shimizu, Toshiyuki Kawakami

    2007-01-01

    Full Text Available Histopathological and immunohistochemical examinations were carried out in a case of pleomorphic adenoma with bone formation, occurring in the chin of a 34-year-old Japanese man. Examination results showed the modified neoplastic myoepithelial cells reacted positively to S-100 protein. The S-100-positive modified neoplastic myoepithelial cells were proliferated in the closely related area of the bone tissue. Furthermore, positive reaction was detected in the bone forming cells: osteoblasts and osteocytes. These cells also reacted positively to Runx2 as a marker of bone forming cells. These results suggest that the origin of the bone forming cells in this case of pleomorphic adenoma was modified neoplastic myoepithelial cells.

  1. Pyogenic liver abscess associated with large colonic tubulovillous adenoma

    Hsueh-Chou Lai; Cho-Yu Chan; Cheng-Yuan Peng; Chih-Bin Chen; Wen-Hsin Huang

    2006-01-01

    Pyogenic liver abscesses usually occur in association with a variety of diseases. Rarely, liver abscess has been reported as the presenting manifestation of colonic tubulovillous adenoma. We report two cases of pyogenic liver abscess without hepatobiliary disease or other obvious etiologies except that one had a history of diabetes mellitus (DM). The pathogen in the patient with DM was Klebsiella pneumonia (KP). In both of the patients, ileus developed about two to three weeks after the diagnosis of liver abscess. Colonoscopy revealed large polypoid tumors with pathological findings of tubulovillous adenoma in both cases. Two lessons were learned from these two cases: (1) an underlying cause should be aggressively investigated in patients with cryptogenic liver abscess; (2) DM could be one of the etiologies but not necessarily the only cause of KP liver abscess.

  2. Radiation therapy in the multimodal treatment approach of pituitary adenoma

    In this paper, literature will be reviewed to assess the role of modern radiotherapy and radiosurgery in the management of pituitary adenomas. Material and Methods: Nowadays, magnetic resonance imaging for the definition of the target volume and a real three-dimensional (3-D) treatment planning with field conformation and the possibility for non-coplanar irradiation has to be recommended. Most groups irradiate these benign tumors with single doses of 1.8-2.0 Gy up to a total dose of 45 Gy or 50.4 Gy in extensive parasellar adenomas. Adenomas are mostly small, well circumscribed lesions, and have, therefore, attracted the use of stereotactically guided high-precision irradiation techniques which allow extreme focussing and provide steep dose gradients with selective treatment of the target and optimal protection of the surrounding brain tissue. Results: Radiation therapy controls tumor growth in 80-98% of patients with non-secreting adenomas and 67-89% for endocrine active tumors. Reviewing the recent literature including endocrine active and non-secreting adenomas, irradiated postoperatively or in case of recurrence the 5-, 10- and 15-year local control rates amount 92%, 89% and 79%. In cases of microprolactinoma primary therapy consists of dopamine agonists. Irradiation should be preferred in patients with macroprolactinomas, when drug therapy and/or surgery failed or for patients medically unsuitable for surgery. Reduction and control of prolactin secretion can be achieved in 44-70% of patients. After radiotherapy in acromegaly patients somatomedin-C and growth hormone concentrations decrease to normal levels in 70-90%, with a decrease rate of 10-30% per year. Hypercortisolism is controlled in 50-83% of adults and 80% of children with Cushing's disease, generally in less than 9 months. Hypopituitarism is the most common side effect of pituitary irradiation with an incidence of 13-56%. Long-term overall risk for brain necrosis in a total of 1,388 analyzed patients

  3. Radiation therapy in the multimodal treatment approach of pituitary adenoma

    Becker, G. [Klinik am Eichert, Goeppingen (Germany). Dept. of Radiooncology and Radiation Therapy; Radiooncologic Univ. Clinic, Tuebingen (Germany); Kocher, M.; Mueller, R.P. [Koeln Univ. (Germany). Clinic of Radiation Therapy; Kortmann, R.D.; Paulsen, F.; Jeremic, B.; Bamberg, M. [Radiooncologic Univ. Clinic, Tuebingen (Germany)

    2002-04-01

    In this paper, literature will be reviewed to assess the role of modern radiotherapy and radiosurgery in the management of pituitary adenomas. Material and Methods: Nowadays, magnetic resonance imaging for the definition of the target volume and a real three-dimensional (3-D) treatment planning with field conformation and the possibility for non-coplanar irradiation has to be recommended. Most groups irradiate these benign tumors with single doses of 1.8-2.0 Gy up to a total dose of 45 Gy or 50.4 Gy in extensive parasellar adenomas. Adenomas are mostly small, well circumscribed lesions, and have, therefore, attracted the use of stereotactically guided high-precision irradiation techniques which allow extreme focussing and provide steep dose gradients with selective treatment of the target and optimal protection of the surrounding brain tissue. Results: Radiation therapy controls tumor growth in 80-98% of patients with non-secreting adenomas and 67-89% for endocrine active tumors. Reviewing the recent literature including endocrine active and non-secreting adenomas, irradiated postoperatively or in case of recurrence the 5-, 10- and 15-year local control rates amount 92%, 89% and 79%. In cases of microprolactinoma primary therapy consists of dopamine agonists. Irradiation should be preferred in patients with macroprolactinomas, when drug therapy and/or surgery failed or for patients medically unsuitable for surgery. Reduction and control of prolactin secretion can be achieved in 44-70% of patients. After radiotherapy in acromegaly patients somatomedin-C and growth hormone concentrations decrease to normal levels in 70-90%, with a decrease rate of 10-30% per year. Hypercortisolism is controlled in 50-83% of adults and 80% of children with Cushing's disease, generally in less than 9 months. Hypopituitarism is the most common side effect of pituitary irradiation with an incidence of 13-56%. Long-term overall risk for brain necrosis in a total of 1,388 analyzed

  4. A thyrotropin-secreting pituitary adenoma as a cause of thyrotoxic periodic paralysis.

    Alings, A M; Fliers, E; de Herder, W W; Hofland, L J; Sluiter, H E; Links, T P; van der Hoeven, J H; Wiersinga, W M

    1998-11-01

    We describe a patient with thyrotoxic periodic paralysis (TPP) caused by a thyrotropin-secreting pituitary adenoma. The diagnosis TPP was based on the combination of episodes of reversible hypokalaemic paralysis, hyperthyroidism and electrophysiological findings. A thyrotropin-secreting pituitary adenoma was diagnosed on the basis of endocrinological function tests and MRI of the pituitary gland. Before transsphenoidal resection of the adenoma, treatment with octreotide restored euthyroidism both clinically and biochemically. Immunocytochemistry of the pituitary adenoma was positive for TSH exclusively. Incubation with octreotide or quinagolide induced decreased TSH and alpha-subunit production by the cultured adenoma cells, in agreement with the pre-operative in vivo data. This paper is the first to describe in vivo and in vitro characteristics of a thyrotropin-secreting pituitary adenoma in a patient presenting with periodic paralysis. PMID:9854688

  5. Advanced age is a risk factor for proximal adenoma recurrence following colonoscopy and polypectomy

    Pommergaard, H-C; Burcharth, J; Rosenberg, J;

    2016-01-01

    BACKGROUND: Knowledge of risk factors for recurrence of colorectal adenomas may identify patients who could benefit from individual surveillance strategies. The aim of this study was to identify risk factors for recurrence of colorectal adenomas in a high-risk population. METHODS: Data were used...... from a randomized clinical trial that showed no effect of aspirin-calcitriol-calcium treatment on colorectal adenoma recurrence. Patients at high risk of colorectal cancer who had one or more sporadic colorectal adenomas removed during colonoscopy were followed up for 3 years. Independent risk factors...... associated with recurrence and characteristics of recurrent adenomas were investigated in a generalized linear model. RESULTS: After 3 years, the recurrence rate was 25·8 per cent in 427 patients. For younger subjects (aged 50 years or less), the recurrence rate was 19 per cent; 18 of 20 recurrent adenomas...

  6. Vesical nephrogenic adenoma: an unusual presentation of a bladder tumour

    Martínez-Sanchíz, Carlos; Martínez-Ruiz, Jesús; Anguita-Fernandez, Pedro J.; Giménez-Bachs, José M.; Atiénzar-Tobarra, Manuel; Rodríguez, Julio Antonio Virseda; Salinas-Sánchez, Antonio S

    2011-01-01

    Vesical nephrogenic adenoma is a rare, benign entity that appears most commonly in middle-aged males. Its etiology is unknown, but it has been linked to chronic irritating factors, such as infection, trauma, urological surgery, kidney stones, foreign bodies and chemical agents, such as Bacille Calmette-Guerin. We report 2 new cases with a history of transurethral resection of the bladder and the prostate and a history of prolonged voiding symptoms. In both cases, the findings of encysted tubu...

  7. Intraoperative 3-D mapping of parathyroid adenoma using freehand SPECT

    Rahbar, K.; Colombo-Benkmann, M. (Mario); Haane, C. (Christina); Wenning, C. (Christian); Vrachimis, A. (Alexis); Weckesser, J.M. (Jochen); Schober, O.

    2013-01-01

    Background: Freehand single photon emission computed tomography (fSPECT) is a three-dimensional (3-D) tomographic imaging modality based on data acquisition with a handheld detector that is moved freely, in contrast to conventional, gantry-mounted gamma camera systems. In this pilot study, we evaluated the feasibility of fSPECT for intraoperative 3-D mapping in patients with parathyroid adenomas. Methods: Three patients (range 30 to 45 years) diagnosed with hyperparathyroidism (one primary...

  8. Surgical treatment for mediastinal parathyroid adenoma causing primary hyperparathyroidism

    Kitada, Masahiro; Yasuda, Shunsuke; Nana, Takahashi; Ishibashi, Kei; Hayashi, Satoshi; Okazaki,Satoru

    2016-01-01

    Background Primary hyperparathyroidism is a rare disease characterized by excessive secretion of parathyroid hormone from parathyroid adenoma, hyperplasia, or malignancy. The clinical symptoms of the condition are those of hypercalcemia. Although the lesions are commonly located in the neck region, in about 1–2 % of cases, the lesions are ectopically located within the mediastinum, where surgical excision using the cervical approach is difficult. The principal treatment of the condition is su...

  9. Childhood parathyroid adenoma: a rare but important cause of nephrolithiasis.

    Menon, Prema; Dayal, Devi; Rao, Suhitha G; Bhattacharya, Anish; Narasimha Rao, Katragadda Lakshmi

    2016-07-01

    Primary hyperparathyroidism is very rare in children and adolescents. The management of a 12-year-old boy with renal calculi due to parathyroid adenoma is discussed. The single tumor after localization with sestamibi scintigraphy and SPECT-CT scan was excised with amelioration of symptoms. The case is reported due to the rarity of the disease and successful unilateral exploration. The association with hypopigmented areas of skin has also not been previously reported in literature. PMID:27054596

  10. [Hyperthyroidism caused by a TSH producing pituitary adenoma].

    Prasch, F; Knosp, S E; Steinbach, R; Wogritsch, S; Hurtl, I; Greifeneder, M; Holm, C; Najemnik, C; Dudczak, R

    1999-01-01

    Elevated levels of free triiodothyronine (fT3) of 8.8 ng/dl (normal range 2.0 to 4.2) and free thyroxin (fT4) of 3.5 pg/ml (0.8 to 1.7) were found in the course of an examination of a 53-year old patient due to a planned hysterectomy. As thyrotropin (TSH) also was elevated with 5.8 mU/l (0.4 to 4.5), these findings corresponded to an inappropriate secretion of TSH (IST). Additional examinations revealed a blunted rise of TSH secretion after i.v. injection of 200 micrograms thyrotropin releasing hormone (TRH) as well as lacking suppression of TSH secretion after oral doses of 75 micrograms T3 during one week. alpha-TSH levels with 3.7 micrograms/l were elevated in comparison to a matched normal sample just as the molar ratio alpha-TSH/TSH with 6.95 and sex hormone-binding globulin (SHBG) with 175 nmol/l and showed an absence of inhibition in the T3 suppression test. These results were suggestive of neoplastic inappropriate secretion of TSH (nIST) due to a TSH-secreting pituitary adenoma. In concordance, the magnetic resonance imaging (MRI) showed a 1 cm tumor in the sella. The adenoma could also be visualized by 111In-octreotide and 123I-epidepride scintigraphies of the pituitary gland. After transsphenoidal resection, histological examination of the tumor resulted in the finding of a TSH-secreting adenoma. Postoperative TSH levels were not detectable, indicating the complete removal of the adenoma. Levels of fT3 and fT4 were slightly below normal with 1.9 pg/ml and 0.7 ng/dl, respectively. A control scintigraphy with 111In-octreotide following an equivocal MRI showed no uptake in the pituitary. PMID:10230475

  11. Pyogenic liver abscess associated with large colonic tubulovillous adenoma

    Lai, Hsueh-Chou; Chan, Cho-Yu; Peng, Cheng-Yuan; Chen, Chih-Bin; Huang, Wen-Hsin

    2006-01-01

    Pyogenic liver abscesses usually occur in association with a variety of diseases. Rarely, liver abscess has been reported as the presenting manifestation of colonic tubulovillous adenoma. We report two cases of pyogenic liver abscess without hepatobiliary disease or other obvious etiologies except that one had a history of diabetes mellitus (DM). The pathogen in the patient with DM was Klebsiella pneumonia (KP). In both of the patients, ileus developed about two to three weeks after the diagn...

  12. Pregnancy and liver adenoma management: PALM-study

    van Aalten Susanna M; Bröker Mirelle E E; Busschbach J J V; de Koning Harry J; de Man Robert A; Steegers Eric A P; Steyerberg Ewout W; Terkivatan Turkan; IJzermans Jan N M

    2012-01-01

    Abstract Background Hepatocellular adenoma (HCA) in pregnant women requires special considerations because of the risk of hormone induced growth and spontaneous rupture, which may threaten the life of both mother and child. Due to scarcity of cases there is no evidence-based algorithm for the evaluation and management of HCA during pregnancy. Most experts advocate that women with HCA should not get pregnant or advise surgical resection before pregnancy. Whether it is justified to deny a young...

  13. Ectopic Functioning Adrenocortical Oncocytic Adenoma (Oncocytoma) with Myelolipoma Causing Virilization

    Surrey, Lea F.; Thaker, Ashesh A.; Zhang, Paul J; Giorgos Karakousis; Feldman, Michael D.

    2012-01-01

    Functioning adrenal adenomas are well-described entities that can rarely occur outside the adrenal gland in the ectopic adrenal tissue. Similarly, myelolipoma is an another benign lesion of the adrenal tissue which can rarely occur outside the adrenal gland. We report the first case of a testosterone producing an extra-adrenal adrenocortical oncocytoma accompanied by a myelolipoma. The patient presented with virilization and elevated androgen levels. Imaging revealed a retroperitoneal mass, w...

  14. Pleomorphic adenoma mimicking lymphoma of the palatine tonsil

    Full text: Introduction: Pleomorphic adenoma is a mixed benign tumor of the salivary glands having myoepithelial and epithelial components. It is frequently encountered in big salivary glands such as parotid glands. Those originating from small salivary glands are usually seen in the palatal region. They can be rarely seen in buccal region, tongue, base of the oral cavity, tonsils, pharynx, retromolar region and nasal cavity. Objectives and tasks: In this article, we aimed to represent computed tomography (CT) and Magnetic resonance imaging findings of a case with pleomorphic adenoma located in the palatine tonsil region mimicking lymphoma. Material and methods: 19-year-old boy was referred to our radiology clinic due asymmetrical hypertrophic changes in the left palatine tonsil region. The case was evaluated by contrast enhanced CT and MR. Results: In CT, a 2.5x3 cm hypodense solid lesion without prominent contrast enhancement located in the left palatine tonsil region narrowing the nasopharyngeal-oropharyngeal passage was revealed. In MR imaging lesion was isointense to the muscle tissue in T1WI and hyperintense in T2WI. It was showing heterogeneous contrast enhancement in postcontrast T1WI. As a consequence, palatine tonsil lymphoma was compatible with radiologic features. But, diagnosis was turned out to be pleomorphic adenoma by histopathologic assessment. Conclusion: Salivary gland neoplasia is rarely seen in the minor salivary glands. The diagnosis of atypically located salivary gland tumor may be challenging. CT and MR imaging can be used to assess the location, dimensions, extension and relationship with the adjacent structures of the tumor. The minor salivary gland tumor such as pleomorphic adenoma should be included in the differential diagnoses in lesion located in the oral-nasal-pharyngeal regions

  15. Systemic AA amyloidosis induced by liver cell adenoma.

    Fievet, P; Sevestre, H; Boudjelal, M; Noel, L H; Kemeny, F; D. Franco; Delamarre, J; Capron, J.P.

    1990-01-01

    Systemic AA amyloidosis is a rare complication of benign tumours. This report describes a patient with hepatocellular adenoma associated with reactive AA amyloidosis. He had a nephrotic syndrome with deteriorating renal function and an increase of serum concentrations of acute phase proteins, mainly C-reactive protein. Resection of the tumour was followed by improvement in renal function and a marked decrease of the serum concentrations of acute phase proteins.

  16. Basal Cell Adenoma of the Upper Lip from Minor Salivary Gland Origin

    Minicucci, Eliana Maria; de Campos, Eloisa Bueno Pires; Weber, Silke Anna Thereza; Domingues, Maria Aparecida Custodio; Ribeiro, Daniel Araki

    2008-01-01

    Basal cell adenoma is an uncommon benign salivary gland neoplasm, presenting isomorphic basaloid cells with a prominent basal cell layer. Taking into account that basal cell adenomas represent 1% of all salivary gland tumors, being the majority of cases in the parotid glands, the goal of this paper is to report a case of basal cell adenoma of the upper lip arising from minor salivary gland.

  17. Diagnosis of adrenal adenoma and hyperplasia by CT and adrenal scintigraphy

    The evaluation of X-CT and adrenal scintigraphy in diagnosis of Cushing syndrome and primary aldosteronism was studied in 18 patients. In Cushing syndrome, CT appearance of adenoma is commonly larger than that of primary aldosteronism and cleary deliniated by surrounding fat. So, in Cushing syndrome, diagnosis of adenoma on CT is much easier than that of primary aldosteronism, and absence of adenoma on CT suggests adrenal hyperplasia. In primary aldosteronism both of CT and scintigraphy must be performed. (author)

  18. Parathyroid Adenoma In a Young Male with Multiple Fractures and Varied Clinical Features

    Bhanu Murthy, R.; Srihari, V.; Lakshmi Narayana, M.

    2012-01-01

    Primary hyperparathyroidism is due to parathyroid adenoma (80–85%), hyperplasia (10–15%), carcinoma (2–3%) of cases. The most common presentation is asymptomatic hypercalcemia. Multiple pathological fractures, nephrocalcinosis as a presenting feature of primary hyperparathyroidism due to parathyroid adenoma is extremely rare at the age of 19 years. A case of parathyroid adenoma with multiple fractures of left femur, renal calculi, nephrocalcinosis, weight loss, constipation, dyspepsia abdomin...

  19. STAT3 upregulation in pituitary somatotroph adenomas induces growth hormone hypersecretion

    Zhou, Cuiqi; Jiao, Yonghui; Wang, Renzhi; Ren, Song-Guang; Wawrowsky, Kolja; Melmed, Shlomo

    2015-01-01

    Pituitary somatotroph adenomas result in dysregulated growth hormone (GH) hypersecretion and acromegaly; however, regulatory mechanisms that promote GH hypersecretion remain elusive. Here, we provide evidence that STAT3 directly induces somatotroph tumor cell GH. Evaluation of pituitary tumors revealed that STAT3 expression was enhanced in human GH-secreting adenomas compared with that in nonsecreting pituitary tumors. Moreover, STAT3 and GH expression were concordant in a somatotroph adenoma...

  20. Pleomorphic adenoma of the vulva, clinical reminder of a rare occurrence

    Moatamed, Neda A.; Apple, Sophia K; Albert Su

    2012-01-01

    Pleomorphic adenoma, also known as mixed tumor, is a benign tumor which typically presents as a painless and persistent mass. The majority of pleomorphic adenomas involve the salivary glands, most commonly the parotid gland. Other sites include breast and skin. It is a rare tumor in the vulva. In this article we are reporting a case of pleomorphic adenoma of labia with characteristic pathologic and clinical findings, as reminder of a common benign neoplasm occurring with rare locality.

  1. The value of CT and MRI in diagnosis of parathyroid adenoma

    Objective: To report authors' experience of CT and MRI techniques for detecting parathyroid adenoma, their manifestations and diagnostic efficacy. Methods: 45 patients with 45 parathyroid adenomas proved histologically were examined, by CT scan in 43 and by MRI in 7 patients, before operation. Results: CT scan allowed accurate diagnosis in 37 adenomas (37/43), 27 of which were located in the groove beside the trachea and the esophagus and 10 were ectopic. On plain CT scan, the density of the adenoma was similar to that of the vessels in the neck, whereas low density foci were found within some adenomas. On enhanced CT scan, the solid parts of the adenomas were significantly enhanced but still less than that of the vessels. MRI allowed accurate diagnosis in all 7 adenomas (7/7), 6 of which were located in the groove beside the trachea and the esophagus, and 1 ectopic adenoma was within the mediastinum. In all but one case, adenomas had homogeneous signal intensity similar to or slightly more intense than that of the muscles on T1WI and obviously hyperintense as compared with the muscles on T2WI. One case presented heterogeneous and high signal intensity similar to that of fat on both T1WI and T2WI. On Gd-DTPA enhanced imaging, all adenomas were significantly homogeneously enhanced but in one of them the enhancement was inhomogeneous. Conclusions: Most of the parathyroid adenomas could be accurately diagnosed with CT scan or MRI before operation. MRI is easy to detect the lesion, especially in ectopic adenoma within the mediastinum, showing slightly higher diagnostic accuracy than CT

  2. Laparoscopic simple prostatectomy: A reasonable option for large prostatic adenomas

    Abdulrahman Al-Aown

    2015-01-01

    Full Text Available Aim of the Study: In this work, surgical technique followed by two academic departments on laparoscopic simple prostatectomy (LSP of large prostatic adenomas is being described. Materials and Methods: The initial cumulative experience from 11 patients with lower urinary tract symptoms of benign prostatic hyperplasia origin subjected to LSP is being presented. Results: All cases had prostatic adenomas greater than 80 ml. Mean operation time was 99.5 min (values from 70 to 150 min and mean blood loss was 205 ml (values from 100 to 300 ml. Blood transfusion was deemed necessary in one case. Bladder catheter was removed successfully on postoperative day 5 in all cases. No significant postoperative complication was noted. At a 3 months follow-up a significant decrease in International Prostate Symptom Score (IPSS was evident in all patients (mean IPSS 27.7 vs. 15.3 preoperative vs. postoperative accordingly. Conclusions: According to our data and similarly to the rest of the LSP literature, laparoscopic excision of voluminous prostatic adenomas is a feasible and safe procedure. Nevertheless, further investigation including a larger number of patients and long-term follow-up is deemed necessary before making definite conclusions regarding the approach.

  3. A Case of Metanephric Adenoma and Acute Myocardial Infarction.

    Dusan, Ruzicic; Relja, Kovacevic; Marija, Mirkovic; Jelena, Radovanovic; Vesna, Krstevska; Milijana, Terzic; Vladimir, Pantelic; Irena, Matic; Dragan, Hrncic

    2016-07-01

    Metanephric adenoma (MA) is a rare neoplasm that acounts for 0.2% of adult renal neoplasms. MAs are typically discover incidentally during detailed examinations for nonspecific symptoms such as abdominal or flank pain, hematuria, fever and palpable abdominal mass. Additionally, polycythemia has occasionally been reported as well. Herein we describe a case of metanephric adenoma which was an incidental finding in the course of a clinical autopsy in a patient with complete AV block and polycythemia. Histologically, the tumor was composed of small and uniform tubular structures reminiscent of renal tubuli, without signs of cellular atypia and pleomorphism. Such tumor histomorphology was consistent with the diagnosis of metanephric adenoma. Thrombosis is a common complication of polycythemia that often causes death. Polycythemia with an increasing number of blood cells causes hyperviscosity and, in 20-40% of cases, lethal thrombosis or hemorrhage. Hyperviscosity and coronary artery disease in our patient caused acute myocardial infarction with the subsequent rupture of posterior left ventricle wall and hemopericardium. PMID:27471365

  4. Expression of p53 protein in pituitary adenomas

    Oliveira M.C.

    2002-01-01

    Full Text Available Inactivating mutations of TP53, a tumor suppressor gene, are associated with abnormal cell proliferation. Although p53 expression is common in many human malignancies, p53 protein has seldom been evaluated in pituitary tumors. When detected, the percentage of p53-positive cells is low, and, in general, it is exclusive for invasive lesions. The aim of the present study was to use immunohistochemistry to determine the presence of p53 protein in pituitary adenomas from tumor samples of 163 surgeries performed in 148 patients (40% male, 60% female. In 35% of the cases the adenoma was nonfunctional, while in the others it was associated with PRL, GH and/or ACTH endocrine hypersecretion syndrome. Macroadenomas were observed in 83.2% of the cases with available neuroimage evaluation, of which 28% invaded the cavernous, sphenoid and/or ethmoidal sinus, bone, third ventricle or subfrontal lobe. p53 protein was detected in 2/148 patients (1.3%. Immunohistochemistry was positive for PRL and GH in these cases. Due to the high percentage of invasive pituitary adenomas found in our study, the low frequency of p53 detection suggests that it is inadequate as a routine marker for aggressiveness and as a predictive factor of tumor behavior.

  5. Carcinoma ex pleomorphic adenoma of the parotid gland

    Kashiwagi, Nobuo; Murakami, Takamichi (Dept. of Radiology, Kinki Univ. School of Medicine, Osaka (Japan)), Email: kashiwaginobuo@yahoo.co.jp; Chikugo, Takaaki (Dept. of Pathology, Kinki Univ. School of Medicine, Osaka (Japan)); Tomita, Yasuhiko (Dept. of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan)); Kawano, Kiyoshi (Dept. of Pathology, Belland General Hospital, Sakai City, Osaka (Japan)); Nakanishi, Katsuyuki (Dept. of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan)); Mori, Kazunori (Dept. of Otolaryngology, Kinki Univ. School of Medicine, Osakasayama City, Osaka (Japan)); Tomiyama, Noriyuki (Dept. of Radiology, Osaka Univ. Graduate School of Medicine, Osaka, Japan (Japan))

    2012-04-15

    Background: Carcinoma ex pleomorphic adenoma (CXPA) is a rare aggressive epithelial malignancy arising from a primary or recurrent benign mixed tumor. Only a few case reports describing the radiologic features of CXPA have been published. Purpose: To describe and characterize the magnetic resonance (MR) imaging findings of CXPA in the parotid gland and correlate them with pathologic findings. Material and Methods: The MR images of surgically proven CXPA in the parotid gland of five men and five women ranging in age from 28 to 75 years (mean 52 years) were retrospectively reviewed. All MR images were evaluated with emphasis on the size, margin characteristics, extraparotid infiltration, the presence of an encapsulated component, and signal intensity on T2-weighted or short-inversion-time inversion recovery (STIR) images. Results: The average maximal diameter was 4.3 cm. All 10 tumors had ill-defined boundaries, and seven tumors showed extraparotid infiltration, reflecting invasive growth of the malignant component identified on histological examination. Eight tumors had a round encapsulated component and seven of those signal intensities were a mixture of hypo- and hyperintensity on T2-weighted or STIR images. Histological correlation of these components revealed fibrously encapsulated tumors containing hyalinization and myxoid tissue, suggesting degenerated pleomorphic adenoma. Invasive malignant components had non-specific and various signal intensities. Conclusion: An invasive parotid mass co-existing with a round encapsulated component is suggestive of carcinoma ex pleomorphic adenoma

  6. Carcinoma ex pleomorphic adenoma of the parotid gland

    Background: Carcinoma ex pleomorphic adenoma (CXPA) is a rare aggressive epithelial malignancy arising from a primary or recurrent benign mixed tumor. Only a few case reports describing the radiologic features of CXPA have been published. Purpose: To describe and characterize the magnetic resonance (MR) imaging findings of CXPA in the parotid gland and correlate them with pathologic findings. Material and Methods: The MR images of surgically proven CXPA in the parotid gland of five men and five women ranging in age from 28 to 75 years (mean 52 years) were retrospectively reviewed. All MR images were evaluated with emphasis on the size, margin characteristics, extraparotid infiltration, the presence of an encapsulated component, and signal intensity on T2-weighted or short-inversion-time inversion recovery (STIR) images. Results: The average maximal diameter was 4.3 cm. All 10 tumors had ill-defined boundaries, and seven tumors showed extraparotid infiltration, reflecting invasive growth of the malignant component identified on histological examination. Eight tumors had a round encapsulated component and seven of those signal intensities were a mixture of hypo- and hyperintensity on T2-weighted or STIR images. Histological correlation of these components revealed fibrously encapsulated tumors containing hyalinization and myxoid tissue, suggesting degenerated pleomorphic adenoma. Invasive malignant components had non-specific and various signal intensities. Conclusion: An invasive parotid mass co-existing with a round encapsulated component is suggestive of carcinoma ex pleomorphic adenoma

  7. Endoscopic transsphenoidal approach to pituitary adenomas invading the cavernous sinus

    TAO Yu-xin; QU Qiu-yi; WANG Zhen-lin; ZHANG Qiu-hang

    2010-01-01

    Background Surgery of pituitary adenomas invading cavernous sinus has always been thought as a challenge due to the complex anatomical structures and high risk of complications. The purpose of this study was to evaluate endoscopic trarssphenoidal approach to pituitary adenomas invading cavernous sinus.Methods The clinical data of 22 patients who admitted to Xuanwu Hospital with pituitary adenomas invading cavernous sinus were analyzed retrospectively. All patients underwent endoscopic transsphenoidal surgery. To expose the surgical field sufficiently, the opening of sellar floor was exceeded the bone overlying the invaded cavernous sinus, and synthetic dura was used to repair and strengthen the sella floor for preventing the leak of cerebrospinal fluid.Results Among 22 patients, total resection was achieved in 14, subtotal resection in 5, and partial resection in 3; no patient underwent insufficient resection. Visual symptoms improved in 7 of 9 patients. In one patient diplopia disappeared.Headache was relieved to various extents in all patients. No serious complications were found. Patient's hospital stay ranged from 7 to 20 days.Conclusion These data suggest that the endoscopic transsphenoid approach is a safe, minimally invasive, and efficient surgical technique, which might be an important therapeutic strategy for the pituitary adenoms invading cavernous sinus.

  8. Clinicopathologic analysis of pituitary adenoma: a single institute experience.

    Cho, Hwa Jin; Kim, Hanna; Kwak, Yoon Jin; Seo, Jeong Wook; Paek, Sun Ha; Sohn, Chul-Ho; Yun, Jung Min; Kim, Da Seu Ran; Kang, Peter; Park, Peom; Park, Sung-Hye

    2014-03-01

    Pituitary adenoma (PA) is a common benign neuroendocrine tumor; however, the incidence and proportion of hormone-producing PAs in Korean patients remain unknown. Authors analyzed 506 surgically resected and pathologically proven pituitary lesions of the Seoul National University Hospital from 2006 to 2011. The lesions were categorized as: PAs (n = 422, 83.4%), Rathke's cleft cysts (RCCs) (n = 54, 10.6%), inflammatory lesions (n = 8, 1.6%), meningiomas (n = 4), craniopharyngiomas (n = 4), granular cell tumors (n = 1), metastatic renal cell carcinomas (n = 2), germinomas (n = 1), ependymomas (n = 1), and unsatisfactory specimens (n = 9, 1.8%). PAs were slightly more prevalent in women (M: F = 1:1.17) with a mean age of 48.8 yr (9-80 yr). Immunohistochemical analysis revealed that prolactin-producing PAs (16.6%) and growth hormone-producing adenomas (9.2%) were the most common functional PAs. Plurihormonal PAs and nonfunctioning (null cell) adenomas were found in 14.9% and 42.4% of patients with PAs, respectively. The recurrence rate of PAs was 11.1%, but nearly 0% for the remaining benign lesions such as RCCs. 25.4% of patients with PAs were treated by gamma-knife after surgery due to residual tumors or regrowth of residual tumor. In conclusion, the pituitary lesions and the proportions of hormone-producing PAs in Korean patients are similar to those of previous reports except nonfunctioning (null cell) PAs, which are unusually frequent. PMID:24616591

  9. Irradiation of human pituitary adenomas in organ culture

    Stereotactic radiosurgery with gamma irradiation (60Co) is an alternative in the treatment of small pituitary adenomas. Following this type of surgery in cases of growth hormone (GH) and ACTH producing adenomas considerable fluctuations occur in hormone plasma level during the first week after irradiation. A permanent decrease in hormone plasma level is in general not encountered until several months later. The present investigation describes early irradiation induced effects in vitro with regard to cell morphology, hormone production and survival time in an organ culture system with GH producing adenomas. Acute increase of the GH concentration in vitro is found following irradiation, which is interpreted as a direct effect of ionizing irradiation on the cell membrane with a subsequent release of those GH granules which are lining the cell membrane. Pituitary specimens investigated 5-6 days after irradiation frequently revealed confluent areas with ultrastructurally normal cells. The increased number of hormone granules in irradiated cells 5-6 days after irradiation, as compared to after only 24 hours, indicates a recommenced hormone synthesis. (Auth.)

  10. The clinical pathologic research of invasive pituitary adenomas

    Objective: To study the pathological morphologic characteristics of invasive pituitary tumor and the affect of vascularization to the tumor's invasion. Methods: One hundred and thirty cases of pituitary adenoma patients were divided into two groups, including invasive pituitary adenomas and non-invasive pituitary adenomas, and the clinical data of two groups were analysed and compared. Results : The difference was statistically significant between the invasive group and the non-invasive group in the incidence rate of pathological morphologic characteristics such as high nuclear cytoplasmic ratio, cell pleomorphism, nuclear atypia and nucleoli appearance (P<0.05); there were nuclear atypia and nucleolus margination in the invasive group through electron microscopy. And there was statistical significant difference in rate of MVD expression which was higher in the invasive group than that of noninvasive group (P<0.05). Conclusion: The pathological morphologic characteristics of pituitary tumor and the high expression of MVD are significantly reference valuable in tumor aggression diagnosis, which provides valuable indicators for early clinical diagnosis of tumor invasion. (authors)

  11. Ectopic Intrathymic Parathyroid adenoma demonstrated on Tc-99m Sestamibi SPECT-CT.

    Usmani, S; Oteifa, M; Abu Huda, F; Javaid, A; Amanguno, H G; Al Kandari, F

    2016-05-01

    Intrathymic parathyroid adenoma is a rare cause of primary hyperparathyroidism. In this case, Tc-99m Sestamibi SPECT-CT successfully localized abnormal tracer uptake in the mediastinum with corresponding low density lesion on CT images suggestive of mediastinal parathyroid adenoma which late on confirmed on histopathology. After the median sternotomy a large intrathymic parathyroid adenoma was identified and excised. With the help of gamma probe the surgeons detect the lesion early and with more confidence as well as reducing the total operation time. Tc-99m Sestamibi SPECT-CT scintigraphy and gamma probe localization is recommended for preoperative and intra operative localization of ectopic parathyroid adenomas. PMID:27250890

  12. A case of lipomatous pleomorphic adenoma in the parotid gland: a case report

    Kondo Takeshi

    2009-06-01

    Full Text Available Abstract Introduction Pleomorphic adenoma is the most common benign neoplasm of the salivary glands. Extensive lipomatous involvement of the tumor is, however, a very rare finding. Case report Herein, a rare case of lipomatous pleomorphic adenoma arising in the parotid gland of a 14-year-old Japanese woman is presented. Conclusion This is the sixth case of lipomatous pleomorphic adenoma in the English literature. Recognition of this rare subtype of pleomorphic adenoma is important for clinical diagnosis and management. On CT scan, it may not be detected possibly due to the extensive fatty component.

  13. Signal intensity of magnetic resonance imaging of pituitary adenoma reflects its collagen content

    Hui Wang; Xianrui Yuan; Weixi Jiang

    2006-01-01

    BACKGROUND:At present,results of a few studies demonstrate that preoperative magnetic resonance imagling (MRI)examination reveals the texture of pituitary adenoma,I.e.on the T2-weighted image,solid pituitary adenoma shows weak signal and soft one shows strong signal.Also,solid pituitary adenoma is caused by fibrosis,which is confirmlea.However,some key problems are still in question and disputation,such as how to exactly quantize MRI signal intensity,which signal is used as prediction index,and the relationship of MRI signal and collagen content which reflects the texture of pituitary adenoma,and so on.OBJECTIVE:To observe the relationship of MRI signal intensity of different textures of pituitary adenoma and its collagen content,and investigate the best prediction index of the texture of pituitary adenoma.DESIGN:Case-control observation.SETTING:Department of Neurosurgery,Third Hospital Affiliated to Sun Yat-sen University;Department of Neurosurgery,Xiangya Hospital,Central South University.PARTICIPANTS:Fifty-seven patients with pituitary adenoma,including 32 males and 25 females,aged 20 to 65 years,who received treatment in the Department of Neurosurgery,Xiangya Hospital,Central South University during June 2003 to January 2004.The involved patients were all diagnosed by MRI and confirmed by pathological resection.Informed consents were obtained from all the patients.The samples of above-mentioned patients resected by operation were fixed with 40 g/L formaldehyde for sirius red staining.METHODS:①Accordling to the texture of pituitary adenoma observed in the operation:The 57 samples of pituitary adenoma were divided into 2 groups:non-flbrosis group(n=49)and fibrosis group(n=8).In the non-fibrosis group,the texture of pituitary adenoma was soft,I.e.pituitary adenoma tissue automatically flew out,and could be aspirated by aspirater or erased by curette,and the superior part of saddle could fall in the saddle,In the fibrosis group,pituitary adenoma tissue could be

  14. Hepatic adenoma in an elderly male patient: A rare case report

    Ravi Swami, Nimbargi RC, Karandikar MN, Jagdale KA

    2014-04-01

    Full Text Available Hepatocellular adenomas are usually affect females in their 3rd and 4th decades of life. Uses of oral contraceptives use or anabolic steroids have been blamed for this. This is rare in old age and in an elderly male presented with hepatic adenoma. Such cases are difficult to diagnose on fine needle aspiration cytology and can cause under or over diagnosis. Here we present a rare case of hepatic adenoma in an elderly male with both cytological as well as histopathology features of adenoma.

  15. Sessile serrated adenomas and classical adenomas: an epigenetic perspective on premalignant neoplastic lesions of the gastrointestinal tract

    Dhir, Mashaal; Yachida, Shinichi; Van Neste, Leander; Glöckner, Sabine C.; Jeschke, Jana; Pappou, Emmanouil P.; Montgomery, Elizabeth A.; Herman, James G.; Baylin, Stephen B.; Iacobuzio-Donahue, Christine; Ahuja, Nita

    2011-01-01

    The diagnosis of sessile serrated adenomas (SSAs) is challenging, and there is a great deal of interobserver variability amongst pathologists in differentiating SSAs from hyperplastic polyps (HPPs). The aim of this study was (i) to assess the utility of epigenetic changes such as DNA methylation in differentiating SSAs from HPPs and (ii) to identify common methylation based molecular markers potentially useful for early detection of premalignant neoplastic lesions of gastrointestinal tract. A...

  16. Epithelial and organ-related marker expression in pituitary adenomas.

    Cykowski, Matthew D; Takei, Hidehiro; Baskin, David S; Rivera, Andreana L; Powell, Suzanne Z

    2016-08-01

    The histologic expression of epithelial and organ-related immunohistochemical markers in primary sellar region tumors has received little attention to date. This lack of empirical data may lead to mistaken assumptions in the evaluation of sellar region neoplasms. To address this issue, the frequency and specificity of epithelial (cytokeratin 7(CK7), CK20) and organ-related differentiation markers (gross cystic disease fluid protein-15 (GCDFP-15), thyroid transcription factor-1 (TTF-1), Napsin A, paired box 8 (PAX-8), hepatocyte paraffin 1 (HepPar1) and estrogen receptor (ER)) were studied in 40 patients with adenomas comprising five hormonal sub-types. Non-parametric statistical procedures were used to examine associations between marker expression and tumor sub-type. CK7 and CK20 immunoreactivity were seen in 48% and 8% of tumors, respectively, although never in a diffuse pattern. CK20 expression was nearly exclusive to corticotrophs, whereas CK7 frequently highlighted cells with dendritic-type morphology. The specificity of organ-related differentiation markers was 100% (monoclonal Napsin A, GCDFP-15 and TTF-1), 97% (HepPar1 and PAX-8), 90% (polyclonal Napsin A) and 72% (ER); no tumors demonstrated significant co-expression of these organ-related markers with either CK7 or CK20. The first major conclusion of this study is that CK7 staining in adenoma is more frequent than has been previously than has been previously described. CK7 immunoreactive cells often displayed a dendritic-type morphology, including within large macroadenomas, which raises the question as to whether these represent tumor cells with folliculo-stellate cell-type differentiation, as these also have dendritic cell-type morphology and express CK7 in non-neoplastic glands. The second major conclusion, which confirms earlier findings, is that CK20 staining is a very infrequent immunohistochemical finding in adenomas that is virtually limited to corticotrophs and thus is helpful in diagnostic

  17. Radiotherapy for pituitary adenomas: long-term outcome and complications

    Rim, Chai Hong; Yang, Dae Sik; Park, Young Je; Yoon, Won Sup; Lee, Jung AE; Kim, Chul Yong [Korea University Medical Center, Seoul (Korea, Republic of)

    2011-09-15

    To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-fi ve patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing

  18. Radiotherapy for pituitary adenomas: long-term outcome and complications

    To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-fi ve patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing's disease

  19. Bukkal bölgede pleomorfik adenoma: bir olgu sunumu

    Defne Akpinar

    2011-10-01

    Full Text Available

    Introduction: Pleomorphic adenoma is most common tumor (%50 of the major and minor salivary glands. Seventy percent of the tumors of the minor salivary glands are pleomorphic adenomas, and the most common intraoral site is the palate, followed by the upper lip and buccal mucosa. The tumor is usually solitary and presents as a slow growing, painless, firm single nodular mass.

    Case report: A 56 -year-old female with a painless buccal mass that slowly increased in size was referred Department of Oral and Maxillofacial Surgery of Dentistry Faculty of Gazi University. Clinic examination and radiographic evaluation was determined painless, firm and extraoral expansive mass in the right buccal region. Lesion was enucleationed with its capsule. Histologic analysis confirmed the diagnosis of pleomorphic adenoma with no carcinomatous foci. The 24-month follow up showed good healing of the buccal mucosa. Conclusion: Through the present case report and review literatures, it is suggested that the minor salivary gland tumors are characterized by the higher incidence benign tumors, especially of pleomorphic adenoma.

    ÖZET

    Giriş: Pleomorfik adenoma majör ve minör tükürük bezlerinin en yaygın (%50 görülen tümörüdür. Minör tükürük bezi tümörlerinin %70’ini pleomorfik adenomalar oluşturur ve en sık görülen intraoral bölge palatinaldir, üst dudak ve bukkal mukoza bu sıralamayı takip eder. Bu tümör genellikle tek taraflı ve yavaş büyüme gösteren, ağrısız, katı kitle şeklindedir.

    Olgu: 56 yaşındaki bayan hasta bukkal bölgede büyüklüğü yavaşça artan ağrısız bir kitle ile Gazi Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş, Çene Hastalıkları ve Cerrahisi Anabilim dalına başvurmuştur. Yapılan klinik ve radyolojik muayenede sağ bukkal b

  20. Imaging characteristics of hepatocellular adenoma compared with pathologic findings

    Objective: To retrospectively compare CT and MR features of hepatocellular adenoma with pathologic findings. Methods: Twelve patients with histopathologically proved hepatocellular adenoma were classified on the basis of pathologic and genotype phenotype findings into four groups: steatotic type, cytological abnormality type, telangiectatic adenoma with inflammatory infiltrates type and atypical adenoma type. The CT and MR features of each type were reviewed retrospectively compared with the pathological results. Results: In this retrospective study, 12 patients were examined with CT (8 patients) and MR (8 patients). Among 12 patients, 4 patients showed a steatotic type. One patient showed hypo-density on the non-enhanced CT and 3 patients demonstrated hypo-density on all phases of the post-contrast scans. Two lesions showed iso-intense signal on the in-phase T1WI with signal dropout on the out-of-phase T1WI, and hypo-intense signal on the T2WI with fat suppression sequences. One lesion demonstrated moderate hypointense signal on all phases of the post-contrast MRI scans. Two patients with the telangiectatic adenoma inflammatory infiltrates type were found. One patient showed hypo-density on the non-enhanced CT scans and hyper-density on all phases of the post-contrast CT scans. One patient demonstrated iso-intense signal and the other hypo-intense signal on the T1WI, and both displayed moderate hyper-intense signal on the T2WI with fat suppression sequences and hyper-intense signal with gradual enhancement on all phases of post-contrast MR scans. There were 3 patients with a cytological abnormality type. One patient appeared hypo-density and 1 patient showed uniform iso-density on non-enhanced CT scans. All patients who had undergone contrast-enhanced CT scans were found to have hyper-density on the hepatic arterial-dominant phase and became slightly lower on the portal venous phase. On the delay phase the density reduced further. One mass showed iso

  1. Pleomorphic adenoma presenting with conductive hearing loss in the ear canal: a case report and review of the literature

    Maruyama, Ayako; Tokumaru, Takao; Kitamura, Ken

    2014-01-01

    Introduction Pleomorphic adenoma accounts for 65 percent of all salivary gland tumors. It has been identified in several anatomical regions, but pleomorphic adenoma arising in the ear canal, first described in 1951, is extremely rare. Case presentation A 40-year-old Japanese man’s left ear canal was obstructed by a pleomorphic adenoma that caused mild conductive hearing loss. The tumor was resected and he remains disease-free two years after surgery. Conclusions Pleomorphic adenoma usually ar...

  2. Allelic losses at genomic instability-associated loci in villous adenomas and adjacent colorectal cancers.

    Brenner, Bruce M; Stoler, Daniel L; Rodriguez, Luz; Karpenko, Matthew J; Swede, Helen; Petrelli, Nicholas J; Anderson, Garth R

    2007-04-01

    Allelic imbalances in premalignant villous adenomas were compared with those in adjacent microdissected colorectal carcinoma that had arisen directly from the adenomas. Carcinoma-adenoma pairs were examined from 17 patients who underwent resections for colorectal cancer. In all, 28 microsatellite markers were examined, from regions of the genome where individual allelic losses have been associated with overall genomic instability in colorectal carcinomas. Microsatellite instability (MSI) was also evaluated for each marker in each tissue type. Loss of heterozygosity for multiple markers was found in 35% of adenomas and 65% of carcinomas; the average fractional allelic loss rate was 2.5 times higher in carcinomas than in adenomas. Of the 17 patients, 4 had MSI for >30% of markers in both adenoma and carcinoma, with no significant differences between the two tissues. Markers with particularly high imbalance rates in adenomas were seen on chromosomes 11, 14, and 15. These findings provide further evidence that genomic instability is an ongoing process during carcinogenesis, with a markedly increased frequency of allelic losses seen in carcinomas, compared with adjacent adenomas. Markers on chromosomes 11, 14, and 15 may become valuable tools in the identification of patients destined to progress to colorectal carcinomas. PMID:17350461

  3. Protein kinase C (PKC) activity and PKC messenger RNAs in human pituitary adenomas.

    Jin, L; Maeda, T; Chandler, W F; Lloyd, R V

    1993-02-01

    Protein kinase C (PKC) is involved in the differentiation and growth regulation of a variety of tissues including anterior pituitary gland cells. To determine the distribution of PKC in different types of adenomas, PKC activity was analyzed in human pituitary tumors and the effects of hypothalamic hormone stimulation on PKC activity were examined in cultured adenoma cells. Gonadotroph (LH/FSH) and null cell adenomas had significantly higher levels of particulate, soluble, and total PKC activity compared with growth hormone (GH) adenomas (P delta, epsilon, and zeta) were localized by in situ hybridization, normal and neoplastic pituitaries expressed abundant mRNA for PKC epsilon, whereas some tumors and one normal pituitary had a few cells positive for PKC zeta mRNA as evaluated by grain density and the number of cells labeled. These results indicate that there is a variable distribution of PKC mRNA isozymes in human pituitary adenomas and that normal pituitaries and pituitary adenoma cells express the mRNA for both the calcium-dependent and some of the calcium-independent PKC isozymes. Chronic treatment with the hypothalamic gonadotropin hormone-releasing hormone and GH-releasing hormone, which increased LH/FSH and GH secretion, respectively, did not increase PKC activity in cultured adenoma cells. The presence of calcium-dependent and calcium-independent PKC isozymes in normal and neoplastic pituitary cells indicates that PKC probably plays a major role in signal transduction in the human pituitary adenomas examined in this study. PMID:8434650

  4. Hepatic adenoma and focal nodular hyperplasia: differential diagnosis and treatment.

    Herman, P; Pugliese, V; Machado, M A; Montagnini, A L; Salem, M Z; Bacchella, T; D'Albuquerque, L A; Saad, W A; Machado, M C; Pinotti, H W

    2000-03-01

    The diagnosis of benign hepatic tumors as hepatic adenoma (HA) and focal nodular hyperplasia (FNH) remains a challenge for clinicians and surgeons. The importance of differentiating between these lesions is based on the fact that HA must be surgically resected and FNH can be only observed. A series of 23 female patients with benign liver tumors (13 FNH, 10 HA) were evaluated, and a radiologic diagnostic algorithm was employed with the aim of establishing preoperative criteria for the differential diagnosis. All patients were submitted to surgical biopsy or hepatic resection to confirm the diagnosis. Based only on clinical and laboratory data, distinction was not possible. According to the investigative algorithm, the diagnosis was correct in 82.6% of the cases; but even with the development of imaging methods, which were used in combination, the differentiation was not possible in four patients. For FNH cases scintigraphy presented a sensitivity of 38.4% and specificity of 100%, whereas for HA the sensitivity reached 60% and specificity 85.7%. Magnetic resonance imaging, employed when scintigraphic findings were not typical, presented sensitivities of 71.4% and 80% and specificities of 100% and 100% for FNH and HA, respectively. Preoperative diagnosis of FNH was possible in 10 of 13 (76.9%) patients and was confirmed by histology in all of them. In one case, FNH was misdiagnosed as HA. The diagnosis of HA was possible in 9 of 10 (90%) adenoma cases. Surgical biopsy remains the best method for the differential diagnosis between HA and FNH and must be performed in all doubtful cases. Surgical resection is the treatment of choice for all patients with adenoma and can be performed safely. With the evolution of imaging methods it seems that the preoperative diagnosis of FNH may be considered reliable, thereby avoiding unnecessary surgical resection. PMID:10658075

  5. Clinical Features and Ultrasonographic Findings of Lactating Adenoma

    Purpose: This study was designed to evaluate the clinical manifestations and characteristic ultrasonographic findings of lactating adenoma in pregnant or lactating women. Ultrasonographic findings of nine lactating adenomas in nine patients (age range, 19-38 years; mean age, 30.4 years) were retrospectively reviewed. All of the lesions were histologically diagnosed with the use of an ultrasound (US) guided core needle biopsy. Ultrasonographic findings were categorized according to the ACR/BI-RADS classification. The size of the lesions varied from 13 to 43 mm (mean, 27.8 mm). The most common findings of the breast lesions were an oval-shape (n = 9, 100%), presence of circumscribed margins (n = 5, 55.6%), a location parallel to the chest wall (n = 9, 100%), the presence of complex or hypoechoic lesions (n = 7, 77.8%), posterior acoustic enhancement (n = 5, 55.6%) and no microcalcifications (n = 8, 88.9%). Six lesions (66.7%) were classified as category 3 (probably benign lesions) and three lesions (33.3%) were classified as category 4A (low-suspicion for malignancy). Followup ultrasonography was performed in six patients; four (66.7%) patients showed complete resolution and two (33.3%) patients showed a decreased size of the lesions. One patient developed a milk fistula as a complication of the core needle biopsy as seen on a follow-up evaluation. Conclusion: Ultrasonographic findings of lactating adenomas are generally benign, with some lesions displaying suspicious malignant findings. On follow-up US images after the use of an US-guided core needle biopsy, all lesions showed complete regression or a decreased size

  6. Pituitary adenoma: A case report with special emphasis on approach to diagnosis

    Shaista M Vasenwala

    2014-01-01

    Full Text Available Pituitary tumors are common in sellar area. The prevalence of clinically apparent pituitary lesions is estimated to comprise approximately 10% of all intracranial lesions, while incidental pituitary tumors are detected in approximately 11% of individuals at autopsy. Pituitary tumors are mostly found to be benign adenomas, however pituitary carcinoma has been reported to comprise about 0.5% of pituitary tumors. Pituitary adenomas are associated with an immense diversity in their endocrine manifestations secondary to hypo or hyperfunction of pituitary gland and ophthalmological manifestations due to mass effect. Progress in the diagnostic examination of pituitary adenomas and advances in the treatment of these tumors offers excellent prospects for a successful therapeutic outcome. We hereby discuss a case of pituitary macro-adenoma in a young adult male and review the recent advances in the classification and diagnosis of pituitary adenoma.

  7. Mucins and associated glycan signatures in colon adenoma-carcinoma sequence

    Krishn, Shiv Ram; Kaur, Sukhwinder; Smith, Lynette M;

    2016-01-01

    study, we investigated the combined expression of multiple mucins and mucin-associated glycans during the adenoma-carcinoma sequence of colon cancer progression. Further, we evaluated their applicability as markers for differentiating adenomas/adenocarcinomas from hyperplastic polyps....... Immunohistochemical analyses performed on colon disease tissue microarrays revealed downregulation of MUC2 and MUC4 expression (p < 0.0001) while MUC1 and MUC5AC expressions were upregulated (p = 0.01) during adenoma-adenocarcinoma progression. Expression of MUC17 was downregulated in inflamed tissues compared to...... normal tissues, but its increased expression differentiated adenomas (p = 0.0028) and adenocarcinomas (p = 0.025) from inflammation. Glycan epitope-Tn/STn on MUC1 showed higher expression in hyperplastic polyps (p = 0.023), adenomas (p = 0.042) and adenocarcinomas (p = 0.0096) compared to normal tissues...

  8. CASE REPORT: A RARE CASE OF ACCESSORY NIPPLE (POLYTHELIA PRESENTING AS PAPILLARY ADENOMA

    Shekappa C

    2014-02-01

    Full Text Available Nipple adenoma is a relatively rare benign breast neoplasm, and cases of the disease arising from the Accessory breast nipple are a rare entity. We report a case of nipple adenoma arising from accessory nipple. A 24 - year - old woman presented with the complaint of pain and bleeding from accessory nipple since 4 months in right breast. Physical examination confirmed a well - defined nipp le in the milk line 5 cm below right nipple. The diagnosis of nipple adenoma was made from an excisional specimen on the basis of characteristic histological findings. Because clinically nipple adenoma may resemble Paget’s disease and pathologically can be misinterpreted as tubular carcinoma, the correct identification of nipple adenoma is an important factor in the differential diagnosis for nipple neoplasms

  9. Increased rectal microbial richness is associated with the presence of colorectal adenomas in humans.

    Sanapareddy, Nina; Legge, Ryan M; Jovov, Biljana; McCoy, Amber; Burcal, Lauren; Araujo-Perez, Felix; Randall, Thomas A; Galanko, Joseph; Benson, Andrew; Sandler, Robert S; Rawls, John F; Abdo, Zaid; Fodor, Anthony A; Keku, Temitope O

    2012-10-01

    Differences in the composition of the gut microbial community have been associated with diseases such as obesity, Crohn's disease, ulcerative colitis and colorectal cancer (CRC). We used 454 titanium pyrosequencing of the V1-V2 region of the 16S rRNA gene to characterize adherent bacterial communities in mucosal biopsy samples from 33 subjects with adenomas and 38 subjects without adenomas (controls). Biopsy samples from subjects with adenomas had greater numbers of bacteria from 87 taxa than controls; only 5 taxa were more abundant in control samples. The magnitude of the differences in the distal gut microbiota between patients with adenomas and controls was more pronounced than that of any other clinical parameters including obesity, diet or family history of CRC. This suggests that sequence analysis of the microbiota could be used to identify patients at risk for developing adenomas. PMID:22622349

  10. Challenging neck mass: non-functional giant parathyroid adenoma.

    Mossinelli, Chiara; Saibene, Alberto Maria; De Pasquale, Loredana; Maccari, Alberto

    2016-01-01

    A 46-year-old man was referred to our ear, nose and throat department after the accidental discovery of a large retrotracheal mass. In order to obtain the diagnosis and to plan treatment he underwent a full battery of tests (CT, MRI, blood tests, hormonal assays, ultrasounds, thyroid scintigraphy, urine tests and fine-needle aspiration of the mass), but none of these was able to define the true nature of such cervical mass. Only after surgical excision and histological evaluation, it was diagnosed as an exceptional case of giant non-functional parathyroid adenoma. PMID:27535730

  11. Análisis de un registro de adenomas pituitarios

    Carolina Albiero; Lea Juárez-Allen; Vanesa Longobardi; Karina Danilowicz; Marcos P. Manavela; Bruno, Oscar D.

    2010-01-01

    Dada la complejidad que reviste el enfoque diagnóstico y terapéutico de los tumores pituitarios, el registro y análisis de la experiencia clínica acumulada es de gran ayuda en la toma de decisiones. En este trabajo se informan datos clínico-terapéuticos, extraídos de un registro computarizado, sobre 519 de un total de 670 pacientes con adenomas pituitarios. Trescientos cuarenta y cinco fueron mujeres (66%) y 174 varones (34%), de 14 a 80 años de edad. El diagnóstico final fue: acromegalia en ...

  12. Marfan Syndrome Accompanied by Pituitary Adenomas: A Case Report

    Qi HUANG

    2014-04-01

    Full Text Available Marfan syndrome (MFS is a dominant inherited connective tissue disease. It has variable clinical manifestations and affects a number of systems, such as the cardiovascular system, eyes, skeletal, lung, skin etc. Fibrillin-1(FBN1)gene mutations are found in approximately 90% patients. The abnormal proteins originated from the mutant gene play a dominant negative effect on normal proteins or change their susceptibility of protease, which leads to the change of connective tissue. This paper reports the clinical data of a patient with Marfan syndrome accompanied by pituitary adenomas and reviews related literatures at home and abroad, to explore its pathogenesis.

  13. [Rare giant salivary gland pleomorphic adenoma on the neck].

    Shi, Dongling; Li, Qinghuai

    2013-12-01

    The patient has found his neck mass for more than 30 years, and the neck mass has slowly growed into giant tumor. Five days ago, the neck giant mass suddenly burst, hemorrhage and overflow liquid. The giant mass with irregular in shape, surface uneven, skin highly tension and superficial venous engorgement, was seen in left lateral neck. CT scan demonstrates a mixture of solid, cystic and lobulated mass shadow within subcutaneous fat spaces of left lateral neck. Postoperative pathological examination proved that it is salivary gland pleomorphic adenoma. PMID:24620671

  14. Radiotherapy for pituitary adenoma: long-term outcome and sequelae

    Purpose/Objective: To review outcome and treatment sequelae in patients treated with external-beam radiotherapy for pituitary adenomas. Materials and Methods: One hundred forty-one patients with pituitary adenomas received radiotherapy and had 2-year minimum follow-up. One hundred twenty-one patients had newly diagnosed adenomas and 20 patients had recurrent tumors. Newly diagnosed tumors were treated with surgery and radiotherapy (S + RT; n=98) or radiotherapy alone (RT; n=23). Patients with recurrent tumors received salvage treatment with S+RT (n=10) or RT (n=10). The impact of age, sex, presenting symptoms, tumor extent, surgery type, degree of resection, hormonal activity, primary or salvage therapy, and radiotherapy dose on local control and cause-specific survival was analyzed. Effect of therapy on vision, hormonal function, life satisfaction, neurocognitive function, and affective symptoms was examined. A Likert scale survey was used for assessment of life satisfaction, neurocognitive status, and affective symptoms after therapy. Survey results from the RT patients were compared to a control group treated with transsphenoidal surgery alone (S). Survival analysis employed the Kaplan-Meier method. Multivariate analysis used the forward step-wise sequence of chi-squares for the log-rank test. Results: At 10 years, local control for the S+RT group (S + RT) was 95% and not statistically different (p=.58) than for patients in the RT group (90%). Cause-specific survival rates were also similar (p=.88) between the S+RT (97%) and RT (99%) groups. Patients with prolactin- and ACTH-secreting tumors had significantly worse local control, as did patients treated for recurrent tumors. Cause-specific survival was not decreased in any patient group. Multivariate analysis for local control and cause-specific survival revealed only young age to be predictive of worse outcome (p=.0354 and p=.0355 respectively). Visual function was either unaffected or improved in most patients

  15. Radiotherapy for pituitary adenoma: long-term outcome and sequelae

    Purpose: To review outcome and treatment sequelae in patients treated with external beam radiotherapy for pituitary adenomas. Methods and Materials: One hundred forty-one patients with pituitary adenomas received radiotherapy at the University of Florida and had 2-year minimum potential follow-up. One hundred twenty-one had newly diagnosed adenomas, and 20 had recurrent tumors. Newly diagnosed tumors were treated with surgery and radiotherapy (n = 98) or radiotherapy alone (n = 23). Patients with recurrent tumors received salvage treatment with surgery and radiotherapy (n = 10) or radiotherapy alone (n = 10). The impact of age, sex, presenting symptoms, tumor extent, surgery type, degree of resection, hormonal activity, primary or salvage therapy, and radiotherapy dose on tumor control was analyzed. Tumor control is defined by the absence of radiographic progression and stable or decreased hormone level (in hormonally active tumors) after treatment. Effect of therapy on vision, hormonal function, neurocognitive function, life satisfaction, and affective symptoms were examined. A Likert categorical scale survey was used for assessment of neurocognitive, life satisfaction, and affective symptom status. Survey results from the radiotherapy patients were compared with a control group treated with transsphenoidal surgery alone. Multivariate analysis used the forward step-wise sequence of chi squares for the log rank test. Results: At 10 years, tumor control for the surgery and radiotherapy group (S + RT) was 95% and not statistically different (p = 0.58) than for patients treated with radiotherapy alone (RT) (90%). Patients with prolactin- and ACTH-secreting tumors had significantly worse tumor control, as did patients treated for recurrent tumors. Multivariate analysis for tumor control revealed that only young age was predictive of worse outcome (p = 0.0354). Visual function was either unaffected or improved in most patients, although four patients developed visual

  16. Spontaneous Resolution of Primary Hyperparathyroidism in Parathyroid Adenoma

    Sara J. Micale

    2012-01-01

    Full Text Available A 71 yo woman with primary hyperparathyroidism awaiting surgery because of significant hypercalcemia and hypercalciuria presented to the local emergency department with the chief complaints of discomfort in her neck, sore throat, and difficulty swallowing. She was found to be hypocalcemic with a calcium level of 8.1 mg/dL. She was seen by her endocrinologist three days later at which time serum calcium, iPTH, and serum phosphate levels were all within normal limits. Based on history and a series of ultrasounds the patient was diagnosed with spontaneous infarction of her parathyroid adenoma, which resulted in resolution of her primary hyperparathyroidism.

  17. Adenoma of the distal common bile duct -a case report-

    Do, Young Soo; Lee, Hyun Gon; Han, Ho Seong; Ko, Gyung Hyuck; Kim, Jae Hyoung; Kim, Hyung Jin; Chung, Sung Hoon [College of Medicine, Gyeongsang National University, Jinju (Korea, Republic of)

    1991-05-15

    On rare occasions, Obstructive Jaundice may be caused by a benign tumor of the biliary tract. We describe a patient in whom the diagnosis of an adenoma of the distal common bile duct (CBD) was established. The CT showed a soft tissue density mass in the distal CBD and diffuse dilatation of the intrahepatic duct, gall the bladder, and CBD. Endoscopic retrograde cholangiopnacreatography showed an irregularly marginated polypoid mass in the distal CBD. The clinical, radiological, and histological features of this neoplasm are reviewed. The clinical, radiological and histological features of this neoplasm are reviewed.

  18. Adenoma viloso com transformação carcinomatosa da ampola de Vater Villous adenoma with carcinomatous degeneration of the ampulla of Vater

    Guilherme Pinto Bravo Neto

    2001-02-01

    Full Text Available Villous adenomas of the duodenum and ampulla of Vater are uncommon, but they have been diagnosed more frequently with the increasing use of upper gastrointestinal endoscopy. Differential diagnosis with villous adenocarcinoma may be difficult. The authors present a case of a 47-year-old man with a giant villous adenoma of the duodenum, with intermittent jaundice, that was treated by pancreatoduodenectomy.

  19.  Immunohistochemical Expression of ki-67 and p53 in Colorectal Adenomas: A Clinicopathological Study

    Hussam Hasson Ali

    2011-07-01

    Full Text Available  Objectives: To evaluate the significance of P53 and Ki-67 expression as immunohistochemical markers in early detection of premalignant changes in different types of colorectal adenomas. Also, to correlate immunohistochemical expression of the two markers with different clinicopathological parameters including; age, and sex of the patient, type, site, size and grade of dysplasia of colorectal adenomas.Methods: Forty-seven polypectomy specimens of colorectal adenomas were retrieved from the archival materials of the Gastrointestinal and Hepatic Diseases Teaching Hospital in Baghdad from 2009 - 2010. Four µm section specimens were stained by immunohistochemical technique with Ki-67 and P53 tumor markers. P-values <0.05 were considered statistically significant.Results: Immunohistochemical expressions of Ki-67 and P53 had a significant correlation with the size and grade of dysplasia in colorectal adenomas. However, there was no significant correlation among the immunohistochemical expression of Ki-67 and P53 with the age and gender of the patient, and the type and site of colorectal adenomas. There was no significant correlation between Ki-67 and P53 expressions in colorectal adenomas. Villous adenomas of colorectum showed a significant correlation with the grade of dysplasia, while there was no significant correlation between size and site of colorectal adenoma with the grade of dysplasia.Conclusion: High grade dysplasia with significant positive immunohistochemical markers of Ki-67 and P53 could be valuable parameters for selecting from the total colorectal adenoma population, those most deserving of close surveillance in follow-up cancer prevention programs. It is closely linked with increasing age particularly in patients with a large size adenoma of villous component in their histology.

  20. Analysis of regulatory networks constructed based on gene coexpression in pituitary adenoma

    Jie Gong; Bo Diao; Guo Jie Yao; Ying Liu; Guo Zheng Xu

    2013-12-01

    Gene coexpression patterns can reveal gene collections with functional consistency. This study systematically constructs regulatory networks for pituitary tumours by integrating gene coexpression, transcriptional and posttranscriptional regulation. Through network analysis, we elaborate the incidence mechanism of pituitary adenoma. The Pearson’s correlation coefficient was utilized to calculate the level of gene coexpression. By comparing pituitary adenoma samples with normal samples, pituitary adenoma-specific gene coexpression patterns were identified. For pituitary adenoma-specific coexpressed genes, we integrated transcription factor (TF) and microRNA (miRNA) regulation to construct a complex regulatory network from the transcriptional and posttranscriptional perspectives. Network module analysis identified the synergistic regulation of genes by miRNAs and TFs in pituitary adenoma. We identified 142 pituitary adenoma-specific active genes, including 43 TFs and 99 target genes of TFs. Functional enrichment of these 142 genes revealed that the occurrence of pituitary adenoma induced abnormalities in intracellular metabolism and angiogenesis process. These 142 genes were also significantly enriched in adenoma pathway. Module analysis of the systematic regulatory network found that three modules contained elements that were closely related to pituitary adenoma, such as FGF2 and SP1, as well as transcription factors and miRNAs involved in the tumourigenesis. These results show that in the occurrence of pituitary adenoma, miRNA, TF and genes interact with each other. Based on gene expression, the proposed method integrates interaction information from different levels and systematically explains the occurrence of pituitary tumours. It facilitates the tracing of the origin of the disease and can provide basis for early diagnosis of complex diseases or cancer without obvious symptoms.

  1. Plasma Inflammatory Markers and Risk of Advanced Colorectal Adenoma in Women.

    Song, Mingyang; Mehta, Raaj S; Wu, Kana; Fuchs, Charles S; Ogino, Shuji; Giovannucci, Edward L; Chan, Andrew T

    2016-01-01

    Evidence remains inconclusive about the association of systemic inflammatory markers with colorectal neoplasia. We investigated whether circulating inflammatory markers were associated with risk of advanced colorectal adenoma. We measured plasma macrophage inhibitory cytokine-1 (MIC-1), C-reactive protein (CRP), interleukin-6 (IL6), and soluble TNF receptor 2 (sTNFR-2) in blood samples drawn from 32,826 women in 1989 to 1990 in the Nurses' Health Study. Through 2008, we documented 757 cases of advanced colorectal adenomas (≥1 cm or any size with advanced histology); each case was matched by age and time of blood draw with one control randomly selected from participants who underwent lower endoscopy and did not have neoplasia. Plasma MIC-1 was associated with higher risk of advanced adenoma (Ptrend = 0.04), with an OR of 1.55 (95% confidence interval, 1.03-2.32) comparing extreme quintiles of MIC-1 after adjusting for colorectal cancer-risk factors and other inflammatory markers. Among cases, MIC-1 level was positively associated with the number of adenomas (P < 0.001) and gradually increased from adenomas located in the rectum, distal colon, and up to the proximal colon. There was a strong positive association between MIC-1 and risk of adenomas with multiplicity, ≥1 cm size and location in the proximal colon (all Ptrend < 0.05). CRP, IL6, or sTNFR-2 was not associated with adenoma risk. In conclusion, plasma MIC-1 was associated with higher risk of colorectal adenoma, especially multiple, large, and proximal adenomas. Our results provide further support for a role for MIC-1 in carcinogenesis and the potential for MIC-1 as an adjunctive biomarker for detection of advanced colorectal adenoma. PMID:26511487

  2. Prevalence of colorectal adenomas in asymptomatic young adults: a window to early intervention?

    Kwak, Ji Yeong; Kim, Kwang Min; Yang, Hae Jin; Yu, Kil Jong; Lee, Jae Gon; Jeong, Yeon Oh; Shim, Sang Goon

    2016-06-01

    Objective The prevalence of colorectal adenoma is increasing in the average-risk population. However, little research is available on colorectal adenoma in young adults under age 40. The aim of this study was to investigate the prevalence and risk factors of colorectal adenoma in 20- to 39-year-old adults. Methods We evaluated 4286 asymptomatic young adults aged 20 to 39 years who underwent first colonoscopy screening as part of an employer-provided health wellness programme at the Health Promotion Centre of Samsung Changwon Hospital, Korea from January 2011 to December 2013. Logistic regression modelling was used to identify risk factors for colorectal adenoma in asymptomatic young adults. Results The prevalence of colorectal adenoma and advanced adenoma was 11.6% (497/4286) and 0.9% (39/4286), respectively. By age group, the prevalence of colorectal adenoma was 5.4% (33/608) in participants aged 20 to 29 years and 12.6% (464/3678) in participants aged 30 to 39. Colorectal adenoma was found in 13.1% (403/3072) of men and 7.7% (94/1214) of women. Increased risk of colorectal adenoma was associated with age over 30 years (OR, 2.37; 95% CI, 1.64-3.42), current smoker status (OR, 1.48; 95% CI, 1.14-1.91), and alcohol consumption (OR, 1.29; 95% CI, 1.03-1.63). Conclusions Our findings indicate that even if the prevalence of colorectal adenoma was low in young adults aged 20 to 39, being over 30, cigarette smoking, and alcohol consumption can affect young adults who have no other CRC risks. PMID:26863602

  3. Seesaw nystagmus caused by giant pituitary adenoma: case report Nistagmo em gangorra causado por adenoma pituitário gigante: relato de caso

    Frederico Castelo Moura

    2006-03-01

    Full Text Available Giant pituitary adenomas are uncommonly large tumors, greater than 4 cm in size that can produces endocrine symptoms, visual loss and cranial nerve palsies. We report the rare occurrence of seesaw nystagmus as the presenting sign of giant pituitary adenoma. A 50-year-old man presented with headache associated with visual loss and seesaw nystagmus. Perimetry revealed bitemporal hemianopia and magnetic resonance imaging showed a giant pituitary adenoma. After surgery, nystagmus disappeared. Our case is relevant in understanding its pathogenesis since it documents seesaw nystagmus in a patient bitemporal hemianopia due to a large tumor but without mesencephalic compression.Adenoma pituitário gigante é um tumor incomum, maior que 4 cm que produz sintomas endócrinos, perda visual e paralisia de nervos cranianos. Relatamos um caso de nistagmo em gangorra como sinal de apresentação de adenoma pituitário gigante. Um paciente de 50 anos, masculino, apresentava cefaléia, perda visual e nistagmo em gangorra. A perimetria revelou hemianopsia bitemporal e a imagem por ressonância magnética demonstrou um adenoma pituitário gigante. Após a cirurgia, o nistagmo desapareceu. Nosso caso é importante na compreensão da fisiopatogenia do nistagmo em gangorra, pois documenta sua ocorrência em paciente com hemianopsia bitemporal decorrente de tumor hipofisário sem compressão mesencefálica.

  4. 99mTc(V)-DMSA. A useful radio isotopic material for the diagnosis of pituitary adenoma

    Suzuki, Shinichi; Yamamura, Koji; Chang, Chia-Cheng; Kojima, Yasuhiro; Yamamoto, Isao; Ikegami, Tadashi [Yokohama City Univ., Kanagawa (Japan). School of Medicine

    2000-06-01

    We compared images of pituitary adenoma, parasellar tumors, and non-pituitary adenoma using the tumor-seeking agent technetium-99m-labeled pentavalent dimercaptosuccinic acid (99mTc(V)-DMSA) and evaluated the relationship between 99mTc(V)-DMSA uptake and pituitary hormone level. Fifteen patients with pituitary adenoma were studied: 3 non-functioning adenoma, 6 prolactinoma, 4 GH secreting adenoma, and 2 ACTH secreting adenoma. As a control group, we studied 6 patients without adenoma who had undergone a pathological examination. Planar and SPECT images were obtained 2-hours after intravenous injection of approximately 740 MBq 99mTc(V)-DMSA. Uptake ratios between normal background and tumor lesion were calculated. Three non-functioning adenoma (100%), five prolactinoma (83%), three GH secreting adenoma (75%) and no ACTH secreting adenoma (0%) significantly concentrated 99mTc(V)-DMSA. One of the non-adenomatous tumors, a Rathke's cleft cyst concentrated 99mTc(V)-DMSA in the pituitary while the others did not. The 99mTc(V)-DMSA scintigraphy showed an overall sensitivity of 73% (11/15) in detecting pituitary adenomas. Uptake ratios were higher in hormone-secreting adenoma than non-secreting adenoma. We were able to detect residual tumors and distinguish pituitary adenoma from surgical non-tumoral lesion with 99mTc(V)-DMSA. These results suggest that 99mTc(V)-DMSA imaging is useful in detecting pituitary adenoma and noninvasively differentiating tumor types in parasellar lesion. (author)

  5. 99mTc(V)-DMSA. A useful radio isotopic material for the diagnosis of pituitary adenoma

    We compared images of pituitary adenoma, parasellar tumors, and non-pituitary adenoma using the tumor-seeking agent technetium-99m-labeled pentavalent dimercaptosuccinic acid (99mTc(V)-DMSA) and evaluated the relationship between 99mTc(V)-DMSA uptake and pituitary hormone level. Fifteen patients with pituitary adenoma were studied: 3 non-functioning adenoma, 6 prolactinoma, 4 GH secreting adenoma, and 2 ACTH secreting adenoma. As a control group, we studied 6 patients without adenoma who had undergone a pathological examination. Planar and SPECT images were obtained 2-hours after intravenous injection of approximately 740 MBq 99mTc(V)-DMSA. Uptake ratios between normal background and tumor lesion were calculated. Three non-functioning adenoma (100%), five prolactinoma (83%), three GH secreting adenoma (75%) and no ACTH secreting adenoma (0%) significantly concentrated 99mTc(V)-DMSA. One of the non-adenomatous tumors, a Rathke's cleft cyst concentrated 99mTc(V)-DMSA in the pituitary while the others did not. The 99mTc(V)-DMSA scintigraphy showed an overall sensitivity of 73% (11/15) in detecting pituitary adenomas. Uptake ratios were higher in hormone-secreting adenoma than non-secreting adenoma. We were able to detect residual tumors and distinguish pituitary adenoma from surgical non-tumoral lesion with 99mTc(V)-DMSA. These results suggest that 99mTc(V)-DMSA imaging is useful in detecting pituitary adenoma and noninvasively differentiating tumor types in parasellar lesion. (author)

  6. Human Pituitary Adenoma Proteomics: New Progresses and Perspectives.

    Zhan, Xianquan; Wang, Xiaowei; Cheng, Tingting

    2016-01-01

    Pituitary adenoma (PA) is a common intracranial neoplasm that impacts on human health through interfering hypothalamus-pituitary-target organ axis systems. The development of proteomics gives great promises in the clarification of molecular mechanisms of a PA and discovery of effective biomarkers for prediction, prevention, early-stage diagnosis, and treatment for a PA. A great progress in the field of PA proteomics has been made in the past 10 years, including (i) the use of laser-capture microdissection, (ii) proteomics analyses of functional PAs (such as prolactinoma), invasive and non-invasive non-functional pituitary adenomas (NFPAs), protein post-translational modifications such as phosphorylation and tyrosine nitration, NFPA heterogeneity, and hormone isoforms, (iii) the use of protein antibody array, (iv) serum proteomics and peptidomics, (v) the integration of proteomics and other omics data, and (vi) the proposal of multi-parameter systematic strategy for a PA. This review will summarize these progresses of proteomics in PAs, point out the existing drawbacks, propose the future research directions, and address the clinical relevance of PA proteomics data, in order to achieve our long-term goal that is use of proteomics to clarify molecular mechanisms, construct molecular networks, and discover effective biomarkers. PMID:27303365

  7. Human pituitary adenoma proteomics: new progresses and perspectives

    Xianquan eZhan

    2016-05-01

    Full Text Available Pituitary adenoma (PA is a commonly intracranial neoplasm that impacts on human health through interfering hypothalamus-pituitary-target organ axis systems. The development of proteomics gives great promises in clarification of molecular mechanisms of a pituitary adenoma and discovery of effective biomarkers for prediction, prevention, early-stage diagnosis and treatment of a PA. A great progress in the field of PA proteomics has been made in the past ten years, including (i the use of laser capture microdissection, (ii proteomics analyses of functional PAs (FPAs, such as prolactinoma, invasive and noninvasive nonfunctional PAs (NFPAs, protein post-translational modifications (PTMs including phosphorylation and tyrosine nitration, NFPA heterogeneity, and hormone isoforms, (iii the use of protein antibody array, (iv serum proteomics and peptidomics, (v integration of proteomics and other omics data, and (vi proposal of multi-parameter systematic strategy for a PA. This review will summarize those progresses of proteomics in PAs, point out the existing drawbacks, propose the future research directions, and address the clinical relevance of PA proteomics data, in order to achieve our long-term goal that is use of proteomics to clarify molecular mechanisms, construct molecular networks, and discover effective biomarkers.

  8. Testosterone-secreting adrenal adenoma in a peripubertal girl

    A 15-year-old girl who presented with primary amenorrhea and virilization had an adrenocortical adenoma that secreted predominantly testosterone. To the authors' knowledge, she is the first peripubertal and second youngest patient with a testosterone-secreting adrenal tumor described. Serum dehydroepiandrosterone sulfate and urinary 17-ketosteroid an 17-hydroxycorticosteroid levels were normal. A tumor was located by a computed tomographic (CT) scan and by uptake of 6-β-[75Se] selenomethylnorcholesterol. Microscopic examination of the tumor showed typical features of an adrenocortical adenoma with no histologic features characteristic of Leydig cells. Postoperatively, her hirsutism regressed, she rapidly went through puberty, and regular monthly menstruation started four months later. Finding the source of testosterone in a virilized patient can be difficult. Eleven of the 14 previously described patients with testosterone-secreting adrenal tumors initially underwent misdirected surgery on the ovaries. Review of these cases revealed that results of hormone stimulation and suppression tests are unreliable and that these tumors are usually large. Therefore, CT scanning of the adrenal glands is recommended in all patients suspected of having a testosterone-secreting tumor

  9. Thyrotropin-secreting pituitary adenomas: epidemiology, diagnosis, and management.

    Amlashi, Fatemeh G; Tritos, Nicholas A

    2016-06-01

    Inappropriate secretion of TSH was first described in 1960 in a patient with evidence of hyperthyroidism and expanded sella on imaging. It was later found that a type of pituitary adenoma that secretes TSH (thyrotropinoma) was the underlying cause. The objective of the present review article is to summarize data on the epidemiology, pathogenesis, diagnosis, and management of thyrotropinomas. The prevalence of thyrotropinomas is lower than that of other pituitary adenomas. Early diagnosis is now possible thanks to the availability of magnetic resonance imaging and sensitive laboratory assays. As a corollary, many patients now present earlier in the course of their disease and have smaller tumors at the time of diagnosis. Treatment also has evolved over time. Transsphenoidal surgery is still considered definitive therapy. Meanwhile, radiation therapy, including radiosurgery, is effective in achieving tumor control in the majority of patients. In the past, radiation therapy was used as second line treatment in patients with residual or recurrent tumor after surgery. However, the availability of somatostatin analogs, which can lead to normalization of thyroid function as well as shrink these tumors, has led to an increase in the role of medical therapy in patients who are not in remission after pituitary surgery. In addition, dopamine agonists have shown some efficacy in the management of these tumors. Better understanding of the molecular pathogenesis of thyrotropinomas may lead to rationally designed therapies for patients with thyrotropinomas. PMID:26792794

  10. Liver cell adenoma with malignant transformation: A case report

    Masahiro Ito; Makoto Sasaki; Chun-Yang Wen; Masahiro Nakashima; Toshihito Ueki; Hiromi Ishibashi; Michitami Yano; Masayoshi Kage; Masamichi Kojiro

    2003-01-01

    A 57-year-old woman was referred to our hospital because of a liver mass detected by computed tomography. She had taken oral contraceptives for only one month at the age of thirty. Physical examination revealed no abnormalities, and laboratory data, including hepatic function tests, were within the normal range, with the exception of elevated levels of those serum proteins induced by the absence of vitamin K or by raised levels of the antagonist (PIVKA)-Ⅱ (3 502 AU/ml).Abdominal ultrasonography revealed a hyperechoic mass measuring 10x10 cm in the left posterior segment of the liver. Because hepatocellular carcinoma could not be completely excluded, this mass was resected. The tumor consisted of sheets of uniform cells with clear cytoplasm,perinuclear eosinophilic granules and round nuclei. These histological findings were consistent with liver cell adenoma.Background hepatic tissue appeared normal. After resection of the tumor, serum PIVKA-Ⅱ fell to within the normal range.An area of hepatocellular carcinoma (HCC) with a midtrabecular pattern was immunohistochemically found, which was positive for PIVKA-Ⅱ. Sinusoidal endothelial cells were CD34-positive, containing scattered PIVKA-Ⅱ positive cells.This tumor was therefore finally diagnosed as liver cell adenoma with focal malignant transformation to HCC.

  11. Oral rehabilitation after surgical removal of pleomorphic adenoma.

    Goiato, Marcelo Coelho; Tamae, Adriano Caires; Silva, Pedro Ivo Santos; dos Santos, Daniela Micheline; Iyda, Mariana Garib; Moreno, Amalia; Magro-Filho, Osvaldo; Bertoz, André Pinheiro Magalhães

    2011-11-01

    Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. The treatment of choice for most of maxillary tumors is surgical through either a total or partial maxillectomy. However, surgical defects caused by such type of treatment lead to both clinical and psychologic disorders for the patient. The immediate oral rehabilitation using interim palate obturator after maxillectomy provides optimization on the healing process, recovers the stomatognathic functions after surgery, and avoids psychosocial sequelae for the patients. This clinical report aimed to present the rehabilitation with immediate palate obturator of a patient who underwent a partial maxillectomy due to a hard palate pleomorphic adenoma of minor salivary glands. We report the clinical importance of the prosthetic rehabilitation and the improvements on both quality of life and stomatognathic functions of this patient. It can be concluded that the immediate rehabilitation of the patient after partial maxillectomy by using an interim palate obturator was a great option and provided clinical benefits in the immediate postoperative period, improving the patient’s quality of life, allowing the patient’s reinsertion into society, and reducing the surgical treatment sequelae. PMID:22067849

  12. ELEVATED SOLUBLE EPIDERMAL GROWTH FACTOR RECEPTOR LEVEL IN PITUITARY ADENOMA AND CARCINOMA

    Yan-guo Kong; Zu-yuan Ren; Chang-bao Su; Ren-zhi Wang; Wen-bing Ma; Wei Lian

    2004-01-01

    Objective To investigate effect of the soluble epidermal growth factor receptor (sEGFR/sErbB1) level in the peripheral blood in development, invasiveness, apoplexy of each type of pituitary tumor.Methods The sEGFR level was determined in peripheral serum from 190 patients with pituitary diseases by enzyme linked immunosobent assay. The sEGFR levels were measured in 10 pituitary Rathke's pouch, 18 pituitary hyperplasia, 161pituitary adenomas including 30 microadenomas, 83 large adenomas, 48 giant adenomas, 1 pituitary carcinoma, and 28 healthy controls.Results In the patients with pituitary hyperplasia, microadenoma, large adenoma, giant adenoma, and pituitary carcinoma, the sEGFR level was 188.92 + 32.62, 209.83 + 19.01,333.20 + 69.33, 405.85 + 37.38, and 617.45 fmol/mL independently. They were all significantly higher than patients with pituitary Rathke's pouch (156.78 + 18.24 fmol/mL, P < 0.001)and healthy control group (159.11 +40.50 fmol/mL, P < 0.05). The sEGFR level in pituitary carcinoma was higher than pituitary adenoma. In patients with pituitary adenoma, the sEGFR level was positive correlated to the size of pituitary adenomas (r = 0.998), the significant difference was observed for the sEGFR level in each group of the patients with pituitary adenomas (P < 0.001). Furthermore, in patients with pituitary ACTH-secrefing microadenomas, the serum sEGFR levels in invasiveness (295.00+77.80 fmol/mL) was higher than that in non-invasiveness (210.60+ 16.4 fmol/mL, P < 0.05). In patients with pituitary ACTH-secreting, PRL-secreting, GH-secreting, and non-functioning large adenomas, the serum sEGFR levels in invasiveness (407.86 + 28.50, 399.25 + 30.10, 386.00 + 13.08, and 369.25 + 36.70 fmol/mL) was higher than that in non-invasiveness (335.25 +63.49, 300.64+47.57, 297.00+61.93, and 269.30+25.68 fmol/mL) respectively (P < 0.05). In patients with invasive pituitary PRL-secreting, GH-secreting, and non-functioning giant adenomas, the serum sEGFR levels not

  13. Adenoma development in familial adenomatous polyposis and MUTYH-associated polyposis: somatic landscape and driver genes.

    Rashid, Mamunur; Fischer, Andrej; Wilson, Cathy H; Tiffen, Jessamy; Rust, Alistair G; Stevens, Philip; Idziaszczyk, Shelley; Maynard, Julie; Williams, Geraint T; Mustonen, Ville; Sampson, Julian R; Adams, David J

    2016-01-01

    Familial adenomatous polyposis (FAP) and MUTYH-associated polyposis (MAP) are inherited disorders associated with multiple colorectal adenomas that lead to a very high risk of colorectal cancer. The somatic mutations that drive adenoma development in these conditions have not been investigated comprehensively. In this study we performed analysis of paired colorectal adenoma and normal tissue DNA from individuals with FAP or MAP, sequencing 14 adenoma whole exomes (eight MAP, six FAP), 55 adenoma targeted exomes (33 MAP, 22 FAP) and germline DNA from each patient, and a further 63 adenomas by capillary sequencing (41 FAP, 22 MAP). With these data we examined the profile of mutated genes, the mutational signatures and the somatic mutation rates, observing significant diversity in the constellations of mutated driver genes in different adenomas, and loss-of-function mutations in WTX (9%; p < 9.99e-06), a gene implicated in regulation of the WNT pathway and p53 acetylation. These data extend our understanding of the early events in colorectal tumourigenesis in the polyposis syndromes. PMID:26414517

  14. Identification of an epigenetic biomarker panel with high sensitivity and specificity for colorectal cancer and adenomas

    Lind Guro E

    2011-07-01

    Full Text Available Abstract Background The presence of cancer-specific DNA methylation patterns in epithelial colorectal cells in human feces provides the prospect of a simple, non-invasive screening test for colorectal cancer and its precursor, the adenoma. This study investigates a panel of epigenetic markers for the detection of colorectal cancer and adenomas. Methods Candidate biomarkers were subjected to quantitative methylation analysis in test sets of tissue samples from colorectal cancers, adenomas, and normal colonic mucosa. All findings were verified in independent clinical validation series. A total of 523 human samples were included in the study. Receiver operating characteristic (ROC curve analysis was used to evaluate the performance of the biomarker panel. Results Promoter hypermethylation of the genes CNRIP1, FBN1, INA, MAL, SNCA, and SPG20 was frequent in both colorectal cancers (65-94% and adenomas (35-91%, whereas normal mucosa samples were rarely (0-5% methylated. The combined sensitivity of at least two positives among the six markers was 94% for colorectal cancers and 93% for adenoma samples, with a specificity of 98%. The resulting areas under the ROC curve were 0.984 for cancers and 0.968 for adenomas versus normal mucosa. Conclusions The novel epigenetic marker panel shows very high sensitivity and specificity for both colorectal cancers and adenomas. Our findings suggest this biomarker panel to be highly suitable for early tumor detection.

  15. A Case of Cushing's Syndrome with Multiple Adrenocortical Adenomas Composed of Compact Cells and Clear Cells.

    Asakawa, Masahiro; Yoshimoto, Takanobu; Ota, Mitsutane; Numasawa, Mitsuyuki; Sasahara, Yuriko; Takeuchi, Takato; Nakano, Yujiro; Oohara, Norihiko; Murakami, Masanori; Bouchi, Ryotaro; Minami, Isao; Tsuchiya, Kyoichiro; Hashimoto, Koshi; Izumiyama, Hajime; Kawamura, Naoko; Kihara, Kazunori; Negi, Mariko; Akashi, Takumi; Eishi, Yoshinobu; Sasano, Hironobu; Ogawa, Yoshihiro

    2016-06-01

    A 58-year-old woman was referred to our hospital for Cushingoid features and diagnosed as adrenal Cushing's syndrome due to a right adrenocortical mass (60 × 55 mm). The mass was composed of three different tumors; the first one was homogeneously lipid-poor neoplasm measuring 20 × 13 mm located at the most dorsal region, the second one was heterogeneous and lipid-rich tumor containing multiple foci of calcification measuring 50 × 32 mm located at the central region, and the last one was heterogeneous harboring dilated and tortuous vessels and lipid-poor one measuring 35 × 18 mm at the most ventral region of the adrenal gland. A right adrenalectomy was subsequently performed by open surgery. Macroscopic and microscopic analyses revealed that all three tumors were adrenocortical adenomas; the first one represents a pigmented adrenocortical adenoma, the second one adrenocortical adenoma associated with degeneration, and the third one adrenocortical adenoma harboring extensive degeneration. Immunohistochemical analysis of the steroidogenic enzymes also revealed that all of the tumors had the capacity of synthesizing cortisol. This is a very rare case of Cushing's syndrome caused by multiple adrenocortical adenomas including a pigmented adenoma. Immunohistochemical analysis of steroidogenic enzymes contributed to understanding of steroidogenesis in each of these three different adrenocortical adenomas in this case. PMID:26961704

  16. Differential gene expression by fiber-optic beadarray and pathway in adrenocorticotrophin-secreting pituitary adenomas

    JIANG Zhi-quan; GUI Song-bo; ZHANG Ya-zhuo

    2010-01-01

    Background Adrenocorticotrophin (ACTH)-secreting pituitary adenomas account for approximately 7%-14% of all pituitary adenomas, but its pathogenesis is still enigmatic. This study aimed to explore mechanisms underlying the pathogenesis of ACTH-secreting pituitary adenomas.Methods We used fiber-optic beadarray to examine gene expression in three ACTH-secreting adenomas compared with three normal pituitaries. Four differentially expressed genes from the three ACTH-secreting adenomas and three normal pituitaries were chosen randomly for validation by reverse transcriptase-real time quantitative polymerase chain reaction (RT-qPCR). We then analyzed the differentially expressed gene profile with Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway.Results Fiber-optic beadarray analysis showed that the expression of 28 genes and 8 expressed sequence tags (ESTs)were significantly increased and the expression of 412 genes and 31 ESTs were significantly decreased. Bioinformatic and pathway analysis showed that the genes HIGD1B, EPS8, HPGD, DAPK2, and IGFBP3 and the transforming growth factor (TGF)-β signaling pathway and extracellular matrix (ECM)-receptor interaction pathway may play important roles in tumorigenesis and progression of ACTH-secreting pituitary adenomas.Conclusions Our data suggest that numerous aberrantly expressed genes and several pathways are involved in the pathogenesis of ACTH-secreting pituitary adenomas. Fiber-optic beadarray combined with pathway analysis of differential gene expression appears to be a valid method of investigating tumour pathogenesis.

  17. The association of serum lipids with the histological pattern of rectosigmoid adenoma in Taiwanese adults

    Lu Feng-Hwa

    2011-05-01

    Full Text Available Abstract Background The mortality rate of colorectal cancer ranks third behind lung and hepatic cancer in Taiwan. Colorectal cancer mostly arises from adenomatous polyps of left colon. The aim of our study was to examine the association of serum lipids with the histological pattern of rectosigmoid adenoma. Methods There were 2,506 eligible examinees aged 20 and above who underwent sigmoidoscopy as a screening examination in National Cheng Kung University Hospital between January 2003 and October 2006. They were classified into three groups: tubular adenoma (333 subjects, villous-rich (tubulovillous/villous adenoma (53 subjects and normal (2,120 subjects. We defined high total cholesterol (TC as a level ≧200 mg/dl, low high-density lipoprotein cholesterol (HDL-C as a level Results Among the study population, 333 subjects (13.3% had tubular adenomas and 53 subjects (2.1% had villous-rich adenomas. The odds ratio (OR for villous-rich adenoma in subjects with TG≧200 mg/dL compared to those with TG Conclusions Our study showed that subjects with high serum TG tended to have a higher risk of tubulovillous/villous adenoma in rectosigmoid colon. Therefore, reducing the serum TG level might be one method to prevent the incidence of colorectal cancer.

  18. The Occurrence of Primary Hepatic Adenoma in Deceased Donor Renal Transplant Recipient

    Yu-Tso Liao

    2014-01-01

    Full Text Available Main findings: We reported a case of new-onset, multi-focal hepatic adenoma in an 18 year-old man with no classic risk factors occurring forty months after a renal transplant from a cadaver donor. Histopathology of the adenoma was examined and genotype and phenotype were also analyzed. Histopathologic examination of the adenoma showed no malignancy. Genotype and phenotype analysis revealed no HNF1α or β-catenin gene mutations and no inflammatory infiltration. The patient was well and disease-free postoperatively. Case hypothesis: Hepatic adenoma occurs mostly in those taking oral contraceptives or androgenic-anabolic steroids or in those with hereditary diseases. Hepatic adenoma in a renal transplant recipient is rare and has only been reported in one case with glycogen storage disease type Ia. Immunosuppressive treatment might have contributed to the development of the neoplasm. Promising future implications: Although malignant change occurs most often in β-catenin gene mutation hepatic adenoma, surgical resection of the adenoma in a patient under immunosuppressive therapy should be considered in order to avoid the possibility of malignant transformation or hemorrhagic rupture.

  19. Discriminatory power of MRI for differentiation of adrenal non-adenomas vs adenomas evaluated by means of ROC analysis: Can biopsy be obviated?

    The purpose of our study was to evaluate the discriminatory power of MRI in high-field magnet (1.5 T) for differentiation of adrenal non-adenomas vs adenomas assessing the following parameters separately and in combination: mean diameter of adrenal mass; previously described and new ratios as well as index calculated from signal intensity (SI) on SE T2-weighted images, chemical shift imaging (CSI), and Gd-DTPA-enhanced dynamic studies. One hundred eight adrenal masses (36 non-hyperfunctioning adenomas, 27 pheochromocytomas, 23 aldosterone-secreting adenomas, 20 malignant masses and 2 cortisol-secreting adenomas) in 95 patients were evaluated with SE sequences, CSI and Gd-DTPA dynamic studies. Indices and ratios of SI for all examined MRI methods were calculated and examined retrospectively for significance of differences between the groups with calculation of sensitivity and specificity. Receiver operating characteristics (ROC) analysis of calculated parameters in combination was performed. The multifactorial analysis of all four parameters, including size of the tumor, T2liver index, CSI ratio reflecting lipid content in the tumor and Womax/last ratio reflecting maximal washout of contrast agent from the tumor had 100 % sensitivity and 100 % specificity in characterization of adrenal non-adenoma. The best performance of combination of mean tumor diameter with single MRI SI parameter was achieved in combination with T2liver index for all adrenal masses (area under ROC 0.987) and CSI ratio for non-hyperfunctioning adrenal masses (area under ROC 0.991). Magnetic resonance imaging enables sensitive and specific diagnosis of adrenal non-adenoma. (orig.)

  20. Appearance of Hürthle cell carcinoma soon after surgical extirpation of Hürthle cell adenoma and follicular adenoma of the thyroid gland

    Hürthle cell neoplasms could be benign (Hürthle cell adenoma) or malignant (Hürthle cell carcinoma). Hürthle cell carcinoma is a rare tumour, representing 5% of all differentiated thyroid carcinomas. The cytological evaluation of Hürthle cell neoplasms by fine needle aspiration biopsy (FNAB) is complicated because of the presence of Hürthle cells in both Hürthle cell adenoma and Hürthle cell carcinoma. Thus, the preoperative distinction between these two entities is very difficult and possible only with pathohistological findings of the removed tumour. A 57-year old female patient was admitted at our Department, for investigation of nodular thyroid gland. She was euthyroid and FNAB of the nodules in both thyroid lobes were consistent of Hürthle cell adenoma with cellular atypias. After thyroidectomy the histopathology revealed Hürthle cell adenoma with high cellular content and discrete cellular atypias in the left lobe and follicular thyroid adenoma without cellular atypias in the right lobe. One year after substitution therapy, a palpable tumour on the left side of the remnant tissue was found, significantly growing with time, presented as hot nodule on 99mTc-sestamibi scan and conclusive with Hürthle cell adenoma with marked cellularity on FNAB. Tumorectomy was performed and well-differentiated Hürthle cell carcinoma detected. The patient received ablative dose of 100 mCi 131I. No signs of metastatic disease are present up to date. The differences between Hürthle cell adenomas and Hürthle cell carcinomas could be clearly made only by histopathological evaluation. Patients with cytological diagnosis of Hürthle cell neoplasms should proceed to total thyroidectomy, especially if tumour size is > 1cm, FNAB findings comprise cellular atypias and/or multiple bilateral nodules are detected in the thyroid gland

  1. Pituitary tumor transforming gene-1 haplotypes and risk of pituitary adenoma: a case-control study

    Liu Jinfang

    2011-03-01

    Full Text Available Abstract Background It has been suggested that pituitary adenoma results from accumulation of multiple genetic and/or epigenetic aberrations, which may be identified through association studies. As pituitary tumor transforming gene-1 (PTTG1/securin plays a critical role in promoting genomic instability in pituitary neoplasia, the present study explored the association of PTTG1 haplotypes with the risk of pituitary adenoma. Methods We genotyped five PTTG1 haplotype-tagging SNPs (htSNP by PCR-RFLP assays in a case-control study, which included 280 Han Chinese patients diagnosed with pituitary adenoma and 280 age-, gender- and geographically matched Han Chinese controls. Haplotypes were reconstructed according to the genotyping data and linkage disequilibrium status of the htSNPs. Results No significant differences in allele and genotype frequencies of the htSNPs were observed between pituitary adenoma patients and controls, indicating that none of the individual PTTG1 SNPs examined in this study is associated with the risk of pituitary adenoma. In addition, no significant association was detected between the reconstructed PTTG1 haplotypes and pituitary adenoma cases or the controls. Conclusions Though no significant association was found between PTTG1 haplotypes and the risk of pituitary adenoma, this is the first report on the association of individual PTTG1 SNPs or PTTG1 haplotypes with the risk of pituitary adenoma based on a solid study; it will provide an important reference for future studies on the association between genetic alterations in PTTG1 and the risk of pituitary adenoma or other tumors.

  2. Hepatic adenomas with synchronous or metachronous fibrolamellar carcinomas: both are characterized by LFABP loss.

    Graham, Rondell P; Terracciano, Luigi M; Meves, Alexander; Vanderboom, Patrick M; Dasari, Surendra; Yeh, Matthew M; Torbenson, Michael S; Cruise, Michael W

    2016-06-01

    Rare hepatic adenomas are associated with synchronous or metachronous fibrolamellar carcinomas. The morphology of these adenomas has not been well described and they have not been subclassifed using the current molecular classification schema. We examined four hepatic adenomas co-occurring with or preceding a diagnosis of fibrolamellar carcinoma in three patients. On histological examination, three of the adenomas showed the typical morphology of HNF1-α inactivated adenomas, whereas one showed a myxoid adenoma morphology. All of the adenomas were negative for PRKACA rearrangements by Fluorescence in situ Hybridization (FISH) analysis. All four of the adenomas showed complete loss or significant reduction of liver fatty acid binding protein (LFABP) expression by immunohistochemistry. Interestingly, the fibrolamellar carcinomas in each case also showed loss of LFABP by immunohistochemistry. One of the fibrolamellar carcinomas was negative for PRKACA rearrangements by FISH, whereas the others were positive. To investigate if LFBAP loss is typical of fibrolamellar carcinomas in general, an additional cohort of tumors was studied (n=19). All 19 fibrolamellar carcinomas showed the expected PRKACA rearrangements and immunostains showed loss of LFABP in each case, consistent with HNF1-α inactivation. To validate this observation, mass spectrometry-based proteomics was performed on tumor-normal pairs of six fibrolamellar carcinomas and showed an average 10-fold reduction in LFABP protein levels, compared with matched normal liver tissue. In conclusion, hepatic adenomas co-occurring with fibrolamellar carcinomas show LFABP loss and are negative for PRKACA rearrangements, indicating they are genetically distinct lesions. These data also demonstrate that LFABP loss, which characterizes HNF1-α inactivation, is a consistent feature of fibrolamellar carcinoma, indicating HNF1-α inactivation is an important event in fibrolamellar carcinoma pathogenesis. PMID:27015136

  3. Localization of Parathyroid Adenoma With Real-Time Ultrasound: Freehand SPECT Fusion.

    Bluemel, Christina; Kirchner, Paul; Kajdi, Georg W; Werner, Rudolf A; Herrmann, Ken

    2016-03-01

    Preoperative localization of parathyroid adenoma in primary hyperparathyroidism gains in importance as there is a trend toward minimally invasive parathyroid surgery. Besides MRI, 4-dimensional CT, PET/CT, invasive-selective venous sampling, or angiography, both ultrasound and scintigraphy are standard of care for lesion localization. Here we report on a 53-year-old woman with suspicion of primary hyperparathyroidism using real-time fusion of scintigraphic (freehand SPECT) and ultrasound imaging for adenoma localization. Real-time fusion of ultrasound and freehand SPECT allowed noninvasive dedicated metabolic and anatomic adenoma localization and treatment planning. PMID:26284776

  4. Hepatic adenoma: incidence and management between the year 2002-2006 Hospital R. Calderon Guardia

    The incidence and management of hepatic adenoma at the Hospital Calderon Guardia are analyzed between the years 2002-2006. The main hepatic pathologies diagnosed by biopsy are shown. The relationship of hepatic adenoma with the above risk factors and presentation of each case of hepatic adenoma found are analyzed. The media diagnosed in this type of pathology were investigated. The evolution and control of each case of hepatic adenoma have been studied. The results of the management of each case are compared with the recommended in literature. The ideal management of this type of pathology is analyzed. Among the conclusions is given benign liver pathology as the most frequent cause of liver biopsy in the Hospital Calderon Guardia. Metastatic disease of the digestive tract has been the primary neoplastic disease at the hepatic level. Focal nodular hyperplasia has been the biopsy of benign tumor that is performed more frequently. Hepatic adenoma has been a rare entity, but with significant mortality rates. All cases were presented as solitary lesions. It is more common in women of childbearing age but can occur also in older people and in men. A close relationship has existed between the use of oral gestagens and the incidence of hepatic adenoma. Hepatic adenomas and its complications have been related to its size. Most cases of hepatic adenoma were presented with symptoms. The preoperative studies have shown high sensitivity in the detection of lesions, but little specificity. A protocol for the study of hepatic masses is required. A relationship between the size of the adenoma and possible complications was demonstrated. The reason for surgery in most cases has been the possibility of malignancy in the liver injury. The correlation between preoperative diagnosis and the end was unsuccessful in 75 percent of cases. The mortality related to the procedures did not exist, but if a case of morbidity. The study of liver masses should be more exhaustive to improve

  5. An intelligent system for automatic detection of gastrointestinal adenomas in video endoscopy.

    Iakovidis, Dimitris K; Maroulis, Dimitris E; Karkanis, Stavros A

    2006-10-01

    Today 95% of all gastrointestinal carcinomas are believed to arise from adenomas. The early detection of adenomas could prevent their evolution to cancer. A novel system for the support of the detection of adenomas in gastrointestinal video endoscopy is presented. Unlike other systems, it accepts standard low-resolution video input thus requiring less computational resources and facilitating both portability and the potential to be used in telemedicine applications. It combines intelligent processing techniques of SVMs and color-texture analysis methodologies into a sound pattern recognition framework. Concerning the system's accuracy this was measured using ROC analysis and found to exceed 94%. PMID:16293240

  6. First-pass perfusion computed tomography: Initial experience in differentiating adrenal adenoma from metastasis

    Objective: To differentiate adrenal adenoma from metastasis in patients using perfusion computed tomography (PCT) imaging. Methods: Thirty-two patients with adrenal masses underwent first-pass PCT imaging. Of these patients, twenty-one were diagnosed with adrenal adenoma, and the others with metastases. Perfusion maps of blood volume (BV), blood flow (BF), mean transit time (MTT) and permeability surface-area production (PS) were generated with an Advantage Windows workstation using the CT perfusion 3.0 software (General Electric Medical Systems, Milwaukee, WI). Histopathologic sections immunostained for CD34 were quantitatively evaluated for microvessel density (MVD). Results: The perfusion parameters such as BV, BF and PS were statistically significant different between the two groups, with adenomas showing higher mean BV (12.18 versus 3.86), BF (97.51 versus 45.99) and PS (21.73 versus 10.93) compared with metastases (p < 0.05). For BV, a cutoff point of 7.30 was found to have a sensitivity of 95.2% and a specificity of 100% to differentiate between adenoma and metastasis. The sensitivity and specificity were 81.0 and 80.0%, respectively, for BF with a cutoff point of 71.96; and 85.7 and 86.7%, respectively, for PS with a cutoff point of 12.70 to differentiate adenoma and metastasis. A comparison of MVD counts from adenomas with those from metastases showed a significant difference (p < 0.05). However, no significant differences were observed in the four perfusion parameters and MVD between lipid rich and lipid poor adenomas. Conclusion: PCT may be useful for evaluating the neovascularization of adrenal masses and differentiating adenoma from metastasis on the basis of PCT parameters. Adenomas show higher BV, BF and PS compared with metastases. According our data, the optimal threshold BV is 7.30, resulting in a sensitivity of 95.2% and a specificity of 100% for the differentiation of adenoma from metastasis. Adrenal adenomas have similar hemodynamic profiles

  7. Radiologic localization of parathyroid adenomas in the previously operated patient; Part II: Invasive localization procedures

    The authors studied intraarterial digital subtraction angiography (DSA), conventional selective angiography (CA), parathyroid venous sampling (PVS), and intraoperative US as localization procedures in 53 patients with proved parathyroid adenomas and in whom parathyroid surgery had been unsuccessful. PVS had the highest overall sensitivity (80%), followed by intraoperative US (78%), CA (61%), and DSA (49%). Invasive procedures successfully localized adenomas in 41 of 43 patients (95%). False positive studies were uncommon. The optimum sequence of invasive procedures to localize parathyroid adenoma is determined by clinical factors. The authors recommend DSA first, followed by CA, PVS, and intraoperative US. All of the invasive localization procedures they studied are valuable

  8. Medical therapies in pituitary adenomas: Current rationale for the use and future perspectives.

    Cuny, Thomas; Barlier, Anne; Feelders, Richard; Weryha, Georges; Hofland, Leo J; Ferone, Diego; Gatto, Federico

    2015-02-01

    Pituitary adenomas (PA) represent in the majority of cases, benign tumors whose treatment currently associate surgery, medical therapies and radiotherapy in a multidisciplinary approach. While trans-sphenoidal surgery remains, except for prolactin-secreting adenomas, the first-line treatment of PA, it can considerably be hampered by the existence of an invasive and/or aggressive tumor for which medical therapies are often requested. In this review, we extensively discuss, both at molecular and clinical levels, the medical therapies currently used and in development in the different phenotypes of pituitary adenomas. PMID:25556152

  9. Establishment and characterization of pleomorphic adenoma cell systems: an in-vitro demonstration of carcinomas arising secondarily from adenomas in the salivary gland

    Among the salivary gland carcinomas, carcinoma in pleomorphic adenoma has been regarded as a representative carcinoma type which arises secondarily in the background of a pre-existent benign pleomorphic adenoma. It is still poorly understood how and which benign pleomorphic adenoma cells transform into its malignant form, carcinoma ex pleomorphic adenoma. We have established five cell systems from a benign pleomorphic adenoma of the parotid gland of a 61-year-old woman. They were characterized by immunofluorescence, classical cytogenetics, p53 gene mutational analysis, fluorescence in-situ hybridization, and histopathological and immunohistochemical examinations of their xenografts, to demonstrate their potency of secondary transformation. We established and characterized five cell systems (designated as SM-AP1 to SM-AP5) from a benign pleomorphic adenoma of the parotid gland. SM-AP1 to SM-AP3 showed polygonal cell shapes while SM-AP4 and SM-AP5 were spindle-shaped. SM-AP1-3 cells were immunopositive for keratin only, indicating their duct-epithelial or squamous cell differentiation, while SM-AP4/5 cells were positive for both keratin and S-100 protein, indicating their myoepithelial cell differentiation. Chromosome analyses showed numeral abnormalities such as 5n ploidies and various kinds of structural abnormalities, such as deletions, translocations, derivatives and isodicentric chromosomes. Among them, der(9)t(9;13)(p13.3;q12.3) was shared by all five of the cell systems. In addition, they all had a common deletion of the last base G of codon 249 (AGG to AG-) of the p53 gene, which resulted in generation of its nonsense gene product. Transplanted cells in nude mice formed subcutaneous tumors, which had histological features of squamous cell carcinoma with apparent keratinizing tendencies. In addition, they had ductal arrangements or plasmacytoid appearances of tumor cells and myxoid or hyaline stromata, indicating some characteristics of pleomorphic adenoma

  10. Diagnostic imaging of dopamine receptors in pituitary adenomas.

    de Herder, Wouter W; Reijs, Ambroos E M; Feelders, Richard A; van Aken, Maarten O; Krenning, Eric P; van der Lely, Aart-Jan; Kwekkeboom, Dik J

    2007-04-01

    Dopamine D2 receptor scintigraphy of pituitary adenomas is feasible by single-photon emission computed tomography using (123)I-S-(-)-N-[(1-ethyl-2-pyrrolidinyl)methyl]-2-hydroxy-3-iodo-6-methoxybenzamide ((123)I-IBZM) and (123)I-epidepride. (123)I-epidepride is generally superior to (123)I-IBZM for the visualization of D2 receptors on pituitary macroadenomas. However, (123)I-IBZM and (123)I-epidepride scintigraphy are generally not useful to predict the response to dopaminergic treatment in pituitary tumour patients. These techniques might allow discrimination of non-functioning pituitary macroadenomas from other non-tumour pathologies in the sellar region. Dopamine D2 receptors on pituitary tumours can also be studied using positron emission tomography with (11)C-N-raclopride and (11)C-N-methylspiperone. PMID:17413189

  11. Progress in the diagnosis and classification of pituitary adenomas

    Luis V Syro

    2015-06-01

    Full Text Available Pituitary adenomas are common neoplasms. Their classification is based upon size, invasion of adjacent structures, sporadic or familial cases, biochemical activity, clinical manifestations, morphological characteristics, response to treatment and recurrence. Although they are considered benign tumors, some of them are difficult to treat due to their tendency to recur, despite standardized treatment. Functional tumors present other challenges for normalizing their biochemical activity. Novel approaches for early diagnosis as well as different perspectives on classification may help to identify subgroups of patients with similar characteristics, creating opportunities to match each patient with the best personalized treatment option. In this paper we present the progress in the diagnosis and classification of different subgroups of patients with pituitary tumors that may be managed with specific considerations according to their tumor subtype.

  12. Recurrence of chromophobe pituitary adenomas after operation and postoperative radiotherapy

    The rate of recurrence is reported in a prospective study of 56 patients (28 men, 28 women) with large chromophobe pituitary adenoma (with or without hyperprolactinemia). The surgical approach was transfrontal in 44 and transseptospehnoidal in 12 patients. Cryoapplication was combined with the transsphenoidal operation. All but one patient received postopertive pituitary irradiation. Altogether, 11 (20 %) clinical relapses (10 men) occurred between 0.5 and 6 years after the transfrontal operation. Patients that relapsed had had larger tumors than those remaining in remission. Occurence of the tumors appeared with a deterioration of the visual field defect in 9 patients. There were no differences in the degrees of hypopituitarism in patients who relapsed as compared to patients remaining in remission. (author)

  13. Recurrence of chromophobe pituitary adenomas after operation and postoperative radiotherapy

    Salmi, J.; Pelkonen, R. (Third Department of Medicine, University of Helsinki, Finland); Grahne, B. (Department of Otorhinolaryngology, University oF Helsinki, finland); Valtonen, S. (Department of Neurosurgery, University of Helsinki, Finland)

    1982-01-01

    The rate of recurrence is reported in a prospective study of 56 patients (28 men, 28 women) with large chromophobe pituitary adenoma (with or without hyperprolactinemia). The surgical approach was transfrontal in 44 and transseptospehnoidal in 12 patients. Cryoapplication was combined with the transsphenoidal operation. All but one patient received postopertive pituitary irradiation. Altogether, 11 (20 %) clinical relapses (10 men) occurred between 0.5 and 6 years after the transfrontal operation. Patients that relapsed had had larger tumors than those remaining in remission. Occurence of the tumors appeared with a deterioration of the visual field defect in 9 patients. There were no differences in the degrees of hypopituitarism in patients who relapsed as compared to patients remaining in remission.

  14. Does the corticoadrenal adenoma with ''pre-Cushing's syndrome'' exist

    An adrenal tumor was discovered fortuitously in a patient with no clinical features of Cushing's syndrome. On adrenal imaging, there was good uptake in the nodule but no visualization of the contralateral adrenal. The latter was seen, however, in a second scan performed under ACTH treatment. In the hormone assessment, basal cortisol and 17-hydroxycorticoids were normal and cortisol diurnal variation was near normal, but a dexamethasone suppression test and ACTH responses to metyrapone and insulin hypoglycemia were abnormal. Eight months after excision of a spongiocytic-type adenoma, the remaining adrenal was visible on scintigram and the hormonal tests were normal. This pattern suggests that the clinical Cushing's syndrome was enough to partially suppress ACTH and, consequently, visualization of the contralateral gland

  15. Análisis de un registro de adenomas pituitarios

    Carolina Albiero

    2010-10-01

    Full Text Available Dada la complejidad que reviste el enfoque diagnóstico y terapéutico de los tumores pituitarios, el registro y análisis de la experiencia clínica acumulada es de gran ayuda en la toma de decisiones. En este trabajo se informan datos clínico-terapéuticos, extraídos de un registro computarizado, sobre 519 de un total de 670 pacientes con adenomas pituitarios. Trescientos cuarenta y cinco fueron mujeres (66% y 174 varones (34%, de 14 a 80 años de edad. El diagnóstico final fue: acromegalia en 176, enfermedad de Cushing en 153, prolactinoma en 101 y adenoma clínicamente no-funcionante (ANF en 89. La edad media al momento del diagnóstico de acromegalia fue 43.9 ± 13.5 (16-80, para enfermedad de Cushing 35.7 ± 12.9 (14-72, para prolactinomas 30.0 ± 13.4 (15-79 y para ANF 52.1 ± 15.2 (17-79 años. La creación de un registro institucional de tumores de hipófisis es un instrumento de gran utilidad para el análisis de la experiencia adquirida y constituye una herramienta valiosa para mejorar la estrategia terapéutica, optimizar la relación costo/beneficio y mejorar el cuidado del paciente. Contribuye a la docencia médica, tanto en el pre como en el posgrado y da base a la realización de trabajos de investigación clínica, aportando a la difusión y transferencia de conocimientos.

  16. An unusual cause of hypercalcemia in polycythemia vera: parathyroid adenoma.

    Tiryakioglu O

    2002-06-01

    Full Text Available In this paper we describe a patient with polycythemia vera (PV, who presented with hypercalcemia due to a parathyroid adenoma. In November 1999, the patient was admitted to our hospital with meteorism and constipation. Her physical examination revealed plethora and hepatosplenomegaly. Laboratory data revealed hyperparathyroidism in addition to PV: Rbc 8 x 10(6/mm3, Hct 63.7%, serum calcium 13.4 mg/dl, serum phosphorus 1.2 mg/dl, albumin 4.25 mg/dl, and alkaline phophatase activity 433 U/l. Intact Parathyroid Hormone level (iPTH was 376 pg/ml (n.v.12-72 pg/ml. Twenty-four hour urinary calcium excretion was higher than normal (900 mg. A parathyroid adenoma was detected with Tc-99m sesta-MIBI scanning under the left lobe of the thyroid gland and an ultrasonographic examination of the neck also supported the diagnosis. The patient was recommended for surgery. The histopathological examination confirmed the diagnosis. Postoperatively, iPTH dropped to 53.4 pg/ml at the 15 th minute and to 33.5 pg/ml at the first hour. The calcium level was 7.5 mg/dl one hour after the operation. Five days later, Hct was 40.8%. This case represents a rare association between PV and primary hyperparathyroidism, and may provide evidence for a causal link between PTH and polycythemia vera in our patient. In conclusion, this case indicates that the differential diagnosis of hypercalcemia and polycythemia vera should also include the possibility of a parathyroid tumor in addition to malignancy.

  17. Endoscopic mucosal resection of flat and sessile colorectal adenomas: Our experience with long-term follow-ups

    Grgov Saša

    2014-01-01

    Full Text Available Bacground/Aim. Endoscopic mucosal resection (EMR or mucosectomy is a removing method of flat or sessile lesions, laterally spreading tumors and carcinoma of the colon or the rectum limited to mucosa or the surface part of the submucosa. The aim of the study was to estimate the efficacy and safety of EMR in removing flat and sessile colorectal adenomas. Methods. This prospective study involved 140 patients during the period of 8 years. A total of 187 colorectal adenomas were removed using the EMR method “inject and cut with snare”. Results. The approximate size of mucosectomised adenomas was 13.6 mm (from 8 mm to 60 mm. There was a total of 48 (25.7% flat adenomas and 139 (74.3% sessile adenomas, (p < 0.01. Using “en bloc” and “piecemeal” resection, 173 (92.5% and 14 (7.5% of colorectal adenomas were removed, respectively. In all the cases, a complete removal of colorectal adenomas was achieved. Two (1.4% patients had adenoma removal with intramucosal carcinoma each. In the average follow-up period of 21.2 ± 17.8 months, 2 (1.4% patients had adenoma relapse after EMR. Considering complications, there was bleeding in 1 (0.7% patient with a big rectum adenoma removed with EMR. Furthermore, one (0.7% patient had a postcoagulation syndrome after cecal adenoma was removed by EMR. Conclusion. EMR is an efficient, safe and minimally invasive technique of removing flat and sessile adenomas in the colon and the rectum, with a very low percentage of adenoma recurrence over a long period of monitoring.

  18. Carcinoma ex pleomorphic adenoma originating from ectopic salivary gland in the neck region: case report

    Vayısoğlu, Yusuf; Arpaci, Rabia Bozdogan; Eti, Can; Pütürgeli, Tuğçe; Gorur, Kemal; Ozcan, Cengiz

    2015-01-01

    Carcinoma ex pleomorphic adenoma (CEPA) is the malignant salivary gland tumor originating from primary (de novo) or recurrent pleomorphic adenoma. Although parotid gland is the most common site, it can also be seen in submandibular gland or minor salivary glands. It can be seen rarely in head and neck region, such as oral cavity, trachea, nasal cavity and lacrimal gland. Although pleomorphic adenoma cases originating from ectopic salivary gland tissue in the neck region are present in the English literature, there is no published pleomorphic adenoma ex carcinoma case. In this case report we presented a CEPA as a 7.5 cm long neck mass in a 72-year-old woman originating from the submandibular region apart from submandibular gland. Difficulties in diagnosis and way to appropriate treatment are discussed with current literature. PMID:26645012

  19. Original technique for preoperative preparation of patients and intraoperative localization of parathyroid adenomas.

    Pasta, V; Monteleone, F; Del Vecchio, L; Iacobelli, S; Urciuoli, P; D'Orazi, V

    2015-01-01

    Surgical approach of single parathyroid adenoma treatment is turning to a less invasive surgery, allowing us to obtain better aesthetic results, reduction of duration of surgical operation, reduction of post-operative morbidity and hospital stay. Tc99m-sestaMIBI scintigraphy is mainly performed for preoperative localization of parathyroid adenomas. Our technique is instead based on the possibility to inhibit the interference of Tc99m-sestaMIBI uptake of the thyroid gland by means of the administration of Lugol's solution. Indeed, to confirm the identification and removal of the hyperfunctional parathyroid, it is accepted as adequate an ex vivo radioactivity count of the adenoma 20% or 40% greater than the value of the post-excisional background radioactivity, in association or not with intraoperative measurement of PTH. This method allows us to perform surgery with no timetable restriction, and to clearly distinguish the radioactivity of parathyroid adenoma from that of the surrounding tissues and thyroid gland. PMID:26188752

  20. A rare case of giant parathyroid adenoma presenting with recurrent episodes of pancreatitis.

    Krishnamurthy, Arvind; Raghunandan, Gorantlu Chowdappa; Ramshankar, Vijayalakshmi

    2016-01-01

    Parathyroid adenomas are usually small in size; (weighing 70 mg-1 g) those weighing more than 2-3 g are classified as giant parathyroid adenomas. Giant parathyroid adenomas are in fact rarely encountered among patients with primary hyperparathyroidism. They are believed to have distinct clinical and biochemical features related to specific genomic alterations. We chanced to manage a unique and possibly the first case of giant parathyroid adenoma (6 cm diameter and weighing 20 g) presenting with recurrent episodes of pancreatitis and discuss its surgical management with an added emphasis on the role of nuclear imaging in its preoperative localization. Our case demonstrates that clinicians should have a high index of suspicion of primary hyperparathyroidism in patients presenting with recurrent episodes of pancreatitis. Timely diagnosis, appropriate preoperative localization techniques, which would include a parathyroid scintigraphy and a focused surgical intervention are crucial to resolve complications and improve outcomes. PMID:26917892

  1. Pleomorphic adenoma with squamous and appendageal metaplasia mimicking mucoepidermoid carcinoma on cytology

    Batrani Meenakshi

    2009-01-01

    Full Text Available Background: Histological diversity is the hallmark of pleomorphic adenoma, the most common salivary gland tumor. It may cause difficulty in cytological interpretation, due to limited and selective sampling. Case presentation: A 16-year-old female patient presented with right cheek swelling. Fine needle aspiration cytology showed squamous cells, basaloid cells, and foamy cells, along with extracellular keratin and foreign body giant cells. Characteristic metachromatic fibrillary chondromyxoid stroma, which is usually seen in pleomorphic adenoma, was not seen in the aspirate. A diagnosis of mucoepidermoid carcinoma was given on cytology. Subsequent resection revealed an encapsulated pleomorphic adenoma, with extensive squamous metaplasia and appendageal differentiation on histology. Conclusion: This case illustrates that pleomorphic adenoma with squamous metaplasia presents a potential for misinterpretation as mucoepidermoid carcinoma on cytology. We discuss the various pitfalls and the features that are helpful in distinguishing these two lesions.

  2. Identification and validation of highly frequent CpG island hypermethylation in colorectal adenomas and carcinomas

    Øster, Bodil; Thorsen, Kasper; Lamy, Philippe;

    2011-01-01

    Resolution Melting (MS-HRM) analysis, and Exon arrays (Affymetrix) the DNA methylation pattern of ~14.000 genes and their transcript levels were investigated in six normal mucosas, six adenomas, and 30 MSI and MSS carcinomas. Sixty eight genes with tumor-specific hypermethylation were identified (p<0.......005). Identified hypermethylated sites were validated in an independent sample set of eight normal mucosas, 12 adenomas, 40 MSS and nine MSI cancer samples. The methylation patterns of 15 selected genes, hypermethylated in adenomas and carcinomas (FLI1, ST6GALNAC5, TWIST1, ADHFE1, JAM2, IRF4, CNRIP1, NRG1, and EYA......, indicating that methylation of these genes may play a direct regulatory role. The hypermethylation changes often occurred already in adenomas, indicating that they may be used as biomarkers for early detection of CRC....

  3. Brunner's gland adenoma of duodenum:A case report and literature review

    Yu-Ping Gao; Jian-Shan Zhu; Wen-Jun Zheng

    2004-01-01

    AIM: To analyze the clinicopathological features of Brunner's gland adenoma of the duodenum.METHODS: A rare case of Brunner's gland adenoma of the duodenum was described and related literature was reviewed.RESULTS: Brunner's gland adenoma of the duodenum appeared to be nodular hyperplasia of the normal Brunner's gland with an unusual admixture of normal tissues, including ducts, adipose tissue and lymphoid tissue. We suggested that it might be designated as a duodenal hamartoma rather than a true neoplasm.CONCLUSION: The most common location of the lesion is the posterior wall of the duodenum near the junction of its first and second portions. It can result in gastrointestinal hemorrhage and duodenal obstruction. Endoscopic polypectomy is a worthy treatment for benign Brunner's gland adenomas,as malignant changes in these tumors have never been proven.

  4. Microcystic adenoma of the pancreas associated with non-functioning islet cell tumor: a case report

    Among cystic tumors arising in the pancreas, microcystic adenoma is relatively uncommon;it is usually benign, and is comprised of cysts that vary in size from microscopic to 2 cm in diameter. It has recently been reported to be associated with other pancreatic tumors with malignant potential; in particular, microcystic adenoma with coexistent islet cell tumor has been reported in von Hippel-Lindau disease. We report a case of microcystic adenoma of the pancreas associated with coexistent surgically-proven islet cell tumor. On spiral CT, the islet cell tumor was seen as a highly enhanced inhomogeneous solid mass in the pancreatic head, and microcystic adenoma as numerous small cysts throughout the pancreas.=20

  5. Infiltrating adenocarcinoma arising in a villous adenoma of the anal canal

    Marni Colvin; Aris Delis; Erika Bracamonte; Hugo Villar; Luis R Leon Jr

    2009-01-01

    Primary neoplasms arising in the anal canal are relatively unusual. In particular, adenomas and adenocarcinomas are distinctly rare entities in this region. We describe an infiltrating, well-differentiated adenocarcinoma arising in a villous adenoma from the distal anal canal, in an otherwise healthy patient at low risk for gastrointestinal malignancy. This is the case of an octogenarian man with a several year history of hemorrhoids and intermittent rectal bleeding, more recently complaining of continuous hematochezia. Examination revealed a blood-covered pedunculated mass with a long stalk protruding from the anus. The lesion was amputated at the bedside. Microscopic evaluation revealed an infiltrating well-differentiated adenocarcinoma, arising from a villous adenoma. This was further evaluated under anesthesia and complete excision of distal anal tissue was performed. Our report is the first describing the possible malignant degeneration of a villous adenoma in the anal canal.

  6. Adenoma of nonpigmented epithelium in ciliary body:literature review and case report

    2007-01-01

    Adenomas of the nonpigmented ciliary epithelium (NPCE) are often clinically indistinguishable from amelanotic malignant melanomas of the ciliary body or metastatic carcinomas. This paper reports a case study of a distinctive variant of adenoma of the NPCE, which clinically appears as epiretinal membrane in the macular region. Histopathologic studies have revealed this is an adenoma of the NPCE. Identification of this clinic feature is important because it will miss the diagnosis of the adenoma of the NPCE. In this case study, B-scan ultrasonography as well as computerized tomography (CT) has been used to provide help in diagnosing the ciliary body tumor. Because of their anterior location in the ciliary body, partial lamellar sclerouvectomy is an effective method of treatment.

  7. A randomized trial on folic acid supplementation and risk of recurrent colorectal adenoma

    Background: Evidence from observational studies suggests that inadequate folate status enhances colorectal carcinogenesis, but results from some randomized trials do not support this hypothesis. Objective: To assess the effect of folic acid supplementation on recurrent colorectal adenoma, we conduc...

  8. Expression of NDRG2 is down-regulated in high-risk adenomas and colorectal carcinoma

    Lorentzen, Anders; Vogel, Lotte K.; Lewinsky, Rikke H;

    2007-01-01

    examine NDRG2 mRNA expression in colon cancer. By examining affected and normal tissue from individuals with colorectal adenomas and carcinomas, as well as in healthy individuals, we aim to determine whether and at which stages NDRG2 down-regulation occurs during colonic carcinogenesis. METHODS: Using...... quantitative RT-PCR, we have determined the mRNA levels for NDRG2 in low-risk (n = 15) and high-risk adenomas (n = 57), colorectal carcinomas (n = 50) and corresponding normal tissue, as well as control tissue from healthy individuals (n = 15). NDRG2 levels were normalised to beta-actin. RESULTS: NDRG2 m......RNA levels were lower in colorectal carcinomas compared to normal tissue from the control group (p < 0.001). When comparing adenomas/carcinomas with adjacent normal tissue from the same individual, NDRG2 expression levels were significantly reduced in both high-risk adenoma (p < 0.001) and in colorectal...

  9. Comparative sonographic and scintigraphic investigations in autonomous adenomas of the thyroid gland

    The distribution of active thyroid tissue can be detected on scintigraphic images and consequently the diagnosis of an autonomous thyroid adenoma is established on the basis of scintigraphic examinations. The sonographic examination is considerably supplemented by scintigraphic information. Domain of sonography is the determination of size and structure of adenomas and of the extranodular tissue. In the primary diagnosis of a decompensated autonomous a adenoma, sonography permits the fast differential diagnostical delineation of a shape anomaly or an aplasia of the thyroid lobes and the detection of the contralateral lobe (for example due to a tumor, a focal inflammation, a cyst). When the diagnosis has been confirmed, besides in-vitro tests sonography is the preferential non-invasive follow-up technique which can be repeated at choice. One disadvantage of this method is that retrosternal parts of larger struma and adenomas cannot be imaged and detected sonographically. (orig./MG)

  10. Percutaneous ablation of functioning adenoma in a patient with a single adrenal gland

    Nunes, Thiago Franchi; Szejnfeld, Denis; Xavier, Ana Carolina Wanderley; Goldman, Suzan Menasce

    2013-01-01

    The conventional treatment of functioning adrenal adenomas is laparoscopic resection. Since the 1990s, radiofrequency ablation has been increasingly applied to the treatment of tumours of the liver, lungs and musculoskeletal system. However, the use of radiofrequency ablation to treat adrenal nodules is still an uncommon procedure, particularly in aldosterone-producing adenomas. We report the case of a 35-year-old male patient with resistant hypertension, hypokalaemia and aldosterone-producing adenoma in a single adrenal gland. The patient underwent CT-guided percutaneous radiofrequency ablation. Clinical, laboratory and MRI follow-up data indicated excellent response to treatment. This case report is the first in the literature to describe the use of CT-guided percutaneous radiofrequency ablation in the treatment of a functioning adrenal adenoma in a patient with a single adrenal gland. PMID:23737584

  11. Sonography of intrathyroid parathyroid adenomas: Are there distinctive features that allow for preoperative identification?

    Objective: The purpose of our study was to determine if intra-thyroid parathyroid adenomas can be accurately identified by applying proposed criteria to preoperative ultrasound examinations in patients with primary hyperparathyroidism. Materials/methods: Fifty-three patients with pathology proven intra-thyroid parathyroid adenomas and pre-operative ultrasounds were identified from a surgical database for a blinded, retrospective review. A contemporary, age-matched cohort of 54 patients with extra-thyroid parathyroid adenomas was identified as a control. A total of 64 patients within these cohorts had co-existing thyroid nodules. Proposed ultrasound criteria for identifying a parathyroid adenoma included solid composition, profound hypoechogenicity, and presence of a feeding polar vessel. Parathyroid adenomas were classified as extra-thyroid or intra-thyroid (partial or complete) based on their relationship with the thyroid gland during ultrasound evaluation and results were compared to surgical and histopathology reports as the gold standard. The results from the blinded, retrospective review during which the proposed, specific ultrasound criteria were applied were compared to the initial, pre-operative reports during which the proposed criteria were not applied. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the blinded, retrospective review and initial, pre-operative reports were calculated. Additionally, in patients with co-existing thyroid nodules, an attempt was made to differentiate parathyroid adenomas from the thyroid nodules. Results: Application of the proposed ultrasound criteria during blinded retrospective review yielded a sensitivity and specificity for detecting intra-thyroid parathyroid adenomas of 76% and 92%, respectively. The sensitivity and specificity of ultrasound for detecting intra-thyroid parathyroid adenomas on the initial reports was 29% and 95%, respectively. The sensitivity and

  12. Sonography of intrathyroid parathyroid adenomas: Are there distinctive features that allow for preoperative identification?

    Heller, Matthew T., E-mail: hellermt@upmc.edu [University of Pittsburgh Medical Center, Department of Radiology, 200 Lothrop St, Suite 3950 PUH S. Tower, Pittsburgh, PA 15213 (United States); Yip, Linwah, E-mail: yipl@upmc.edu [University of Pittsburgh Medical Center, Department of Endocrine Surgery, Kaufmann Building, 3471 Fifth Ave, Suite 101, Pittsburgh, PA 15213 (United States); Tublin, Mitchell E., E-mail: tublme@upmc.edu [University of Pittsburgh Medical Center, Department of Radiology, 200 Lothrop St, Suite 3950 PUH S. Tower, Pittsburgh, PA 15213 (United States)

    2013-01-15

    Objective: The purpose of our study was to determine if intra-thyroid parathyroid adenomas can be accurately identified by applying proposed criteria to preoperative ultrasound examinations in patients with primary hyperparathyroidism. Materials/methods: Fifty-three patients with pathology proven intra-thyroid parathyroid adenomas and pre-operative ultrasounds were identified from a surgical database for a blinded, retrospective review. A contemporary, age-matched cohort of 54 patients with extra-thyroid parathyroid adenomas was identified as a control. A total of 64 patients within these cohorts had co-existing thyroid nodules. Proposed ultrasound criteria for identifying a parathyroid adenoma included solid composition, profound hypoechogenicity, and presence of a feeding polar vessel. Parathyroid adenomas were classified as extra-thyroid or intra-thyroid (partial or complete) based on their relationship with the thyroid gland during ultrasound evaluation and results were compared to surgical and histopathology reports as the gold standard. The results from the blinded, retrospective review during which the proposed, specific ultrasound criteria were applied were compared to the initial, pre-operative reports during which the proposed criteria were not applied. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the blinded, retrospective review and initial, pre-operative reports were calculated. Additionally, in patients with co-existing thyroid nodules, an attempt was made to differentiate parathyroid adenomas from the thyroid nodules. Results: Application of the proposed ultrasound criteria during blinded retrospective review yielded a sensitivity and specificity for detecting intra-thyroid parathyroid adenomas of 76% and 92%, respectively. The sensitivity and specificity of ultrasound for detecting intra-thyroid parathyroid adenomas on the initial reports was 29% and 95%, respectively. The sensitivity and

  13. Genomic profiling of rectal adenoma and carcinoma by array-based comparative genomic hybridization

    Shi Zhi-Zhou

    2012-11-01

    Full Text Available Abstract Background Rectal cancer is one of the most common cancers in the world. Early detection and early therapy are important for the control of death caused by rectal cancer. The present study aims to investigate the genomic alterations in rectal adenoma and carcinoma. Methods We detected the genomic changes of 8 rectal adenomas and 8 carcinomas using array CGH. Then 14 genes were selected for analyzing the expression between rectal tumor and paracancerous normal tissues as well as from adenoma to carcinoma by real-time PCR. The expression of GPNMB and DIS3 were further investigated in rectal adenoma and carcinoma tissues by immunohistochemistry. Results We indentified ten gains and 22 losses in rectal adenoma, and found 25 gains and 14 losses in carcinoma. Gains of 7p21.3-p15.3, 7q22.3-q32.1, 13q13.1-q14.11, 13q21.1-q32.1, 13q32.2-q34, 20p11.21 and 20q11.23-q12 and losses of 17p13.1-p11.2, 18p11.32-p11.21 and 18q11.1-q11.2 were shared by both rectal adenoma and carcinoma. Gains of 1q, 6p21.33-p21.31 and losses of 10p14-p11.21, 14q12-q21.1, 14q22.1-q24.3, 14q31.3-q32.1, 14q32.2-q32.32, 15q15.1-q21.1, 15q22.31 and 15q25.1-q25.2 were only detected in carcinoma but not in adenoma. Copy number and mRNA expression of EFNA1 increased from rectal adenoma to carcinoma. C13orf27 and PMEPA1 with increased copy number in both adenoma and carcinoma were over expressed in rectal cancer tissues. Protein and mRNA expression of GPNMB was significantly higher in cancer tissues than rectal adenoma tissues. Conclusion Our data may help to identify the driving genes involved in the adenoma-carcinoma progression.

  14. Meat, vegetables and genetic polymorphisms and the risk of colorectal carcinomas and adenomas

    Hansteen Inger-Lise

    2007-12-01

    Full Text Available Abstract Background The risk of sporadic colorectal cancer (CRC is mainly associated with lifestyle factors, particularly dietary factors. Diets high in red meat and fat and low in fruit and vegetables are associated with an increased risk of CRC. The dietary effects may be modulated by genetic polymorphisms in biotransformation genes. In this study we aimed to evaluate the role of dietary factors in combination with genetic factors in the different stages of colorectal carcinogenesis in a Norwegian population. Methods We used a case-control study design (234 carcinomas, 229 high-risk adenomas, 762 low-risk adenomas and 400 controls to test the association between dietary factors (meat versus fruit, berries and vegetables genetic polymorphisms in biotransformation genes (GSTM1, GSTT1, GSTP1 Ile105Val, EPHX1 Tyr113His and EPHX1 His139Arg, and risk of colorectal carcinomas and adenomas. Odds ratio (OR and 95% confidence interval (95% CI were estimated by binary logistic regression. Results A higher ratio of total meat to total fruit, berry and vegetable intake was positively associated with both high and low-risk adenomas, with approximately twice the higher risk in the 2nd quartile compared to the lowest quartile. For the high-risk adenomas this positive association was more obvious for the common allele (Tyr allele of the EPHX1 codon 113 polymorphism. An association was also observed for the EPHX1 codon 113 polymorphism in the low-risk adenomas, although not as obvious. Conclusion Although, the majority of the comparison groups are not significant, our results suggest an increased risk of colorectal adenomas in individuals for some of the higher ratios of total meat to total fruit, berry and vegetable intake. In addition the study supports the notion that the biotransformation enzymes GSTM1, GSTP1 and EPHX1 may modify the effect of dietary factors on the risk of developing colorectal carcinoma and adenoma.

  15. Surgical treatment of pituitary adenomas via the trans-sphenoidal route in Uzbekistan

    Zamira Khalimova

    2013-12-01

    Full Text Available Pituitary adenomas, noncancerous tumors that occur in the pituitary gland, represent from 7% to 24% of all primary intracranial neoplasms. Worldwide the trans-sphenoidal approach is the preferred and more widely spread one. The work was initiated to study early and late complications in patients undergoing surgical treatment for pituitary adenomas via the trans-sphenoidal route at the Neuroendocrinology Department with pituitary neurosurgery, Center for the Scientific and Clinical Study of Endocrinology, Uzbekistan Public Health Ministry.

  16. TSH-secreting pituitary adenoma: benefits of pre-operative octreotide

    Wallace, I. R.; Healy, E.; Cooke, R. S.; Ellis, P K; Harper, R.; S. J. Hunter

    2015-01-01

    Summary TSH-secreting pituitary adenomas are rare and the optimal investigation and management is uncertain. We describe a case of a 43 year-old woman with a TSH-secreting pituitary adenoma, highlighting diagnostic testing and our use, pre-operatively of somatostatin analogue therapy, which induced biochemical euthyroidism and a reduction in tumour size. Learning points The differential diagnosis of the syndrome of inappropriate TSH secretion is non-thyroidal illness, medications, assay inter...

  17. A black adrenocortical adenoma causing Cushing's syndrome not imaged by radiocholesterol scintigraphy

    In a 33-year-old female patient with left adrenal tumour and Cushing's syndrome, adrenocortical scintigraphy with radiocholesterol did not image the tumour nor the suppressed contralateral gland. Histology showed a black adrenocortical adenoma composed only of compact cells; there was no evidence of malignancy. This demonstrates that non-visualization of the adrenal glands in a patient with Cushing's syndrome is not invariably due to adrenal carcinoma. The literature on black adrenal adenomas causing Cushing's syndrome is reviewed. (orig.)

  18. CT and MR images of pleomorphic adenoma in major and minor salivary glands

    Purpose: To investigate the CT and MR imaging features of pleomorphic adenoma in the head and neck area. Materials and methods: Our materials of this study consisted of 50 pleomorphic adenomas from 50 patients which were all histopathologically diagnosed. The CT and MR images were retrospectively evaluated. The following features were evaluated: the detectability of the lesion, the tumor margin, the border of the lesion, the aspect of the lesion, the contrast between the lesion and surrounding tissue, the signal intensity of the lesion, the enhancement of contrast medium, the aspect of the lesion after the injection of contrast medium, the detectability of the capsule, and the detectability of bone resorption of the lesion. Results: The tumor detectabilities were 77% on axial plain CT images and 90% on axial CE CT images, respectively. On CT images, pleomorphic adenoma tended to show a well-defined margin, a smooth border, an inhomogeneous aspect, a low or high contrast, and intermediate or high signal intensity. After contrast medium administration, pleomorphic adenoma tended to show a slightly high enhancement and either an inhomogeneous or a periphery enhancement on the CE CT images. The capsule could be hardly detected on CT images. The tumor detectabilities were 86% on axial T1-weighted MR images, 88% on axial T2-weighted MR images, and 85% on axial CE T1-weighted MR images, respectively. On MR images, pleomorphic adenomas tended to show well-defined margin, a lobulate border, an inhomogeneous aspect, a high contrast, and intermediate or high signal intensity. After contrast medium administration, pleomorphic adenoma tended to show a high enhancement and either an inhomogeneous or a periphery enhancement on MR images. The capsule could be detected in many cases on MR images. Conclusions: It was possible to detect the capsule in pleomorphic adenoma using MR images. The pleomorphic adenomas in head and neck area should be evaluated with MR images.

  19. Meat consumption and the risk of incident distal colon and rectal adenoma

    Ferrucci, L.M.; R Sinha; Huang, W-Y; Berndt, S I; Katki, H.A.; Schoen, R E; Hayes, R B; Cross, A J

    2011-01-01

    Background: Most studies of meat and colorectal adenoma have investigated prevalent events from a single screening, thus limiting our understanding of the role of meat and meat-related exposures in early colorectal carcinogenesis. Methods: Among participants in the screening arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial who underwent baseline and follow-up sigmoidoscopy (n=17 072), we identified 1008 individuals with incident distal colorectal adenoma. We calculate...

  20. Parathyroid adenoma detected with 99mTc-tetrofosmin dual-phase scintigraphy: a case report

    Romanidis, Konstantinos; Karathanos, Evangelos; Nagorni, Eleni-Aikaterini; Giatromanolaki, Alexandra; Sibridis, Efthimios; Zissimopoulos, Athanassios; Vogiatzaki, Theodosia; Simopoulos, Constantinos; Pitiakoudis, Michael

    2014-01-01

    Background Tc-sestamibi is the most frequently used radionuclide agent for the detection of parathyroid adenomas in the clinical setting. However, Tc-tetrofosmin is another such agent that may be used for this purpose. This case report presents the significance and practicality of 99mTc-tetrofosmin for the diagnosis of parathyroid adenomas with probable high p-glycoprotein levels. Case presentation A 45-year-old woman was referred to our Nuclear Department with a palpable neck nodule suspicio...

  1. Original technique for preoperative preparation of patients and intraoperative localization of parathyroid adenomas

    PASTA, V.; F. Monteleone; DEL VECCHIO, L.; Iacobelli, S.; URCIUOLI, P.; D’ORAZI, V.

    2015-01-01

    Surgical approach of single parathyroid adenoma treatment is turning to a less invasive surgery, allowing us to obtain better aesthetic results, reduction of duration of surgical operation, reduction of post-operative morbidity and hospital stay. Tc99m-sestaMIBI scintigraphy is mainly performed for preoperative localization of parathyroid adenomas. Our technique is instead based on the possibility to inhibit the interference of Tc99m-sestaMIBI uptake of the thyroid gland by means of the admin...

  2. AMACR is associated with advanced pathologic risk factors in sporadic colorectal adenomas

    Sotiris; Lakis; Theodora; Papamitsou; Constantina; Pana

    2010-01-01

    AIM: To analyze α-methylacyl CoA racemase (AMACR) expression in relation to various dysplasia phenotypes and clinicopathological parameters of sporadic colorectal adenomas.METHODS: Fifty-f ive cases of sporadic colorectal adenomas were categorized according to the Vienna classif ication for Gastrointestinal Neoplasia.These corresponded to a total of 98 different intra-lesion microscopic f ields that were further independently assigned a histological grade based on the old nomenclature (mild,moderate,severe ...

  3. DNA methylation alterations of AXIN2 in serrated adenomas and colon carcinomas with microsatellite instability

    MUTO, YUTA; Maeda, Takafumi; Suzuki, Koichi; Kato, Takaharu; Watanabe, Fumiaki; KAMIYAMA, HIDENORI; Saito, Masaaki; Koizumi, Kei; Miyaki, Yuichiro; Konishi, Fumio; Alonso, Sergio; Perucho, Manuel; Rikiyama, Toshiki

    2014-01-01

    Background Recent work led to recognize sessile serrated adenomas (SSA) as precursor to many of the sporadic colorectal cancers with microsatellite instability (MSI). However, comprehensive analyses of DNA methylation in SSA and MSI cancer have not been conducted. Methods With an array-based methylation sensitive amplified fragment length polymorphism (MS-AFLP) method we analyzed 8 tubular (TA) and 19 serrated (SSA) adenomas, and 14 carcinomas with (MSI) and 12 without (MSS) microsatellite in...

  4. Vulva Fibroadenoma Associated with Lactating Adenoma in a 26-Year-Old Nigerian Female

    Anunobi, C. C.; F. J. N. Obiajulu; Banjo, A. A. F.; Okonkwo, A. O. E.

    2013-01-01

    Background. Vulva lactating adenoma is rare and may be misdiagnosed as adenocarcinoma in frozen section and aspiration cytology if breast tissue is not anticipated. Objective. To raise the awareness of lactating vulva ectopic breast lesion among clinicians and pathologists. Case Report. We present a case of vulva fibroadenoma associated with lactating adenoma in a 26-year-old Nigerian female. Conclusion. The rarity of vulva ectopic breast tissue can present a diagnostic challenge for both the...

  5. CT and MR images of pleomorphic adenoma in major and minor salivary glands

    Kakimoto, Naoya [Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: kakimoto@dent.osaka-u.ac.jp; Gamoh, Shoko [Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: margot@dent.osaka-u.ac.jp; Tamaki, Junko [Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: tamako@dent.osaka-u.ac.jp; Kishino, Mitsunobu [Department of Oral Pathology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: mkishino@dent.osaka-u.ac.jp; Murakami, Shumei [Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: shumei@dent.osaka-u.ac.jp; Furukawa, Souhei [Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: furu@dent.osaka-u.ac.jp

    2009-03-15

    Purpose: To investigate the CT and MR imaging features of pleomorphic adenoma in the head and neck area. Materials and methods: Our materials of this study consisted of 50 pleomorphic adenomas from 50 patients which were all histopathologically diagnosed. The CT and MR images were retrospectively evaluated. The following features were evaluated: the detectability of the lesion, the tumor margin, the border of the lesion, the aspect of the lesion, the contrast between the lesion and surrounding tissue, the signal intensity of the lesion, the enhancement of contrast medium, the aspect of the lesion after the injection of contrast medium, the detectability of the capsule, and the detectability of bone resorption of the lesion. Results: The tumor detectabilities were 77% on axial plain CT images and 90% on axial CE CT images, respectively. On CT images, pleomorphic adenoma tended to show a well-defined margin, a smooth border, an inhomogeneous aspect, a low or high contrast, and intermediate or high signal intensity. After contrast medium administration, pleomorphic adenoma tended to show a slightly high enhancement and either an inhomogeneous or a periphery enhancement on the CE CT images. The capsule could be hardly detected on CT images. The tumor detectabilities were 86% on axial T1-weighted MR images, 88% on axial T2-weighted MR images, and 85% on axial CE T1-weighted MR images, respectively. On MR images, pleomorphic adenomas tended to show well-defined margin, a lobulate border, an inhomogeneous aspect, a high contrast, and intermediate or high signal intensity. After contrast medium administration, pleomorphic adenoma tended to show a high enhancement and either an inhomogeneous or a periphery enhancement on MR images. The capsule could be detected in many cases on MR images. Conclusions: It was possible to detect the capsule in pleomorphic adenoma using MR images. The pleomorphic adenomas in head and neck area should be evaluated with MR images.

  6. Simultaneous Serous Cyst Adenoma and Ovarian Pregnancy in An Infertile Woman

    Mahbod Ebrahimi; Firoozeh Akbari Asbagh

    2014-01-01

    Ovarian pregnancy is a rare form of extra uterine pregnancy. Serous cyst adenoma is a benign variant of epithelial cell tumors of ovary. The coexistence of a cyst adenoma with an ovarian pregnancy in the same ovary is extremely rare. Some studies suggested that infertility or ovulation-inducing drugs can be involved in increased risk of ovarian tumors and ovarian pregnancies. A 28-year-old infertile woman presented with a ruptured ovarian pregnancy following ovulation induction...

  7. A Case of Ampullary Adenoma that Developed to Cancer 7 Years After Initial Diagnosis

    Iwashita, Yuji; Ito, Kei; Noda, Yutaka; Koshita, Shinsuke; Kanno, Yoshihide; Ogawa, Takahisa; Masu, Kaori; Michikawa, Yosuke

    2015-01-01

    Patient: Male, 81 Final Diagnosis: Ampullary cancer Symptoms: Jaundice Medication: — Clinical Procedure: Endoscopy Specialty: Gastroenterology and Hepatology Objective: Unusual clinical course Background: Although ampullary adenomas have been reported to be considered as precancerous lesions, there have been very few reports of cases in which cancer occurred after long-term follow-up. We herein report a case of ampullary adenoma that developed to cancer after long-term observation. Case Repor...

  8. Clinicopathologic Characteristics Associated with Complications and Long-Term Outcomes of Endoscopic Papillectomy for Adenoma

    Shim, Choong Nam; Chung, Moon Jae; Bang, Seungmin; Park, Seung Woo; Song, Si Young; Chung, Jae Bock; Park, Jeong Youp

    2014-01-01

    Purpose Endoscopic papillectomy (EP) is currently employed for the treatment of ampullary adenoma. This study aimed to evaluate the clinical, endoscopic, and histologic characteristics related to complications and long-term outcomes of EP. Materials and Methods Thirty-nine patients underwent EP for ampullary adenoma. Patients were grouped according to the occurrence of procedure-related complications: no complication group (n=28) and complication group (n=11). Results The overall complication...

  9. Postirradiation sarcomatous transformation of a pituitary adenoma: a combined pituitary tumor. Case report

    A case is reported in which a fibrosarcoma developed 20 years after irradiation of a pituitary chromophobe adenoma. This rare lesion, like most of the other documented postirradiation pituitary sarcomas, was a combination of fibrosarcoma and pituitary adenoma. These lesions tend to behave in a characteristic fashion, with onset after a long latent interval following irradiation, growth to a large size, and failure to metastasize

  10. A clinicopathological and immunohistochemical study of clinically non-functioning pituitary adenomas: A single institutional experience

    Rishi Arvind

    2010-01-01

    Full Text Available Background : Non-functioning pituitary adenomas (NFPA are characterized by the lack of clinical syndrome as compared to functioning adenomas (FA but not all functioning adenomas have clinical effects. Their exact incidence varies in different series. Materials and Methods : This study was undertaken to analyze the hormonal profile of NFPA at the immunohistochemical level in the Indian population and to see if any differences exist from the earlier studies. Their biological aggressiveness was also studied by MIB-1 labeling index (MIB-! LI and Epidermal Growth Factor Receptor (EGFR expression. These parameters along with their clinical behavior were correlated with radiological features of invasiveness and size. Results : Of the 151 pituitary adenomas diagnosed during a period of one and half years, 77 (51% were NFPA with a male predominance. There was increase in the incidence of NFPA with increase in age. Immunopositivity for various hormones was observed in 64 (83% cases, either singly or in various combinations. On the basis of immunohistochemistry, NFPA were classified into three subtypes; gonadotroph adenomas, silent adenomas, and null cell adenomas. Gonadotroph adenomas were the commonest subtype. In general, NFPA showed low MIB-1LI but invasive NFPA had LI on the higher side, however, this difference was not significant. We observed EGFR positivity in two cases only; therefore the tumorigenesis mechanism may be different in NFPA. Conclusion : Although non-functional at the clinical level immunohistochemistry showed reactivity for various hormones. If a battery of immunostains including seven hormones is studied, a significant number of cases are shifted to the functional group.

  11. Endoscopic Laser Treatment for Rectosigmoid Villous Adenoma: Factors Affecting the Results

    Brunetaud, JM; Maunoury, V; Cochelard, D; Boniface, B.; Cortot, A; Paris, JC

    1992-01-01

    Endoscopic laser treatment is now commonly used for palliation of advanced digestive cancers in nonsurgical candidates. lt has also been used for treatment of benign rectosigmoid villous adenoma. The present work reports the long term results in 387 patients with benign rectosigmoid villous adenomas revealed by biopsy. Patients included 39% who had contraindications to surgery, 19% who had a tumour recurrence after a nonlaser treatment, 41 % for whom surgical resection appeared to be too dras...

  12. Meat, vegetables and genetic polymorphisms and the risk of colorectal carcinomas and adenomas

    The risk of sporadic colorectal cancer (CRC) is mainly associated with lifestyle factors, particularly dietary factors. Diets high in red meat and fat and low in fruit and vegetables are associated with an increased risk of CRC. The dietary effects may be modulated by genetic polymorphisms in biotransformation genes. In this study we aimed to evaluate the role of dietary factors in combination with genetic factors in the different stages of colorectal carcinogenesis in a Norwegian population. We used a case-control study design (234 carcinomas, 229 high-risk adenomas, 762 low-risk adenomas and 400 controls) to test the association between dietary factors (meat versus fruit, berries and vegetables) genetic polymorphisms in biotransformation genes (GSTM1, GSTT1, GSTP1 Ile105Val, EPHX1 Tyr113His and EPHX1 His139Arg), and risk of colorectal carcinomas and adenomas. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated by binary logistic regression. A higher ratio of total meat to total fruit, berry and vegetable intake was positively associated with both high and low-risk adenomas, with approximately twice the higher risk in the 2nd quartile compared to the lowest quartile. For the high-risk adenomas this positive association was more obvious for the common allele (Tyr allele) of the EPHX1 codon 113 polymorphism. An association was also observed for the EPHX1 codon 113 polymorphism in the low-risk adenomas, although not as obvious. Although, the majority of the comparison groups are not significant, our results suggest an increased risk of colorectal adenomas in individuals for some of the higher ratios of total meat to total fruit, berry and vegetable intake. In addition the study supports the notion that the biotransformation enzymes GSTM1, GSTP1 and EPHX1 may modify the effect of dietary factors on the risk of developing colorectal carcinoma and adenoma

  13. Adrenal incidentalomas showing unilateral concordant visualization by adrenocortical scintigraphy. Comparison with adenomas in Cushing's syndrome

    An adrenocortical adenoma causing Cushing's syndrome (Cushing's adenoma) produces a unilateral concordant visualization (UCV) imaging pattern in which the adenoma is only visualized on radioiodocholesterol adrenocortical scintigraphy. But because this imaging pattern is also noted in some patients with adrenal incidentalomas, we examined whether the UCV-incidentaloma was essentially identical with Cushing's adenoma and would develop Cushing's syndrome. The subjects were 9 patients with UCV-incidentalomas (mean size, 30 mm; range, 20-45 mm) and 6 patients with Cushing's adenomas (mean size, 28 mm; range, 25-35 mm). Endocrinological evaluations showed several abnormalities including blunted diurnal rhythm of plasma cortisol within the normal range, low plasma ACTH and/or high 24-hr urinary 17-OHCS levels in 8 of 9 patients with UCV-incidentalomas, but these abnormalities did not meet the diagnostic criteria of Cushing's syndrome. Adrenal uptake of the tracer in the patients with UCV-incidentalomas was not statistically different from that in the patients with Cushing's adenomas and had no relationship with hormonal values in either patient group. Tumor size on CT correlated with the levels of 24-hr urinary 17-OHCS (r=0.75, p=0.02) and plasma cortisol at 7:00 (r=0.82, p=0.007) in the patients with UCV-incidentalomas, but not in the patients with Cushing's adenomas. Although 3 UCV-incidentalomas increased slightly in size, none of 9 patients with UCV-incidentalomas has developed Cushing's syndrome for 4 to 52 months. These results suggest that the UCV-incidentaloma may be essentially different from the Cushing's adenoma and unlikely to develop Cushing's syndrome. (author)

  14. Serum IGF1, IGF2, and IGFBP3 and risk of advanced colorectal adenoma

    GAO, YING; Katki, Hormuzd; Graubard, Barry; Pollak, Michael; Martin, Michael; Tao, Yuzhen; Schoen, Robert E.; Church, Timothy; Hayes, Richard B; Greene, Mark H.; Berndt, Sonja I

    2011-01-01

    The insulin-like growth factor (IGF) signaling pathway is involved in cell proliferation and differentiation. Elevated serum IGF1 levels have been associated with increased colorectal cancer risk; however, studies of this association with colorectal adenoma are inconclusive. We examined serum IGF1, IGF2, and IGFBP3 levels in relation to risk of advanced colorectal adenoma in a case-control study within the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. A total of 764 advanced...

  15. Metalloproteinases ADAM12 and MMP-14 are associated with cavernous sinus invasion in pituitary adenomas.

    Wang, Junwen; Voellger, Benjamin; Benzel, Julia; Schlomann, Uwe; Nimsky, Christopher; Bartsch, Jörg W; Carl, Barbara

    2016-09-15

    Invasion of tumor cells critically depends on cell-cell or cell-extracellular matrix interactions. Enzymes capable of modulating these interactions belong to the proteinase families of ADAM (a disintegrin and metalloprotease) and MMP (matrix metalloprotease) proteins. Our objective is to examine their expression levels and evaluate the relationship between expression levels and cavernous sinus invasion in pituitary adenomas. Tissue samples from 35 patients with pituitary adenomas were analyzed. Quantitative real-time polymerase chain reaction (qPCR) was employed to assess mRNA expression levels for ADAM and MMP genes. Protein levels were examined using immunohistochemistry and Western Blot. Correlation analyses between expression levels and clinical parameters were performed. By silencing ADAM12 and MMP-14 with siRNA in a mouse pituitary adenoma cell line (TtT/GF), their cellular effects were investigated. In our study, nine women and 26 men were included, with a mean age of 53.1 years (range 15-84 years) at the time of surgery. There were 19 cases with cavernous sinus invasion. The proteins ADAM12 and MMP-14 were significantly up-regulated in invasive adenomas compared to noninvasive adenomas. Both human isoforms of ADAM12 (ADAM12L and ADAM12s) were involved in tumor invasion; moreover, ADAM12L was found to correlate positively with Ki-67 proliferation index in pituitary adenomas. In TtT/GF pituitary adenoma cells, silencing of ADAM12 and MMP-14 significantly inhibited cell invasion and migration, respectively, whereas only silencing of ADAM12 suppressed cell proliferation. We conclude that ADAM12 and MMP-14 are associated with cavernous sinus invasion in pituitary adenomas, which qualifies these proteins in diagnosis and therapy. PMID:27144841

  16. Percutaneous ablation of functioning adenoma in a patient with a single adrenal gland

    Nunes, Thiago Franchi; Szejnfeld, Denis; Xavier, Ana Carolina Wanderley; Goldman, Suzan Menasce

    2013-01-01

    The conventional treatment of functioning adrenal adenomas is laparoscopic resection. Since the 1990s, radiofrequency ablation has been increasingly applied to the treatment of tumours of the liver, lungs and musculoskeletal system. However, the use of radiofrequency ablation to treat adrenal nodules is still an uncommon procedure, particularly in aldosterone-producing adenomas. We report the case of a 35-year-old male patient with resistant hypertension, hypokalaemia and aldosterone-producin...

  17. Basal cell adenoma in the parotid: a bizarre myoepithelial-derived stroma rich variant

    Huang, Yong

    2014-01-01

    Basal cell adenoma (BCA) is a specific entity that lacks the myxochondroid stromal component of a pleomorphic adenoma. There are six histopathological types of BCA: solid, tubular, trabecular, membranous, cribriform, and myoepithelial-derived stroma rich. Myoepithelial-derived stroma rich variant is so rare, especially with cellular atypia. Herin we describe a rare case of BCA arising in the parotid on a 25-year-old man. A well-demarcated nodule arising in the parotid that was composed of bas...

  18. Ornithine Decarboxylase-1 Polymorphism, Chemoprevention With Eflornithine and Sulindac, and Outcomes Among Colorectal Adenoma Patients

    Zell, Jason A.; McLaren, Christine E.; Chen, Wen-Pin; Thompson, Patricia A.; Gerner, Eugene W.; Meyskens, Frank L.

    2010-01-01

    The ornithine decarboxylase-1 (ODC1) polymorphism at position +316 affects binding by transcriptional activators and repressors and modulates the risk of metachronous colorectal adenomas, particularly in association with aspirin use. We investigated the effects of ODC1 after treatment with difluoromethylornithine (eflornithine)/sulindac or placebo. Two hundred twenty-eight colorectal adenoma patients in a randomized phase III trial were genotyped for ODC1. We used Wilcoxon rank sums tests on ...

  19. THE ROLE OF CALCIUM ION IN THE PATHOGENESIS OF HUMAN PITUITARY GH-SECRETING ADENOMAS

    邓洁英; 史轶蘩; 尹娟娟

    1996-01-01

    To study the role of Ca2+ in the pathogenesis of pituitary growth hormone secreting adenornas,the function of Ca2+ in 23 cases of human pituitary GH-secreting adenoma was investigated in monolayer cell culture.It was found that Ca2- channel blockers nicardipin and nifedipin inhibited hasal and growth hormone releasing hormone (GRH)-stimulated GH secretion in 87.5% and 100.0% of the GH adenomas.respectively,demonstrating that in most human pituitary GH agonist octreotide regulated the processes of GH secretion via Ca2+ had defects in different steps including receptor.postreceptor Ca2+ channel and Ca2+-GH secreting coupling in 6(66.6%)and 5(55.5%) cases of 9 GH adenomas respectively.Among them,the defects in GRH receptor and SRIF regulated Ca2+ channel are the main causes of the dysfunction of GH adenomas.These defects may be related to GH hypersecretion in GH adenomas.Our data provides advance evidences for intrinsic defects of GH adenomas.

  20. Clinical results of LINAC-based stereotactic radiosurgery for pituitary adenoma

    Muramatsu, Julia; Yoshida, Masanori; Shioura, Hiroki; Kawamura, Yasutaka; Ito, Harumi; Takeuchi, Hiroaki; Kubota, Toshihiko [Fukui Medical Univ., Matsuoka (Japan); Maruyama, Ichiro [The Wakasa Wan Energy Research Center, Tsuruga, Fukui (Japan)

    2003-05-01

    We retrospectively evaluated our clinical results of stereotactic radiosurgery (SRS) for pituitary adenoma. Between 1995 and 2000, 13 patients were treated with SRS for pituitary adenoma. In all cases, the tumors had already been surgically resected. The adenomas were functional in 5 and non-functional in 8 patients. The median follow-up period was 30 months. SRS was performed with the use of a dedicated stereotactic 10-MV linear accelerator (LINAC). The median dose to the tumor margin was 15 Gy. The dose to the optic apparatus was limited to less than 8 Gy. MR images of 12 patients revealed tumor complete response (CR) in one case and partial response (PR) in 9 cases; in the remaining two patients, tumor size decreased by less than 50%. There was no recognizable regrowth of any of the tumors. In two of four GH-secreting adenomas, hormonal overproduction normalized, while the other two showed reduced hormonal production. One PRL-secreting adenoma did not respond. Reduction of visual acuity and field was seen in one patient. This patient also had a brain infarction. None of the patients developed brain radionecrosis or radiation-induced hypopituitarism. Although further studies based on greater numbers of cases and longer follow-up periods are needed, our results suggest that SRS seems to be a safe, effective treatment for pituitary adenoma. (author)

  1. TNF-α-Induced VEGF and MMP-9 Expression Promotes Hemorrhagic Transformation in Pituitary Adenomas

    Qin Liu

    2011-06-01

    Full Text Available Pituitary apoplexy is a clinical syndrome with unknown pathogenesis. Therefore, identifying the underlying mechanisms is of high clinical relevance. Tumor necrosis factor alpha (TNF-α is a critical cytokine mediating various hemorrhagic events, but little is known about its involvement in pituitary apoplexy. Here we show that TNF-α may be an important regulator of hemorrhagic transformation in pituitary adenomas. In this study, sixty surgical specimens of hemorrhagic and non-hemorrhagic human pituitary adenomas were examined. Hemorrhagic pituitary adenomas displayed higher protein and mRNA levels of TNF-α, vascular endothelial growth factor (VEGF and matrix metalloproteinase-9 (MMP-9 compared with those of non-hemorrhagic tumors. Exposure of MMQ pituitary adenoma cells to TNF-α induced VEGF and MMP-9 expression in vitro. Additionally, TNF-α administration caused hemorrhagic transformation and enhanced VEGF and MMP-9 expression in MMQ pituitary adenoma cell xenografts in mice. Blockers of VEGF or MMP-9, either alone or in combination, attenuated but not abrogated TNF-α mediated hemorrhagic transformation in xenografts. This study suggests that TNF-α may play a role in the development of intratumoral hemorrhage in pituitary adenomas via up-regulation of VEGF and MMP-9.

  2. Can single-phase dual-energy CT reliably identify adrenal adenomas?

    Helck, A.; Hummel, N.; Meinel, F.G.; Johnson, T.; Nikolaou, K.; Graser, A. [University of Munich, Institute for Clinical Radiology, Munich (Germany)

    2014-07-15

    To evaluate whether single-phase dual-energy-CT-based attenuation measurements can reliably differentiate lipid-rich adrenal adenomas from malignant adrenal lesions. We retrospectively identified 51 patients with adrenal masses who had undergone contrast-enhanced dual-energy-CT (140/100 or 140/80 kVp). Virtual non-contrast and colour-coded iodine images were generated, allowing for measurement of pre- and post-contrast density on a single-phase acquisition. Adrenal adenoma was diagnosed if density on virtual non-contrast images was ≤10 HU. Clinical follow-up, true non-contrast CT, PET/CT, in- and opposed-phase MRI, and histopathology served as the standard of reference. Based on the standard of reference, 46/57 (80.7 %) adrenal masses were characterised as adenomas or other benign lesions; 9 malignant lesions were detected. Based on a cutoff value of 10 HU, virtual non-contrast images allowed for correct identification of adrenal adenomas in 33 of 46 (71 %), whereas 13/46 (28 %) adrenal adenomas were lipid poor with a density ≥10 HU. Based on the threshold of 10 HU on the virtual non-contrast images, the sensitivity, specificity, and accuracy for detection of benign adrenal lesions was 73 %, 100 %, and 81 % respectively. Virtual non-contrast images derived from dual-energy-CT allow for accurate characterisation of lipid-rich adrenal adenomas and can help to avoid additional follow-up imaging. (orig.)

  3. Can single-phase dual-energy CT reliably identify adrenal adenomas?

    To evaluate whether single-phase dual-energy-CT-based attenuation measurements can reliably differentiate lipid-rich adrenal adenomas from malignant adrenal lesions. We retrospectively identified 51 patients with adrenal masses who had undergone contrast-enhanced dual-energy-CT (140/100 or 140/80 kVp). Virtual non-contrast and colour-coded iodine images were generated, allowing for measurement of pre- and post-contrast density on a single-phase acquisition. Adrenal adenoma was diagnosed if density on virtual non-contrast images was ≤10 HU. Clinical follow-up, true non-contrast CT, PET/CT, in- and opposed-phase MRI, and histopathology served as the standard of reference. Based on the standard of reference, 46/57 (80.7 %) adrenal masses were characterised as adenomas or other benign lesions; 9 malignant lesions were detected. Based on a cutoff value of 10 HU, virtual non-contrast images allowed for correct identification of adrenal adenomas in 33 of 46 (71 %), whereas 13/46 (28 %) adrenal adenomas were lipid poor with a density ≥10 HU. Based on the threshold of 10 HU on the virtual non-contrast images, the sensitivity, specificity, and accuracy for detection of benign adrenal lesions was 73 %, 100 %, and 81 % respectively. Virtual non-contrast images derived from dual-energy-CT allow for accurate characterisation of lipid-rich adrenal adenomas and can help to avoid additional follow-up imaging. (orig.)

  4. Clinical results of LINAC-based stereotactic radiosurgery for pituitary adenoma

    We retrospectively evaluated our clinical results of stereotactic radiosurgery (SRS) for pituitary adenoma. Between 1995 and 2000, 13 patients were treated with SRS for pituitary adenoma. In all cases, the tumors had already been surgically resected. The adenomas were functional in 5 and non-functional in 8 patients. The median follow-up period was 30 months. SRS was performed with the use of a dedicated stereotactic 10-MV linear accelerator (LINAC). The median dose to the tumor margin was 15 Gy. The dose to the optic apparatus was limited to less than 8 Gy. MR images of 12 patients revealed tumor complete response (CR) in one case and partial response (PR) in 9 cases; in the remaining two patients, tumor size decreased by less than 50%. There was no recognizable regrowth of any of the tumors. In two of four GH-secreting adenomas, hormonal overproduction normalized, while the other two showed reduced hormonal production. One PRL-secreting adenoma did not respond. Reduction of visual acuity and field was seen in one patient. This patient also had a brain infarction. None of the patients developed brain radionecrosis or radiation-induced hypopituitarism. Although further studies based on greater numbers of cases and longer follow-up periods are needed, our results suggest that SRS seems to be a safe, effective treatment for pituitary adenoma. (author)

  5. Hypertriglyceridemia is positively correlated with the development of colorectal tubular adenoma in Japanese men

    Masafumi Tabuchi; Joji Kitayama; Hirokazu Nagawa

    2006-01-01

    AIM: To determine the real association between serum lipid levels and colonic polyp formation.METHODS: We performed a large scale retrospective study to analyze the correlation between the incidence of colorectal adenoma or carcinoma and the fasting serum levels of total cholesterol (TC) and triglycerides (TG) in patients who underwent total colonoscopy for screening for colon cancer.RESULTS: Both levels were significantly elevated in patients with adenomas as compared with patients without any neoplastic lesion (TC 207.6±29.5 vs199.5±34.3, n=4883, p<0.001; TG 135.0±82.2 vs 108.7±71.5, n= 4874, p< 0.001). The difference was significant in patients with tubular adenoma but not in those with villous or serrated adenoma. Multiple logistic regression analysis including age and sex revealed that TG was an independent correlation factor in male (p < 0.01), but not in female patients. The level of TG in patients with invasive carcinoma did not show a significant elevation from that in patients with adenoma. These findings suggest that hypertriglyceridemia is an independent risk factor for colonic adenoma in men.CONCLUSION: Although a high level of serum triglyceride does not appear to be mechanically involved in the development of carcinoma, reduction of serum TG and intensive surveillance with total colonoscopy may have benefit in men with hypertriglyceridemia.

  6. Loss of Hes1 Differentiates Sessile Serrated Adenoma/polyp from Hyperplastic Polyp

    Cui, Min; Awadallah, Amad; Liu, Wendy; Zhou, Lan; Xin, Wei

    2016-01-01

    Sessile serrated adenoma/polyp (SSA/p) is a precancerous lesion, and its differential diagnosis from hyperplastic polyp (HP) could be challenging in certain circumstances based on morphology alone. Hes1 is a downstream target of Notch signaling pathway and plays an important role in intestinal development by regulating differentiation of enterocytes. In this study, we evaluated the expression patterns of Hes1 in SSA/p and hyperplastic polyp (HP), and determine whether Hes1 immunostaining can help differentiate between these two entities. Serrated polyps with cytological dysplasia (sessile serrated adenoma with cytological dysplasia, tubular adenoma, and traditional serrated adenoma) were also studied. Hes1 is ubiquitously expressed in the nuclei of normal colon epithelial cells. The complete loss or a very weak expression of Hes1 is observed in the majority of the SSA/p in the study (58/63, 92%) compared to the normal expression of Hes1 in HP (35/35,100%). In SSA/p with cytological dysplasia, dysplastic area demonstrated cytoplasmic and/or nuclear staining for Hes1. Tubular adenoma and traditional serrated adenoma showed variability of Hes1 staining within the polyp with a mixed positive and negative staining pattern. Our study suggests that loss of Hes1 could be used as a sensitive and specific marker to differentiate SSA/p from HP, which helps the diagnosis in morphologically challenging cases. PMID:26448192

  7. Adenoma velloso de recto con alteración hidroelectrolítica severa. Informe de dos casos

    Ernesto Sierra-Montenegro; José Luis Rocha-Ramírez; Eduardo Villanueva-Sáenz; Iván de la Serna-Ortiz; José Manuel Fernández-Rivero; René Soto-Quirino

    2007-01-01

    Background: Approximately 10 % of all colorectal adenomas are constituted by villous adenomas. Their relationship with hydroelectrolytic depletion is rare. We report two cases with villous adenoma that presented hydroelectrolytic depletion with clinical and surgical management, exclusively. Clinical cases: Case 1. Patient was a 76-year-old female with hypertension and 3 months evolution of symptoms such as asthenia, adynamia, unexplained weight loss, and abundant mucus with diarrhea. Serum po...

  8. Technetium-99m methoxyisobutylisonitrile imaging for parathyroid adenoma: relationship to P-glycoprotein or multidrug resistance-related protein expression

    Gland size has been reported to have a major influence on localisation of parathyroid adenomas by technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) imaging. It has also been suggested that P-glycoprotein (Pgp) expression in parathyroid adenomas may influence localisation because false negative studies have been reported with large tumours and true positives with very small tumours. Therefore, the purpose of this study was to retrospectively evaluate the relationship between 99mTc-MIBI parathyroid imaging results and Pgp or multidrug resistance-related protein (MRP) expression in parathyroid adenomas. Before surgery, 47 patients with large parathyroid adenomas (larger than 1.5 g) underwent early and delayed parathyroid imaging, 10 min and 2 h after intravenous injection of 99mTc-MIBI. Immunohistochemical analyses (IHA) were performed, using multiple non-consecutive sections of the operative specimens, to detect Pgp or MRP expression. According to the results of IHA, the 34 parathyroid adenomas were separated into four groups: (1) three adenomas positive for both Pgp and MRP expression, (2) one adenoma positive for Pgp but negative for MRP expression, (3) four adenomas negative for Pgp but positive for MRP expression and (4) 39 adenomas with negative for both Pgp and MRP expression. All 39 adenomas in group 4 could be detected by 99mTc-MIBI parathyroid imaging. None of the eight adenomas in groups 1-3 could be detected by 99mTc-MIBI parathyroid imaging (P99mTc-MIBI imaging in localising parathyroid adenomas preoperatively. (orig.)

  9. Design and baseline characteristics of participants in a phase III randomized trial of celecoxib and selenium for colorectal adenoma prevention

    Thompson, Patricia; Roe, Denise J.; Fales, Liane; Buckmeier, Julie; Wang, Fang; Hamilton, Stanley R.; Bhattacharyya, Achyut; Green, Sylvan; Hsu, Chiu-Hsieh; Chow, H-H Sherry; Ahnen, Dennis J.; Boland, C Richard; Russell I. Heigh; Fay, David E.; Martinez, Maria Elena

    2012-01-01

    Cyclooxygenase (COX) inhibitors reduce colorectal adenoma recurrence by up to 45% and selenium supplementation may prevent colorectal cancer. Following colonoscopic adenoma resection, 1,600 men and women aged 40-80 years were randomized to celecoxib (400 mg daily), a selective COX-2 inhibitor, and/or selenium (200 μg daily as selenized yeast), or double placebo. The trial was initiated in November, 2001. The primary trial endpoint is adenoma recurrence in each intervention group compared to p...

  10. Investigation into the controversial association of Streptococcus gallolyticus with colorectal cancer and adenoma

    The seroprevalence of IgG antibodies of Streptococcus gallolyticus subspecies gallolyticus, CIP 105428, was evaluated to investigate the controversial association of S. gallolyticus with colorectal carcinoma and adenoma in attempt to investigate the nature of such association if any, by exploring the mRNA expression of NF-κB and IL-8. Moreover, the serological behavior of S. gallolyticus IgG antibodies was compared to that of an indicator bacterium of bowel, Bacteroides fragilis. ELISA was used to measure IgG antibodies of S. gallolyticus and B. fragilis in sera of 50 colorectal cancer, 14 colorectal adenoma patients, 30 age- and sex- matched apparently healthy volunteers (HV) and 30 age- and sex- matched colonoscopically-proven tumor-free control subjects. NF-κB and IL-8 mRNA expression was evaluated in tumorous and non-tumorous tissue sections of carcinoma and adenoma patients in comparison with that of control subjects by using in situ hybridization assay. Colorectal cancer and adenoma patients were associated with higher levels of serum S. gallolyticus IgG antibodies in comparison with HV and control subjects (P < 0.05) while no similar association was found with serum IgG antibodies of B. fragilis (P > 0.05). ELISA cutoff value for the seropositivity of S. gallolyticus IgG was calculated from tumor-free control group. The expression of NF-κB mRNA was higher in tumorous than non-tumorous tissue sections of adenoma and carcinoma, higher in carcinoma/adenoma sections than in control subjects, higher in tumorous sections of carcinoma than in adenoma patients, and higher in S. gallolyticus IgG seropositive than in seronegative groups in both tumorous and non-tumorous sections (P < 0.05). IL-8 mRNA expression in tumorous sections of adenoma and carcinoma was higher than in non-tumorous sections, higher in carcinoma/adenoma than in control subjects, and higher in S. gallolyticus IgG seropositive than in seronegative groups in tumorous rather than non

  11. Pregnancy and liver adenoma management: PALM-study

    van Aalten Susanna M

    2012-06-01

    Full Text Available Abstract Background Hepatocellular adenoma (HCA in pregnant women requires special considerations because of the risk of hormone induced growth and spontaneous rupture, which may threaten the life of both mother and child. Due to scarcity of cases there is no evidence-based algorithm for the evaluation and management of HCA during pregnancy. Most experts advocate that women with HCA should not get pregnant or advise surgical resection before pregnancy. Whether it is justified to deny a young woman a pregnancy, as the biological behavior may be less threatening than presumed depends on the incidence of HCA growth and the subsequent clinical events during pregnancy. We aim to investigate the management and outcome of HCA during pregnancy and labor based on a prospectively acquired online database in the Netherlands. Methods/design The Pregnancy And Liver adenoma Management (PALM - study is a multicentre prospective study in three cohorts of pregnant patients. In total 50 pregnant patients, ≥ 18 years of age with a radiologically and/or histologically proven diagnosis of HCA will be included in the study. Radiological diagnosis of HCA will be based on contrast enhanced MRI. Lesions at inclusion must not exceed 5 cm. The study group will be compared to a healthy control group of 63 pregnant patients and a group of 63 pregnant patients with diabetes mellitus without HCA. During their pregnancy HCA patients will be closely monitored by means of repetitive ultrasound (US at 14, 20, 26, 32 and 38 weeks of gestation and 6 and 12 weeks postpartum. Both control groups will undergo US of the liver at 14 weeks of gestation to exclude HCA lesions in the liver. All groups will be asked to fill out quality of life related questionnaires. Discussion The study will obtain information about the behaviour of HCA during pregnancy, the clinical consequences for mother and child and the impact of having a HCA during pregnancy on the health related quality

  12. Differentiation of pituitary adenomas from other sellar and parasellar tumors by {sup 99m}Tc(V)-DMSA scintigraphy

    Yamamura, Koji [Yokohama City Univ. (Japan). Medical Center; Suzuki, Shinichi; Yamamoto, Isao [Yokohama City Univ. (Japan). School of Medicine

    2003-04-01

    Pentavalent technetium-99m dimercaptosuccinic acid [{sup 99m}Tc(V)-DMSA] scintigraphy was evaluated for the differentiation of pituitary adenomas, especially non-functioning adenomas, from other sellar and parasellar lesions. Diffuse {sup 99m}Tc(V)-DMSA accumulation within the tumor was found in seven of seven non-functioning, three of four growth hormone-secreting, and seven of eight prolactin-secreting adenomas, but only partial accumulation in only two of 16 non-pituitary adenomas and normal pituitary glands. There were no significant relationship between tumor-to-background ratios and tumor size or serum hormone level. {sup 99m}Tc(V)-DMSA scintigraphy showed overall sensitivity of 81% (17/21 cases) for detecting pituitary adenomas, in particular 100% for non-functioning adenomas. {sup 99m}Tc(V)-DMSA may be useful for detecting pituitary adenomas, especially non-functioning adenomas, and for the differentiation of non-functioning pituitary adenomas from other sellar and parasellar lesions. (author)

  13. Differentiation of pituitary adenomas from other sellar and parasellar tumors by 99mTc(V)-DMSA scintigraphy

    Pentavalent technetium-99m dimercaptosuccinic acid [99mTc(V)-DMSA] scintigraphy was evaluated for the differentiation of pituitary adenomas, especially non-functioning adenomas, from other sellar and parasellar lesions. Diffuse 99mTc(V)-DMSA accumulation within the tumor was found in seven of seven non-functioning, three of four growth hormone-secreting, and seven of eight prolactin-secreting adenomas, but only partial accumulation in only two of 16 non-pituitary adenomas and normal pituitary glands. There were no significant relationship between tumor-to-background ratios and tumor size or serum hormone level. 99mTc(V)-DMSA scintigraphy showed overall sensitivity of 81% (17/21 cases) for detecting pituitary adenomas, in particular 100% for non-functioning adenomas. 99mTc(V)-DMSA may be useful for detecting pituitary adenomas, especially non-functioning adenomas, and for the differentiation of non-functioning pituitary adenomas from other sellar and parasellar lesions. (author)

  14. Dynamic contrast enhanced MRI in the differential diagnosis of adrenal adenomas and malignant adrenal masses

    Objective: To evaluate the value of dynamic MR imaging in the differential diagnosis of adrenal adenomas and malignant tumors, especially in cases with atypical adenomas. Materials and methods: Sixty-four masses (48 adenomas, 16 malignant tumors) were included in this prospective study. Signal loss of masses was evaluated using chemical shift MR imaging. Five dynamic series of T1-weighted spoiled gradient echo (FFE) images were obtained, with the acquisition starting simultaneously with i.v. contrast administration (0-100 s) followed by a T1-weighted FFE sequence in the late phase (5th minute). Contrast enhancement patterns in the early (25th second) and late (5th minute) phase images were evaluated. For the quantitative evaluation, signal intensity (SI)-time curves were obtained according to the SIs on the 0th, 25th, 50th 75th and 100th second. Also, the wash-in rate, maximum relative enhancement, time-to-peak, and wash-out of contrast at 100 s of masses in both groups were calculated. The statistical significance was determined by Mann-Whitney U test. To evaluate the diagnostic performance of the quantitative tests, receiver operating characteristic (ROC) analysis was performed. Results: Chemical shift MR imaging was able to differentiate 44 out of 48 adenomas (91.7%) from non-adenomas. The 4 adenomas (8.3%) which could not be differentiated from non-adenomas by this technique did not exhibit signal loss on out-of-phase images. With a cut-off value of 30, SI indices of adenomas had a sensitivity of 93.8%, specificity of 100% and a positive predictive value of 100%. On visual evaluation of dynamic MR imaging, early phase contrast enhancement patterns were homogeneous in 75% and punctate in 20,83% of the adenomas; while patchy in 56.25% and peripheral in 25% of the malignant tumors. On the late phase images 58.33% of the adenomas showed peripheral ring-shaped enhancement and 10.41% showed heterogeneous enhancement. All of the malignant masses showed heterogeneous

  15. Non-Alcoholic Fatty Liver Disease in Subjects with Non-functioning Adrenal Adenomas

    Serkan Yener

    2011-12-01

    Full Text Available Objectives: The relation between non-functioning adrenal adenoma and unfavorable metabolic status has been a debate so far. We aimed to demonstrate the prevalence of non-alcoholic fatty liver disease (NAFLD in subjects with silent adrenal adenomas.Materials and Methods: 130 consecutive subjects with non-functioning adrenal adenomas, 170 age-, gender- and BMI-matched individuals without adrenal gland disorders, and 20 patients with Cushing’s syndrome were included in the study. Fatty liver disease was diagnosed by ultrasonography and the severity was scored semiquantitatively. Liver function tests were performed. Cushing’s syndrome and non-functioning adrenal adenoma were diagnosed using appropriate tests of hypothalamus-pituitary-adrenal function.Results: The prevalence of NAFLD was 30.7%, 65.0% and 39.4% in adenoma group, Cushing’s syndrome group and control group, respectively. There was no significant difference in terms of Type 2 diabetes mellitus, hypertension and NAFLD prevalence between adenoma group and controls. NAFLD was not only more common in subjects with Cushing’s syndrome but was also more severe. Hypercortisolemia strongly predicted the development of metabolic syndrome (OR: 10.571, p=0.004. When age, gender, hypercortisolemia and metabolic syndrome were assessed, metabolic syndrome remained as the sole independent predictor of fatty liver development (OR: 9.162, p<0.001.Conclusion: Comparable prevalence between adenoma and control group was likely to be associated with similar rates of metabolic derangements and similar BMI. Cortisol excess seemed to be related with fatty liver development mainly through its unfavorable metabolic effects. Türk Jem 2011; 15: 116-20

  16. Local IGFBP-3 mRNA expression, apoptosis and risk of colorectal adenomas

    Omofoye Oluwaseun

    2008-05-01

    Full Text Available Abstract Background IGF binding protein-3 (IGFBP-3 regulates the bioavailability of insulin-like growth factors I and II, and has both anti-proliferative and pro-apoptotic properties. Elevated plasma IGFBP-3 has been associated with reduced risk of colorectal cancer (CRC, but the role of tissue IGFBP-3 is not well defined. We evaluated the association between tissue or plasma IGFBP-3 and risk of colorectal adenomas or low apoptosis. Methods Subjects were consenting patients who underwent a clinically indicated colonoscopy at UNC Hospitals and provided information on diet and lifestyle. IGFBP-3 mRNA in normal colon was assessed by real time RT-PCR. Plasma IGFBP-3 was measured by ELISA and apoptosis was determined by morphology on H & E slides. Logistic regression was used to compute odds ratio (OR and 95% confidence intervals. Results We observed a modest correlation between plasma IGFBP-3 and tissue IGFBP-3 expression (p = 0.007. There was no significant association between plasma IGFBP-3 and adenomas or apoptosis. Tissue IGFBP-3 mRNA expression was significantly lower in cases than controls. Subjects in the lowest three quartiles of tissue IGFBP-3 gene expression were more likely to have adenomas. Consistent with previous reports, low apoptosis was significantly associated with increased risk of adenomas (p = 0.003. Surprisingly, local IGFBP-3 mRNA expression was inversely associated with apoptosis. Conclusion Low expression of IGFBP-3 mRNA in normal colonic mucosa predicts increased risk of adenomas. Our findings suggest that local IGFBP-3 in the colon may directly increase adenoma risk but IGFBP-3 may act through a pathway other than apoptosis to influence adenoma risk.

  17. Folic acid supplementation inhibits recurrence of colorectal adenomas: A randomized chemoprevention trial

    Richard Jaszewski; Adhip PN Majumdar; Sabeena Misra; Martin Tobi; Nadeem Ullah; Jo Ann Naumoff; Omer Kucuk; Edi Levi; Bradley N Axelrod; Bhaumik B Patel

    2008-01-01

    AIM: To determine whether folic acid supplementation will reduce the recurrence of colorectal adenomas,the precursors of colorectal cancer, we performed a double-blind placebo-controlled trial in patients with adenomatous polyps.METHODS: In the current double-blind, placebo-controlled trial at this VA Medical Center, patients with colorectal adenomas were randomly assigned to receive either a daily 5 mg dose of folic acid or a matched identical placebo for 3 years. All polyps were removed at baseline colonoscopy and each patient had a follow up colonoscopy at 3 years. The primary endpoint was a reduction in the number of recurrent adenomas at 3 years.RESULTS: Of 137 subjects, who were eligible after confirmation of polyp histology and run-in period to conform compliance, 94 completed the study; 49 in folic acid group and 45 in placebo group. Recurrence of adenomas at 3-year was compared between the two groups. The mean number of recurrent polyps at 3-year was 0.36 (SD, 0.69) for folic acid treated patients compared to 0.82 (SD, 1.17) for placebo treated subjects, resulting in a 3-fold increase in polyp recurrence in the placebo group. Patients below 70 years of age and those with left-sided colonic adenomas or advanced adenomas responded better to folic acid supplementation.CONCLUSION: High dose folic acid supplementation is associated with a significant reduction in the recurrence of colonic adenomas suggesting that folic acid may be an effective chemopreventive agent for colorectal neoplasia.

  18. Loss of expression and promoter methylation of SLIT2 are associated with sessile serrated adenoma formation.

    Andrew D Beggs

    2013-05-01

    Full Text Available Serrated adenomas form a distinct subtype of colorectal pre-malignant lesions that may progress to malignancy along a different molecular pathway than the conventional adenoma-carcinoma pathway. Previous studies have hypothesised that BRAF mutation and promoter hypermethylation plays a role, but the evidence for this is not robust. We aimed to carry out a whole-genome loss of heterozygosity analysis, followed by targeted promoter methylation and expression analysis to identify potential pathways in serrated adenomas. An initial panel of 9 sessile serrated adenomas (SSA and one TSA were analysed using Illumina Goldengate HumanLinkage panel arrays to ascertain regions of loss of heterozygosity. This was verified via molecular inversion probe analysis and microsatellite analysis of a further 32 samples. Methylation analysis of genes of interest was carried out using methylation specific PCR (verified by pyrosequencing and immunohistochemistry used to correlate loss of expression of genes of interest. All experiments used adenoma samples and normal tissue samples as control. SSA samples were found on whole-genome analysis to have consistent loss of heterozygosity at 4p15.1-4p15.31, which was not found in the sole TSA, adenomas, or normal tissues. Genes of interest in this region were PDCH7 and SLIT2, and combined MSP/IHC analysis of these genes revealed significant loss of SLIT2 expression associated with promoter methylation of SLIT2. Loss of expression of SLIT2 by promoter hypermethylation and loss of heterozygosity events is significantly associated with serrated adenoma development, and SLIT2 may represent a epimutated tumour suppressor gene according to the Knudson "two hit" hypothesis.

  19. Local IGFBP-3 mRNA expression, apoptosis and risk of colorectal adenomas

    IGF binding protein-3 (IGFBP-3) regulates the bioavailability of insulin-like growth factors I and II, and has both anti-proliferative and pro-apoptotic properties. Elevated plasma IGFBP-3 has been associated with reduced risk of colorectal cancer (CRC), but the role of tissue IGFBP-3 is not well defined. We evaluated the association between tissue or plasma IGFBP-3 and risk of colorectal adenomas or low apoptosis. Subjects were consenting patients who underwent a clinically indicated colonoscopy at UNC Hospitals and provided information on diet and lifestyle. IGFBP-3 mRNA in normal colon was assessed by real time RT-PCR. Plasma IGFBP-3 was measured by ELISA and apoptosis was determined by morphology on H & E slides. Logistic regression was used to compute odds ratio (OR) and 95% confidence intervals. We observed a modest correlation between plasma IGFBP-3 and tissue IGFBP-3 expression (p = 0.007). There was no significant association between plasma IGFBP-3 and adenomas or apoptosis. Tissue IGFBP-3 mRNA expression was significantly lower in cases than controls. Subjects in the lowest three quartiles of tissue IGFBP-3 gene expression were more likely to have adenomas. Consistent with previous reports, low apoptosis was significantly associated with increased risk of adenomas (p = 0.003). Surprisingly, local IGFBP-3 mRNA expression was inversely associated with apoptosis. Low expression of IGFBP-3 mRNA in normal colonic mucosa predicts increased risk of adenomas. Our findings suggest that local IGFBP-3 in the colon may directly increase adenoma risk but IGFBP-3 may act through a pathway other than apoptosis to influence adenoma risk

  20. Serum IGF1, IGF2 and IGFBP3 and risk of advanced colorectal adenoma.

    Gao, Ying; Katki, Hormuzd; Graubard, Barry; Pollak, Michael; Martin, Michael; Tao, Yuzhen; Schoen, Robert E; Church, Timothy; Hayes, Richard B; Greene, Mark H; Berndt, Sonja I

    2012-07-15

    The insulin-like growth factor (IGF) signaling pathway is involved in cell proliferation and differentiation. Elevated serum IGF1 levels have been associated with increased colorectal cancer risk; however, studies of this association with colorectal adenoma are inconclusive. We examined serum IGF1, IGF2 and IGFBP3 levels in relation to risk of advanced colorectal adenoma in a case-control study within the prostate, lung, colorectal and ovarian cancer screening trial. A total of 764 advanced, left-sided colorectal adenoma cases and 775 controls frequency-matched on gender and ethnicity, without evidence of a left-sided polyp on sigmoidoscopy were included in the current study. Serum levels of IGF1, IGF2 and IGFBP3 were measured using an enzyme linked immunosorbent assay in serum samples collected at baseline. Logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the associations adjusting for age, race, sex, year of blood draw, body mass index, smoking and education. Higher IGF1 levels were associated with increased adenoma risk: ORs = 1.58 (95% CI = 1.16-2.16), 1.42 (95% CI = 1.04-1.93), and 1.80 (95% CI = 1.30-2.47) for the second, third and fourth quartiles, respectively (p(trend) = 0.002). Elevated IGF2 levels were also associated with increased adenoma risk (OR = 1.43, 95% CI = 1.05-1.96 for the fourth vs. first quartile, p(trend) = 0.02), but the association was no longer significant after adjustment for IGF1 (p(trend) = 0.28). IGFBP3 levels were not associated with adenoma risk. Our analysis showed a significant positive association between circulating IGF1 levels and risk of advanced colorectal adenoma, suggesting that IGF1 is associated with the pivotal precursor to colorectal cancer. PMID:21932422

  1. Adenomas hipofisários não secretantes: Estudo de 36 casos Nonfuntional pituitary adenomas: evaluation of 36 patients with surgical treatment

    Oswaldo Inácio de Tella Jr

    2002-03-01

    Full Text Available Apresentamos nossa experiência com 36 casos de adenomas hipofisários não secretantes. Estes adenomas foram divididos em não reativos e inativos de acordo com a imuno-histoquímica. Manifestaram-se por sintomas visuais, principalmente hemianopsia bitemporal; são macroadenomas, não havendo predomínio de adenomas circunscritos ou invasivos nos dois grupos. O tratamento é cirúrgico geralmente por via transeptoesfenoidal, com ressecção total ao redor de 40% dos casos e com melhora visual próxima aos 90% dos casos.We present our experience with 36 cases of nonfunctional pituitary adenomas. These tumors were divided into non reactive and inactive in agreement with the immunohistochemical study. They present with visual symptoms, mainly bitemporal hemianopsia; they were macroadenomas, either invasive or non invasive, in both groups. The treatment is surgical using the transsphenoidal approach. Total resection was possible in about 40% of the cases. Visual improvement occurred in 90% of the patients.

  2. Stereotactic Irradiation of GH-Secreting Pituitary Adenomas

    G. Minniti

    2012-01-01

    Full Text Available Radiotherapy (RT is often employed in patients with acromegaly refractory to medical and/or surgical interventions in order to prevent tumour regrowth and normalize elevated GH and IGF-I levels. It achieves tumour control and hormone normalization up to 90% and 70% of patients at 10–15 years. Despite the excellent tumour control, conventional RT is associated with a potential risk of developing late toxicity, especially hypopituitarism, and its role in the management of patients with GH-secreting pituitary adenomas remains a matter of debate. Stereotactic techniques have been developed with the aim to deliver more localized irradiation and minimize the long-term consequences of treatment, while improving its efficacy. Stereotactic irradiation can be given in a single dose as stereotactic radiosurgery (SRS or in multiple doses as fractionated stereotactic radiotherapy (FSRT. We have reviewed the recent published literature on stereotactic techniques for GH-secreting pituitary tumors with the aim to define the efficacy and potential adverse effects of each of these techniques.

  3. Conventional Minimally Invasive Parathyroidectomy for Single Parathyroid Adenoma

    Cristian Velicescu

    2015-04-01

    Full Text Available Background: Minimally invasive parathyroidectomy is actually the gold standard in the treatment of primary hyperparathyroidism (PHPT due to parathyroid adenoma (PA. Material and Methods: A clinical retrospective study was performed on a series of 40 cases operated for pHPT by single PA from January 2013 to March 2015, in the surgical department of the “St. Spiridon” Hospital of Iasi, a refferal center for endocrine surgery. Biochemical markers achieved the diagnosis of PHPT and PA was localized using cervical US and MIBI scintigraphy. Conventional minimally invasive parathyroidectomy (C-MIP was performed in all cases where PA was accurately localised by preoperative imaging, whereas conventional cervical exploration was necessary in cases with concomitant thyroid pathology. Results: Preoperative localisation findings were concordant with the intraoperative findings, except for one case when conversion to bilateral exploration was deemed and the PA was identified on the other side. In 8 cases, additional thyroid pathology – uni/multinodular goiter and a papillary microcarcinoma imposed a conventional PT adenomectomy and concomitant lobectomy/total thyroidectomy. The values of calcemia and PTH decreased significantly postoperatively and reached normal range in all cases. With the exception of a transient reccurrent nerve paresis (in a patient with total thyroidectomy, no postoperative morbidity and mortality was encountered. Conclusion: Conventional mini-incision parathyroidectomy (C-MIP has an excellent cure rate and minimal morbidity, with a reduced hospital stay and cost compared with the conventional extensive approach.

  4. Histological and Immunohistochemical Revision of Hepatocellular Adenomas: A Learning Experience

    S. Fonseca

    2013-01-01

    Full Text Available Light has been shed on the genotype/phenotype correlation in hepatocellular adenoma (HCA recognizing HNF1α-inactivated HCA (H-HCA, inflammatory HCA (IHCA, and β-catenin-activated HCA (b-HCA. We reviewed retrospectively our surgical HCA series to learn how to recognize the different subtypes histopathologically and how to interpret adequately their immunohistochemical staining. From January 1992 to January 2012, 37 patients underwent surgical resection for HCA in our institution. Nine had H-HCA (25% characterized by steatosis and loss of L-FABP expression; 20 had IHCA (55.5% showing CRP and/or SAA expression, sinusoidal dilatation, and variable inflammation; and 1 patient had both H-HCA and IHCA. In 5 patients (14%, b-HCA with GS and β-catenin nuclear positivity was diagnosed, two already with hepatocellular carcinoma. Two cases (5.5% remained unclassified. One of the b-HCA showed also the H-HCA histological and immunohistochemical characteristics suggesting a subgroup of β-catenin-activated/HNF1α-inactivated HCA, another b-HCA exhibited the IHCA histological and immunohistochemical characteristics suggesting a subgroup of β-catenin-activated/inflammatory HCA. Interestingly, three patients had underlying vascular abnormalities. Using the recently published criteria enabled us to classify histopathologically our retrospective HCA surgical series with accurate recognition of b-HCA for which we confirm the higher risk of malignant transformation. We also underlined the association between HCA and vascular abnormalities.

  5. TSH RECEPTOR GENETIC ALTERATIONS IN THE AUTONOMOUSLY FUNCTIONING THYROID ADENOMAS

    施秉银; 李雪萍; 李社莉; 薛明战; 王毅; 徐莉

    2004-01-01

    Objective To determine the relationship between TSH receptor gene mutations and autonomously functioning thyroid adenomas (AFTAs). Methods The thyroid samples from 14 cases of diagnosed AFTAs were analyzed, with normal thyroid specimens adjacent to the tumors as controls. The 155 base pairs DNA fragments which encompassed the third cytoplasmic loop and the sixth transmembrane segments in the TSH receptor gene exon 10 were amplified by Polymerase chain reaction (PCR) and analyzed by the single-strand conformation polymorphism (SSCP). Direct sequencing of the PCR products was performed with Prism Dye Terminator Cycle Sequencing Core Kit. Results 6 of 14 AFTA specimens displayed abnormal migration in SSCP analysis. In sequence analysis of 3 abnormally migrated samples, one base substitution at nucleotide 1957 (A to C) and two same insertion mutations of one adenosine nucleotide between nucleotide 1972 and 1973 were identified. No mutations were found in controls. Conclusion This study confirmed the presence of TSH receptor gene mutations in AFTAs; both one-point substitution mutation and one-base insertion mutation were found to be responsible for the pathogenesis of AFTAs.

  6. Activating mutations in CTNNB1 in aldosterone producing adenomas.

    Åkerström, Tobias; Maharjan, Rajani; Sven Willenberg, Holger; Cupisti, Kenko; Ip, Julian; Moser, Ana; Stålberg, Peter; Robinson, Bruce; Alexander Iwen, K; Dralle, Henning; Walz, Martin K; Lehnert, Hendrik; Sidhu, Stan; Gomez-Sanchez, Celso; Hellman, Per; Björklund, Peyman

    2016-01-01

    Primary aldosteronism (PA) is the most common cause of secondary hypertension with a prevalence of 5-10% in unreferred hypertensive patients. Aldosterone producing adenomas (APAs) constitute a large proportion of PA cases and represent a surgically correctable form of the disease. The WNT signaling pathway is activated in APAs. In other tumors, a frequent cause of aberrant WNT signaling is mutation in the CTNNB1 gene coding for β-catenin. Our objective was to screen for CTNNB1 mutations in a well-characterized cohort of 198 APAs. Somatic CTNNB1 mutations were detected in 5.1% of the tumors, occurring mutually exclusive from mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D. All of the observed mutations altered serine/threonine residues in the GSK3β binding domain in exon 3. The mutations were associated with stabilized β-catenin and increased AXIN2 expression, suggesting activation of WNT signaling. By CYP11B2 mRNA expression, CYP11B2 protein expression, and direct measurement of aldosterone in tumor tissue, we confirmed the ability for aldosterone production. This report provides compelling evidence that aberrant WNT signaling caused by mutations in CTNNB1 occur in APAs. This also suggests that other mechanisms that constitutively activate the WNT pathway may be important in APA formation. PMID:26815163

  7. Activating mutations in CTNNB1 in aldosterone producing adenomas

    Åkerström, Tobias; Maharjan, Rajani; Sven Willenberg, Holger; Cupisti, Kenko; Ip, Julian; Moser, Ana; Stålberg, Peter; Robinson, Bruce; Alexander Iwen, K.; Dralle, Henning; Walz, Martin K.; Lehnert, Hendrik; Sidhu, Stan; Gomez-Sanchez, Celso; Hellman, Per; Björklund, Peyman

    2016-01-01

    Primary aldosteronism (PA) is the most common cause of secondary hypertension with a prevalence of 5–10% in unreferred hypertensive patients. Aldosterone producing adenomas (APAs) constitute a large proportion of PA cases and represent a surgically correctable form of the disease. The WNT signaling pathway is activated in APAs. In other tumors, a frequent cause of aberrant WNT signaling is mutation in the CTNNB1 gene coding for β-catenin. Our objective was to screen for CTNNB1 mutations in a well-characterized cohort of 198 APAs. Somatic CTNNB1 mutations were detected in 5.1% of the tumors, occurring mutually exclusive from mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D. All of the observed mutations altered serine/threonine residues in the GSK3β binding domain in exon 3. The mutations were associated with stabilized β-catenin and increased AXIN2 expression, suggesting activation of WNT signaling. By CYP11B2 mRNA expression, CYP11B2 protein expression, and direct measurement of aldosterone in tumor tissue, we confirmed the ability for aldosterone production. This report provides compelling evidence that aberrant WNT signaling caused by mutations in CTNNB1 occur in APAs. This also suggests that other mechanisms that constitutively activate the WNT pathway may be important in APA formation. PMID:26815163

  8. Cushing’s Syndrome During Pregnancy Secondary to Adrenal Adenoma

    Fateme Mostaan

    2012-01-01

    Full Text Available Pregnancy rarely occurs in untreated cases of Cushing's syndrome (CS , because most of them are infertile due to significant maternal and fetal complications during pregnancy. Diagnosis of CS may be difficult during pregnancy. Since physiological changes of pregnancy are overlapped by classical presentation and biological confirmation of CS. Therefore the high clinical suspicious is needed for diagnosis. We present a 33 years old pregnant woman with a history of chronic hypertension from 10 years ago that referred to Imam Khomeini hospital for uncontrolled hypertension, gestational diabetes and fetal tachycardia at the 30 weeks of gestation. After initial studies abdominal MRI detected a 43 x 35 x 29 mm right adrenal mass. She was treated by anti-hypertensive drugs. But at 31.5 weeks of gestational age cesarean section was performed due to sever preeclampsia. Then two weeks after delivery open right adrenalectomy was carried out without any complications and in the histopathological evaluation benign adrenocortical adenoma was reported. CS is associated with considerable fetal and maternal morbidity and mortality. Selection of treatment method is variable and it depends on gestational age. Medical and surgical approaches have been used in managing CS in pregnancy. Surgical treatment is the first choice for CS which is recommended at the second trimester and in the late pregnancy medical treatment is preferred.

  9. Multiple intracranial aneurysms following radiation therapy for pituitary adenoma

    A rare case is reported in which multiple cerebral aneurysm occurred after radiotherapy. A female aged 51 was hospitalized with a chief complaint of consciousness disorder. The patient was discharged from the hospital 1 year before, after undergoing subtotal extirpation of a tumor through the transsphenoidal sinus in a case of pituitary adenoma, and post-operative radiotherapy (topical 50 Gy). Mild hyperlipidemia associated with hypothyroidism was observed by blood biochemical test during hospitalization. Multiple cerebral infarction was observed by CT scanning and MR imaging. Conservative treatment including intensified endocrine-supplementing treatment was performed. Thyroid gland function and hyperlipidemia improved, but the consciousness disorder occurred suddenly 6 weeks after hospitalization. Subarachnoid hemorrhage and hydrocephalus were observed by CT scanning. Cerebral angiography detected a saccular aneurysm in the trifuraction of the right middle cerebral artery, 3 fusiform aneurysms in the periphery of the right middle cerebral artery, 2 fusiform aneurysms in the posterior cerebral artery. These findings were not observed at the initial hospitalization but were unexceptionally confined to all the irradiation fields. The patient died 8 weeks after hospitalization, and no autoptic findings was obtained. We presumed that radiation vasculopathy, caused by radiation therapy done one year previously, had led to the occurrence of multiple cerebral aneurysms. We think that hyperlipidemia may have acted as an exacerbating factor responsible for these aneurysms. (author)

  10. Exome capture sequencing of adenoma reveals genetic alterations in multiple cellular pathways at the early stage of colorectal tumorigenesis.

    Donger Zhou

    Full Text Available Most of colorectal adenocarcinomas are believed to arise from adenomas, which are premalignant lesions. Sequencing the whole exome of the adenoma will help identifying molecular biomarkers that can predict the occurrence of adenocarcinoma more precisely and help understanding the molecular pathways underlying the initial stage of colorectal tumorigenesis. We performed the exome capture sequencing of the normal mucosa, adenoma and adenocarcinoma tissues from the same patient and sequenced the identified mutations in additional 73 adenomas and 288 adenocarcinomas. Somatic single nucleotide variations (SNVs were identified in both the adenoma and adenocarcinoma by comparing with the normal control from the same patient. We identified 12 nonsynonymous somatic SNVs in the adenoma and 42 nonsynonymous somatic SNVs in the adenocarcinoma. Most of these mutations including OR6X1, SLC15A3, KRTHB4, RBFOX1, LAMA3, CDH20, BIRC6, NMBR, GLCCI1, EFR3A, and FTHL17 were newly reported in colorectal adenomas. Functional annotation of these mutated genes showed that multiple cellular pathways including Wnt, cell adhesion and ubiquitin mediated proteolysis pathways were altered genetically in the adenoma and that the genetic alterations in the same pathways persist in the adenocarcinoma. CDH20 and LAMA3 were mutated in the adenoma while NRXN3 and COL4A6 were mutated in the adenocarcinoma from the same patient, suggesting for the first time that genetic alterations in the cell adhesion pathway occur as early as in the adenoma. Thus, the comparison of genomic mutations between adenoma and adenocarcinoma provides us a new insight into the molecular events governing the early step of colorectal tumorigenesis.

  11. Exome capture sequencing of adenoma reveals genetic alterations in multiple cellular pathways at the early stage of colorectal tumorigenesis.

    Zhou, Donger; Yang, Liu; Zheng, Liangtao; Ge, Weiting; Li, Dan; Zhang, Yong; Hu, Xueda; Gao, Zhibo; Xu, Jinghong; Huang, Yanqin; Hu, Hanguang; Zhang, Hang; Zhang, Hao; Liu, Mingming; Yang, Huanming; Zheng, Lei; Zheng, Shu

    2013-01-01

    Most of colorectal adenocarcinomas are believed to arise from adenomas, which are premalignant lesions. Sequencing the whole exome of the adenoma will help identifying molecular biomarkers that can predict the occurrence of adenocarcinoma more precisely and help understanding the molecular pathways underlying the initial stage of colorectal tumorigenesis. We performed the exome capture sequencing of the normal mucosa, adenoma and adenocarcinoma tissues from the same patient and sequenced the identified mutations in additional 73 adenomas and 288 adenocarcinomas. Somatic single nucleotide variations (SNVs) were identified in both the adenoma and adenocarcinoma by comparing with the normal control from the same patient. We identified 12 nonsynonymous somatic SNVs in the adenoma and 42 nonsynonymous somatic SNVs in the adenocarcinoma. Most of these mutations including OR6X1, SLC15A3, KRTHB4, RBFOX1, LAMA3, CDH20, BIRC6, NMBR, GLCCI1, EFR3A, and FTHL17 were newly reported in colorectal adenomas. Functional annotation of these mutated genes showed that multiple cellular pathways including Wnt, cell adhesion and ubiquitin mediated proteolysis pathways were altered genetically in the adenoma and that the genetic alterations in the same pathways persist in the adenocarcinoma. CDH20 and LAMA3 were mutated in the adenoma while NRXN3 and COL4A6 were mutated in the adenocarcinoma from the same patient, suggesting for the first time that genetic alterations in the cell adhesion pathway occur as early as in the adenoma. Thus, the comparison of genomic mutations between adenoma and adenocarcinoma provides us a new insight into the molecular events governing the early step of colorectal tumorigenesis. PMID:23301059

  12. Deficiency of Adenomatous Polyposis Coli protein in sporadic colorectal adenomas and its associations with clinical phenotype and histology

    Martin Bortlík; Ivana Vítková; Martina Pape(z)ová; Milada Kohoutová; Ale(s) Novotn(y); Stanislav Adamec; Petra Chalupná; Milan Luká(s)

    2006-01-01

    AIM: To evaluate the frequency of the loss of the Adenomatous Polyposis Coli (APC) protein and to compare the APC status with the characteristics of colorectal adenomas.METHODS: Immunohistochemical analysis of the APC protein was performed on 118 adenomas and the results were compared with parameters of malignant potential,location of adenomas, macroscopic appearance and age of the patients.RESULTS: A complete loss of the APC protein was found in 28 (24%) adenomas, while 90 (76%) were APC positive. The mean size of adenomas was 13.5 ± 14.2 mm (95% CI 10.5-16.5) in APC-positive, and 13.8 ± 15.5mm (95% CI 7.8-19.8) in APC-negative adenomas (P = 0.364). Statistical analysis revealed no difference between APC-positive and negative adenomas as to the histological type (P = 0.327) and grade of dysplasia (P =0.494). We found that even advanced adenomas did not differ in their APC status from the non-advanced tumors (P = 0.414). Finally, no difference was found when the location (P = 0.157), macroscopic appearance (P =0.571) and age of patients (P = 0.438) were analysed and compared between both APC positive and negative adenomas.CONCLUSION: Most adenomas expressed full-length APC protein, suggesting that protein expression is not a reliable marker for assessment of APC gene mutation.Complete loss of APC protein did not influence morphology, location, or appearance of adenomas, nor was it affected by the patient's age.

  13. Lack of correlation between Ki-67 labelling index and tumor size of anterior pituitary adenomas

    Guiducci Antonio

    2001-08-01

    Full Text Available Abstract Aims and background The Ki-67 is a nuclear antigen detected by the monoclonal antibody MIB-1 and its Labeling Index (LI is considered a marker of normal and abnormal cell proliferation. Pituitary adenomas are generally well differentiated neoplasms, even if in about one third of cases they are invasive of surrounding tissues. The aim of this study is to evaluate the correlation between Ki-67 labelling index and tumor size of pituitary adenomas extimated by means CT and MRI and confirmed at operation. Methods Using the monoclonal antibody MIB-1, we evaluated the expression of Ki-67 in 121 anterior pituitary adenomas consecutively operated on in a 48-month period. Results In relation to neuroradiological (CT and MRI and surgically verified tumor size, we identified 24 microadenomas, 27 intrasellar macroadenomas, 34 intra-suprasellar macroadenomas, and 36 intra-supra-parasellar macroadenomas. The adenomas were non-infiltrating (76 cases and infiltrating (45 cases adenomas. The wall of the cavernous sinus (CS was infiltrated in 18 cases. Forty-eight adenomas were non-functioning and 73 functioning. The overall mean ± SD Ki-67 LI was 2.72 ± 2.49% (median 1.6. It was 2.59 ± 1.81 in microadenomas, 2.63 ± 3.45 in intrasellar macroadenomas, 1.91 ± 2.11 in intra-suprasellar macroadenomas, and 3.29 ± 5.45 in intra-supra-parasellar macroadenomas (p = 0.27. It was 3.73 ± 5.13% in infiltrating and 2.03 ± 2.41% in non-infiltrating adenomas (p = 0.02, and 5.61 ± 7.19% in CS-infiltrating versus 2.09 ± 2.37% in CS-non-infiltrating adenomas (p = 0.0005. Conclusions Our preliminary results seem to exclude significative correlations between Ki-67 LI and tumor size of anterior pituitary adenomas, even if this index can be considered a useful marker in the determination of the infiltrative behaviour of these tumors.

  14. Lack of correlation between Ki-67 labelling index and tumor size of anterior pituitary adenomas

    The Ki-67 is a nuclear antigen detected by the monoclonal antibody MIB-1 and its Labeling Index (LI) is considered a marker of normal and abnormal cell proliferation. Pituitary adenomas are generally well differentiated neoplasms, even if in about one third of cases they are invasive of surrounding tissues. The aim of this study is to evaluate the correlation between Ki-67 labelling index and tumor size of pituitary adenomas extimated by means CT and MRI and confirmed at operation. Using the monoclonal antibody MIB-1, we evaluated the expression of Ki-67 in 121 anterior pituitary adenomas consecutively operated on in a 48-month period. In relation to neuroradiological (CT and MRI) and surgically verified tumor size, we identified 24 microadenomas, 27 intrasellar macroadenomas, 34 intra-suprasellar macroadenomas, and 36 intra-supra-parasellar macroadenomas. The adenomas were non-infiltrating (76 cases) and infiltrating (45 cases) adenomas. The wall of the cavernous sinus (CS) was infiltrated in 18 cases. Forty-eight adenomas were non-functioning and 73 functioning. The overall mean ± SD Ki-67 LI was 2.72 ± 2.49% (median 1.6). It was 2.59 ± 1.81 in microadenomas, 2.63 ± 3.45 in intrasellar macroadenomas, 1.91 ± 2.11 in intra-suprasellar macroadenomas, and 3.29 ± 5.45 in intra-supra-parasellar macroadenomas (p = 0.27). It was 3.73 ± 5.13% in infiltrating and 2.03 ± 2.41% in non-infiltrating adenomas (p = 0.02), and 5.61 ± 7.19% in CS-infiltrating versus 2.09 ± 2.37% in CS-non-infiltrating adenomas (p = 0.0005). Our preliminary results seem to exclude significative correlations between Ki-67 LI and tumor size of anterior pituitary adenomas, even if this index can be considered a useful marker in the determination of the infiltrative behaviour of these tumors

  15. Association of plasma endotoxin, inflammatory cytokines and risk of colorectal adenomas

    Recent studies suggest that bacterial endotoxins may be associated with various chronic diseases, including colorectal adenomas and cancer. Given the evidence linking inflammation and colorectal cancer, we sought to determine if plasma endotoxin concentrations are associated with indicators of systemic or local inflammation and colorectal adenomas. This cross-sectional study consisted of participants who underwent screening colonoscopies and included adenoma cases (n=138) and non-adenoma controls (n=324). Plasma concentrations of endotoxin were measured with Limulus Amebocyte Lysate (LAL) assay. We quantified concentrations of inflammatory cytokines, interleukin-4 (IL-4), IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-alpha (TNF-α), and interferon-γ (IFN-γ) in plasma by ELISA and mRNA expression levels in rectal mucosal biopsies by quantitative RT-PCR. Interleukin-17 was evaluated only in the rectal mucosa. Compared to subjects with low plasma endotoxin concentrations, those with higher concentrations were more likely to have adenomas (OR 1.4, 95% CI 1.0-2.1). Among subjects with adenomas, those with villous histology were more likely to have higher endotoxin concentrations (5.4 vs. 4.1EU/mL, p=0.05) and lower plasma IFN-γ (0 vs. 1.64 pg/mL, p=0.02) compared to those with only tubular adenomas. Cases showed a trend of having higher plasma TNF-α levels than controls (p=0.06), but none of the other plasma or rectal mucosal cytokine levels differed between cases and controls. Elevated mucosal IL-12 levels were associated with having multiple adenomas (p=0.04). Higher concentrations of plasma endotoxin predicted increased plasma IL-12 levels (OR 1.5, 95% CI 1.0-2.2) and rectal mucosal IL-12 (OR 1.9, 95% CI 1.0-3.7) and IL-17 gene expression (OR 2.2, 95% CI 1.0-4.6). These findings suggest that interactions between elevated plasma endotoxin concentrations and inflammatory cytokines may be relevant to the development of colorectal adenomas

  16. Diagnostic accuracy of 18F-FDG PET/CT for detection of advanced colorectal adenoma

    Aim: To determine the accuracy of 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) positron-emission tomography (PET) in the detection of advanced colorectal adenomas. Materials and methods: In this retrospective study, patient consent was waived by the institutional review board. Combined FDG whole-body PET and computed tomography (CT) images (2000–2009) were re-read and compared with reports of complete colonoscopy performed up to 1 year after the PET examination. One or more areas of focal colonic uptake greater than the background indicated a positive PET result, irrespective of standardized uptake value (SUV). Lesion and patient-level measures of PET accuracy with their 95% confidence intervals (CI) were calculated. Results: One hundred and eighty patients undergoing colonoscopy with or without biopsy underwent PET within 1 year prior to colonoscopy. There were 92 women and 88 men (mean age 63.3 years). Indications for PET were extent of disease and treatment response in all cases. Patients had non-colorectal cancer (n = 160) or colon cancer (n = 20). One hundred and fourteen FDG-avid lesions were present. In 33, there was no colonoscopic correlate. Two hundred and fifty-eight biopsies revealed tubular adenomas (n = 91, one with intra-mucosal cancer), tubulovillous adenomas (n = 28), adenocarcinoma (n = 37), inflammation (n = 22), hyperplastic polyps (n = 54), serrated adenoma (n = 5), metastatic disease (n = 5), normal/benign mucosa or submucosal benign tumors (n = 13) or miscellaneous (n = 3). Per-lesion performance of PET showed a sensitivity of 38% (95% CI: 31–46; 64/167) for all adenomas and carcinomas and 58% (95% CI: 49–67; 57/98) for lesions ≥10 mm. At the patient level, for all adenomas and carcinomas the sensitivity was 54% (95% CI: 44–63; 61/113), specificity 100% (pre-defined), positive predictive value (PPV) 100% (pre-defined), and negative predictive value (NPV) 56% (95% CI: 47–65; 67/119). For patients with advanced

  17. Interleukin-8 production from human somatotroph adenoma cells is stimulated by interleukin-1β and inhibited by growth hormone releasing hormone and somatostatin

    Vindeløv, Signe Diness; Hartoft-Nielsen, Marie-Louise; Rasmussen, Åse Krogh;

    2011-01-01

    Pituitary adenomas cause morbidity and mortality due to their localization and influence on pituitary hormone secretion. Although the pathogenesis of pituitary adenomas is unclear, studies have indicated that cytokines are involved. We investigated the role of cytokines, in particular interleukin...

  18. Pleomorphic adenoma of the lower lip: A rare site of location

    Sengul, Ilker; Sengul, Demet; Aribas, Duygu

    2011-01-01

    Context: Pleomorphic adenoma is the most common neoplasm of the minor salivary glands which are uncommon among the entire salivary gland tumors. The lower lip is a very rare site of occurrence for pleomorphic adenoma. We intended to present a case of pleomorphic adenoma of the lower lip. Case Report: A 49-year-old Turkish man presented with the painless mass on his lower lip. A total excision was choiced for the mass by both we and the patient because of some cosmetic reasons. The histopathological evaluation revealed the diagnosis of pleomorphic adenoma and neither complication nor recurrence was observed during a clinical follow-up for 40 months. Conclusions: A clinician should be vigilant for the possibility of existence of a pleomorphic adenoma located on the lower lip even it is rare. Once it is diagnosed concisely, a wide excision is suggested in general if there is no cosmetic care and no risk of damage to functional structures of head and neck. PMID:22540103

  19. HYALINIZING TRABECULAR ADENOMA FEIGNING PAPILLARY CARCINOMA THYROID: CASE REPORT WITH REVIEW OF LITERATURE

    Kandukuri Mahesh

    2014-05-01

    Full Text Available Hyalinizing Trabecular Adenoma (HTA of the thyroid is a rare neoplasm that was first described by Carney in 1987. It is a tumor of follicular derivation with peculiar nuclear, architectural, histochemical, and immunohistochemical features. We report a case of Hyalinizing trabecular adenoma in a 36-year-old woman with enlarged thyroid lobe. Ultrasonographic features and fine needle aspiration cytology (FNAC of the enlarged thyroid was performed and the diagnosis given was Papillary carcinoma of the thyroid. The patient underwent total thyroidectomy, with a histopathological diagnosis of hyalinizing trabecular Adenoma (HTA. We present this case in view of its rarity and to discuss the clinical and diagnostic approach, including the role of FNAC, and the pathologic features of HTA with special reference to the possible differential diagnosis and also review of literature. Although rare cases of malignant Hyalinizing trabecular adenoma (HTA have been documented, this tumor should be considered a benign neoplasm or at most, a neoplasm of extremely low malignant potential, however invasion of the capsule should be considered on histopathology. An awareness of hyalinizing trabecular adenomas and their characteristic features is valuable for their recognition and management as well as for the possible prevention of over diagnosis and over treatment for benign disease

  20. Evaluation of triphasic contrast enhanced spiral CT for diagnosing hepatocellular adenoma (report of 5 cases)

    Objective: To evaluate the diagnostic and differential value of triphasic, especially the arterial phase, contrast enhanced CT scans for the hepatocellular adenoma, and to improve CT diagnostic accuracy. Methods: Spiral CT scanning of pre- and post-contrast arterial phase, portal venous phase and delayed phase was performed in 5 patients with hepatocellular adenomas proved surgically and pathologically. The enhancement was administrated with venous injection of 3 ml/sec, totally 100 ml angiografin. Arterial phase of contrast-enhanced scanning started 20-30 sec, portal venous phase 60-70 sec and delay scanning 3 min after the injection of contrast medium. The degrees of the enhancement of adenoma and normal tissues of liver in the three contrast enhanced phases were calculated and compared statistically. Results: In plain CT, the lesions were iso-density in 4 cases and slight hypo density in 1 case, which was hardly distinguished from the normal tissue. In all 5 cases, the lesions showed marked enhancement in the arterial phase compared with normal tissue of liver (38 HU high), and there were markedly statistical difference (t = 18.94, P 0.05). The mean CT value of hepatocellular adenoma in the arterial phase was much higher than that in portal venous and delay phase, there were statistical differences between them (F = 18.39, P < 0.01). Conclusion: Triphasic contrast enhanced spiral CT scan, especially the arterial phase scan, is valuable in detecting and differentiating hepatocellular adenoma

  1. Three-tesla magnetic resonance imaging of GH-producing pituitary adenomas

    We report our clinical experience with three-tesla (3T) MR imaging of growth hormone (GH)-producing pituitary adenomas. Because of the high signal-to-noise ratio, 3T MRI was superior to 1.5T MRI in visualization of tumors and the surroundings. In particular, T2-weighted images provided high anatomical and contrast resolution. These images demonstrated well-defined relationships between the tumor and its surroundings, as well as the tumor contents. Because hypointensity was exclusive to densely granulated GH-producing adenomas, the border of adenomas was identified clearly on T2-weighted images. Tumor-to-brain contrast after gadolinium administration was significantly higher at 3T. Three D-spoiled gradient echo (SPGR) sequence was used routinely on T1-weighted images at 3T. This sequence provided significantly better images in terms of the border of adenomas. Our results indicate that T2-weighted and postcontrast SPGR T1-weighted images are suitable sequences for evaluating GH-producing pituitary adenomas at 3T. (author)

  2. Synchronous giant hepatic adenoma in siblings-A case report and brief literature review.

    Zhang, Chengsheng; Shi, Xuetao; Zhao, Lei

    2016-07-01

    A 47-year-old woman was referred to our department for a hepatic mass. She denied history of hepatitis or alcohol consumption and regular oral contraceptive use, except for the emergency contraceptive pill taken once a decade ago. Hepatitis B surface antigen and anti-hepatitis C antibody were negative, α-fetoprotein was within normal limit. CT scan revealed an enormous mass measuring 26.0×16 5×13 0 cm that almost totally replaced the right hepatic lobe. The neoplasm was completely resected and pathologically diagnosed as hepatic adenoma. Literature review indicates this is the largest hepatic adenoma reported so far. At the same time, clinical examination also revealed a hepatic mass in the patient's 42-year-old brother, which was pathologically confirmed as hepatic adenoma, too. He denied history of anabolic steroid use. Immunohistochemical analysis revealed the subtypes of both tumors as the inflammatory hepatic adenoma. Literature review indicates this is the first report of synchronous hepatic adenomas in siblings. PMID:27096392

  3. Sodium Valproate Enhances the Urethane-Induced Lung Adenomas and Suppresses Malignization of Adenomas in Ovariectomized Female Mice

    Donatas Stakisaitis

    2015-01-01

    Full Text Available In the present study, the possible effect of sodium valproate (NaVP on urethane-induced lung tumors in female mice has been evaluated. BALB/c mice (n=60; 4–6 weeks old, females were used in the following groups: (1 urethane-treated; (2 urethane-NaVP-treated; (3 only NaVP-treated; (4 control. In the same groups, ovariectomized female mice (n=60 were investigated. Urethane was given intraperitoneally, with a total dose of 50 mg/mouse. In NaVP-treated mice groups, 0.4% aqueous solution of NaVP was offered to mice ad libitum. The duration of the experiment was 6 months. The number of tumors per mouse in ovariectomized mice and in those treated with urethane and NaVP was significantly higher than in mice treated with urethane only (8.29±0.58 versus 6.0±0.63, p<0.02. No significant difference in the number of tumors per mouse was revealed while comparing the nonovariectomized urethane- and urethane-NaVP-treated groups (p=0.13. A significant decrease of adenocarcinoma number in ovariectomized mice treated with a urethane-NaVP as compared with ovariectomized mice treated with urethane only was found (p=0.031. NaVP together with low estrogen may have a protective effect on the malignization of adenomas in ovariectomized mice.

  4. Effectiveness of 131I nor-cholesterol uptake per unit volume of adrenal adenoma in the diagnosis of aldosteronoma

    Diagnosis of adrenal adenomas for patients with primary aldosteronism is sometimes difficult only by referring to the visualization pattern in adrenocortical scintigraphy without regards to standard scintigraphy or suppression scintigraphy with dexamethasone. We studied if quantitative evaluation of the standard scintigraphy without dexamethasone suppression can be useful to diagnose aldosteronomas. Twenty-nine patients who had undergone adrenalectomy with different clinical manifestations (16 patients with primary aldosteronism, 6 patients with Cushing's syndrome and 7 patients without hormonal abnormality) were included in the study. Volume of the adrenocortical adenomas, 131I nor-cholesterol uptake of the adrenocortical adenomas, and 131I nor-cholesterol uptake per unit volume of the adrenocortical adenomas were compared between the 3 groups. The volume of adrenocortical adenomas in the patients with primary aldosteronism was significantly lower than those in the other two groups (Cushing's syndrome p131I nor-cholesterol uptake of adrenocortical adenoma. The 131I nor-cholesterol uptake per unit volume of adrenocortical adenomas was significantly higher in the patients with primary aldosteronism than those in the other two groups (Cushing's syndrome p131I nor-cholesterol uptake per unit volume of adenoma obtained from adrenocortical scintigraphy without dexamethasone suppression can be useful in the diagnosis of aldosteronoma. (author)

  5. EXPRESSION OF TGF-β1 AND TGF-β R II IN COLORECTAL ADENOMAS OF VARYING STAGES

    2001-01-01

    To study the function of transforming growth factor β1 (TGF-β1)and transforming growth factor-β type II receptor (TGF-βR II) in varying stages of colorectal adenoma during neoplastic transformation,fifty-five cases of resected colorectal adenomas were examined immunohistochemically.Our results showed that the expression of TGF-β1 ranged from high to low,with the progression of low-grade to high-grade dysplasia of adenomas to carcinoma.And there was significantly different expression of TGF-β1 between moderate and high dysplasia adenomas (P<0.05),but no significantly different expression of TGF-β R II was found among varying stages of adenomas.Our results suggested that the quantities of TGF-β1 secreted by adenoma cells decrease dramatically in moderate to severe dysplasia colorectal adenomas.It is the decreased secretion of TGF-β1,rather than the mutated TGF-βR II that may play an important role in transforming colorectal adenomas to adenocarcinomas.

  6. 脂代谢紊乱及脂质过氧化与结肠腺瘤恶变的关系%Lipid disorders and lipid peroxidation associated with the malignant transformation of colorectal adenoma*

    Didi Tao; Zhongyin Zhou; Ximing Xu; Hesheng Luo

    2011-01-01

    Objective: The aim of this study was to investigate lipid disorders and lipid peroxidation associated with the malignant transformation of colorectal adenoma. Methods: Analyses were based on data from 100 subjects with histologically confirmed adenomas (cases) and 50 adenoma-free control subjects, all of whom had colonoscopy. The subjects were divided into two groups: those with no adenoma and those with adenoma. According to subsite of adenomas the subjects with adenoma were divided into group of distal adenoma and group of proximal adenoma. According to histology of adenomas the subjects with adenoma were divided into group of villiform adenoma and group of tubular + tubulo-villous adenoma. Among the groups, the serum levels of triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), Iow density lipoprotein cholesterol (LDL-C), and lipid peroxidation product malondialdehyde (MDA) were compared in all the patients.Results: Plasma total cholesterol and MDA level in group of adenomas were significantly higher than that in group of control subjects, but plasma HDL-C level was Iow in group of adenomas (P < 0.05). Plasma total cholesterol and MDA levels were positively related to distal and villiform adenomas (P < 0.05). Conclusion: The findings suggest that altered lipid metabolism may be differentially associated with colorectal adenomas.

  7. Molecular and cellular mechanisms of aldosterone producing adenoma development

    Sheerazed eBoulkroun

    2015-06-01

    Full Text Available Primary aldosteronism (PA is the most common form of secondary hypertension with an estimated prevalence of ~10% in referred patients. PA occurs as a result of a dysregulation of the normal mechanisms controlling adrenal aldosterone production. It is characterized by hypertension with low plasma renin and elevated aldosterone and often associated with hypokalemia. The two major causes of PA are unilateral aldosterone producing adenoma (APA and bilateral adrenal hyperplasia, accounting together for ~95% of cases. In addition to the well-characterized effect of excess mineralocorticoids on blood pressure, high levels of aldosterone also have cardiovascular, renal and metabolic consequences. Hence, long-term consequences of PA include increased risk of coronary artery disease, myocardial infarction, heart failure and atrial fibrillation. Despite recent progress in the management of patients with PA, critical issues related to diagnosis, subtype differentiation and treatment of non-surgically correctable forms still persist. A better understanding of the pathogenic mechanisms of the disease should lead to the identification of more reliable diagnostic and prognostic biomarkers for a more sensitive and specific screening and new therapeutic options. In this review we will summarize our current knowledge on the molecular and cellular mechanisms of APA development. On one hand, we will discuss how various animal models have improved our understanding of the pathophysiology of excess aldosterone production. On the other hand, we will summarize the major advances made during the last few years in the genetics of APA due to transcriptomic studies and whole exome sequencing. The identification of recurrent and somatic mutations in genes coding for ion channels (KCNJ5 and CACNA1D and ATPases (ATP1A1 and ATP2B3 allowed highlighting the central role of calcium signaling in autonomous aldosterone production by the adrenal.

  8. Das gastral differenzierte Adenom (pyloric gland adenoma. Fact or Fiction?

    Vieth M

    2005-01-01

    Full Text Available Das gastral differenzierte Adenom des Magens wird in der englischen Literatur als "pyloric gland adenoma" bezeichnet. Der erste Bericht zu dieser Entität erschien 1976 als Buchbeitrag, allerdings wurde die Läsion damals als eine Adenom-artige Hyperplasie mukoider Drüsen beschrieben. Erst ab 1990 wurden Pylorusdrüsen-Adenome korrekt als gastral differenzierte Adenome identifiziert und diagnostische Kriterien entwickelt. Die Bezeichnung Pylorusdrüsen-Adenom spiegelt die Entstehung aus den tiefen gastralen Drüsenverbänden wieder. Sicher sind die Pylorusdrüsen-Adenome bereits im Routine-HE-Präparat zu diagnostizieren und durch die Immunhistochemie zu bestätigen. Typischerweise exprimieren die Pylorusdrüsen-Adenome Mucin 6, das sonst nur im tiefen Drüsenkörper gefunden werden kann, über die gesamte Breite der Läsion, oft bis zur Oberfläche. Das oberflächliche Mucin 5AC ist oft nur auf eine schmale oberflächliche Zone beschränkt; die Expression kann jedoch stark variieren. Eine Kombination mit Anteilen gewöhnlicher tubulärer Adenome (intestinale Differenzierung kann beobachtet werden. Überproportional häufig ist die Magen-Corpusschleimhaut älterer Patientinnen mit Autoimmungastritis betroffen. Die Häufigkeit von Pylorusdrüsen-Adenomen wird mit 2,7 % aller Magenpolypen angegeben und ist damit nicht so selten wie vermutet. Die wenigen vorhandenen Publikationen zu diesem Thema deuten darauf hin, daß diese Entität meist fehlinterpretiert wird. Pylorusdrüsen-Adenome können im gesamten Gastrointestinaltrakt entstehen. Die klinische Bedeutung liegt in der hohen Rate (30 % der malignen Entartung. Allerdings handelt es sich hierbei vorwiegend um hochdifferenzierte Frühkarzinome mit entsprechend guter Prognose nach endoskopischer Abtragung.

  9. Giant cystic parathyroid adenoma with thrombosis of internal jugular vein seen on CT and Tc-99m methoxy isobutyl isonitrile parathyroid scan

    Primary hyper-parathyroidism is attributed by a solitary parathyroid adenoma in 80-85% cases and mostly are non-palpable and needs imaging for localization. Cystic degeneration of parathyroid adenoma is rarely seen in primary hyperparathyroidism. We are presenting a case of giant cystic functioning parathyroid adenoma with associated localized co-morbids. (author)

  10. Magnetic resonance in the preoperative localization of parathyroid adenomas in patients with primary hyperparathyroidism

    We assess the role of magnetic resonance (MR) as an imaging method for the preoperative localization of pathological parathyroid glands in a series of 14 patients with primary hyperparathyroidism secondary to parathyroid adenoma who underwent surgical resection. We selected 14 patients diagnosed as having primary hyperparathyroidism who underwent preoperative MR. All the studies were carried out with a toshiba MRT 50 MR unit with a 0.5 T superconductor magnet. MR located the adenoma in nine of the 14 patients (64%), including the only two who had previously undergone surgery. Our results indicate that MR without contrast is not effective in the preoperative localization of parathyroid adenomas and should be performed only in patients with recurrent hyperparathyroidism or that persisting after surgical treatment. (Author)

  11. Middle ear adenoma with neuroendocrine differentiation: relate of two cases and literature review

    Bittencourt, Aline Gomes; Tsuji, Robinson Koji; Cabral, Francisco; Pereira, Larissa Vilela; Fonseca, Anna Carolina de Oliveira; Alves, Venâncio; Bento, Ricardo Ferreira

    2013-01-01

    Summary Introduction: Adenomas with neuroendocrine differentiation are defined as neuroendocrine neoplasms, and they are rarely found in the head and neck. Objective: To describe two cases of a middle ear adenoma with neuroendocrine differentiation, with a literature review. Case Report: Patient 1 was a 41-year-old woman who presented with a 3-year history of left aural fullness associated with ipsilateral “hammer beating” tinnitus. Patient 2 was a 41-year-old male who presented with unilateral conductive hearing loss. Conclusion: Adenoma with neuroendocrine differentiation of the middle ear is a rare entity, but it should be considered in patients with tinnitus, aural fullness, and a retrotympanic mass and remembered as a diferential diagnosis of tympanic paraganglioma. PMID:25992031

  12. Small intestinal tubular adenoma in a pediatric patient with Turner syndrome

    Tang, Wen-Juan; Huang, Ying; Chen, Lian; Zheng, Shan; Dong, Kui-Ran

    2013-01-01

    Turner syndrome (TS) is a female chromosomal disorder caused by the lack of an X chromosome. The loss of this chromosome may result in the deficiency of tumor-suppressive or DNA repair genes, leading to tumorigenesis. Recombinant human growth hormone (GH) has been popularly used for treatment in TS patients for growth promotion. Although treatment with GH has been correlated with precancerous and cancerous lesions in TS children, its associations with gastric or colonic tumors, especially ileal tubular adenomas, have not been reported frequently. We here report a case of a 16-year-old patient with TS and tubular adenoma of the small intestine. Whether the ileal adenoma was caused by TS itself or GH therapy was discussed. PMID:23599636

  13. PALATAL PLEOMORPHIC ADENOMA WITH FLORID SQUAMOUS ME TAPLASIA: A POTENTIAL DIAGNOSTIC PITFALL

    Abdul Hakeem

    2012-07-01

    Full Text Available ABSTRACT: Pleomorphic adenoma is the most common benign tumor occurring in the major and minor salivary glands. We report a case of pleo morphic adenoma with extensive squamous metaplasia in the palate of a 20 year old man. The dimensions of the tumor were 3x2x2cm. More than 75% 0f the epithelial element in the tumor was composed of sheets of squamous cells, with multiple keratin filled cysts. This case illustrates that pleomorphic adenoma with squamous metaplasia presents a potenti al for misinterpretation as mucoepidermoid carcinoma and squamous cell carcinom a. We discuss the various pitfalls and the features that are helpful in distinguishing between these lesions.

  14. Research progress of MRI in preoperative evaluation of pituitary adenoma's consistency

    As the most common primary disease in pituitary fossa, the incidence of pituitary adenoma ranks 3rd in the primary tumors of the brain. To remove those resectable pituitary adenomas, there are 2 surgical approaches, named trans-sphenoidal endoscopic surgery and craniotomy. Which approach should be used depends on the size, invasive extension and the consistency of the tumors. The trans-sphenoidal endoscopic surgery is more suitable for the tumors with soft consistency which are easy to pull out, while the craniotomy is suitable for the hard ones. So, preoperative evaluation of the tumors' consistency can help to find the best surgical approach and treatments. MRI is not only an ideal method to show the structure of brain, but also can be used to evaluate consistency of tumor. This review illustrated the forming mechanism of the different consistency of pituitary adenoma and the research process in evaluating the consistency. (authors)

  15. Pituitary adenoma and vestibular schwannoma: Case report and review of the literature

    Niu Y

    2010-01-01

    Full Text Available The concurrence of the intracranial multiple primary tumors (MPTs consisting of acoustic neuroma (AN and pituitary adenoma is very rare. Here, we report a 42-year-old female who presented with left AN associated with pituitary adenoma. A total of three such cases have been reported before and which also presented with left AN with pituitary adenoma. Recently, a new "field cancerization" model has been proposed, which could explain MPTs and is consistent with the pathogenesis of such cases. The model also indicates that when a pituitary tumor or AN is detected separately, we might consider the development of "expanding field" after oncological treatment especially after radiotherapy in order to prevent the second field tumor occurring.

  16. Immunohistochemical detection of dopamine D2 receptors in human pituitary adenomas.

    Pawlikowski, Marek

    2010-09-30

    Thirty one pituitary adenomas and 3 samples of peritumoral anterior pituitary tissue were immunostained with an antibody raised against dopamine D2 receptor protein. The positive reactions were found in cell cytoplasm, a subpopulation of cell nuclei and the intratumoral blood vessels walls. As expected, the positive immunostaining was shown in cytoplasm and/or cell nuclei of all examined prolactinomas (7/7). In acromegaly the positive D2 staining occurred in 5/7 samples, in gonadotropinomas in 6/8 and in plurihormonal adenomas 2/4. The lowest expression was observed in corticotropinomas (1/5). These findings corroborate with the well known efficacy of D2 agonists in the treatment of prolactinomas and somatotropinomas, and support the rationale of the therapeutic trials with these compounds in gonadotropinomas. Moreover, the presence of D2 receptors in intratumoral blood vessels walls constitutes the possibility of the anti-angiogenic action of D2 agonists in pituitary adenomas. PMID:21071344

  17. Immunohistochemical detection of dopamine D2 receptors in human pituitary adenomas.

    Marek Pawlikowski

    2010-11-01

    Full Text Available Thirty one pituitary adenomas and 3 samples of peritumoral anterior pituitary tissue were immunostained with an antibody raised against dopamine D2 receptor protein. The positive reactions were found in cell cytoplasm, a subpopulation of cell nuclei and the intratumoral blood vessels walls. As expected, the positive immunostaining was shown in cytoplasm and/or cell nuclei of all examined prolactinomas (7/7. In acromegaly the positive D2 staining occurred in 5/7 samples, in gonadotropinomas in 6/8 and in plurihormonal adenomas 2/4. The lowest expression was observed in corticotropinomas (1/5. These findings corroborate with the well known efficacy of D2 agonists in the treatment of prolactinomas and somatotropinomas, and support the rationale of the therapeutic trials with these compounds in gonadotropinomas. Moreover, the presence of D2 receptors in intratumoral blood vessels walls constitutes the possibility of the anti-angiogenic action of D2 agonists in pituitary adenomas.

  18. Differential diagnosis between nonhyperfunctioning adenoma and adrenal metastasis on adrenocortical scintigraphy

    Adrenocortical scintigraphy using I-131-adosterol was performed in six cases of nonhyperfunctioning adenoma incidentally discovered on CT scans and four cases of adrenal metastasis. In all six cases of nonhyperfunctioning adenoma, there was increased uptake of the I-131-adosterol on the side of the adrenal mass discovered on CT. In three of four cases of adrenal metastasis, there was no uptake of the I-131 adosterol on the side of the mass detected on CT. Uptake was symmetrical in one case of adrenal metastasis. Adrenocortical scintigraphy is able to differentiate nonhyperfunctioning adenoma from adrenal metastasis in recognition of increased uptake of I-131-adosterol on the side of the adrenal mass discovered on CT scans. (author)

  19. PRELIMINARY APPLICATION OF COLOR DOPPLER FLOW IMAGING IN THE LOCALIZATION OF PARATHYROID ADENOMAS

    张缙熙; 李建初

    1994-01-01

    From December 1991 to April 1993,we performed color Doppler flow imaging(CDFI) in 11 patients with parathyroid adenoma,and all cases were confirmed by toperation and pathology.In all the parathyroid adenomas,vessels were clearly revealed at the periphery of the upper pole and /or anterior periphery,where arterial signals were elicited.These arteries had branches into the adenomas and originated from inferior thyroid arteries on the same side in most cases.The internal flow signals were increased markedly as compared to normal thyroid,and high-velocity arterial signals were detected.Because of the thyroid's rich blood supply and landmark peripheral vessels.CDFI can distinguish parathyroid foci from thyroid nodules,lymph nodes,and normal tissues and provide a sound basis for the diagnosis of small parathyroid foci.

  20. Electrical stimulation treatment for facial palsy after revision pleomorphic adenoma surgery

    Goldie, Simon; Sandeman, Jack; Cole, Richard; Dennis, Simon; Swain, Ian

    2016-01-01

    Surgery for pleomorphic adenoma recurrence presents a significant risk of facial nerve damage that can result in facial weakness effecting patients’ ability to communicate, mental health and self-image. We report two case studies that had marked facial weakness after resection of recurrent pleomorphic adenoma and their progress with electrical stimulation. Subjects received electrical stimulation twice daily for 24 weeks during which photographs of expressions, facial measurements and Sunnybrook scores were recorded. Both subjects recovered good facial function demonstrating Sunnybrook scores of 54 and 64 that improved to 88 and 96, respectively. Neither subjects demonstrated adverse effects of treatment. We conclude that electrical stimulation is a safe treatment and may improve facial palsy in patients after resection of recurrent pleomorphic adenoma. Larger studies would be difficult to pursue due to the low incidence of cases. PMID:27106613

  1. Expression for peroxisome proliferator-activated receptor gamma in pituitary adenomas 38 cases for semi-quantitative immunohistochemical analysis

    Xiaojie Lu; Kailai Chen; Weiyang Ji; Qing Wang; Bing Li; Jiang'an Li; Jiyong Sun

    2008-01-01

    BACKGROUND:It has been reposed that peroxisome proliferator-activated receptor γ(PPAR γ)is highly expressed in lung cancer,colon cancer,and gastric cancer,as well as other tumors.OBJECTIVE:To study expression of PPAR γ in pituitary adenomas and analyze the role of PPAR γ in hormonal typing of pituitary adenomas.DESIGN,TIME AND SETTING:Semi-quantitative immunohistochemistry of pathological specimens.The experiment was conducted at the Department of Neurosurgery,Wuxi Second Hospital Affiliated to Nanjing Medical University between January 2002 and May 2005.MATERIALS:Surgical resection samples of pituitary adenomas from 38 cases(18 male and 20 female)were analyzed.Eight cases were determined to be invasive pituitary adenomas and 30 cases were non-invasive pituitary adenomas.Hormonal classification of the types of pituitary adenomas revealed somatotrophic adenomas in six cases,corticotrophic adenoma in five cases,prolactinomas in 13 cases,multi-hormone secreting adenomas in six cases,and eight cases of adenoma without altered endocrine function.Five autopsy specimens were collected dunng the same period from patients of matching age that died from unrelated diseases and were included as normal anterior pituitary controls.METHODS:Cell counts for positive immunohistochemical signals were recorded from histopathological sections.The percentage of positive cells was reported as a semi-quantitative analysis.MAIN OUTCOME MEASURES:The rate of PPAR γ positive cells in different types of adenoma was based on hormonal levels and invasiveness of pituitary tumor cells.RESULTS:All tumor biopsies were determined to express PPAR γ.T1le rate of PPAR γ-positive cells ranged between 8%-65% in the pituitary adenomas.According to hormonal type,PPAR γ expression did not vary between the groups.In addition.there was no significant difference in PPAR γ expression between the non-invasive and invasive pituitary adenomas.CONCLUSIONS:Human pituitary adenomas express PPAR γ,and this

  2. Usefulness of {sup 99m}Tc-methoxy-isobutyl-isonitrile scintigraphy for preoperative localization of adenoma in primary hyperparathyroidism

    Yamaguchi, Seiji; Kobayashi, Yoshiyuki; Tsujikawa, Kozo [Ikeda Municipal Hospital, Osaka (Japan)] (and others)

    2001-09-01

    We evaluated the usefulness of {sup 99m}Tc-methoxy-isobutyl-isonitrile (MIBI) dual phase scintigraphy for detecting hyperfunctioning parathyroid adenoma. We retrospectively reviewed 18 hyperparathyroid patients who received MIBI prior to neck exploration and compared the radiological findings of MIBI with ultrasonography (US) and magnetic resonance imaging (MRI). Fifteen patients were studied with MRI, and 17 patients were examined with US. All patients were found to have a solitary parathyroid adenoma histopathologically. MIBI correctly revealed the location of 17 adenomas among 18 confirmed tumors. In our series, there was one false-positive case that was found to have thyroid adenoma. The diagnostic sensitivity of MIBI MRI and US and 94.4%, 80% and 52.5%, respectively. The positive predictive value (PPV) was 94.4% for MIBI, 81.8% for MRI and 92.3% for US. We conclude that MIBI is useful and accurate for the preoperative localization of adenoma in primary hyperparathyroidism. (author)

  3. Usefulness of 99mTc-methoxy-isobutyl-isonitrile scintigraphy for preoperative localization of adenoma in primary hyperparathyroidism

    We evaluated the usefulness of 99mTc-methoxy-isobutyl-isonitrile (MIBI) dual phase scintigraphy for detecting hyperfunctioning parathyroid adenoma. We retrospectively reviewed 18 hyperparathyroid patients who received MIBI prior to neck exploration and compared the radiological findings of MIBI with ultrasonography (US) and magnetic resonance imaging (MRI). Fifteen patients were studied with MRI, and 17 patients were examined with US. All patients were found to have a solitary parathyroid adenoma histopathologically. MIBI correctly revealed the location of 17 adenomas among 18 confirmed tumors. In our series, there was one false-positive case that was found to have thyroid adenoma. The diagnostic sensitivity of MIBI MRI and US and 94.4%, 80% and 52.5%, respectively. The positive predictive value (PPV) was 94.4% for MIBI, 81.8% for MRI and 92.3% for US. We conclude that MIBI is useful and accurate for the preoperative localization of adenoma in primary hyperparathyroidism. (author)

  4. Chromosome abnormalities in colorectal adenomas: two cytogenetic subgroups characterized by deletion of 1p and numerical aberrations

    Bomme, L; Bardi, G; Pandis, N;

    1996-01-01

    Cytogenetic analysis of short-term cultures from 34 benign colorectal polyps, all histologically verified as adenomas, revealed clonal chromosome aberrations in 21 of them. Eight polyps had structural rearrangements, whereas only numerical changes were found in 13. A combination of structural and...... changes were +20, +13, and monosomy 18, found in six, five, and two adenomas, respectively. Rearrangement of chromosome 1 was the most common structural change. Abnormalities involving 1p were seen in six adenomas, leading to visible loss of material in three. One adenoma had one clone with a large and...... another with a small 1p deletion. In three adenomas, del(1)(p36) was the only cytogenetic aberration, supporting the authors' previous conclusion that loss of one or more gene loci in band 1p36 is a common early change in colorectal tumorigenesis. Chromosome 8 was involved in structural changes in two...

  5. Contribution of imaging techniques to the differential diagnosis of adenoma and focal nodular hyperplasia of the liver

    The most common hepatocyte tumors are focal modular hyperplasia and adenoma. Both are benign and predominantly affect women. Hepatocyte adenomas may be directly related to oral contraceptive use. The diagnosis of focal nodular hyperplasia currently rests on color Doppler ultrasonography and on magnetic resonance imaging with dynamic sequences and intravenous gadolinium to demonstrate the central scar. No treatment is needed if the imaging study findings are characteristic, which is the case in about 70 % of patients. Adenomas can contain fat and structures that bleed, which can make then difficult to differentiate from primary liver cancer. There are no specific imaging study findings for adenoma. All suspected adenomas should be removed surgically, unless there is a major contraindication. Follow-up is in order after the procedure and oral contraceptive use should be stopped. (author)

  6. Pleomorphic Adenoma of the Breast: A Diagnosis Using an Ultrasound-Guided Core-Needle Biopsy Case Report

    Kim, In Wha; Yun, Jung Hyun; Kim, Tae Heon; Lee, Kyung Po; Jung, Hea Kyung; Ko, Kyung Hee; Lee, Jong Tae [CHA Bundang Medical Center, CHA University, College of Medicine, Seongnam (Korea, Republic of)

    2012-08-15

    Pleomorphic adenoma is a tumor rarely seen in the breast. To date, only about 70 cases have been reported in the literature. Many reports have used fine-needle aspiration biopsy in the preoperative diagnosis of these lesions. However, pleomorphic adenoma is sometimes mistaken for a malignant tumor because of its cytologic features. In this study, we present a 56-year-old woman with a palpable breast mass. Ultrasound indicated a 15 mm oval-shaped hypoechoic mass with complex echogenicity in the palpable region. Ultrasound-guided core needle biopsy (US-CNB) revealed a pleomorphic adenoma of the breast, which was confirmed through surgical excision. Although pleomorphic adenoma is rarely seen in the breast, results demonstrate the usefulness and accuracy of US-CNB in diagnosing pleomorphic adenoma of the breast.

  7. Pleomorphic Adenoma of the Breast: A Diagnosis Using an Ultrasound-Guided Core-Needle Biopsy Case Report

    Pleomorphic adenoma is a tumor rarely seen in the breast. To date, only about 70 cases have been reported in the literature. Many reports have used fine-needle aspiration biopsy in the preoperative diagnosis of these lesions. However, pleomorphic adenoma is sometimes mistaken for a malignant tumor because of its cytologic features. In this study, we present a 56-year-old woman with a palpable breast mass. Ultrasound indicated a 15 mm oval-shaped hypoechoic mass with complex echogenicity in the palpable region. Ultrasound-guided core needle biopsy (US-CNB) revealed a pleomorphic adenoma of the breast, which was confirmed through surgical excision. Although pleomorphic adenoma is rarely seen in the breast, results demonstrate the usefulness and accuracy of US-CNB in diagnosing pleomorphic adenoma of the breast.

  8. Differentiation of adrenal tumors in patients with hepatocellular carcinoma: Adrenal adenoma versus metastasis

    Objective: To investigate whether computed tomography (CT) attenuation test for differential diagnosis of adrenal nodule is applicable in patients with hepatocellular carcinoma (HCC) which shows similar image characteristics to adrenal adenoma. Materials and methods: This retrospective study was approved by our institutional review board, and the requirement for informed consent from study patients was waived. Searching picture archiving and communication system, we identified 3678 patients with HCC who underwent upper abdominal unenhanced CT scans between April 2002 and March 2010, and 114 adrenal nodules (39 adenomas and 75 metastases) were included for analysis. Ten nodules were confirmed pathologically while 104 had imaging diagnosis (enlarged or emerged during the study period). Size, CT number, and the internal characteristics of the lesions were recorded. Results: Mean CT numbers of adrenal adenomas were significantly lower than those of metastases (P < 0.0001, t-test) on unenhanced CT. Thresholds of 17 and 33 Hounsfield units (HU) provided the following sensitivity, specificity, and accuracy: 46.2%, 100%, and 81.6% at 17 HU, and 94.9%, 89.3%, and 91.2% at 33 HU, respectively. The area under receiver operating characteristic curve for the CT number test was 0.96. Metastases were significantly larger than adrenal adenoma (P = 0.009, t-test). However, the accuracy of testing using mass size was 64.0% at most. All adenomas and metastases were depicted as homogeneous masses with the exception of two metastases that presented as heterogeneous masses (necrotic or lipomatous). Conclusion: Adrenal adenomas can be differentiated from HCC metastases using CT number on unenhanced CT

  9. Differentiation of adrenal tumors in patients with hepatocellular carcinoma: Adrenal adenoma versus metastasis

    Yasaka, Koichiro, E-mail: koyasaka@gmail.com [Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Gonoi, Wataru; Akai, Hiroyuki; Katsura, Masaki; Akahane, Masaaki [Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Kiryu, Shigeru [Department of Radiology, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639 (Japan); Ohtomo, Kuni [Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan)

    2013-08-15

    Objective: To investigate whether computed tomography (CT) attenuation test for differential diagnosis of adrenal nodule is applicable in patients with hepatocellular carcinoma (HCC) which shows similar image characteristics to adrenal adenoma. Materials and methods: This retrospective study was approved by our institutional review board, and the requirement for informed consent from study patients was waived. Searching picture archiving and communication system, we identified 3678 patients with HCC who underwent upper abdominal unenhanced CT scans between April 2002 and March 2010, and 114 adrenal nodules (39 adenomas and 75 metastases) were included for analysis. Ten nodules were confirmed pathologically while 104 had imaging diagnosis (enlarged or emerged during the study period). Size, CT number, and the internal characteristics of the lesions were recorded. Results: Mean CT numbers of adrenal adenomas were significantly lower than those of metastases (P < 0.0001, t-test) on unenhanced CT. Thresholds of 17 and 33 Hounsfield units (HU) provided the following sensitivity, specificity, and accuracy: 46.2%, 100%, and 81.6% at 17 HU, and 94.9%, 89.3%, and 91.2% at 33 HU, respectively. The area under receiver operating characteristic curve for the CT number test was 0.96. Metastases were significantly larger than adrenal adenoma (P = 0.009, t-test). However, the accuracy of testing using mass size was 64.0% at most. All adenomas and metastases were depicted as homogeneous masses with the exception of two metastases that presented as heterogeneous masses (necrotic or lipomatous). Conclusion: Adrenal adenomas can be differentiated from HCC metastases using CT number on unenhanced CT.

  10. Immunohistochemical and Molecular Study of p16INK4A Expression in Pituitary Adenoma

    Background and Objectives: Pituitary adenomas comprise 10-25% of primary intracranial tumours. The molecular mechanisms underlying their development and progression have not yet been clearly defined. P16INK4A is frequently disrupted in human tumors including pituitary adenomas. Our aim was to evaluate the expression of P16 protein expression and its relation with gene methylation in pituitary adenoma development and progression. Material and Methods: Immunohistochemistry was performed on 34 formalin fixed paraffin embedded specimens of pituitary adenoma. The p16INK4A gene methylation status was screened using an enzyme restricted polymerase chain reaction. Results: Loss of p16 protein expression occurred in 19/34 (55.9%) and P16INK4A methylation was detected in 14/34 (41.2%) of tumor samples. Both p16INK4A methylation and lack of p16 immunoreactivity were significantly related to larger tumor size and increased grade. Patients with either p16-negative or methylated tumors were significantly older than patients with p16-positive or unmethylated tumors. A significant positive correlation between loss of p16 protein expression and p16INK4A gene methylation was found. Conclusion: These data suggest that p16 downregulation is a common event in pituitary adenoma and that its alteration might play an important role in genesis, growth progression, and biological behavior of pituitary adenomas. Our findings could imply that hyper methylation of the p16INK4A gene; represents the major target and perhaps a required epigenetic event in human pituitary tumorigenesis.

  11. Intracranial tumours after external fractionated radiotherapy for pituitary adenomas in northern Sweden

    Norberg, Lars; Johansson, Robert; Rasmuson, Torgny (Dept. of Radiation Sciences, Oncology, Umeaa Univ., Umeaa (Sweden)), E-mail: Torgny.Rasmuson@onkologi.umu.se

    2010-11-15

    We analysed the incidence of second primary intracranial tumours in patients with pituitary adenomas treated with radiotherapy compared to the risk of patients not exposed to irradiation and to the general population. Materials and methods. This retrospective cohort study includes 298 patients with pituitary adenomas that received radiotherapy to the pituitary from 1960 to 2007. The patients were recruited from the Cancer Registry of northern Sweden and the local radiotherapy-registry of the Univ. Hospital in Umeaa. Only patients with =12 months follow-up after diagnosis of pituitary adenoma were included. A cohort of 131 patients with pituitary adenomas not treated with radiotherapy was used as reference. Standard incidence ratios (SIR) between observed and expected number of second primary intracranial tumours were calculated. Results. The median observation time after diagnosis of pituitary adenoma in 298 patients treated with radiotherapy was 14 years, and the total number of person-years at risk was 4 784. Six (2.0%) of the patients developed second primary intracranial tumours between 7 and 31 years after radiotherapy. Two patients had gliomas and four had meningiomas. The expected number of intracranial tumours was 1.15 giving a SIR of 5.20 (95% CI 1.90-11.31). No significant correlations were found between radiation technique or administered dose and the risk of developing a second primary intracranial tumour. The cumulative risk for second intracranial tumours at 10 and 20 years was 1.3%. Patients not treated with radiotherapy were followed 1 601 years and no second primary intracranial tumour occurred. Discussion. The results indicate an increased risk of second primary intracranial tumours in patients treated with radiotherapy for pituitary adenomas, compared to patients not exposed to irradiation and to the general population. Meningiomas were more frequent than gliomas and the median time interval between radiotherapy and second intracranial tumour was

  12. Effect of bromocriptine on PRL-secreting pituitary adenomas. Analysis by CT scan

    Niwa, Jun; Sato, Osamu; Daibo, Masahiko; Inoue, Yoshitoshi; Tanabe, Sumiyoshi (Sapporo Medical Coll. (Japan))

    1982-06-01

    The effect of bromocriptine on the CT scan was examined in eight patients with prolactinsecreting pituitary adenomas. All the patients showed a high serum PRL level (> 30 ng/ml) after surgical treatment. Bromocriptine was administered at the rate of from 7.5 to 25 mg per day. The effects on the CT scan and metrizamide CT cisternography were then evaluated. The data suggest: (1) The effect of bromocriptine on the CT scan was shown in the reduction of enhanced area or the decrease in the enhanced density, and it was classified into three types: Type I showed a reduction of the enhanced area, Type II showed a decrease in the enhanced density, and Type III showed no change on the CT sacn. When the shrinkage of the adenoma was examined by means of metrizamide CT cisternography, Type I showed an actual shrinkage of the adenoma, but Type II showed only a pseudoshrinkage of the adenoma. Thus, the shrinkage of the adenoma should be determined by metrizamide CT cisternography. (2) The normalization of the serum PRL level was related to the effect on the CT scan, but it occurred before the effect on the CT scan. Therefore, the normalization of the serum PRL level can not be used to distinguish between Type I and Type II. (3) An initial shrinkage of the adenoma occurred within one or two months, and there was a notable shrinkage by nine months after treatment. A change from an enhanced high density to isodensity occurred by one month and to a low density by seven months after treatment, therefore, a reduction in the enhanced density occurred earlier than a decrease in the enhanced area.

  13. Potential role of endocrine gastrin in the colonic adenoma carcinoma sequence

    Watson, S A; Morris, T M; McWilliams, D F; Harris, J.; Evans, S.; Smith, A.; Clarke, P.A.

    2002-01-01

    The role of hyper-gastrinaemia in the incidence of colonic cancer remains to be clarified. The aim of this study was to determine whether cholecystokinin-2 (CCK-2) receptor expression predicts the sensitivity of human colonic adenomas to the proliferative effects of serum hyper-gastrinaemia. Gene expression of the classical (74 kDa) CCK-2 receptor in human colonic adenoma specimens and cell lines, was quantified by real-time PCR. Western blotting, using a CCK-2 receptor antiserum, confirmed p...

  14. Adenomas hipofisários produtores de ACTH: Aspectos neurocirúrgicos

    Tella Jr Oswaldo Inácio

    2002-01-01

    Full Text Available Relatamos nossa experiência com 19 casos de adenomas hipofisários produtores de ACTH que foram tratados cirurgicamente. Os adenomas mono hormonais produtores de ACTH eram microadenomas em 50% dos casos, apresentando-se com o quadro típico da síndrome de Cushing. Os pluri-hormonais manifestaram-se por alterações visuais. O resultado do tratamento cirúrgico, geralmente por via transeptoesfenoidal, foi satisfatório na maioria dos casos. Para os pacientes em que não conseguimos cura cirúrgica, foi indicada a radioterapia.

  15. Exceptional localisation of an ectopic parathyroid adenoma at the level of the hyoid bone

    Musters, Linde; van Ginhoven, Tessa M.; Smit, Casper

    2014-01-01

    Primary hyperparathyroidism is characterised by high parathyroid hormone (PTH) levels and concomitant hypercalcaemia. Ninety per cent is caused by solitary parathyroid adenomas, 10% by multiple adenomas, hyperplasia and carcinomas. Less than 0.1% of the inferior parathyroid glands are ectopically located. This case is of a 54-year-old woman with hypercalcaemia 3.05 mmol/L and high PTH 22 pmol/L. Scintigraphy and CT scan of the neck in 2009 showed no signs of ectopic tissue. After treatment wi...

  16. A Case of Congenital Hypothyroidism Due to Organification Defect Associated wth Huerthle Cell Adenoma

    Congenital hypothyroidism due to organification defect was first reported by Haddad and Sidbury in 1959. The organification defect is easily proved by perchlorate discharge test. We experienced a patient who had large goiter, growth and mental retardation, and revealed positive response to perchlorate discharges test, and the surgical biopsied specimen showed Huerthle cell adenoma, which was probably due to chronic stimulation of thyroid stimulating hormone, or coexisted incidentally. Described here a case of congenital hypothyroidism due to organification defect associated with Huerthle cell adenoma, with review of some literatures.

  17. Increased tumor necrosis factor receptor 1 expression in human colorectal adenomas

    Kunihiro Hosono; Eiji Yamada; Hiroki Endo; Hirokazu Takahashi; Masahiko Inamori; Yoshitaka Hippo; Hitoshi Nakagama

    2012-01-01

    AIM:To determine the expression statuses of tumor necrosis factor (TNF)-α,its receptors (TNF-R) and downstream effector molecules in human colorectal adenomas.METHODS:We measured the serum concentrations of TNF-α and its receptors in 62 colorectal adenoma patients and 34 healthy controls.The protein expression of TNF-α,TNF-R1,TNF-R2 and downstream signals of the TNF receptors,such as c-Jun N-terminal kinase (JNK),nuclear factor-κ B and caspase-3,were also investigated in human colorectal adenomas and in normal colorectal mucosal tissues by immunohistochemistry.Immunofluorescence confocal microscopy was used to investigate the consistency of expression of TNF-R1 and phospho-JNK (p-JNK).RESULTS:The serum levels of soluble TNF-R1 (sTNF-R1) in adenoma patients were significantly higher than in the control group (3.67 ± 0.86 ng/mL vs 1.57 ± 0.72 ng/mL,P < 0.001).Receiver operating characteristic analysis revealed the high diagnostic sensitivity of TNF-R1 measurements (AUC was 0.928)for the diagnosis of adenoma,and the best cut-off level of TNF-R1 was 2.08 ng/mL,with a sensitivity of 93.4% and a specificity of 82.4%.There were no significant differences in the serum levels of TNF-α or sTNF-R2 between the two groups.Immunohistochemistry showed high levels of TNF-R1 and p-JNK expression in the epithelial cells of adenomas.Furthermore,a high incidence of co-localization of TNF-R1 and p-JNK was identified in adenoma tissue.CONCLUSION:TNF-R1 may be a promising biomarker of colorectal adenoma,and it may also play an important role in the very early stages of colorectal carcinogenesis.

  18. FSH-secreting pituitary adenomas: stimulation and suppression studies in two patients.

    Friend, J N; Judge, D M; Sherman, B M; Santen, R J

    1976-09-01

    Two patients with pituitary adenomas, partial hypopituitarism and abnormally high serum concentrations of FSH are described. In neither patient was FSH increased after the administration of LH releasing hormone and in one patient tested, there was no FSH response to clomiphene citrate. The decrease in serum FSH in response to high concentrations of testosterone (greater than 1100 ng/dl) was less than in normal men. These results indicate partial autonomy of FSH producing adenomas. Since the elevated serum FSH produced no obvious clinical symptoms, it may be undetected unless serum FSH concentrations are measured routinely in patients with pituitary tumors. PMID:956349

  19. Pleomorphic Adenoma (Benign Mixed Tumour) of the Minor Salivary Glands of the Upper Lip

    Debnath, Subhas Chandra; Adhyapok, A. K.

    2010-01-01

    Pleomorphic adenoma is the benign tumor of salivary glands, which originates from the myoepithelial cells and intercalated duct cells. This tumor is more common in major salivary glands. This case report describes a rare and unusual lesion in a 55-year-old female, which was diagnosed as pleomorphic adenoma of the minor salivary glands in the upper lip. The tumor was a circumscribed, submucosal nodule, about 2.0 cm in diameter and was characterized by slow growth and rubbery consistency. Compl...

  20. MASEP gamma knife radiosurgery for secretory pituitary adenomas: experience in 347 consecutive cases

    Yuan Shubin

    2009-03-01

    Full Text Available Abstract Background Secretory pituitary adenomas are very common brain tumors. Historically, the treatment armamentarium for secretory pituitary adenomas included neurosurgery, medical management, and fractionated radiotherapy. In recent years, MASEP gamma knife radiosurgery (MASEP GKRS has emerged as an important treatment modality in the management of secretory pituitary adenomas. The goal of this research is to define accurately the efficacy, safety, complications, and role of MASEP GKRS for treatment of secretory pituitary adenomas. Methods Between 1997 and 2007 a total of 347 patients with secretory pituitary adenomas treated with MASEP GKRS and with at least 60 months of follow-up data were identified. In 47 of these patients some form of prior treatment such as transsphenoidal resection, or craniotomy and resection had been conducted. The others were deemed ineligible for microsurgery because of body health or private choice, and MASEP GKRS served as the primary treatment modality. Endocrinological, ophthalmological, and neuroradiological responses were evaluated. Results MASEP GKRS was tolerated well in these patients under the follow-up period ranged from 60 to 90 months; acute radioreaction was rare and 17 patients had transient headaches with no clinical significance. Late radioreaction was noted in 1 patient and consisted of consistent headache. Of the 68 patients with adrenocorticotropic hormone-secreting(ACTH adenomas, 89.7% showed tumor volume decrease or remain unchanged and 27.9% experienced normalization of hormone level. Of the 176 patients with prolactinomas, 23.3% had normalization of hormone level and 90.3% showed tumor volume decrease or remain unchanged. Of the 103 patients with growth hormone-secreting(GH adenomas, 95.1% experienced tumor volume decrease or remain unchanged and 36.9% showed normalization of hormone level. Conclusion MASEP GKRS is safe and effective in treating secretory pituitary adenomas. None of the

  1. Observer variability in the assessment of type and dysplasia of colorectal adenomas, analyzed using kappa statistics

    Jensen, P; Krogsgaard, M R; Christiansen, J;

    1995-01-01

    PURPOSE: The aim of this study was to establish the intraobserver and interobserver variability in the assessment of histologic type (tubular, villous, and tubulovillous) and grade of cytologic dysplasia (mild, moderate, and severe) in colorectal adenomas. METHODS: One hundred eighty-seven slides...... of adenomas were assessed twice by three experienced pathologists, with an interval of two months. Results were analyzed using kappa statistics. RESULTS: For agreement between first and second assessment (both type and grade of dysplasia), kappa values for the three specialists were 0.5345, 0...

  2. Coexistence of small cell neuroendocrine carcinoma and villous adenoma in the ampulla of Vater

    Ji-Hong Sun; Ming Chao; Shi-Zheng Zhang; Guang-Qiang Zhang; Bin Li; Jian-Jun Wu

    2008-01-01

    Small cell neuroendocrine carcinoma of the ampulla of Vater is extremely rare and different from the common ampullary adenocarcinoma. The ampullary adenoma is also a rare neoplasm and has the potential to develop an adenocarcinoma. Their coexistence has been rarely reported in the literature. We herein describe an unusual case of a small cell neuroendocrine carcinoma associated with a villous adenoma in the ampulla of Vater with emphasis on computed tomography (CT)and histopathological findings. We also discuss their clinical, histopathological and radiological features as well as possible histogenesis.

  3. Observer reproducibility in grading dysplasia in colorectal adenomas: comparison between two different grading systems

    Fenger, C; Bak, Martin; Kronborg, O;

    1990-01-01

    The two most well known and well defined grading systems for dysplasia in colorectal adenomas were compared with regard to reproducibility. The Konishi-Morson system (KMS) operates with several histological and cytological variables and grades of mild, moderate, and severe dysplasia. The Kozuka...... system (EKS). Fifty six adenomas were graded by two observers, each observer grading twice according to the KMS criteria and twice according to EKS criteria. Intraobserver reproducibility was excellent for the KMS and moderate for the EKS, but this was not significant. The overall interobserver...

  4. Colonic and duodenal flat adenomas in children with classical familial adenomatous polyposis.

    Cohen, Marta; Thomson, Mike; Taylor, Chris; Donatone, Jorge; Quijano, Graciela; Drut, Ricardo

    2006-04-01

    Flat adenomas of the colon and duodenum have been described as associating with familial adenomatous polyposis (FAP), its attenuated variant, and the so-called hereditary nonpolyposis colorectal cancer. There seem to be no report on the occurrence of flat adenomas in pediatric patients with family history of FAP. We are reporting 4 children from 2 cancer-prone families in whom colonic and duodenal moderately dysplastic flat adenomas were found. Gastrointestinal endoscopy and biopsies were performed in 3 female siblings (7, 9, and 11 years old) and 1 male (9 years old) when referred for screening owing to familial history of bowel cancer (family 1) or evidence of bilateral congenital hypertrophy of the retinal pigment epithelium (CHRPE), which is known to be associated with FAP (family 2). Endoscopic visualization of the mucosa was improved by use of 0.2% indigo carmine solution spray. Biopsies were routinely processed for H&E and immunohistochemistry staining. Present patients were asymptomatic, with the exception of 2 weeks rectal bleeding in 1 of them. The colonic videoendoscopy showed in 2/3 siblings hundreds of flat or slightly raised plaques less than 1 cm in diameter as well as some classic polyps throughout the colon. The other sibling showed 40 flat-topped lesions with minimal elevation and central umbilication in the cecum. Upper endoscopy demonstrated a few flat lesions in the nonperiampullary area of the duodenum in 2/4 patients. The colonic videoendoscopy performed on the 9-year-old boy revealed multiple small sessile polyps. Microscopic study demonstrated tubular adenomas with a few neoplastic crypts, slight disarray of the overall architecture, and moderate (low-grade) dysplasia of the epithelium. These features were more obvious at the center and superficial areas of the adenomas. The 4 children had multiple flat adenomas of the colon and duodenum (2/4) matching with those described in adult patients. Flat adenomas in the context of FAP probably

  5. Gallbladder villous adenoma in a patient with acromegaly: A case report

    Miodrag Krstic; Tamara Alempijevic; Bojan Stimec; Marjan Micev; Miroslav Milicevic; Dragan Micic; Goran Jankovic

    2007-01-01

    Villous adenomas are benign epithelial lesions with malignant potential that can occur in any part of the gastrointestinal tract. We present a case of a middle age woman with acromegaly who was investigated for nonspecific gastrointestinal complaints. Ultrasonography and subsequent endosonography diagnosed a large (4.5 cm), hyperechoic, sessile polyp with numerous pedicles. An open cholecystectomy was performed and revealed a villous adenoma with several foci of carcinoma in situ. Detailed investigations showed no other tumors of the gastrointestinal tract. After five years of follow-up, the patient reports no complaints, and the results of laboratory testing and imaging studies are within the normal range.

  6. MRI assessment of parathyroid adenoma. The value of T2-weighted sequences

    A series of 22 patients operated for primary hyperparathyroidism was reportect. The parathyroid adenoma was located preoperatively by MRI and ultrasonography. Measurement of the relaxation time was performed in vitro at 370 C in a 0.47 Tesla field during the 30 minutes following resection. The relaxation times obtained at a precession frequency of 20 mHz were 0.844 ± 0.16 sec for T1 and 0.082 ± 0.025 sec for T2. MRI had a sensitivity of 73% and a specificity of 88% for the localization of the parathyroid adenoma, while ultrasonography had a sensitivity of 73% and a specificity of 98%

  7. Aspirin, Calcitriol, and Calcium Do Not Prevent Adenoma Recurrence in a Randomized Controlled Trial

    Pommergaard, Hans Christian; Burcharth, Jakob; Rosenberg, Jacob;

    2016-01-01

    BACKGROUND & AIMS: Chemopreventive strategies might be used to reduce the recurrence of colorectal adenomas and the incidence of colorectal cancer. We performed a randomized, double-blind, placebo-controlled trial to determine whether a combination of acetylsalicylic acid (aspirin), calcitriol, and...... current smokers OR, 1.70; 95% CI, 0.70-4.09; P value interaction < .05). However, the overall interaction was not significant. CONCLUSIONS: In a prospective study, the combination of calcitriol, aspirin, and calcium carbonate did not prevent recurrence of colorectal adenomas over a 3-year period. The...

  8. Prevalence of adenomas and hyperplastic polyps in mismatch repair mutation carriers among CAPP2 participants: report by the colorectal adenoma/carcinoma prevention programme 2

    Liljegren, Annelie; Barker, Gail; Elliott, Faye;

    2008-01-01

    in smaller studies, and the results have been found to be variable. PATIENTS AND METHODS: Colorectal Adenoma/Carcinoma Prevention Programme 2 trial is a chemoprevention trial in people classified as having HNPCC. The 695 patients with a proven germline MMR mutation and documented screening history...... before the chemoprevention study were the focus of this study. The number, histology, size, and location of polyps found at the participants' first ever colonoscopy were analyzed in a cross-sectional study. RESULTS: Seventy-four patients (10.6%) were found to have at least one adenoma at first...... colonoscopy, whereas 37 (5.3%) had at least one hyperplastic polyp. The frequency of an adenoma at first colonoscopy increased from 5.0% (95% CI, 2.8% to 8.3%) in patients younger than 35 years old to 18.9% (95% CI, 9.4% to 32.0%) in patients age at least 55 years (P = .0001 for trend). No such trend was...

  9. Outcomes of Proton Therapy for Patients With Functional Pituitary Adenomas

    Purpose/Objective(s): This study evaluated the efficacy and toxicity of proton therapy for functional pituitary adenomas (FPAs). Methods and Materials: We analyzed 165 patients with FPAs who were treated at a single institution with proton therapy between 1992 and 2012 and had at least 6 months of follow-up. All but 3 patients underwent prior resection, and 14 received prior photon irradiation. Proton stereotactic radiosurgery was used for 92% of patients, with a median dose of 20 Gy(RBE). The remainder received fractionated stereotactic proton therapy. Time to biochemical complete response (CR, defined as ≥3 months of normal laboratory values with no medical treatment), local control, and adverse effects are reported. Results: With a median follow-up time of 4.3 years (range, 0.5-20.6 years) for 144 evaluable patients, the actuarial 3-year CR rate and the median time to CR were 54% and 32 months among 74 patients with Cushing disease (CD), 63% and 27 months among 8 patients with Nelson syndrome (NS), 26% and 62 months among 50 patients with acromegaly, and 22% and 60 months among 9 patients with prolactinomas, respectively. One of 3 patients with thyroid stimulating hormone—secreting tumors achieved CR. Actuarial time to CR was significantly shorter for corticotroph FPAs (CD/NS) compared with other subtypes (P=.001). At a median imaging follow-up time of 43 months, tumor control was 98% among 140 patients. The actuarial 3-year and 5-year rates of development of new hypopituitarism were 45% and 62%, and the median time to deficiency was 40 months. Larger radiosurgery target volume as a continuous variable was a significant predictor of hypopituitarism (adjusted hazard ratio 1.3, P=.004). Four patients had new-onset postradiosurgery seizures suspected to be related to generously defined target volumes. There were no radiation-induced tumors. Conclusions: Proton irradiation is an effective treatment for FPAs, and hypopituitarism remains the primary

  10. Outcomes of Proton Therapy for Patients With Functional Pituitary Adenomas

    Wattson, Daniel A.; Tanguturi, Shyam K. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Spiegel, Daphna Y. [Tufts University School of Medicine, Boston, Massachusetts (United States); Niemierko, Andrzej [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Biller, Beverly M.K.; Nachtigall, Lisa B. [Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts (United States); Bussière, Marc R. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Swearingen, Brooke; Chapman, Paul H. [Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Loeffler, Jay S. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Shih, Helen A., E-mail: hshih@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-11-01

    Purpose/Objective(s): This study evaluated the efficacy and toxicity of proton therapy for functional pituitary adenomas (FPAs). Methods and Materials: We analyzed 165 patients with FPAs who were treated at a single institution with proton therapy between 1992 and 2012 and had at least 6 months of follow-up. All but 3 patients underwent prior resection, and 14 received prior photon irradiation. Proton stereotactic radiosurgery was used for 92% of patients, with a median dose of 20 Gy(RBE). The remainder received fractionated stereotactic proton therapy. Time to biochemical complete response (CR, defined as ≥3 months of normal laboratory values with no medical treatment), local control, and adverse effects are reported. Results: With a median follow-up time of 4.3 years (range, 0.5-20.6 years) for 144 evaluable patients, the actuarial 3-year CR rate and the median time to CR were 54% and 32 months among 74 patients with Cushing disease (CD), 63% and 27 months among 8 patients with Nelson syndrome (NS), 26% and 62 months among 50 patients with acromegaly, and 22% and 60 months among 9 patients with prolactinomas, respectively. One of 3 patients with thyroid stimulating hormone—secreting tumors achieved CR. Actuarial time to CR was significantly shorter for corticotroph FPAs (CD/NS) compared with other subtypes (P=.001). At a median imaging follow-up time of 43 months, tumor control was 98% among 140 patients. The actuarial 3-year and 5-year rates of development of new hypopituitarism were 45% and 62%, and the median time to deficiency was 40 months. Larger radiosurgery target volume as a continuous variable was a significant predictor of hypopituitarism (adjusted hazard ratio 1.3, P=.004). Four patients had new-onset postradiosurgery seizures suspected to be related to generously defined target volumes. There were no radiation-induced tumors. Conclusions: Proton irradiation is an effective treatment for FPAs, and hypopituitarism remains the primary

  11. Detecting parathyroid adenoma using technetium-99m tetrofosmin: comparison with P-glycoprotein and multidrug resistance related protein expression--a preliminary report

    Shiau, Y.C.; Tsai, S.C.; Wang, J.J.; Ho, S.T.; Kao, A. E-mail: albertkaotw@yahoo.com.tw

    2002-04-01

    The aim of this study was to investigate the relationships among technetium-99m tetrofosmin (Tc-TF) accumulation in parathyroid adenoma and the expression of P-glycoprotein (Pgp) or multidrug resistance related protein (MRP). Before operation, 33 patients with parathyroid adenomas (larger than 1.5 gm) were studied with parathyroid scintigraphy 10 minutes and 2 hours after intravenous injection of Tc-TF before operation. Immunohistochemical analyses (IHA) were performed on multiple nonconsecutive sections of operative parathyroid specimens to detect Pgp or MRP expression. According to the results of IHA, the 33 parathyroid adenomas were separated into four groups: (1) 2 adenomas with both positive Pgp and positive MRP expression, (2) 1 adenomas with positive Pgp but negative MRP expression, (3) 2 adenomas with negative Pgp but positive MRP expression, and (4) 28 adenomas with both negative Pgp and negative MRP expression. All of 28 adenomas in the group 4 could be detected by Tc-TF parathyroid imaging. All of 5 adenomas in the groups 1 to 3 could not be detected by TcTF parathyroid imaging (p < 0.05). Not only the size of parathyroid adenomas, but also significant Pgp or MRP expression limited the sensitivity of Tc-TF parathyroid imaging to localize parathyroid adenomas before operation.

  12. Detecting parathyroid adenoma using technetium-99m tetrofosmin: comparison with P-glycoprotein and multidrug resistance related protein expression--a preliminary report

    The aim of this study was to investigate the relationships among technetium-99m tetrofosmin (Tc-TF) accumulation in parathyroid adenoma and the expression of P-glycoprotein (Pgp) or multidrug resistance related protein (MRP). Before operation, 33 patients with parathyroid adenomas (larger than 1.5 gm) were studied with parathyroid scintigraphy 10 minutes and 2 hours after intravenous injection of Tc-TF before operation. Immunohistochemical analyses (IHA) were performed on multiple nonconsecutive sections of operative parathyroid specimens to detect Pgp or MRP expression. According to the results of IHA, the 33 parathyroid adenomas were separated into four groups: (1) 2 adenomas with both positive Pgp and positive MRP expression, (2) 1 adenomas with positive Pgp but negative MRP expression, (3) 2 adenomas with negative Pgp but positive MRP expression, and (4) 28 adenomas with both negative Pgp and negative MRP expression. All of 28 adenomas in the group 4 could be detected by Tc-TF parathyroid imaging. All of 5 adenomas in the groups 1 to 3 could not be detected by TcTF parathyroid imaging (p < 0.05). Not only the size of parathyroid adenomas, but also significant Pgp or MRP expression limited the sensitivity of Tc-TF parathyroid imaging to localize parathyroid adenomas before operation

  13. Therapeutic options in the management of autonomously functioning thyroid adenomas

    Full text: Autonomously functioning thyroid nodules or adenomas (AFTN or AFTA) was established as a clinical entity in 1918 by Goetsch correlating cellular mitochondrial content with nodular function and showing the inverse correlation between AFTN function and extra nodular tissue function. They are almost always benign and degeneration, which is common in AFTN, can result in the development of hyperthyroidism. It is therefore important to know the function of these nodules by requesting for the thyroid function tests namely T3, T4, and TSH. They are diagnosed by thyroid scans using I-131 or Tc 99m as a hot solitary nodule in one lobe with the other lobe not appearing on scan or suppressed. The frequency of AFTA worldwide is quite variable depending on geography. It ranges from 1% in North America to 10 % in some areas in Europe and Asia or in areas of iodine deficiency. The traditional methods of treatment of these nodules have been surgery and radioactive iodine ablation. Surgical treatment as a rule is indicated in young patients with nodules larger than 3 cm and those with local compressive symptoms. RAI is used in elderly patients and those who are poor surgical risks. The usual dose ranges from 20 to 30 mCi and is definitely larger that when treating Graves' disease. Others have resorted to PEI or percutaneous ethanol injection with reported success. There has been no definite management of these AFTA due to the variable natural history and some would only recommend observation for asymptomatic small adenomas, which are euthyroid. Therefore this paper studied the results of treatment using RAI ablation, surgery or plain observation for AFTA. Percutaneous ethanol injection is not being done in our center. In the local setting, where thyroid disease is still endemic, the incidence of AFTA is not so high. Graves' disease is still the predominating cause of hyperthyroidism followed by multinodular goiter. Toxic AFTA occurs in 3% of the total hyperthyroid

  14. Evaluation of adenohypophyseal reserve in patients carrier of hypophyseal adenoma treated by trans-sphenoidal surgery

    Fifteen patients carrier hypophyseal adenomas, with ages varying between 16 to 53 years were studied. The patients presented sella changes to the conventional plane radiographies and were submited a surgery treatment, with acess to hypophysis by the trans-sphenoidal way. (author)

  15. Parathyroid adenoma in patients with Graves' disease: a report of 21 cases.

    Wei, Shuanzeng; Baloch, Zubair W; LiVolsi, Virginia A

    2015-03-01

    Graves' disease (GD) is frequently associated with mild hypercalcemia. The hypercalcemia may be due to the activation of osteoclastic bone resorption caused by the excess thyroid hormone. In some cases of GD, the hypercalcemia can be attributable to concomitant parathyroid diseases. In this study, 21 patients with a history of GD developed parathyroid adenoma based on histology, intraoperative parathyroid hormone (IOPTH) monitoring, and other clinical features. There were 11 patients with a history of radioactive iodine therapy (RAI) for GD. The latency time of RAI was from 12 to 41 years. The case cohort was divided into two groups: patients with (group GR: 11 patients) and patients without a history of RAI (group G: 10 patients). Mean age of patients in group GR was 54.8 years compared to 62.2 years of group G (P = 0.08). There were no statistically significant differences regarding the parathyroid weight, serum calcium, and pre- and post-parathyroidectomy PTH levels. There was no histopathologic difference between the two groups. In conclusion, we report 21 cases of parathyroid adenoma in patients with Graves' disease. There may be a possible link between GD patients with a RAI history and an increased risk of parathyroid adenoma. The parathyroid adenomas showed no clinicopathological differences between GD patient with and without a history of RAI. PMID:25501495

  16. Novel Molecular Mechanisms of Resistance to Somatostatin Analog Treatment in Pituitary Adenomas

    F. Gatto (Federico)

    2015-01-01

    markdownabstract__Abstract__ In this thesis we confirmed the pivotal role of somatostatin receptor (SSTR) subtype 2 (sst2) receptor expression in driving the biochemical responsiveness to “classical” somatostatin analog (SSA) treatment in GH-secreting adenomas. Moreover, since the variable express

  17. Right thyroid hemiagenesis with adenoma and hyperplasia of parathyroid glands -case report

    Oruci Merima

    2012-11-01

    Full Text Available Abstract Background Thyroid hemiagenesis is a rare anomaly, more commonly seen on the left side (ratio 4:1 and in females (ratio 3:1. The first to describe this anomaly was Handfield Jones in 1852. Case presentation We present a 66 year old female patient with right thyroid hemiagenesis, parathyroid adenoma on the side of hemiagenesis and parathyroid hyperplasia on the contralateral side. The patient had neck pain and was diagnosed as Hashimto thyroiditis with hyperparathyroidism. Parathyroid hormone, thyroglobulin antibodies (Tg-Ab and thyroid peroxidase antibodies (TPO-Ab were elevated. Neck ultrasound and technetium 99mTc-methoxyisobutyl isonitrile (MIBI scintigraphy confirmed the right thyroid hemiagenesis, but not adenoma of parathyroid glands. Intraoperatively, right thyroid hemiagenesis was confirmed and left loboistmectomy was performed with removal of left inferior hyperplastic parathyroid gland. Postoperative PTH (parathyroid hormone levels were within normal range. Five months after the operation PTH level was elevated again with calcium values at the upper limit. MIBI scintigraphy was performed again which showed increased accumulation of MIBI in the projection of the right parathyroid gland. Surgical reexploration of the neck and excision of the right upper parathyroid adenoma was performed which was located behind cricoid laryngeal cartilage. After surgery a normalization of calcium and PTH occured. Conclusion From available literature we have not found the case that described parathyroid adenoma on the side of thyroid hemiagenesis,with parathyroid hyperplasia on the contralateral side.

  18. Spontaneous remission of acromegaly or gigantism due to subclinical apoplexy of pituitary growth hormone adenoma

    WANG Xian-ling; DOU Jing-tao; L(U) Zhao-hui; ZHONG Wen-wen; BA Jian-ming; JIN Du; LU Ju-ming; PAN Chang-yu; MU Yi-ming

    2011-01-01

    Background Subclinical apoplexy of pituitary functional adenoma can cause spontaneous remission of hormone hypersecretion.The typical presence of pituitary growth hormone (GH) adenoma is gigantism and/or acromegaly.We investigated the clinical characteristics of patients with spontaneous partial remission of acromegaly or gigantism due to subclinical apoplexy of GH adenoma.Methods Six patients with spontaneous remission of acromegaly or gigantism were enrolled.The clinical characteristics,endocrinological evaluation and imageological characteristics were retrospectively analyzed.Results In these cases,the initial clinical presences were diabetes mellitus or hypogonadism.No abrupt headache,vomiting,visual function impairment,or conscious disturbance had ever been complained of.The base levels of GH and insulin growth factor-1 (IGF-1) were normal or higher,but nadir GH levels were all still >1 μg/L in 75 g oral glucose tolerance test.Magnetic resonance imaging detected enlarged sella,partial empty sella and compressed pituitary.The transsphenoidal surgery was performed in 2 cases,and the other patients were conservatively managed.All the patients were in clinical remission.Conclusions When the clinical presences,endocrine evaluation,biochemical examination and imageology indicate spontaneous remission of GH hypersecretion in patients with gigantism or acromegaly,the diagnosis of subclinical apoplexy of pituitary GH adenoma should be presumed.To these patients,conservative therapy may be appropriate.

  19. Pituitary adenomas in mice transgenic for growth hormone-releasing hormone

    Asa, S L; Kovacs, K; Stefaneanu, L;

    1992-01-01

    adenomas, which we characterized by histology, immunohistochemistry, in situ hybridization, and electron microscopy. Of 13 animals examined, all developed GH-immunoreactive neoplasms that had diffuse positivity for GH mRNA by in situ hybridization. Eleven also contained PRL immunoreactivity; in situ...

  20. Neuroendocrine tumor in gastric adenoma: a diagnostic pitfall mimicking invasive adenocarcinoma

    Lee Sun-Mi

    2012-08-01

    Full Text Available Abstract Neuroendocrine tumor (NET in adenoma of the gastrointestinal tract is a rare mixed glandular-endocrine neoplasm and has uncommonly been described mostly in the colon. Histologically, this tumor is composed of a predominant proportion of benign adenomatous component and a small portion of well-differentiated NE component. Only three cases of NET in gastric adenoma have been reported in the literature. We present 4 cases of NET in gastric adenoma mimicking invasive adenocarcinoma. The NETs were 0.62 mm to 4.1 mm in size and located at the basal lamina propria, muscularis mucosa and submucosa. Histologically, NETs consisted of nests, cords, tubules, and clusters of cells that predominantly interposed between the foveolar base without disturbing the overall polyp architecture. The lesions were completely removed by endoscopic submucosal dissection in three cases and in one case, subtotal gastrectomy was performed because endoscopic biopsy was invasive adenocarcinoma. The patients’ clinical course was uneventful without an evidence of recurrence or metastasis. The recognition of NET in gastric adenoma will help avoid potential diagnostic pitfalls masquerading as invasvie adenocarcinomas posed by their infiltrative pattern into submucosa. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1688552293761001

  1. Cyclosporine treatment of perianal gland adenoma concurrent with benign prostatic hyperplasia in a dog

    Park, Chul; Yoo, Jong-Hyun; Kim, Ha-Jung; Lim, Chae-Young; Kim, Ju-Won; Lee, So-Young; Kim, Jung-Hyun; Jang, Jae-Im; Park, Hee-Myung

    2010-01-01

    A 13-year-old, intact male, mixed-breed dog was evaluated for multiple intradermal nodules around the anus. The nodules were diagnosed as perianal gland adenoma based on histopathologic examination. After therapy with cyclosporin A for 5 wk, the perianal masses were moderately shrunken. The dog’s condition has remained stable over 6 mo.

  2. A thyrotropin-secreting pituitary adenoma as a cause of thyrotoxic periodic paralysis

    Alings, AMW; Fliers, E; de Herder, WW; Hofland, LJ; Sluiter, HE; Links, TP; van der Hoeven, JH; Wiersinga, WM

    1998-01-01

    We describe a patient with thyrotoxic periodic paralysis (TPP) caused by a thyrotropin-secreting pituitary adenoma. The diagnosis TPP was based on the combination of episodes of reversible hypokalaemic paralysis, hyperthyroidism and electrophysiological findings. A thyrotropin-secreting pituitary ad

  3. Dietary Supplement Use and Colorectal Adenoma Risk in Individuals with Lynch Syndrome: The GEOLynch Cohort Study

    Heine-Broring, R.C.; Winkels, R.M.; Botma, A.; Duijnhoven, F.J.B. van; Jung, A.Y.; Kleibeuker, J.H.; Nagengast, F.M.; Vasen, H.F.; Kampman, E.

    2013-01-01

    BACKGROUND AND AIMS: Individuals with Lynch syndrome have a high lifetime risk of developing colorectal tumors. In this prospective cohort study of individuals with Lynch syndrome, we examined associations between use of dietary supplements and occurrence of colorectal adenomas. MATERIALS AND METHOD

  4. Dietary Supplement Use and Colorectal Adenoma Risk in Individuals with Lynch Syndrome: The GEOLynch Cohort Study

    Heine-Bröring, R.C.; Winkels, R.M.; Botma, A.; Duijnhoven, van F.J.B.; Jung, A.Y.; Kampman, E.

    2013-01-01

    Background and Aims: Individuals with Lynch syndrome have a high lifetime risk of developing colorectal tumors. In this prospective cohort study of individuals with Lynch syndrome, we examined associations between use of dietary supplements and occurrence of colorectal adenomas. Materials and Method

  5. Dietary Supplement Use and Colorectal Adenoma Risk in Individuals with Lynch Syndrome : The GEOLynch Cohort Study

    Heine-Broring, Renate C.; Winkels, Renate M.; Botma, Akke; van Duijnhoven, Franzel J. B.; Jung, Audrey Y.; Kleibeuker, Jan H.; Nagengast, Fokko M.; Vasen, Hans F. A.; Kampman, Ellen

    2013-01-01

    Background and Aims: Individuals with Lynch syndrome have a high lifetime risk of developing colorectal tumors. In this prospective cohort study of individuals with Lynch syndrome, we examined associations between use of dietary supplements and occurrence of colorectal adenomas. Materials and Method

  6. Conscious or unconscious: The impact of sedation choice on colon adenoma detection

    Mark Metwally; Nicholas Agresti; William B Hale; Victor Ciofoaia; Ryan O'Connor; Michael B Wallace; Jonathan Fine; Yun Wang; Seth A Gross

    2011-01-01

    AIM: To determine if anesthesiologist-monitored use of propofol results in improved detection of adenomas when compared with routine conscious sedation. METHODS: This retrospective study was conducted at two separate hospital-based endoscopy units where approximately 12 000 endoscopic procedures are performed annually, with one endoscopy unit exclusively using anesthesiologist-monitored propofol. Three thousand two hundred and fifty-two patients underwent initial screening or surveillance colonoscopies. Our primary end point was the adenoma detection rate, defined as the number of patients in whom at least one adenoma was found, associated with the type of sedation. outpatient colonoscopies were performed by five selected endoscopists. At least one adenoma was detected in 27.6% of patients (95% CI = 26.0-29.1) with no difference in the detection rate between the anesthesiologist -propofol and group and the gastroenterologist-midazolam/fentanyl group (28.1% vs 27.1%, P = 0.53). CONCLUSION: The type of sedation used during co-lonoscopy does not affect the number of patients in whom adenomatous polyps are detected.

  7. [Trabecular hyalinizing adenoma of the thyroid (HAT): A report of two cases].

    Román-González, Alejandro; Simón-Duque, Carlos; Camilo-Pérez, Juan; Vélez-Hoyo, Alejandro

    2016-01-01

    The hyalinizing trabecular adenoma is a rare lesion of the thyroid. There is controversy in the literature about the correct name for this disease. Dr. Carney defended the benign nature of this condition and therefore continues calling it adenoma, the World Health Organization calls for the potential of tumor malignancy, and others qualify it as a variant of papillary carcinoma based on the presence of rearranged in transformation/papillary thyroid carcinoma (RET/PTC) rearrangements. In Latin America there are few reported cases. Two cases of hyalinizing trabecular adenoma are reported. The first is a 40-year-old woman with a thyroid nodule of 3x3 cm. The immunohistochemistry was positive for thyroglobulin and calcitonin and negative for cytokeratin 19 and chromogranin. The second case is a 36-year-old patient with a thyroid nodule of 4x4 cm with an immunohistochemical pattern identical to the first case. Trabecular hyalinizing adenoma is a benign disease, easily confused with papillary or medullary thyroid carcinoma. Awareness of this entity will allow a better classification and management of thyroid conditions. PMID:26927651

  8. High prevalence of radiological vertebral fractures in women with prolactin-secreting pituitary adenomas.

    Mazziotti, Gherardo; Mancini, Tatiana; Mormando, Marilda; De Menis, Ernesto; Bianchi, Antonio; Doga, Mauro; Porcelli, Teresa; Vescovi, Pier Paolo; De Marinis, Laura; Giustina, Andrea

    2011-12-01

    Hyperprolactinemia may cause bone loss but data on fractures are scanty. The aim of this study was to evaluate the prevalence of vertebral fractures in women with prolactin (PRL)-secreting adenoma. In this cross-sectional study, 78 women (median age 45.5 years, range: 20-81) with PRL-secreting pituitary adenoma (66 with microadenoma and 12 with macroadenoma) and 156 control subjects, with normal PRL values and with comparable age to patients with hyperprolactinemia, were evaluated for vertebral fractures by a morphometric approach and for bone mineral density (BMD) by a dual-energy X-ray absorptiometry at lumbar spine. Vertebral fractures were shown in 25 patients with PRL-secreting adenoma (32.6%) and in 20 controls (12.8%, P hyperprolactinemia versus patients treated with cabergoline. Logistic regression analysis demonstrated that duration of disease maintained a significant correlation with vertebral fractures (odds ratio 1.16, C.I. 95% 1.02-1.33) even after correction for age, menopausal status, treatment with cabergoline, BMD, serum IGF-I and serum PRL values. Hyperprolactinemia is associated with high prevalence of radiological vertebral fractures in women with PRL-secreting adenoma. PMID:21301967

  9. Label-free monitoring of colorectal adenoma-carcinoma sequence based on multiphoton microscopy

    Chen, J. X.; Li, H. S.; Chen, Z. F.; Feng, C. Y.; Yang, Y. H.; Jiang, W. Z.; Guan, G. X.; Zhu, X. Q.; Zhuo, S. M.; Xu, J.

    2014-06-01

    The monitoring and evaluation of colorectal adenoma-carcinoma sequence during endoscopy are important for endoscopic resection of precursor lesions to disrupt the adenoma-carcinoma sequence and halt progression to invasive neoplastic disease. In this study, multiphoton microscopy (MPM) was used to identify different stages during the development of colorectal adenocarcinoma including adenoma with low-grade and high-grade dysplasia, and adenocarcinoma invading the submucosa. It was found that by combining two-photon excited fluorescence (TPEF) imaging and second harmonic generation (SHG) imaging, MPM can reveal the morphological changes of the epithelial cells and glands, identify the invasive position and depth of atypical glands and quantitatively describe the change of the cellular nucleus and the nuclear-to-cytoplasmic ratio during the stepwise progression of colorectal adenocarcinoma. These are important pathological findings for pathologists when diagnosing colorectal lesions. With the advancement of a compact and flexible multiphoton endoscope for in vivo imaging and clinical applications, MPM has the potential to provide immediate histological diagnosis for the monitoring and evaluation of the colorectal adenoma-carcinoma sequence during endoscopy.

  10. Endocrinological and MRI features of pituitary adenomas with marked xanthogranulomatous reaction

    Nishioka, Hiroshi; Haraoka, Jo [Tokyo Medical University, Department of Neurosurgery, Tokyo (Japan); Shibuya, Makoto [Tokyo Medical University, Department of Diagnostic Pathology, Ibaraki Medical Center, Tokyo (Japan); Ohtsuka, Kuninori; Ikeda, Yukio [Tokyo Medical University, Department of Neurosurgery, Hachioji Medical Center, Tokyo (Japan)

    2010-11-15

    The study aims to describe the endocrinological and magnetic resonance imaging (MRI) features of the rarely reported xanthogranulomas associated with pituitary adenoma. Of 231 consecutive pituitary adenomas treated surgically, those with xanthogranulomatous reaction on histology were reviewed. Five patients (2.2%) had an adenoma with marked xanthogranulomatous reaction. They were all nonfunctioning macroadenomas and presented with anterior pituitary insufficiencies. On MRI, all adenomas showed mixed signal intensities on T1- and T2-weighted images with heterogeneous gadolinium enhancement, reflecting their complex histological features: Cholesterol clefts typically showed T1 high- and T2 low-signal intensities. Preoperative diagnosis was difficult in a case predominantly featuring xanthogranuloma. Although none of them had episodes of pituitary apoplexy, hemosiderin deposits and cysts with xanthochromic-like fluid were observed in five and four cases, respectively. Xanthogranulomatous reaction may develop in macroadenomas, probably triggered by hemorrhagic processes despite no apoplectic episodes. They typically exhibit complex mixed signal intensity on MRI, particularly T1 high- and T2 low-signal intensities, and patients present with pituitary dysfunction. (orig.)

  11. METANEPHRIC ADENOMA IN CHILDREN: REPORT OF TWO CASES AND REVIEW OF LITERATURE

    LIU Ming; ZHANG Yu-zhen; WU Yun; XUE Lian-yan

    2007-01-01

    Objective To analyze the clinical manifestations and the imaging mainly CT of metanephric adenoma in chidren. Methods We reviewed the manifestations of clinics and the imaging mainly CT at our institution and reported observations on the diagnosis of metanephric adenoma in children based on these 2 patients and an additional 10 cases from the literature. Results More cases of metanephric adenoma could have polycythemia at presentation. Also in more patiens, US image depicted well-circumscribed hyperechoic mass. Un-enhanced CT scan showed the higher attenuation mass with calcification, some cases had cystic mass with a single solid mural nodule. At contrast-enhanced CT, the degrees of enhancement varied. In our new cases, one showed a large polycystic mass abounded with fat-attenuation material. Conclusion Manifestations of metanephric adenoma varied from each other, we should analyze the clinical manifestations as well as the characteristics of imagings and it would help for diagnosis. But the diagnosis of the tumors must be based on histological examinations.

  12. Clinical characteristics of pleomorphic adenoma of salivary glands among Jordanian patients

    Objective: To evaluate the incidence of salivary gland pleomorphic adenoma in Jordanian patients. Methods: The retrospective study involved histopathological reports of 62 patients diagnosed to have pleomorphic adenoma from salivary glands between 2000 and 2008 at King Hussein Medical Centre and the peripheral military hospitals of the Royal Medical Services, Jordan. The files were evaluated. Special attention was given to the distribution of the tumour to major and minor categories. Age, gender and treatment pattern were also noted. Quantitative and categorical variables were worked out for statistical analysis. Results: Out of the 62 cases, 32 (51.6%) occurred in men, with a male-to-female ratio of 1.06:1. The mean age was 40.4+-12 years (range: 8 to 80 years) with peak incidence in the 4th decade of life. The primary tumours were predominantly located in the parotid gland (n=40; 64%), followed by pleomorphic adenoma of the minor salivary glands (n=11; 17%), the submandibular gland (n=10; 16.12%) and the sublingual gland (n=1; 1.6%). Painless swelling was the first finding in 49 (79%), followed by pressure sensation in 10 (16%) and pain in 3 (5%) patients. Conclusion: Pleomorphic adenoma of salivary glands had similar characteristics with patients of most previously published research studies in other countries except that there was no significant difference regarding gender distribution in Jordanian patients. (author)

  13. URINARY MUTAGENICITY AS A BIOMARKER OF COOKED-MEAT-ASSOCIATED MUTAGENS AND RISK FOR COLORECTAL ADENOMA

    Urinary Mutagenicity as a Biomarker of Cooked-Meat-Associated Mutagens and Risk for Colorectal AdenomaIn a controlled feeding study involving 60 subjects, we have investigated urinary mutagenicity as a biomarker of exposure to cooked-meat-associated mutagens. In a separa...

  14. Dosimetric factors associated with pituitary function after Gamma Knife Surgery (GKS) of pituitary adenomas

    Background and purpose: Gamma Knife Surgery (GKS) can be an adjunctive option to surgery in the case of pituitary adenomas. The effect of dosimetric variables on the incidence of new anterior pituitary deficits after GKS requires better definition. Materials and methods: This retrospective study considered 130 patients with a follow up after GKS >6 months. The diagnosis was nonfunctioning pituitary adenoma (NFPA) in 68 patients and secreting pituitary adenoma (SPA) in 62 patients. Median margin dose was 15/25 Gy for NFPA and SPA, respectively. The endocrinological median follow-up was 60 months. Hypopituitarism was defined as a new pituitary deficit in (at least) one of the three hormonal axes (hypogonadism, hypothyroidism and hypoadrenalism). The predictive value of clinical/dosimetric parameters was tested by univariate/multivariate analyses. Results: Sixteen patients (12.3%) showed a new pituitary deficit in one or more axes. Multivariate analysis confirmed that the mean dose to the stalk/pituitary and the amount of healthy tissue within the high dose region were strong independent predictors of pituitary dysfunction; their best cut-off values were around 15.7 Gy, 7.3 Gy and 1.4 cm3, respectively. Conclusions: Our data showed a dose-dependent incidence of new hormonal deficits after GKS for pituitary adenoma. During planning definition, the risk of hypopituitarism could be reduced using the outlined safe dose–volume values.

  15. Endocrinological and MRI features of pituitary adenomas with marked xanthogranulomatous reaction

    The study aims to describe the endocrinological and magnetic resonance imaging (MRI) features of the rarely reported xanthogranulomas associated with pituitary adenoma. Of 231 consecutive pituitary adenomas treated surgically, those with xanthogranulomatous reaction on histology were reviewed. Five patients (2.2%) had an adenoma with marked xanthogranulomatous reaction. They were all nonfunctioning macroadenomas and presented with anterior pituitary insufficiencies. On MRI, all adenomas showed mixed signal intensities on T1- and T2-weighted images with heterogeneous gadolinium enhancement, reflecting their complex histological features: Cholesterol clefts typically showed T1 high- and T2 low-signal intensities. Preoperative diagnosis was difficult in a case predominantly featuring xanthogranuloma. Although none of them had episodes of pituitary apoplexy, hemosiderin deposits and cysts with xanthochromic-like fluid were observed in five and four cases, respectively. Xanthogranulomatous reaction may develop in macroadenomas, probably triggered by hemorrhagic processes despite no apoplectic episodes. They typically exhibit complex mixed signal intensity on MRI, particularly T1 high- and T2 low-signal intensities, and patients present with pituitary dysfunction. (orig.)

  16. CT and magnetic resonance imaging features of middle ear adenoma of neuroendocrine differentiation: A case report

    Lee, Sang Kwon; Choe, Mi Sun [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2013-09-15

    Middle ear adenoma is a rare benign epithelial tumor. We report the CT and magnetic resonance imaging findings of a case of middle ear adenoma of neuroendocrine differentiation in a 36-year-old man. On high-resolution CT, the mass was found to fill the middle ear, in which the ossicles were embedded, but not destroyed, with outward bulging of the intact tympanic membrane. On MRI, the mass, which was intensely enhanced on 3-dimensional (3D) gadolinium (Gd)-enhanced spoiled gradient-recalled (SPGR) sequence, involved the middle ear, aditus ad antrum and a portion of mastoid antrum. Histological and immunohistochemical findings of the specimen obtained by surgical excisions were consistent with middle ear adenoma of neuroendocrine differentiation. Middle ear adenoma of neuroendocrine differentiation should be included in the differential diagnosis of an intensely enhancing mass filling the middle ear/mastoid antrum without ossicular destructions. The extent of the mass can be excellently assessed with 3D Gd-enhanced SPGR sequence.

  17. CT and magnetic resonance imaging features of middle ear adenoma of neuroendocrine differentiation: A case report

    Middle ear adenoma is a rare benign epithelial tumor. We report the CT and magnetic resonance imaging findings of a case of middle ear adenoma of neuroendocrine differentiation in a 36-year-old man. On high-resolution CT, the mass was found to fill the middle ear, in which the ossicles were embedded, but not destroyed, with outward bulging of the intact tympanic membrane. On MRI, the mass, which was intensely enhanced on 3-dimensional (3D) gadolinium (Gd)-enhanced spoiled gradient-recalled (SPGR) sequence, involved the middle ear, aditus ad antrum and a portion of mastoid antrum. Histological and immunohistochemical findings of the specimen obtained by surgical excisions were consistent with middle ear adenoma of neuroendocrine differentiation. Middle ear adenoma of neuroendocrine differentiation should be included in the differential diagnosis of an intensely enhancing mass filling the middle ear/mastoid antrum without ossicular destructions. The extent of the mass can be excellently assessed with 3D Gd-enhanced SPGR sequence.

  18. Diagnosis of parathyroid adenoma - the role of two phase mibi scintigraphy (abstract)

    Dual radionuclide imaging using a combination of /sup 201/Ti with/sup 99m/Tc pertechnetate is a useful procedure in the localization of parathyroid adenomas. Recently /sup 99m/Tc Sesta - Methoxy Isobutyle Isonitrile (MIBI) has been used for detection and localization of parathyroid adenoma in patients with hyperparathyroidism as a single radionuclide imaging procedure (Double phase study). In our study 4 female patients with picture of metabolic bone disease on bone scintigraphy and raised serum parathyroid hormone levels and raised levels of serum calcium, were subjected to two phase parathyroid MIBI scintigraphy. Cervicothoracic planar images (Anterior view) were acquired at 15-20 minutes and 2-4 hours after an intravenous injection of 15-20 mCi /sup 99m/Tc MIBI. A positive scan was defined as an area of increased focal uptake in normal tissue, which progressively decreased over time. All the 4 patients had a positive scan for parathyroid adenoma which was confirmed by histopathological examination of the excised tumor. It was concluded that the two phase 99mTc-MIBI parathyroid scintigraphy is a specific and sensitive modality for detection, localization and even diagnosis of parathyroid adenoma. (author)

  19. Localization of tissue inhibitor of metalloproteinases 1 (TIMP-1) in human colorectal adenoma and adenocarcinoma

    Holten-Andersen, Mads N.; Hansen, Ulla; Brünner, Nils;

    2005-01-01

    hybridization with immunohistochemical staining for alpha-smooth muscle actin or CD68 showed TIMP-1 mRNA in myofibroblasts but not in macrophages. TIMP-1 mRNA was detected in 2 of 7 adenomatous polyps in the adenoma area: in both cases associated with focal stromal inflammation at the epithelial...

  20. Study of serum TSH content in functioning thyroid gland adenoma by 'supersensitive' immunoradiometric assay

    Determinations of serum TSH levels by immunoradiometric assay (IRMA)-math TSH (Mallinckrodt) kit and of the thyroid function by scintiscanning using 99mTc-pertechnetate (20-40 MBq) were carried out paralelly in euthyroid and hyperthyroid patients. A comparison of the two tests allowed a better distinction of preclinical hyperthyreosis from toxic adenomas. (L.E.)