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Sample records for solitary adrenal metastasis

  1. Short-term outcomes and safety of computed tomography-guided percutaneous microwave ablation of solitary adrenal metastasis from lung cancer: A multi-center retrospective study

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    Men, Min; Ye, Xin; Yang, Xia; Zheng, Aimin; Huang, Guang Hui; Wei, Zhigang [Dept. of Oncology, Shandong Provincial Hospital Affiliated with Shandong University, Jinan (China); Fan, Wei Jun [Imaging and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou (China); Zhang, Kaixian [Dept. of Oncology, Teng Zhou Central People' s Hospital Affiliated with Jining Medical College, Tengzhou (China); Bi, Jing Wang [Dept. of Oncology, Jinan Military General Hospital of Chinese People' s Liberation Army, Jinan (China)

    2016-11-15

    To retrospectively evaluate the short-term outcomes and safety of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of solitary adrenal metastasis from lung cancer. From May 2010 to April 2014, 31 patients with unilateral adrenal metastasis from lung cancer who were treated with CT-guided percutaneous MWA were enrolled. This study was conducted with approval from local Institutional Review Board. Clinical outcomes and complications of MWA were assessed. Their tumors ranged from 1.5 to 5.4 cm in diameter. After a median follow-up period of 11.1 months, primary efficacy rate was 90.3% (28/31). Local tumor progression was detected in 7 (22.6%) of 31 cases. Their median overall survival time was 12 months. The 1-year overall survival rate was 44.3%. Median local tumor progression-free survival time was 9 months. Local tumor progression-free survival rate was 77.4%. Of 36 MWA sessions, two (5.6%) had major complications (hypertensive crisis). CT-guided percutaneous MWA may be fairly safe and effective for treating solitary adrenal metastasis from lung cancer.

  2. Solitary Spinal Epidural Metastasis from Gastric Cancer

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    Taisei Sako

    2016-01-01

    Full Text Available Solitary epidural space metastasis of a malignant tumor is rare. We encountered a 79-year-old male patient with solitary metastatic epidural tumor who developed paraplegia and dysuria. The patient had undergone total gastrectomy for gastric cancer followed by chemotherapy 8 months priorly. The whole body was examined for suspected metastatic spinal tumor, but no metastases of the spine or important organs were observed, and a solitary mass was present in the thoracic spinal epidural space. The mass was excised for diagnosis and treatment and was histopathologically diagnosed as metastasis from gastric cancer. No solitary metastatic epidural tumor from gastric cancer has been reported in English. Among the Japanese, 3 cases have been reported, in which the outcome was poor in all cases and no definite diagnosis could be made before surgery in any case. Our patient developed concomitant pneumonia after surgery and died shortly after the surgery. When a patient has a past medical history of malignant tumor, the possibility of a solitary metastatic tumor in the epidural space should be considered.

  3. Spontaneous rupture of adrenal metastasis from hepatocellular carcinoma

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    Lim, Chae Hun; Kim, Hyun Jin; Park, Soo Youn; Hwang, Seong Su; Choi, Hyun Joo [St. Vincent Hospital, Suwon (Korea, Republic of)

    2007-03-15

    Rupture of adrenal tumor from various primary origins is a rather rare event. We report here on a ruptured adrenal metastasis from hepatocellular carcinoma, and this ruptured metastasis was observed at the time of the initial diagnosis.

  4. Analysis of the ultrasonic image of adrenal metastasis in primary lung cancer

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    Bai Ling; Yang Tao; Tang Ying; Mao Jingning; Chen Wei; Wang Yong; Zhang Yan

    2009-01-01

    Objective: To investigate the ultrasonic image of adrenal metastasis in primary lung cancer. Methods: The ultrasonic imaging characteristics of fourteen patients with adrenal metastasis in primary lung cancer were retrospectively reviewed. In all the cases, US-guided percutaneous biopsy was performed for pathological evaluation during the clinical diagnosis. Results and Conclusion: In ultrasonography the adrenal metastatic tumors were manifested as solitary in all the cases, well-defined in 10 cases, irregularly shaped in 10 cases, hypoechoic in 13 cases, and 1 case showed cystoid structure in the tumor. The maximum diameter of the tumor was 3.0-15.3 cm. 9 cases were metastatic adenocarcinoma. The sonographic appearance of adrenal metastasis in primary lung cancer has its characteristics. Ultrasonography can find adrenal metastalic tumors easily and contribute to diagnosis. (authors)

  5. CT findings of solitary intracranial metastasis

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    Suh, Dae Chul; Lee, Kyung Soo; Chang, Kee Hyun

    1987-01-01

    The authors retrospectively reviewed and analyzed CT scans of fifty patients with solitary intracranial lesion selected from 118 patients who had been confirmed to have intracranial metastasis from 1979 to 1985. The results were as follows: 1. The most common primary tumors with solitary metastasis, in order of frequency, were lung cancer, breast cancer, choriocarcinoma, colon cancer, lymphoma and others. 2. Precontrast scans obtained in 35 cases showed cystic very low density in 20%, slightly low density in 9%, isodensity in 20%, high density in 51% when he densities of the lesions were compared with that of the normal brain tissue. 3. After contrast enhancement 43 out of 50 showed one of 4 patterns of enhancement. Homogeneous enhancement without necrosis were found in 26%, homogeneous enhancement with necrosis in 18%, ring-enhancement in 26% and irregular enhancement in 16%. No enhancement was found in 14%. 4. The locations of the metastatic lesions were intra axial in 45 and extra axial in 5. Among the intra axial lesions, the parietal lobe was the most common location. Extra axial metastases were epidural, calvarial and leptomeningeal. 5. Degrees of surrounding edema were mild in 32%, moderate in 19% and severe in 49%

  6. Adrenal failure due to bilateral adrenal metastasis of rectal cancer: A case report

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    Yuki Imaoka

    2017-01-01

    Conclusion: The incidence of adrenal insufficiency may be underestimated in patients with multiple metastasis. Appropriate therapy with adrenal corticosteroid hormone supplementation may lead to a significant improvement in the patient’s symptoms and quality of life.

  7. Adrenal failure due to bilateral adrenal metastasis of rectal cancer: A case report.

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    Imaoka, Yuki; Kuranishi, Fumito; Ogawa, Yoshiteru; Okuda, Hiroshi; Nakahara, Masahiro

    2017-01-01

    It is rare for a patient to present with adrenal insufficiency secondary to bilateral adrenal metastases from a malignant colorectal tumor. An 82-year-old Japanese man presented to our hospital with high fever and malaise. He was receiving oral chemotherapy for the treatment of rectal cancer with multiple metastases. Computed tomography showed new bilateral adrenal gland metastases. A rapid adrenocorticotropic hormone (ACTH) test showed adrenal insufficiency. Treatment with hydrocortisone provided immediate symptom improvement. Adrenal insufficiency secondary to bilateral adrenal metastases from rectal cancer is rare. A rapid ACTH test is useful to diagnose adrenal insufficiency. The incidence of adrenal insufficiency may be underestimated in patients with multiple metastasis. Appropriate therapy with adrenal corticosteroid hormone supplementation may lead to a significant improvement in the patient's symptoms and quality of life. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  8. Alveolar Soft Part Sarcoma Presenting as Hypervascular Adrenal Metastasis

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    Goroshi, Manjunath; Lila, Anurag R.; Bandgar, Tushar; Shah, Nalini S.

    2018-01-01

    Hypervascular adrenal masses include pheochromocytoma, metastases caused by clear renal cell carcinoma/hepatocellular carcinoma. Alveolar soft part sarcoma (ASPS) causing hypervascular metastases is not described in the literature. Here, we describe the first case of ASPS presenting as hypervascular metastasis. Our case was a 23-year-old male incidentally detected right adrenal mass during the evaluation of pain in the abdomen. On computed tomography (CT), adrenal mass showed bright enhanceme...

  9. SOLITARY SPLENIC METASTASIS OF COLON CANCER: A CASE REPORT

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    Sh. Hashemzadeh M. Safari

    2004-11-01

    Full Text Available Although splenic metastasis is fairly common in disseminated cancer, solitary splenic metastasis in the absence of diffuse dissemination is rare. We report a case of 44 year-old man who developed isolated splenic metastasis of colon cancer. The patient had undergone right sided hemicolectomy for colon cancer in 1988. In 2001, he underwent reoperation because of local recurrence of tumor in the anastomotic site. The patient was admitted to our hospital on Sep 2003 with abdominal pain. Chest X-ray was normal. Abdominal CT scan showed a large cystic lesion in the spleen. Splenectomy was performed for the patient. The spleen was enlarged, firm and irregular. Histological examination showed metastatic mucinous adenocarcinoma. Based on this case, we recommend that clinicians consider possibility of metastasis in cystic lesions of spleen, especially in patients with a history of a malignant disease.

  10. Alveolar Soft Part Sarcoma Presenting as Hypervascular Adrenal Metastasis

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    Goroshi, Manjunath; Lila, Anurag R.; Bandgar, Tushar; Shah, Nalini S.

    2018-01-01

    Hypervascular adrenal masses include pheochromocytoma, metastases caused by clear renal cell carcinoma/hepatocellular carcinoma. Alveolar soft part sarcoma (ASPS) causing hypervascular metastases is not described in the literature. Here, we describe the first case of ASPS presenting as hypervascular metastasis. Our case was a 23-year-old male incidentally detected right adrenal mass during the evaluation of pain in the abdomen. On computed tomography (CT), adrenal mass showed bright enhancement in early arterial phase (unenhanced Hounsfield unit [HU]-45.3; arterial phase HU-158.2). 18- flurodeoxyglucose positron emission tomography/CT showed multiple lesions and was confirmed histologically to be due to ASPS. PMID:29398970

  11. Solitary Cystic Metastasis Of Thyroid Papillary Carcinoma: Two Cases Reports

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    Ozgur Tarkan

    2011-02-01

    Full Text Available The appearance of a solitary lateral cervical cystic mass as the only initial presenting symptom of occult thyroid carcinoma is uncommon. Its presence is often related with the more frequently branchial cyst in young adults, but also rarely related with thyroid carcinomas. In most of these cases all such lesions may initially be considered as metastatic foci from a primary thyroid lesion. However, an alternative explanation by means of which ectopic thyroid tissue is associated with a branchial cyst has to be considered, especially if no primary tumour is observed in the histological examination of the thyroid gland. We present two case of solitary cystic lymph node metastasis of occult papillary carcinoma of the thyroid. [Cukurova Med J 2011; 36(1.000: 29-33

  12. Solitary Cystic Metastasis Of Thyroid Papillary Carcinoma: Two Cases Reports

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    Ozgur Tarkan

    2011-03-01

    Full Text Available The appearance of a solitary lateral cervical cystic mass as the only initial presenting symptom of occult thyroid carcinoma is uncommon. Its presence is often related with the more frequently branchial cyst in young adults, but also rarely related with thyroid carcinomas. In most of these cases all such lesions may initially be considered as metastatic foci from a primary thyroid lesion. However, an alternative explanation by means of which ectopic thyroid tissue is associated with a branchial cyst has to be considered, especially if no primary tumour is observed in the histological examination of the thyroid gland. We present two case of solitary cystic lymph node metastasis of occult papillary carcinoma of the thyroid. [Cukurova Med J 2011; 36(1: 29-33

  13. Burned-out seminoma revealed by solitary rib bone metastasis

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    Nishisho, Toshihiko; Miyagi, Ryo; Sairyo, Koichi [Tokushima University Graduate School, Department of Orthopedics, Institute of Biomedical Sciences, Tokushima-city, Tokushima (Japan); Sakaki, Mika [Saitama Medical University International Medical Center, Department of Pathology, Hidaka-city, Saitama (Japan); Takao, Shoichiro [Tokushima University Graduate School, Department of Radiology, Institute of Biomedical Sciences, Tokushima-city, Tokushima (Japan)

    2017-10-15

    Burned-out tumor is a rare phenomenon in which a testicular tumor regresses in the primary lesion and progresses in a metastatic lesion. We report the case of a 30-year-old male with burned-out seminoma revealed by open biopsy of solitary 10th rib bone metastasis. He underwent inguinal orchiectomy, which revealed hyalinization, indicating a spontaneously regressed testicular tumor. Chemotherapy for seminoma was administered in three cycles of bleomycin + etoposide + cisplatin therapy. The chemotherapy was effective, and wide resection of the rib was subsequently performed. No postoperative chemotherapy was performed, and there has been no evidence of recurrence for 3 years postoperatively. (orig.)

  14. Splenectomy for solitary splenic metastasis of ovarian cancer

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    Koh, Yang Seok; Kim, Jung Chul; Cho, Chol Kyoon

    2004-01-01

    Splenic metastases occur in rare cases with a few case reports of patients in the literature. Generally, splenic metastases mean late dissemination of a disease. Solitary splenic metastases from solid tumors are extremely unusual. We report a case of a patient with ovarian mucinous cystadenocarcinoma who underwent splenectomy for isolated parenchymal metastasis. Ovarian epithelial tumors comprised most of isolated splenic metastases from gynecologic tumor. When isolated splenic recurrence is suspected on image studies and serum tumor markers, intraabdominal gross findings should be examined to exclude peritoneal carcinomatosis. If only spleen was under suspicion of recurrence of ovarian cancer, splenectomy may play a therapeutic role

  15. Clinical outcome for patients of solitary bone only metastasis.

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    Hosaka, Seiichi; Katagiri, Hirohisa; Honda, Yosuke; Wasa, Junji; Murata, Hideki; Takahashi, Mitsuru

    2016-03-01

    Solitary bone only metastasis (SBOM) is a rare condition in which metastasis is limited to a single skeletal lesion originating from a previously treated or controllable primary lesion. The study objective was to evaluate the clinical features and survival regarding this rare condition and to clarify its treatment strategy. A total of 1453 patients with bone metastasis registered in our hospital database were enrolled. To assess the primary and/or metastatic lesion we used plain X-ray images, CT, MRI and FDG-PET scans as well as bone scans. Among the patients, only 27 (1.8%) had SBOM. The primary cancers responsible for SBOM were lung in seven patients, breast in five, kidney in four, prostate in two, uterus in two and other types in seven. Treatment of SBOM involved resection in four patients, radiotherapy only in 17, radiotherapy in combination with zoledronate in six and chemotherapy with zoledronate in one. Local recurrence did not develop in the four cases treated with resection. However, in-field recurrence was found in 4 of 22 (18%) patients who underwent radiotherapy. All three patients who received >40 Gy did not develop in-field recurrence. The overall and event free survival rates at 5 years were 63% and 41%, respectively. Solitary bone only metastasis should be treated with wide resection or long-course radiotherapy at doses 40-50 Gy to achieve long lasting local tumor control. Copyright © 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  16. Metachronous Bilateral Isolated Adrenal Metastasis from Rectal Adenocarcinoma: A Case Report

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    H. Jabir

    2014-01-01

    Full Text Available We report a case of adrenal metastasis from colorectal cancer in a 54-year-old woman. Nine months after resection for advanced rectal carcinoma, a computed tomography scan revealed bilateral adrenal metastasis. The level of serum carcinoembryonic antigen was normal. A bilateral adrenalectomy was performed after chemotherapy. Histopathological examination showed adenocarcinoma, compatible with metastasis from the rectal cancer. Adrenal metastasis should be considered in the patients’ follow-up for colorectal cancer.

  17. Surgical resection of solitary distant metastasis from locoregionally controlled advanced hypopharyngeal malignancy: A ray of hope

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    Chelakkot G Prameela

    2018-01-01

    Full Text Available Head and neck malignancies have always been challenging for the clinician, both with regards to locoregional control and distant metastasis. Aggressive approaches translate to an acceptable locoregional control, but distant failures pose a dilemma. Newer, sophisticated, imaging modalities have helped in early diagnosis of solitary metastasis, and in turn have opened up an array of interventional procedures, which to some extent improve the disease-free survival and quality of life, as was seen in the present case of locoregionally controlled advanced hypopharyngeal malignancy who presented with solitary distant metastasis. Still, diligent care needs to be taken not to aggravate the scenario with these interventions.

  18. Chronological study for solitary bone metastasis in the sternum from breast cancer with bone scintigraphy

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    Miyoshi, Hidenao; Otsuka, Nobuaki; Sone, Teruki; Nagai, Kiyohisa; Tamada, Tsutomu; Mimura, Hiroaki; Yanagimoto, Shinichi; Tomomitsu, Tatsushi; Fukunaga, Masao

    1999-01-01

    Since breast cancer is frequently associated with bone metastasis, bone scintigraphies have been performed to determine pre-operative staging and to survey postoperative bone metastasis. The sternum, in particular, is a site at which is difficult to differentiate between benign bone disease and bone metastasis, because of varied uptake and wide individual variations. In this study, chronological bone images were scintigraphied in six cases with solitary sternal metastasis and three cases with benign bone disease including two fracture cases and one arthritis case. On bone scintigrams in which solitary sternal metastasis appeared, increased uptake was found in five cases, and photon deficiency was observed in one case. During follow-up scintigraphies, abnormal accumulations, such as hot spots and cold lesions, increased in the bone metastasis while abnormal uptake disappeared or was unchanged in the benign bone disease cases. On CT, four cases showed osteolytic change, and one exhibited osteosclerotic change. These findings indicate that sternal metastasis usually shows osteolytic change, even if a hot lesion is recognized on bone scintigraphy. In solitary sternal metastasis, for which early diagnosis is difficult, both an integrated diagnosis using other imaging techniques and chronological bone scintigraphy are important. (author)

  19. Solitary metastasis of ampullary carcinoma to the spleen: a case report.

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    Phan, Tri M

    2018-04-01

    Here, we report a first case of ampullary cancer with solitary metastasis of the spleen, which was successfully treated with pancreatoduodenectomy and splenectomy and was discharged 7 days after the operation with outpatient chemotherapy. In such cases, physicians should consider splenectomy as an effective treatment option.

  20. Solitary necrotic nodules of the liver mimicking hepatic metastasis: report of two cases

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    Yoon, Kwon Ha; Yun, Ki Jung; Lee, Jung Min [Wonkwang University School of Medicine, Iksan (Korea, Republic of); Kim, Chang Guhn [Chunbuk National University Medical School, Cheongju (Korea, Republic of)

    2000-09-01

    We present two cases of solitary necrotic nodules of the liver which on radiologic images mimicked hepatic metastasis. Solitary necrotic nodule of the liver is a rare but benign entity which histopathologically consists of an outer fibrotic capsule with inflammatory cells and a central core of amorphous necrotic material. The lesion was seen on contrast-enhanced CT as an ovoid-shaped hypoattenuating nodule; on CT during hepatic arteriography as enhancing nodule; on intraoperative US as a target-appearing hypoechoic nodule; on T2WI as a hyperintensity nodule, and on dynamic MR as a subtle peripheral enhancing nodule. Although the radiologic features are not specific, solitary necrotic nodule of the liver should be included in the differential diagnosis of hepatic metastasis.

  1. Metachronous solitary splenic metastasis arising from early gastric cancer: a case report and literature review.

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    Namikawa, Tsutomu; Kawanishi, Yasuhiro; Fujisawa, Kazune; Munekage, Eri; Munekage, Masaya; Sugase, Takahito; Maeda, Hiromichi; Kitagawa, Hiroyuki; Kumon, Tatsuya; Hiroi, Makoto; Kobayashi, Michiya; Hanazaki, Kazuhiro

    2017-08-29

    The metastasis of malignant tumors to the spleen is rare, and only a small percentage of cases can be treated surgically, as splenic metastases generally occur in the context of multivisceral metastatic cancer at a terminal stage. We report a rare case of metachronous solitary splenic metastasis arising from early gastric cancer. A 75-year-old man was initially referred to our hospital for examination of gastric cancer, diagnosed at a medical check-up. Esophagogastroduodenoscopy showed a slightly elevated lesion with a central irregular depression in the upper-third of the stomach. Biopsy specimens of the lesion showed a moderately-differentiated adenocarcinoma, and abdominal computed tomography showed no evidence of distant metastases. Endoscopic submucosal dissection was performed, with histological confirmation of a moderately-differentiated adenocarcinoma invading the submucosal layer. The patient subsequently underwent laparoscopic total gastrectomy with regional lymph node dissection, resulting in no residual carcinoma and no lymph node metastasis. Computed tomography, 28 months later, showed a well-defined mass measuring 4.2 cm in diameter in the spleen, and the patient underwent a splenectomy, since there was no evidence of further metastatic lesions in any other organs. Histological examination confirmed the diagnosis of a poorly-differentiated adenocarcinoma originating from the previous gastric cancer. The patient was alive 2 months after surgical resection of the splenic metastasis without any recurrence. To the best of our knowledge, this is only the second case of a solitary splenic metastasis from early gastric cancer to be reported in the English literature. The present case suggests surgical resection may be the preferred treatment of choice for patients with a solitary splenic metastasis from gastric cancer.

  2. Malignant Solitary Fibrous Tumor Metastatic to Widely Invasive Hurthle Cell Thyroid Carcinoma: A Distinct Tumor-to-Tumor Metastasis.

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    Kolson Kokohaare, Eva; Riva, Francesco M G; Bernstein, Jonathan M; Miah, Aisha B; Thway, Khin

    2018-04-01

    We illustrate a case of synchronous malignant solitary fibrous tumor of the thoracic cavity, and widely invasive thyroid Hurthle cell carcinoma. The Hurthle cell carcinoma was found to harbor distinct areas of malignant solitary fibrous tumor. This is a unique case of tumor-to-tumor metastasis that, to the best of our knowledge, has not been previously reported.

  3. Solitary bone metastasis to the tibia from colorectal cancer- A case report

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    Abdulsalam Alnajjar

    2014-12-01

    Full Text Available The onset of osseous metastases during the course of colorectal cancer is not common. Although rare, they usually appear in the axial skeleton. In our report, we refer to the case of a 48-year-old patient who presented with colon cancer and eventually developed a solitary bone metastasis in the upper end of left tibia. At the time of diagnosis and staging investigations, the patient had only a primary disease.------------------------------------------------Cite this article as:Alnajjar A, Mohanty AK. Solitary bone metastasis to the tibia from colorectal cancer- A case report. Int J Cancer Ther Oncol 2014; 2(4:02045. DOI: 10.14319/ijcto.0204.5

  4. Long-term survival in bronchogenic carcinoma with a solitary metastasis.

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    Shachor, J; Luria, H; Cordova, M; Bernheim, J; Griffel, B; Bruderman, I

    1986-03-01

    Partial resection of a huge anaplastic large cell carcinoma of the upper lobe of the right lung was performed in a 47-year-old patient in order to relieve symptoms of pulmonary hypertrophic osteoarthropathy. Several months later a solitary metastasis was noted in the muscles of the right forearm. The metastasis was resected and the forearm irradiated. The patient was further treated with injections of autologous tumour cell vaccine and BCG. Today, 7 years later, the patient is alive, without any signs of neoplastic disease.

  5. Evaluation of solitary pulmonary metastasis of extrathoracic tumor with thin-slice computed tomography

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    Shiotani, Seiji; Yamada, Kouzo; Oshita, Fumihiro; Nomura, Ikuo; Noda, Kazumasa; Yamagata, Tatushi; Tajiri, Michihiko; Ishibashi, Makoto; Kameda, Youichi [Kanagawa Cancer Center, Yokohama (Japan)

    1995-10-01

    Thin-slice computed tomography (CT) images were compared with pathological findings in 9 specimens of solitary pulmonary nodules, which had been pathologically diagnosed as pulmonary metastasis of extrathoracic tumor. The thin-slice CT images were 2 mm-thick images reconstructed using a TCT-900S, HELIX (Toshiba, Tokyo) and examined at two different window and level settings. In every case, the surgical specimens were sliced transversely to correlate with the CT images. According to the image findings, the internal structure was of the solid-density type in every case, and the margin showed spiculation in 22%, notching in 67% and pleural indentation in 89%. Regarding the relationship between the pulmonary vessels and tumors, plural vascular involvement was revealed in every case. Thus, it was difficult to distinguish solitary pulmonary metastasis of extrathoracic tumor from primary lung cancer based on the thin-slice CT images. For some solitary pulmonary metastasis of extrathoracic tumor, a comprehensive diagnostic approach taking both the anamnesis and pathological findings into consideration was required. (author).

  6. Evaluation of solitary rib lesions in CA. breast patients for development of skeletal metastasis

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    Fatima, A.; Fatima, S.; Khursheed, K.; Jafri, S.; Asghar, S.

    2004-01-01

    Determination of nature of single or double rib lesion on a bone scan is important but very difficult. In case of breast carcinoma rib lesion have particular importance, as they are one of the most common sites of metastasis. On the contrary surgical trauma and radiotherapy can induce metabolic changes, which can lead to rib lesions of benign etiology. As it is known that breast carcinoma patients having skeletal metastasis have worse prognosis so it is particularly important to differentiate between malignant and benign rib lesions. In this study etiology of rib lesions detected on bone scan was analyzed retrospectively patients. Study population consisted of breast cancer patients having solitary rib lesions on baseline or follow-up bone scan were included in the study. The etiology of solitary rib involvement was established using all the clinical, radiological and biochemical data available. The clinical and serial scintigraphic data were collected and analyzed for correlation in forty-two patients. Patients were followed up for at least two subsequent bone scans. Out of total study population nine patients (21.42%) developed skeletal metastasis on follow-up. Rest of the study population is disease free till last follow-up. All these patients developed metastasis within two years of appearance of the rib lesions. Correlation between sites of initial rib lesion, uptake pattern, size of tumor, mode of primary therapy, age of involvement, interval from initial therapy, biochemical and radiological findings was done. Correlation was seen between sites of uptake, uptake pattern, mode of primary therapy and biochemical findings with subsequent outcome of the patient. It is concluded from our study that solitary rib lesion have low incidence of malignancy if other risk factors are absent. (authors)

  7. Benign adrenal hypertrophy versus metastasis: value of MRI

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    Senac, J.P.; Aubas, P.; Mary, H.

    1987-01-01

    On the basis of a case report, the authors stress the value of MRI in the assessment of an adrenal mass discovered on CT in patients with a lung cancer. The presence of a hypersignal on the weighted T2 sequences is observed more frequently in the case of metastases, while a signal, iso-intense with the liver and the muscles, is generally observed with adenomas. This approach may allow a reduction in the indications for adrenal aspiration biopsy in the context of the pre-operative staging of these patients [fr

  8. Benign adrenal hypertrophy versus metastasis: value of MRI

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    Hercot, O.; Giron, J.; Serres-Cousine, O.

    1988-01-01

    On the basis of a case report, the authors stress the value of MRI in the assessment of an adrenal mass discovered on CT in patients with lung cancer. The presence of a hypersignal on the weighted T2 sequences is observed more frequently in the case of metastases, while a signal, iso-intense with the liver and the muscles, is generally observed with adenomas. This approach may allow a reduction in the indications for adrenal aspiration biopsy in the context of the pre-operative staging of these patients [fr

  9. Solitary thyroid metastasis from colon cancer: fine-needle aspiration cytology and molecular biology approach.

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    Onorati, M; Uboldi, P; Bianchi, C L; Nicola, M; Corradini, G M; Veronese, S; Fascì, A I; Di Nuovo, F

    2015-01-01

    Thyroid gland is one of the most vascularized organs of the body, nevertheless clinical and surgical series report an incidence of secondary malignancies in this gland of only 3%. Colorectal carcinoma metastatic to the thyroid gland is not as uncommon as previously believed, infact the number of cases seems to be increased in recent years due to the more frequent use of fine-needle aspiration cytology (FNAC) guided by ultrasonography. Although kidney, breast and lung metastases to the thyroid are frequent, metastasis from colon cancer is clinically rare with 52 cases reported in the literature in the last 5 decades and three cases described as solitary thyroid metastasis from the colon cancer without any other visceral metastases. To the best of our knowledge, we report the fourth case of solitary, asymptomatic thyroid metastasis from colon cancer without involvement of other organs. We discuss the importance of FNAC to detect metastatazing process as a compulsory step of the diagnostic and therapeutic management algorithm, combined with a molecular biology approach. A review of the last 5 decades literature, to update the number of cases described to date, is also included.

  10. Late solitary pelvic metastasis of hepatocellular carcinoma mimicking alpha-fetoprotein-producing gynaecologic tumour

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    Ji He Kim

    2018-01-01

    Full Text Available Extrahepatic spread of hepatocellular carcinoma (HCC is uncommon; and, pelvic metastasis, in particular, is extremely rare. A 71-year-old woman was admitted for evaluation of pelvic solitary solid mass. She had undergone a left lobectomy 28 years previously. Magnetic resonance imaging of the abdomen and pelvis demonstrated a heterogeneous mass in the right pelvic cavity, whereas no space-occupying lesions or ascites were detected in the liver. CA 125 levels were within normal limits; however, serum alpha-fetoprotein levels were markedly elevated. She underwent laparoscopic pelvic mass excision, total hysterectomy, and bilateral salpingo-oophorectomy. Histopathologic findings and immunochemical staining results indicated metastatic HCC. Herein, we report an unusual case of a patient with solitary recurrence in the pelvic cavity 28 years after initial diagnosis and treatment.

  11. Balint′s Syndrome As a Manifestation of Solitary Right Occipital Lobe Metastasis

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    Sarat Chandra P

    1998-01-01

    Full Text Available Balint′s syndrome is a rare clinical condition characterized by a triad of occulomotor apraxia (psychic paralysis of gaze, optic ataxia and visual inattention and usually follows bilateral parieto-occipital lesions. We report this syndrome occurring in a patient with a solitary metastasis in right occipital lobe. To the best of our knowledge it has not been previously described in English literature. Pressure over the opposite occipital lobe due to mass effect, diaschisis and extension of edema along the corpus callosum involvement may contribute to this exceptional phenomenon.

  12. Solitary brain metastasis as an initial manifestation of gall bladder carcinoma

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    Kamlesh Kumar Harsh

    2015-01-01

    Full Text Available Gallbladder cancer is a common malignancy in Northern India, and it accounts for 2-4% of all malignant gastrointestinal tumors. It is an aggressive tumor with early dissemination to liver and lymph nodes and associated with poor prognosis. Systemic metastases from gall bladder carcinoma (Ca frequently occur; however, metastatic involvement of the central nervous system is rare and late manifestation and remains an ominous sign. Initial presentation of gall bladder Ca with brain metastasis is rare. We report a case of 65-year-old women who initially presented with a solitary brain metastasis from an adenocarcinoma of the gallbladder, which was diagnosed incidentally when the patient presented with headache, vomiting, and right temporal region swelling. Palliative chemotherapy and cranial radiotherapy were prescribed. She is symptom-free from 3 months after the completion of the treatment.

  13. Cholangiocarcinoma presenting as a solitary epididymal metastasis: a case report and review of the literature

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    Bailey David M

    2007-08-01

    Full Text Available Abstract Background Solid tumor metastasis to the epididymis is a rare occurrence and is mostly discovered incidentally at autopsy or after therapeutic orchidectomy for prostate cancer. Other primary carcinomas that have been demonstrated to metastasize to the paratesticular region include those originating in the stomach, kidney, ileum, and colon. Case presentation A 72-year-old gentleman presented with a firm and tender mass involving the right epididymis. On examination, he was jaundiced. Computed tomography of the abdomen demonstrated an obstructive stricture of the extra-hepatic bile ducts, in keeping with a cholangiocarcinoma, through which a metal stent was endoscopically inserted for symptomatic relief. Subsequent right radical orchidectomy yielded a diffusely infiltrative adenocarcinoma obliterating the epididymis, extending into the rete testis, vas deferens and spermatic cord and showing widespread vascular and perineural invasion. Residual epididymal, rete, and testicular tubules showed no in situ neoplasia. Morphologically and immunohistochemically the features were in keeping with a metastasis from a primary cholangiocarcinoma. Conclusion Only two cases of bile duct carcinoma metastasising to the male genital tract have previously been reported in the literature, the testis being the main site of metastasis in both cases. To our knowledge, this is the first described case of cholangiocarcinoma metastasising primarily to the epididymis, and presenting as a solitary epididymal metastasis in the absence of disseminated disease. It serves to highlight the importance of performing a thorough examination of the male external genitalia both clinically, in the follow up of cancer patients, and at autopsy.

  14. Unilateral solitary choroid metastasis from breast cancer: Rewarding results of external radiotherapy

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    Nirmala S

    2008-01-01

    Full Text Available Intraocular metastatic tumor is the commonest intraocular malignancy in adults, with uveal tract the commonest site. In nearly 85% of cases the choroid is the afflicted site due to its vascularity. Breast and lung are the common primaries. In breast primaries, this could be the first metastatic disease. This condition should always be kept in mind in patients with visual symptoms. Fundus examination, ultrasonography and CT/MRI of the orbit help in diagnosis. Early recognition and timely treatment can save the visual function thus imparting good quality of life to the patient. External beam radiotherapy is a good local form of treatment. Hormone therapy in hormone receptor positive tumors can have additional benefits. Here we report a case of unilateral solitary choroid metastasis in a case of breast cancer treated with external beam radiotherapy.

  15. Solitary epidural brain metastasis of Neuroepithelioma (a Primitive Neuroectodermal Tumor: case report

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    Farnaz Farshidfar

    2008-08-01

    Full Text Available A 14 years old male was referred to Computerized tomography scan (CT of our hospital for evaluation of headache. The patient was known case of cervical soft tissue Primitive neuroectodermal tumor (PNET which has undergone surgery and radiotherapy 4 years ago. The CT scan showed large solitary extra axial, epidural lesion in right parietal region, with mass effect and bony involvement. Then surgery was done for him and the resultant biopsy was Neuroepithelioma. After diagnosis the patient has undergone chemotherapy and radiotherapy. He has no signs or symptoms of malignancy, and also follow up CT scan of the brain, chest, and abdomen were normal after two years of surgery. This is the first reported case of epidural metastasis of a head and neck PNET in an adolescent.

  16. Solitary uterine metastasis of invasive lobular carcinoma after adjuvant endocrine therapy: a case report.

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    Toyoshima, Masafumi; Iwahashi, Hideki; Shima, Takashi; Hayasaka, Atsushi; Kudo, Takako; Makino, Hiromitsu; Igeta, Saori; Matsuura, Rui; Ishigaki, Nobuko; Akagi, Kozo; Sakurada, Junko; Suzuki, Hiroyoshi; Yoshinaga, Kosuke

    2015-02-14

    Solitary uterine metastases from extragenital cancers are very rare. Breast cancer is the most frequent primary site of metastasis to the uterine corpus, with invasive lobular carcinoma more likely to spread to gynecologic organs than invasive ductal carcinoma. A 62-year-old postmenopausal Japanese woman was diagnosed with uterine leiomyomata more than 20 years ago and had been managed conservatively until menopause. Seven years prior to her presentation, she was diagnosed with breast cancer and underwent a partial resection of her right breast for stage IIA invasive lobular carcinoma. She underwent adjuvant chemotherapy, radiotherapy, and five years of anastrozole hormonal therapy. She presented with a growing uterine mass. Her tumor marker levels were markedly increased over the course of her follow-up, but a systemic examination revealed only a solitary uterine tumor. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. A histopathological examination, including detailed immunohistochemistry, confirmed metastatic invasive lobular carcinoma, infiltrating both her uterine myometrium and fibroid tissue. We report a very rare metastatic pattern of invasive lobular carcinoma and demonstrate that gross cystic disease fluid protein-15 and mammaglobin are useful in the diagnosis of metastatic breast cancer.

  17. The clinical course and prognosis of patients with renal adenocarcinoma with solitary metastasis

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    Kjaer, M.; Engelholm, S.A.

    1982-01-01

    The present investigation describes a series of 25 patients with solitary metastasis from a renal adenocarcinoma. Forty-eight percent of the patients had metastatic foci in bones, 24% in the lungs, and 28% in a variety of organs. Radiotherapy was the treatment for 64% of the patients, surgery for 36%. Disease control after treatment was obtained in 88% of the patients. The 5-year survival rate was 39%. Sixteen of 25 patients died after a mean survival time of 36 months; 9/25 patients are still living 28-126 months after treatment. Women survived significantly better than men. Patients with normal pre- and post-treatment erythrocyte sedimentation rate (ESR) survived significantly longer than patients with elevated ESR. A definite relationship between ESR and disease activity was demonstrated in 64% of the patients. It is concluded that solitary metastases in bones can be treated with radiotherapy; even if 64% of the patients die there is significant clinical remission to be obtained after aggressive treatment. Furthermore, ESR seems to be an important indicator of prognosis and disease activity

  18. Curative resection by splenectomy for solitary splenic metastasis from early gastric cancer: a case report and literature review.

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    Yoshizawa, Junichi; Kubo, Naoki; Ishizone, Satoshi; Karasawa, Fumitoshi; Nakayama, Ataru

    2017-06-20

    Solitary metastasis of a malignancy to the spleen is rare, particularly for gastric cancer. Only a few case reports have documented isolated splenic metastasis from early gastric cancer. We describe a case of splenic metastasis from early gastric cancer. A 60-year-old man underwent a distal gastrectomy for early gastric cancer. It infiltrated the submucosa with pathological nodal involvement (pT1bN2M0, stage IIB). One year after the gastrectomy, an abdominal computed tomography scan showed a low-density lesion, 17 mm in diameter, at the upper pole of the spleen. Positron emission tomography/computed tomography showed focal accumulation of fluorine-18 fluorodeoxyglucose in the spleen without extrasplenic tumor dissemination or metastasis. We diagnosed splenic metastasis of gastric cancer, and performed a splenectomy. Histological examination confirmed moderately differentiated tubular adenocarcinoma and poorly differentiated adenocarcinoma (solid type) that was consistent with the features of the primary gastric cancer. The splenic tumor was pathologically and immunohistochemically diagnosed as a metastasis from the gastric carcinoma. More than 18 months after the splenectomy, the patient has had no evidence of recurrent gastric cancer. When solitary metastasis to the spleen is suspected during the postoperative follow-up of a patient with gastric cancer, a splenectomy is a potentially effective treatment.

  19. Stereotactic radiosurgery improves the survival in patients with solitary brain metastasis: a reasonable alternative to surgery

    International Nuclear Information System (INIS)

    Kwan, H. Cho; Hall, Walter A.; Lee, Andrew K.; Gerbi, Bruce J.; Higgins, Patrick D.; Nussbaum, Eric S.; Chung, K.K. Lee; Bohen, Marva; Clark, H. Brent

    1996-01-01

    Purpose: To evaluate the efficacy of stereotactic radiosurgery (SRS) in patients with solitary brain metastasis from extracranial primary cancer and to compare the outcome with that of external whole brain irradiation with or without surgical resection. Materials and Methods: Between September 1970 and November, 1995, 231 patients with solitary brain metastasis were treated at the Department of Radiation Oncology, University of Minnesota Hospital. One hundred twenty six patients (56%) were treated with external whole brain irradiation (WBI) only (Group 1), seventy three (32%) underwent surgical resection prior to WBI (Group 2) and thirty two (14%) underwent stereotactic radiosurgery (SRS) with WBI (Group 3). Lung (38%) was the most common site of primary cancer, followed by breast (15%), unknown primary (12%), gastro-intestinal tract (10%), skin (malignant melanoma: 9%), kidney (renal cell carcinoma: 8%) and others (9%). The median dose to the whole brain was 3750 cGy in 15 fractions (ranges from 2000 cGy to 5000 cGy). The median radiosurgical dose of 17.5 Gy (range, 12-40 Gy) was delivered to the 40%-90% isodose line encompassing the target. Eighteen patients were treated with SRS for recurrent or persistent disease following WBI and 14 patients received SRS as a boost in conjunction with WBI. Actuarial survival was calculated from the date of treatment according to the Kaplan-Meier method and statistical significance was assessed with the log-rank test. Results: The actuarial median survivals were 3.8 months for Group 1 (ranges from 1 to 84 months), 10.5 months for Group 2 (ranges from 1 to 125 months) and 9.8 months for Group 3 (ranges from 1 to 36 months). The survivals at one and two years were 19% and 6% for Group 1, 47% and 19% for Group 2, and 44% and 21% for Group 3, respectively. The survival advantage of Groups 2 or 3 over Group 1 was statistically significant (p < 0.0001 by log-rank test). There was no survival advantage of surgery (Group 2) over SRS

  20. Solitary Metastasis to the Facial/Vestibulocochlear Nerve Complex: Case Report and Review of the Literature.

    Science.gov (United States)

    Ariai, M Shafie; Eggers, Scott D; Giannini, Caterina; Driscoll, Colin L W; Link, Michael J

    2015-10-01

    Distant metastasis of mucinous adenocarcinoma from the gastrointestinal tract, ovaries, pancreas, lungs, breast, or urogenital system is a well-described entity. Mucinous adenocarcinomas from different primary sites are histologically identical with gland cells producing a copious amount of mucin. This report describes a very rare solitary metastasis of a mucinous adenocarcinoma of unknown origin to the facial/vestibulocochlear nerve complex in the cerebellopontine angle. A 71-year-old woman presented with several month history of progressive neurological decline and a negative extensive workup performed elsewhere. She presented to our institution with complete left facial weakness, left-sided deafness, gait unsteadiness, headache and anorexia. A repeat magnetic resonance imaging scan of the head revealed a cystic, enhancing abnormality involving the left cerebellopontine angle and internal auditory canal. A left retrosigmoid craniotomy was performed and the lesion was completely resected. The final pathology was a mucinous adenocarcinoma of indeterminate origin. Postoperatively, the patient continued with her preoperative deficits and subsequently died of her systemic disease 6 weeks after discharge. The facial/vestibulocochlear nerve complex is an unusual location for metastatic disease in the central nervous system. Clinicians should consider metastatic tumor as the possible etiology of an unusual appearing mass in this location causing profound neurological deficits. The prognosis after metastatic mucinous adenocarcinoma to the cranial nerves in the cerebellopontine angle may be poor. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Metachronous adrenal metastasis from operated contralateral renal cell carcinoma with adrenalectomy and iatrogenic Addison's disease.

    Science.gov (United States)

    Ozturk, Hakan; Karaaslan, Serap

    2014-09-01

    Metachronous adrenal metastasis from contralateral renal cell carcinoma (RCC) surgery is an extremely rare condition. Iatrogenic Addison's disease occurring after metastasectomy (adrenalectomy) is an even rarer clinical entity. We present a case of a 68-year-old male with hematuria and left flank pain 9 years prior. The patient underwent left transperitoneal radical nephrectomy involving the ipsilateral adrenal glands due to a centrally-located, 75-mm in diameter solid mass lesion in the upper pole of the left kidney. The tumour lesion was confined within the renal capsule, and the histo-pathological examination revealed a Fuhrman nuclear grade II clear cell carcinoma. The patient underwent transperitoneal right adrenalectomy. The histopathological examination revealed metastasis of clear cell carcinoma. The patient was diagnosed with iatrogenic Addison's disease based on the measurement of serum cortisol levels and the adrenocorticotropic hormone (ACTH) stimulation test, after which glucocorticoid and mineralocorticoid replacement was initiated. The patient did not have local recurrence or new metastasis in the first year of the follow-up. The decision to perform ipsilateral adrenalectomy during radical nephrectomy constitutes a challenge, and the operating surgeon must consider all these rare factors.

  2. Frameless stereotactic radiosurgery of a solitary liver metastasis using active breathing control and stereotactic ultrasound

    International Nuclear Information System (INIS)

    Boda-Heggemann, J.; Walter, C.; Mai, S.; Dobler, B.; Wenz, F.; Lohr, F.; Dinter, D.

    2006-01-01

    Background and purpose: radiosurgery of liver metastases is effective but a technical challenge due to respiration-induced movement. The authors report on the initial experience of the combination of active breathing control (ABC registered ) with stereotactic ultrasound (B-mode acquisition and targeting [BAT registered ]) for frameless radiosurgery. Patient and methods: a patient with a solitary, inoperable liver metastasis from cholangiocellular carcinoma is presented. ABC registered was used for tumor/liver immobilization. Tumor/liver position was controlled and corrected using ultrasound (BAT registered ). The tumor was irradiated with a single dose of 24 Gy. Results: using ABC registered , the motion of the tumor was significantly reduced and the overall positioning error was registered allowed a rapid localization of the lesion during breath hold which could be performed without difficulties for 20 s. Overall treatment time was acceptable (30 min). Conclusion: frameless stereotactic radiotherapy with the combination of ABC registered and BAT registered allows the delivery of high single doses to targets accessible to ultrasound with high precision comparable to a frame-based approach. (orig.)

  3. Analysis of prognostic factors after resection of solitary liver metastasis in colorectal cancer: a 22-year bicentre study.

    Science.gov (United States)

    Acciuffi, Sara; Meyer, Frank; Bauschke, Astrid; Settmacher, Utz; Lippert, Hans; Croner, Roland; Altendorf-Hofmann, Annelore

    2018-03-01

    The investigation of the predictors of outcome after hepatic resection for solitary colorectal liver metastasis. We recruited 350 patients with solitary colorectal liver metastasis at the University Hospitals of Jena and Magdeburg, who underwent curative liver resection between 1993 and 2014. All patients had follow-up until death or till summer 2016. The follow-up data concern 96.6% of observed patients. The 5- and 10-year overall survival rates were 47 and 28%, respectively. The 5- and 10-year disease-free survival rates were 30 and 20%, respectively. The analysis of the prognostic factors revealed that the pT category of primary tumour, size and grade of the metastasis and extension of the liver resection had no statistically significant impact on survival and recurrence rates. In multivariate analysis, age, status of lymph node metastasis at the primary tumour, location of primary tumour, time of appearance of the metastasis, the use of preoperative chemotherapy and the presence of extrahepatic tumour proved to be independent statistically significant predictors for the prognosis. Moreover, patients with rectal cancer had a lower intrahepatic recurrence rate, but a higher extrahepatic recurrence rate. The long-term follow-up of patients with R0-resected liver metastasis is multifactorially influenced. Age and comorbidity have a role only in the overall survival. More than three lymph node metastasis reduced both the overall and disease-free survival. Extrahepatic tumour had a negative influence on the extrahepatic recurrence and on the overall survival. Neither overall survival nor recurrence rates was improved using neoadjuvant chemotherapy.

  4. Renal malignant solitary fibrous tumor with single lymph node involvement: report of unusual metastasis and review of the literature

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    Mearini E

    2014-05-01

    Full Text Available Ettore Mearini,1 Giovanni Cochetti,1 Francesco Barillaro,1 Sonia Fatigoni,2 Fausto Roila2 1Department of Medical-Surgical Specialties and Public Health, Division of Urological Andrological Surgery and Minimally Invasive Techniques, University of Perugia, Terni, Italy; 2Medical Oncology, S Maria Hospital, Terni, Italy Abstract: Solitary fibrous tumors are rare mesenchymal spindle cell neoplasms that are usually found in the pleura. The kidneys are an uncommon site and only few cases of renal solitary fibrous tumor exhibit malignant behavior metastasizing to the liver, lung, and bone through the hematogenous pathway. Purpose: To describe the first case of lymph node metastasis from renal solitary fibrous tumor in order to increase the knowledge about the malignant behavior of these tumors. Patients and methods: A 19-year-old female patient had intermittent hematuria for several months without flank pain or other symptoms. A chest and abdomen CT scan was performed and showed a multi-lobed bulky solid mass of 170 × 98 × 120 mm in the left kidney. One day before the surgery, the left renal artery was catheterized and the kidney embolization was performed using a Haemostatic Absorbable Gelatin Sponge and polyvinyl alcohol. We then performed a radical nephrectomy with hilar, para-aortic, and inter-aortocaval lymphadenectomy. Results: Estimated intraoperative blood loss was 200 mL and the operative time was 100 minutes. No postoperative complications occurred. The hospital stay was 7 days long. The histological examination was malignant solitary fibrous tumor of the kidney. Cancerous tissue showed cellular atypia, with an increased mitotic index (up to 7 × 10 hpf. Immunohistochemical analysis showed positive results for CD34, BCL2, partial expression of HBME1, and occasionally of synaptophysin. Histological evaluation confirmed the presence of metastasis in one hilar node. The patient did not receive any other therapy. At 30-month follow-up, the

  5. Radiotherapy for Adrenal Metastasis from Hepatocellular Carcinoma: A Multi-Institutional Retrospective Study (KROG 13-05.

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    Jinhong Jung

    Full Text Available Although the adrenal glands are not common sites of metastasis from hepatocellular carcinoma (HCC, this metastasis can be met in patients with advanced HCC in some clinical settings. However, the effectiveness of radiotherapy against such metastases is unclear. Therefore, we performed the present multi-institutional study to investigate tumor response, overall survival (OS, treatment-related toxicity, and prognostic factors after radiotherapy. We retrospectively reviewed 134 patients who completed a planned radiotherapy for their adrenal metastases. Complete response was noted in 6 (4.3%, partial response in 48 (34.0%, and stable disease in 78 patients (55.3%. The median OS was 12.8 months, and the 1-, 2-, and 5-year OS rates were 53.1%, 23.9%, and 9.3%, respectively. Grade 3 anorexia occurred in 2 patients, grade 3 diarrhea in 1, and grade 3 fatigue in 1. Multivariate analyses revealed that the following factors had significant effects on OS: controlled intrahepatic tumor; controlled extrahepatic metastasis; and Child-Pugh class A. Although patients with adrenal metastasis from HCC had poor OS, radiotherapy provided an objective response rate of 38.3% and disease stability of 93.6%, with minimal adverse events. Therefore, radiotherapy for these patients could represent a good treatment modality, especially for patients with controlled intrahepatic tumors, controlled extrahepatic metastasis, and good hepatic function.

  6. Solitary Skull Metastasis as the First Presentation of a Metachronous Primary Lung Cancer in a Survivor from Pancreatic Cancer

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    Ali Altalhy

    2017-01-01

    Full Text Available Skull metastasis from lung cancer is relatively common, yet the first presentation for this malignant disease is a rare occurrence. We herein report a case of a 54-year-old female, who had a good outcome following Whipple procedure for periampullary adenocarcinoma five years before her current presentation. During a routine follow-up, she was found to have a slowly progressive painless right parietal swelling. The systemic screening workup revealed no abdominal disease, but a solitary pulmonary nodule was identified. The presence of these two lesions raised the diagnosis of metastases from a previously treated pancreatic adenocarcinoma. The patient underwent complete excision of the skull lesion and subsequent lung biopsy, both of which proved on histopathological examination to be consistent with a primary lung cancer. This case emphasizes the importance of imaging and histopathological correlation in the diagnosis of solitary skull metastases and their effect on the subsequent management.

  7. Long-Term Results of Radiochemotherapy for Solitary Lymph Node Metastasis After Curative Resection of Esophageal Cancer

    International Nuclear Information System (INIS)

    Jingu, Keiichi; Ariga, Hisanori; Nemoto, Kenji; Narazaki, Kakutaro; Umezawa, Rei; Takeda, Ken; Koto, Masashi; Sugawara, Toshiyuki; Kubozono, Masaki; Miyata, Go; Onodera, Ko; Yamada, Shogo

    2012-01-01

    Purpose: To evaluate the long-term efficacy and toxicity of definitive radiochemotherapy for solitary lymph node metastasis after curative surgery of esophageal cancer. Methods and Materials: We performed a retrospective review of 35 patients who underwent definitive radiochemotherapy at Tohoku University Hospital between 2000 and 2009 for solitary lymph node metastasis after curative esophagectomy with lymph node dissection for esophageal cancer. Radiotherapy doses ranged from 60 to 66 Gy (median, 60 Gy). Concurrent chemotherapy was platinum based in all patients. The endpoints of the present study were overall survival, cause-specific survival, progression-free survival, irradiated-field control, overall tumor response, and prognostic factors. Results: The median observation period for survivors was 70.0 months. The 5-year overall survival was 39.2% (median survival, 39.0 months). The 5-year cause-specific survival, progression-free survival, and irradiated-field control were 43.3%, 31.0% and 59.9%, respectively. Metastatic lesion, size of the metastatic lymph node, and performance status before radiochemotherapy were significantly correlated with prognosis. Complete response and partial response were observed in 22.9% and 57.1% of the patients, respectively. There was no Grade 3 or higher adverse effect based on theCommon Terminology Criteria for Adverse Events (CTCAE v3.0) in the late phase. Conclusions: Based on our study findings, approximately 40% of patients with solitary lymph node metastasis after curative resection for esophageal cancer have a chance of long-term survival with definitive radiochemotherapy.

  8. Usefulness of F-18 FDG PET/CT in Adrenal Incidentaloma: Differential Diagnosis of Adrenal Metastasis in Oncologic Patients

    International Nuclear Information System (INIS)

    Lee, Hong Je; Song, Bong Il; Kang, Sung Min; Jeong, Shin Young; Seo, Ji Hyoung; Lee, Sang Woo; Yoo, Jeong Soo; Ahn, Byeong Cheol; Lee, Jae Tae

    2009-01-01

    We have evaluated characteristics of adrenal masses incidentally observed in nonenhanced F-18 FDG PET/CT of the oncologic patients and the diagnostic ability of F-18 FDG PET/CT to differentiate malignant from benign adrenal masses. Between Mar 2005 and Aug 2008, 75 oncologic patients (46 men, 29 women; mean age, 60.8±10.2 years; range, 35-87 years) with 89 adrenal masses incidentally found in PET/CT were enrolled in this study. For quantitative analysis, size (cm), Hounsfield unit (HU), maximum standardized uptake value (SUVmax), SUVratio of all 89 adrenal masses were measured. SUVmax of the adrenal mass divided by SUVliver, which is SUVmax of the segment 8, was defined as SUVratio. The final diagnosis of adrenal masses was based on pathologic confirmation, radiologic evaluation (HU<0 : benign), and clinical decision. Size, HU, SUVmax, and SUVratio were all significantly different between benign and malignant adrenal masses.(P < 0.05) And, SUVratio was the most accurate parameter. A cut-off value of 1.0 for SUVratio provided 90.9% sensitivity and 75.6% specificity. In small adrenal masses (1.5 cm or less), only SUVratio had statistically significant difference between benign and malignant adrenal masses. Similarly a cut-off value of 1.0 for SUVratio provided 80.0% sensitivity and 86.4% specificity. F-18 FDG PET/CT can offer more accurate information with quantitative analysis in differentiating malignant from benign adrenal masses incidentally observed in oncologic patients, compared to nonenhanced CT

  9. Differentiation of solitary brain metastasis from glioblastoma multiforme: a predictive multiparametric approach using combined MR diffusion and perfusion

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    Bauer, Adam Herman; Moser, Franklin G.; Maya, Marcel [Cedars-Sinai Medical Center, Department of Medical Imaging, Los Angeles, CA (United States); Erly, William; Nael, Kambiz [University of Arizona Medical Center, Department of Medical Imaging, Tucson, AZ (United States)

    2015-07-15

    Solitary brain metastasis (MET) and glioblastoma multiforme (GBM) can appear similar on conventional MRI. The purpose of this study was to identify magnetic resonance (MR) perfusion and diffusion-weighted biomarkers that can differentiate MET from GBM. In this retrospective study, patients were included if they met the following criteria: underwent resection of a solitary enhancing brain tumor and had preoperative 3.0 T MRI encompassing diffusion tensor imaging (DTI), dynamic contrast-enhanced (DCE), and dynamic susceptibility contrast (DSC) perfusion. Using co-registered images, voxel-based fractional anisotropy (FA), mean diffusivity (MD), K{sup trans}, and relative cerebral blood volume (rCBV) values were obtained in the enhancing tumor and non-enhancing peritumoral T2 hyperintense region (NET2). Data were analyzed by logistic regression and analysis of variance. Receiver operating characteristic (ROC) analysis was performed to determine the optimal parameter/s and threshold for predicting of GBM vs. MET. Twenty-three patients (14 M, age 32-78 years old) met our inclusion criteria. Pathology revealed 13 GBMs and 10 METs. In the enhancing tumor, rCBV, K{sup trans}, and FA were higher in GBM, whereas MD was lower, neither without statistical significance. In the NET2, rCBV was significantly higher (p = 0.05) in GBM, but MD was significantly lower (p < 0.01) in GBM. FA and K{sup trans} were higher in GBM, though not reaching significance. The best discriminative power was obtained in NET2 from a combination of rCBV, FA, and MD, resulting in an area under the curve (AUC) of 0.98. The combination of MR diffusion and perfusion matrices in NET2 can help differentiate GBM over solitary MET with diagnostic accuracy of 98 %. (orig.)

  10. Differentiation of solitary brain metastasis from glioblastoma multiforme: a predictive multiparametric approach using combined MR diffusion and perfusion

    International Nuclear Information System (INIS)

    Bauer, Adam Herman; Moser, Franklin G.; Maya, Marcel; Erly, William; Nael, Kambiz

    2015-01-01

    Solitary brain metastasis (MET) and glioblastoma multiforme (GBM) can appear similar on conventional MRI. The purpose of this study was to identify magnetic resonance (MR) perfusion and diffusion-weighted biomarkers that can differentiate MET from GBM. In this retrospective study, patients were included if they met the following criteria: underwent resection of a solitary enhancing brain tumor and had preoperative 3.0 T MRI encompassing diffusion tensor imaging (DTI), dynamic contrast-enhanced (DCE), and dynamic susceptibility contrast (DSC) perfusion. Using co-registered images, voxel-based fractional anisotropy (FA), mean diffusivity (MD), K trans , and relative cerebral blood volume (rCBV) values were obtained in the enhancing tumor and non-enhancing peritumoral T2 hyperintense region (NET2). Data were analyzed by logistic regression and analysis of variance. Receiver operating characteristic (ROC) analysis was performed to determine the optimal parameter/s and threshold for predicting of GBM vs. MET. Twenty-three patients (14 M, age 32-78 years old) met our inclusion criteria. Pathology revealed 13 GBMs and 10 METs. In the enhancing tumor, rCBV, K trans , and FA were higher in GBM, whereas MD was lower, neither without statistical significance. In the NET2, rCBV was significantly higher (p = 0.05) in GBM, but MD was significantly lower (p < 0.01) in GBM. FA and K trans were higher in GBM, though not reaching significance. The best discriminative power was obtained in NET2 from a combination of rCBV, FA, and MD, resulting in an area under the curve (AUC) of 0.98. The combination of MR diffusion and perfusion matrices in NET2 can help differentiate GBM over solitary MET with diagnostic accuracy of 98 %. (orig.)

  11. What’s the clinical significance of adding diffusion and perfusion MRI in the differentiation of glioblastoma multiforme and solitary brain metastasis?

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    Amr F. Mourad

    2017-09-01

    Full Text Available Objective: To evaluate the additional diagnostic value of diffusion and perfusion MRI in the differentiation of glioblastoma multiforme (GBM and solitary brain metastasis. Patients and methods: This retrospective study included 24 patients with histologically proven brain tumors who underwent conventional MRI with analysis of diffusion (DWI and perfusion (PWI MRI findings of each tumor. The Apparent Diffusion Coefficient (ADC values were calculated in the minimum (ADC-MIN, mean (ADC-MEAN, and maximum (ADC-MAX in all the tumors and the peritumoral regions. The PWI data was expressed as maximum regional cerebral blood volume (rCBV of the tumors and peritumoral regions. Results: After adding diffusion and perfusion to conventional MRI findings, we found that the accuracy of differentiation between glioblastoma multiforme (GBM and solitary metastasis increased from 70% to 90%.There is a significant difference in DWI signal intensity between GBM and metastatic tumors (P < 0.05. The ADC values of GBM were lower than that of metastatic tumors. On perfusion MRI, the maximum rCBV of the peritumoral region (rCBVP of GBM was higher than that of brain metastases (P < 0.001. Conclusion: The addition of diffusion and perfusion to the MRI protocol increases the accuracy of differentiation between GBM and solitary brain metastasis and should be considered routinely. Keywords: Diffusion MRI, Perfusion MRI, GBM, Solitary brain metastases

  12. Effective Treatment of Solitary Pituitary Metastasis with Panhypopituitarism in HER2-Positive Breast Cancer by Lapatinib.

    Science.gov (United States)

    Park, Youngmok; Kim, Hyemin; Kim, Eui-Hyun; Suh, Chang-Ok; Lee, Soohyeon

    2016-01-01

    Brain metastasis affects one third of patients with HER2-positive breast cancer after treatment with trastuzumab. Surgical resection and radiation therapy are often unsuccessful at accomplishing complete control of metastasis. Lapatinib is presumed to cross the blood-brain barrier, and exhibits clinical activities for treatment of HER2-positive breast cancer. A 43-year-old woman was treated for early breast carcinoma with total mastectomy, axillary lymph-node dissection, and adjuvant chemotherapy with cyclophosphamide plus doxorubicin. After the end of adjuvant trastuzumab therapy, she was diagnosed with panhypopituitarism due to pituitary metastasis. Surgical removal and whole brain radiation therapy were performed, but a portion of viable tumor remained. Only taking lapatinib, the size of the metastatic lesion began to shrink. Trastuzumab may have controlled the micro-metastasis of breast cancer, but it was unable to control its progression to the central nervous system. Lapatinib is a possible option for HER2-positive metastatic breast cancer patients with brain metastasis.

  13. Solitary pancreatic metastasis from breast cancer: case report and review of literature

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    Márcio Apodaca-Rueda

    2017-11-01

    Full Text Available ABSTRACT CONTEXT: Pancreatic metastases from primary malignant tumors at other sites are rare, constituting about 2% of the neoplasms that affect the pancreas. Pancreatic metastasis from breast cancer is extremely rare and difficult to diagnose, because its clinical and radiological presentation is similar to that of a primary pancreatic tumor. CASE REPORT: A 64-year-old female developed a lesion in the pancreatic tail 24 months after neoadjuvant therapy, surgery and adjuvant radiation therapy for right-side breast cancer (ductal carcinoma. She underwent distal pancreatectomy with splenectomy and left adrenalectomy, and presented an uneventful outcome. The immunohistochemical analysis on the surgical specimen suggested that the lesion originated from the breast. CONCLUSION: In cases of pancreatic lesions detected in patients with a previous history of breast neoplasm, the possibility of pancreatic metastasis should be carefully considered.

  14. Outcomes of aggressive treatment in esophageal cancer patients with synchronous solitary brain metastasis.

    Science.gov (United States)

    Onal, Cem; Akkus Yildirim, Berna; Guler, Ozan Cem

    2017-07-01

    The aim of the present study was to investigate the outcomes of esophageal cancer (EC) patients with isolated synchronous brain oligometastasis (oligo-BM) treated with chemoradiotherapy (CRT) of the primary site and localized treatment of the BM with surgery, radiotherapy (RT) or radiosurgery. Of 125 EC patients investigated, seven patients (6%) had solitary BM. Six patients were diagnosed prior to, and one patient was diagnosed during, treatment. All patients were treated with neoadjuvant chemotherapy and whole-brain RT (WBRT) for BM. All but one patient received definitive CRT with a median RT dose of 50.4 Gy using conventional fractionation RT. The median age at diagnosis was 59 years (range, 48-77 years). Six patients succumbed to mortality, and one continued to receive systemic chemotherapy at the last visit. The median survival time of the patients was 18.9 months (range, 10.0-27.2 months). Median time to progression after completion of the treatments was 8 months (range, 3-9 months). Two patients had progression of the primary tumor, and one patient had progression of the BM. The neurological status of three patients with BM who were identified during the staging work-up did not deteriorate as a consequence of WBRT. In conclusion, the present study has demonstrated that aggressive treatment of the primary tumor and oligo-BM in patients with EC may prolong the survival time.

  15. Microwave Ablation (MWA) for the Treatment of a Solitary, Chemorefractory Testicular Cancer Liver Metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Violari, Elena G., E-mail: eviolari@live.com; Petre, Elena N., E-mail: petree@mskcc.org [Memorial Sloan-Kettering Cancer Center, Department of Radiology, Weill-Cornell Medical College, Interventional Radiology Service (United States); Feldman, Darren R., E-mail: feldmand@mskcc.org [Memorial Sloan-Kettering Cancer Center, Department of Medicine, Genitourinary Service (United States); Erinjeri, Joseph P., E-mail: erinjerij@mskcc.org; Brown, Karen T., E-mail: brown6@mskcc.org; Solomon, Stephen B., E-mail: solomons@mskcc.org [Memorial Sloan-Kettering Cancer Center, Department of Radiology, Weill-Cornell Medical College, Interventional Radiology Service (United States); D’Angelica, Michael I., E-mail: dangelim@mskcc.org [Memorial Sloan-Kettering Cancer Center, Department of Surgery, Hepatopancreatobiliary Service (United States); Sofocleous, Constantinos T., E-mail: sofoclec@mskcc.org [Memorial Sloan-Kettering Cancer Center, Department of Radiology, Weill-Cornell Medical College, Interventional Radiology Service (United States)

    2015-04-15

    We present a case of a patient with stage IIIC metastatic seminoma with a persistent chemorefractory liver lesion. The patient was deemed a poor surgical candidate due to the tumor’s aggressive biology with numerous other liver lesions treated with chemotherapy and a relatively high probability for additional recurrences. Further chemotherapy with curative intent was not a feasible option due to the fact that the patient had already received second-line high-dose chemotherapy and four cycles of third-line treatment complicated by renal failure, refractory thrombocytopenia, and debilitating neuropathy. After initial failure of laser, microwave ablation of the chemorefractory liver metastasis resulted in prolonged local tumor control and rendered the patient disease-free for more than 35 months, allowing him to regain an improved quality of life.

  16. Solitary extra-skeletal sinonasal metastasis from a primary skeletal Ewing's sarcoma.

    Science.gov (United States)

    Hayes, S M; Jani, T N; Rahman, S M; Jogai, S; Harries, P G; Salib, R J

    2011-08-01

    Ewing's sarcoma is a rare, malignant tumour predominantly affecting young adolescent males. We describe a unique case of an isolated extra-skeletal metastasis from a skeletal Ewing's sarcoma primary, arising in the right sinonasal cavity of a young man who presented with severe epistaxis and periorbital cellulitis. Histologically, the lesion comprised closely packed, slightly diffuse, atypical cells with round, hyperchromatic nuclei, scant cytoplasm and occasional mitotic figures, arranged in a sheet-like pattern. Immunohistochemical analysis showed positive staining only for cluster of differentiation 99 glycoprotein. Fluorescent in situ hybridisation identified the Ewing's sarcoma gene, confirming the diagnosis. Complete surgical resection was achieved via a minimally invasive endoscopic transnasal approach; post-operative radiotherapy. Ten months post-operatively, there were no endoscopic or radiological signs of disease. Metastatic Ewing's sarcoma within the head and neck is incredibly rare and can pose significant diagnostic and therapeutic challenges. An awareness of different clinical presentations and distinct histopathological features is important to enable early diagnosis. This case illustrates one potential management strategy, and reinforces the evolving role of endoscopic transnasal approaches in managing sinonasal cavity and anterior skull base tumours.

  17. A retrospective review of Cyberknife Stereotactic Body Radiotherapy for Adrenal Tumors (Primary and Metastatic: Winthrop University Hospital experience

    Directory of Open Access Journals (Sweden)

    Amishi eDesai

    2015-08-01

    Full Text Available The adrenal gland is a common site of cancer metastasis. Surgery remains a mainstay of treatment for solitary adrenal metastasis. For patients who cannot undergo surgery, radiation is an alternative option. Stereotactic body radiotherapy (SBRT is an ablative treatment option allowing larger doses to be delivered over a shorter period of time. In this study, we report on our experience with the use of SBRT to treat adrenal metastases using Cyberknife technology. We retrospectively reviewed, the Winthrop-University radiation oncology data base to identify 14 patients for whom SBRT was administered to treat malignant adrenal disease. Of the factors examined, the biologic equivalent dose (BED of radiation delivered was found to be the most important predictor of local adrenal tumor control. We conclude that CyberKnife-based SBRT is a safe, non-invasive modality that has broadened the therapeutic options for the treatment of isolated adrenal metastases.

  18. Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Treglia, Giorgio; Luca, Giovanella [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Barbara, Muoio; Carmelo, Caldarella [Catholic Univ., Rome (Italy)

    2014-06-15

    A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation.

  19. Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT

    International Nuclear Information System (INIS)

    Treglia, Giorgio; Luca, Giovanella; Barbara, Muoio; Carmelo, Caldarella

    2014-01-01

    A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation

  20. Long-Term Survival in Patients With Synchronous, Solitary Brain Metastasis From Non-Small-Cell Lung Cancer Treated With Radiosurgery

    International Nuclear Information System (INIS)

    Flannery, Todd W.; Suntharalingam, Mohan; Regine, William F.; Chin, Lawrence S.; Krasna, Mark J.; Shehata, Michael K.; Edelman, Martin J.; Kremer, Marnie; Patchell, Roy A.; Kwok, Young

    2008-01-01

    Purpose: To report the outcome of patients with synchronous, solitary brain metastasis from non-small-cell lung cancer (NSCLC) treated with gamma knife stereotactic radiosurgery (GKSRS). Patients and Methods: Forty-two patients diagnosed with synchronous, solitary brain metastasis from NSCLC were treated with GKSRS between 1993 and 2006. The median Karnofsky performance status (KPS) was 90. Patients had thoracic Stage I-III disease (American Joint Committee on Cancer 2002 guidelines). Definitive thoracic therapy was delivered to 26/42 (62%) patients; 9 patients underwent chemotherapy and radiation, 12 patients had surgical resection, and 5 patients underwent preoperative chemoradiation and surgical resection. Results: The median overall survival (OS) was 18 months. The 1-, 2-, and 5-year actuarial OS rates were 71.3%, 34.1%, and 21%, respectively. For patients who underwent definitive thoracic therapy, the median OS was 26.4 months compared with 13.1 months for those who had nondefinitive therapy, and the 5-year actuarial OS was 34.6% vs. 0% (p < 0.0001). Median OS was significantly longer for patients with a KPS ≥90 vs. KPS < 90 (27.8 months vs. 13.1 months, p < 0.0001). The prognostic factors significant on multivariate analysis were definitive thoracic therapy (p = 0.020) and KPS (p = 0.001). Conclusions: This is one of the largest series of patients diagnosed with synchronous, solitary brain metastasis from NSCLC treated with GKSRS. Definitive thoracic therapy and KPS significantly impacted OS. The 5-year OS of 21% demonstrates the potential for long-term survival in patients treated with GKSRS; therefore, patients with good KPS should be considered for definitive thoracic therapy

  1. Solitary Laryngeal Metastasis from Transitional Cell Carcinoma of the Kidney: Clinical Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Tarek Assi

    2015-01-01

    Full Text Available The urogenital tract is a rare origin of laryngeal metastasis; transitional cell carcinoma with laryngeal metastases had never been reported previously. In this paper, we describe the clinical and pathological characteristics, evolution, and treatment of the first reported case of a laryngeal metastasis of a TCC followed by a brief review of the literature.

  2. Rapid recurrence and bilateral lungs, multiple bone metastasis of malignant solitary fibrous tumor of the right occipital lobe: report of a case and review.

    Science.gov (United States)

    Wu, Zhengrong; Yang, Hongjun; Weng, Desheng; Ding, Yanqing

    2015-07-09

    Intracranial malignant solitary fibrous tumor (MSFT) is extremely rare. The authors report a case of MSFT of the right occipital lobe with a rapid recurrence and bilateral lung, multiple bone metastasis. The patient was a 25-year-old male presenting with headache, nausea and visual disturbances without obvious cause. Three times right-side occipital craniotomies were performed and two times postoperative conformal radiotherapy were administered within one year. 4 months after the third time of right-side occipital craniotomy, the patient felt right chest pain and neck pain. Positron emission tomography/computed tomography (PET/CT) showed tumor recurrence of the right occipital lobe and bilateral lung metastasis, multiple bone metastasis including: vertebrae, libs, the left iliac wing, sacrum, the right ischium and upper parts of both femurs. Ultrasound guided puncture biopsy of left-side back of the neck and CT guided puncture biopsy of the third lumbar vertebra were performed. General sample showed grayish white or grayish red with irregular shape. Histopathologically, the tumor was composed of areas of alternating hypercellularity and hypocellularity with spindle-shaped cells, which arranged as fascicular, storiform pattern or patternless pattern, with intervening irregular eosinophilic collagen bundles. Some areas showed hemangiopericytoma-like perivascular pattern and perivascular hyalinization. Tumor cells were pleomorphic with mitotic counts of more than 4 per 10 high power fields and showed coagulative necrosis. Immunohistochemically, tumor cells were diffusely positive for vimentin and CD99, focal positive for CD34, bcl-2 and Actin. Ki-67 labelling index was more than 40%. The final pathological diagnosis was MSFT of the right occipital lobe, metastatic MSFT of left-side back of the neck and the third lumbar vertebra. The MSFT of the right occipital lobe with recurrence and bilateral lung, multiple bone metastasis is extremely rare. Although intracranial

  3. Just another abdominal pain? Psoas abscess-like metastasis in large cell lung cancer with adrenal insufficiency.

    Science.gov (United States)

    Bernardino, Vera; Val-Flores, Luis Silva; Dias, João Lopes; Bento, Luís

    2015-06-10

    The authors report the case of a 69-year-old man with chronic obstructive pulmonary disease and previous pulmonary tuberculosis, who presented to the emergency department with abdominal and low back pain, anorexia and weight loss, rapidly evolving into shock. An initial CT scan revealed pulmonary condensation with associated cavitation and an iliopsoas mass suggestive of a psoas abscess. He was admitted in an intensive care unit unit; after a careful examination and laboratory assessment, the aetiology was yet undisclosed. MRI showed multiple retroperitoneal lymphadenopathies, bulky nodular adrenal lesions and bilateral iliac lytic lesions. Hypocortisolism was detected and treated with steroids. A CT-guided biopsy to the psoas mass and lytic lesions identified infiltration of non-small lung carcinoma. The patient died within days. Psoas metastases and adrenal insufficiency as initial manifestations of malignancy are rare and can be misdiagnosed, particularly in the absence of a known primary tumour. 2015 BMJ Publishing Group Ltd.

  4. Solitary Plasmacytoma

    OpenAIRE

    Grammatico, Sara; Scalzulli, Emilia; Petrucci, Maria Teresa

    2017-01-01

    Solitary plasmacytoma is a rare disease characterized by a localized proliferation of neoplastic monoclonal plasma cells, without evidence of systemic disease. It can be subdivided into solitary bone plasmacytoma, if the lesion originates in bone, or solitary extramedullary plasmacytoma, if the lesion involves a soft tissue. Incidence of solitary bone plasmacytoma is higher than solitary extramedullary plasmacytoma. Also prognosis is different: even if both forms respond well to treatment, ov...

  5. Solitary Secondary Malignant Melanoma of Clavicle Two Years after Enuclation for Ocular Melanoma

    Directory of Open Access Journals (Sweden)

    Halil Tozum

    2013-01-01

    Full Text Available Solitary metastasis of uveal melanoma to bone is extremely rare and usually associated with other organ involvement. We present a rare case of an ocular melanoma patient presenting with solitary metastasis to the clavicle two years after enucleation, without any other organ involvement. In this report, we tried to present our treatment strategy for the solitary metastasis of bone.

  6. Cavitary pulmonar metastasis

    International Nuclear Information System (INIS)

    Marchiori, E.; Matushita, J.P.K.; Azevedo, C.M. de

    1984-01-01

    Seven cases of cavitary lung metastasis, four from head and neck neoplasma, two from uterine carcinoma and one from hepatoma are reported. The physiopathology and the most common sites of this kind of lesion are discussed. The rarity of the solitary excavated metastasis from hepatoma, not reported previously in the literature reviewed, is emphasized. (Author) [pt

  7. SOLITARY PLASMACYTOMA

    Directory of Open Access Journals (Sweden)

    Sara Grammatico

    2017-08-01

    Full Text Available Solitary plasmacytoma is a rare disease characterized by a localized proliferation of neoplastic monoclonal plasma cells, without evidence of systemic disease. It can be subdivided into solitary bone plasmacytoma, if the lesion originates in bone, or solitary extramedullary plasmacytoma, if the lesion involves a soft tissue. Incidence of solitary bone plasmacytoma is higher than solitary extramedullary plasmacytoma. Also prognosis is different: even if both forms respond well to treatment, overall survival and progression free survival of solitary bone plasmacytoma is poorer than solitary extramedullary plasmacytoma due to its higher rate of evolution in multiple myeloma. However, the recent advances in the diagnosis of multiple myeloma can better refine also the diagnosis of plasmacytoma. Flow cytometry studies and molecular analysis may reveal clonal plasma cells in the bone marrow; magnetic resonance imaging or 18 Fluorodeoxyglucose positron emission tomography could better define osteolytic bone lesions. A more precise exclusion of eventual occult systemic involvement can avoid cases of misdiagnosed multiple myeloma patients, that were previously considered solitary plasmacytoma and less treated, with an unavoidable poor prognosis. Due to the rarity of the disease, there is no uniform consensus about prognostic factors and treatment. Radiotherapy is the treatment of choice; however, some authors debates about the radiotherapy dose and the relationship with the response rate. Moreover, the role of surgery and chemotherapy is still under debate. Nevertheless, we must consider that the majority of studies include a small number of patients and analyze the efficacy of conventional chemotherapy; few cases are reported concerning the efficacy of novel agents. Keywords: solitary plasmacytoma; myeloma; radiotherapy; osteolytic lesions

  8. Adrenal Fatigue

    Science.gov (United States)

    ... Search Featured Resource New Mobile App DOWNLOAD Adrenal Fatigue October 2017 Download PDFs English Editors Irina Bancos, MD Additional Resources Mayo Clinic What is adrenal fatigue? The term “adrenal fatigue” has been used to ...

  9. Solitary Plasmacytoma.

    Science.gov (United States)

    Grammatico, Sara; Scalzulli, Emilia; Petrucci, Maria Teresa

    2017-01-01

    Solitary plasmacytoma is a rare disease characterized by a localized proliferation of neoplastic monoclonal plasma cells, without evidence of systemic disease. It can be subdivided into solitary bone plasmacytoma if the lesion originates in bone, or solitary extramedullary plasmacytoma if the lesion involves a soft tissue. The incidence of solitary bone plasmacytoma is higher than solitary extramedullary plasmacytoma. Also, the prognosis is different: even if both forms respond well to treatment, overall survival and progression-free survival of solitary bone plasmacytoma are poorer than solitary extramedullary plasmacytoma due to its higher rate of evolution in multiple myeloma. However, the recent advances in the diagnosis of multiple myeloma can better refine also the diagnosis of plasmacytoma. Flow cytometry studies and molecular analysis may reveal clonal plasma cells in the bone marrow; magnetic resonance imaging or 18 Fluorodeoxyglucose positron emission tomography could better define osteolytic bone lesions. A more explicit exclusion of possible occult systemic involvement can avoid cases of misdiagnosed multiple myeloma patients, which were previously considered solitary plasmacytoma and less treated, with an unavoidable poor prognosis. Due to the rarity of the disease, there is no uniform consensus about prognostic factors and treatment. Radiotherapy is the treatment of choice; however, some authors debate about the radiotherapy dose and the relationship with the response rate. Moreover, the role of surgery and chemotherapy is still under debate. Nevertheless, we must consider that the majority of studies include a small number of patients and analyze the efficacy of conventional chemotherapy; few cases are reported concerning the efficacy of novel agents.

  10. Clinical analysis of bone scanning in solitary lesion

    International Nuclear Information System (INIS)

    Zhu Jun; Zhu Ruisen; Zhu Jifang

    2002-01-01

    A rational analysis procedure for solitary lesions on whole bone scanning was offered. This study was undertaken to analyze retrospectively solitary lesions which obtained final diagnose through the following aspects: (1) diagnosis of bone metastasis, (2) the incidence of bone metastasis in different tumor, (3) the most possible lesion sites indicating bone metastasis, (4) morphological analysis of solitary lesions. The results are: (1) The incidence of solitary lesions in 2465 cases on whole bone scanning is 15.3%. (2) The rate of bone metastasis is 24.8% in 282 patients with primary malignancy. The rate of bone metastasis of 6.3% in 64 patients without primary malignancy, and the total diagnostic rate of bone metastasis is 21.4% in 346 patients. (3) In patients with primary malignancy, the incidence of bone metastasis of solitary lesions is as follows respectively; bronchi cancer 36.1%(22/61); breast cancer 23.8%(20/84); prostate gland 17.2%(5/29); other urinary system cancer 22.2%(4/18); G.I. system cancer 16.9%(10/59); others 29.0%(9/31). There is no significant difference in different cancer. (4) In patients without primary malignancy, 93.7%(60/64) of solitary lesions are benign. (5) From anatomical point of view, the authors found the diagnostic rate of bone metastasis is as follow: 30% in spine; 34.2% in pelvis; 36.4% in skull; 10.8% in other bones. There are significant differences in four groups. It is concluded that: (1) The diagnostic rate of bone metastasis in solitary lesions is 21.4%. (2) The most possible solitary lesions indicating osseous tumor spread are at spine, pelvic and skull. (3) Special attention to 'cold' and streak like lesions should be paid. (4) A clinical analysis procedure for diagnosis of solitary lesions has been summarized out here

  11. Usefulness of percentage enhancement washout value calculated on unenhanced, contrast-enhanced, and delayed enhanced CT in adrenal masses: adenoma versus metastasis

    International Nuclear Information System (INIS)

    Sohn, Kyung Myung; Lee, Sung Yong; Lee, Keun Ho

    2003-01-01

    To determine the usefulness of percentage enhancement washout value calculated on unenhanced, enhanced and delayed enhanced CT scans for the characterization of adrenal masses. Forty adrenal masses less than 5 cm in size were assessed using a protocol consisting of unenhanced CT, enhanced CT 60 seconds after intravenous administration of contrast material, and delayed enhanced CT at 10 minutes. The CT attenuation value of adrenal tumors was estimated on each scan, and percentage enhancement washout value was calculated as follows:[(attenuation value at enhanced CT-attenuation value at delayed CT)/ (attenuation value at enhanced CT-attenuation value at unenhanced CT)x100]. An adrenal mass was considered benign if its percentage enhancement washout value was at the threshold value, set to 60% and 50%, or higher. The accuracy of the procedure was determined by comparing its findings with the final clinical diagnosis. Twenty-nine massess were benign and 11 were malignant. The mean percentage enhancement washout value of the former was significantly higher than that of the latter (66.7% vs. 21.8%; p<0.01). All adenomas except one had a washout value of more than 50%. With a percentage washout threshold of 60%, 35 of 40 lesions were correctly characterized as benign or malignant [sensitivity 82.7% (24/29), specificity 100% (11/11), accuracy 87.5% (35/40)]; with a threshold of 50%, 39 of 40 lesions were correctly characterized [(sensitivity 96.5% (28/29), specificity 100% (11/11), accuracy 97.5% (39/40)]. Percentage enhancement washout values are useful for characterizing an adrenal mass as benign or malignant. For characterization, a threshold value of 50% was more accurate than one of 60%

  12. Bilateral primary adrenal lymphoma presenting with adrenal insufficiency

    DEFF Research Database (Denmark)

    Holm, Jakob; Breum, Leif; Stenfeldt, Katrine

    2012-01-01

    surgery was performed. A new computerized tomography scan showed rapid progression of disease with further enlargement of the adrenal masses and both pulmonary and hepatic metastasis. Needle biopsy was performed but the patient refused further treatment and died before a diagnosis was obtained...

  13. Adrenal scintigraphy

    International Nuclear Information System (INIS)

    Beierwaltes, W.H.

    1979-01-01

    The following items are discussed:anatomy and physiology of adrenal glands, clinical indications of scintigraphy, radiobiology and radiochemistry, scintigraphic imaging, adrenocortical hyperfunction, aldosteronism and hypertension associated with low renin level, excess of androgen, adrenocortical hyperfunction and future perspectives of adrenal scintigraphy. (M.A.) [pt

  14. Adrenal Insufficiency

    Science.gov (United States)

    ... two kinds of AI: • Primary AI, also called Addison’s disease. In this rare condition, the adrenal glands do ... org (search for adrenal) • Information about AI and Addison’s disease from the National Institutes of Health: www. endocrine. ...

  15. Adrenal incidentaloma

    Directory of Open Access Journals (Sweden)

    Arnaldi G.

    2000-01-01

    Full Text Available Incidentally discovered adrenal masses, or adrenal incidentalomas, have become a common clinical problem owing to wide application of radiologic imaging techniques. This definition encompasses a heterogeneous spectrum of pathologic entities, including primary adrenocortical and medullary tumors, benign or malignant lesions, hormonally active or inactive lesions, metastases, and infections. Once an adrenal mass is detected, the clinician needs to address two crucial questions: is the mass malignant, and is it hormonally active? This article provides an overview of the diagnostic clinical approach and management of the adrenal incidentaloma. Mass size is the most reliable variable to distinguish benign and malignant adrenal masses. Adrenalectomy should be recommended for masses greater than 4.0 cm because of the increased risk of malignancy. Adrenal scintigraphy has proved useful in discriminating between benign and malignant lesions. Finally, fine-needle aspiration biopsy is an important tool in the evaluation of oncological patients and it may be useful in establishing the presence of metastatic disease. The majority of adrenal incidentalomas are non-hypersecretory cortical adenomas but an endocrine evaluation can lead to the identification of a significant number of cases with subclinical Cushing's syndrome (5-15%, pheochromocytoma (1.5-13% and aldosteronoma (0-7%. The first step of hormonal screening should include an overnight low dose dexamethasone suppression test, the measure of urinary catecholamines or metanephrines, serum potassium and, in hypertensive patients, upright plasma aldosterone/plasma renin activity ratio. Dehydroepiandrosterone sulfate measurement may show evidence of adrenal androgen excess.

  16. Adrenal scintigraphy

    International Nuclear Information System (INIS)

    Veen, E.A. van der.

    1978-01-01

    The visualization of functioning adrenocortical tissue by scintigraphy became possible with the introduction of radioiodinated cholesterol derivatives. According to the literature, there is evidence that one of these iodinated cholesterols, 6-β-iodomethyl-nor-cholesterol, concentrates in the adrenal cortex to a much greater extent than 131 I-19-odocholesterol. Results comparing both radiopharmaceuticals are described. The authors investigated the possibility of increasing the uptake of iodinated cholesterol using simultaneous ACTH and the 'cholesterol side-chain cleavage enzymeblocker': aminoglutethimide. The results of adrenal scintigraphy performed in 37 patients are described. Finally, the literature on adrenal scintigraphy is reviewed, and results reported in various studies are compared. (Auth.)

  17. Adrenal Incidentaloma

    Science.gov (United States)

    ... Peer Support Resources Diseases and Conditions Adrenal Disorders Osteoporosis and Bone Health Children and Teen Health Diabetes Heart Health Men's Health Rare Diseases Pituitary Disorders Thyroid Disorders Transgender Health Obesity and Weight Management Women's Health You and Your ...

  18. Adrenal neoplasms

    International Nuclear Information System (INIS)

    Low, G.; Dhliwayo, H.; Lomas, D.J.

    2012-01-01

    Adenoma, myelolipoma, phaeochromocytoma, metastases, adrenocortical carcinoma, neuroblastoma, and lymphoma account for the majority of adrenal neoplasms that are encountered in clinical practice. A variety of imaging methods are available for evaluating adrenal lesions including ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine techniques such as meta-iodobenzylguanidine (MIBG) scintigraphy and positron-emission tomography (PET). Lipid-sensitive imaging techniques such as unenhanced CT and chemical shift MRI enable detection and characterization of lipid-rich adenomas based on an unenhanced CT attenuation of ≤10 HU and signal loss on opposed-phase compared to in-phase T1-weighted images, respectively. In indeterminate cases, an adrenal CT washout study may differentiate adenomas (both lipid-rich and lipid-poor) from other adrenal neoplasms based on an absolute percentage washout of >60% and/or a relative percentage washout of >40%. This is based on the principle that adenomas show rapid contrast washout while most other adrenal neoplasms including malignant tumours show slow contrast washout instead. 18 F-2-fluoro-2-deoxy-D-glucose–PET ( 18 FDG-PET) imaging may differentiate benign from malignant adrenal neoplasms by demonstrating high tracer uptake in malignant neoplasms based on the increased glucose utilization and metabolic activity found in most of these malignancies. In this review, the multi-modality imaging appearances of adrenal neoplasms are discussed and illustrated. Key imaging findings that facilitate lesion characterization and differentiation are emphasized. Awareness of these imaging findings is essential for improving diagnostic confidence and for reducing misinterpretation errors.

  19. Curative surgical management of isolated adrenal recurrence of oesophageal adenocarcinoma.

    LENUS (Irish Health Repository)

    O'Sullivan, K E

    2013-01-01

    Adrenal metastases of oesophageal adenocarcinoma are rarely detected in the clinical setting, more frequently being found as an incidental postmortem finding in the presence of widespread metastases. With improvements in the sensitivity of radiological diagnostic modalities, the incidence of adrenal tumour detection is on the rise. We report herein a particularly rare case of primary operative management by adrenalectomy for an isolated right-sided adrenal metastasis secondary to oesophageal adenocarcinoma, with a long-term survival.

  20. Iris metastasis of gastric adenocarcinoma.

    Science.gov (United States)

    Celebi, Ali Riza Cenk; Kilavuzoglu, Ayse Ebru; Altiparmak, U Emrah; Cosar, C Banu; Ozkiris, Abdullah

    2016-03-08

    Iris metastasis in patients with gastric cancer is extremely rare. Herein, it is aimed to report on a patient with gastric adenocarcinoma and iris metastasis. A 65-year-old patient with the history of gastric cancer was admitted for eye pain and eye redness on his left eye. There was ciliary injection, severe +4 cells with hypopyon in the anterior chamber and a solitary, friable, yellow-white, fleshy-creamy vascularized 2 mm × 4 mm mass on the upper nasal part of the iris within the left eye. The presented patient's mass lesion in the iris fulfilled the criteria of the metastatic iris lesion's appearance. The ocular metastasis occurred during chemotherapy. Iris metastasis can masquerade as iridocyclitis with pseudohypopyon or glaucoma. In patients with a history of gastric cancer that present with an iris mass, uveitis, and high intraocular pressure, ocular metastasis of gastric cancer should be a consideration.

  1. Bumblebees and solitary bees

    DEFF Research Database (Denmark)

    Henriksen, Casper Christian I

    use as a proxy at four different scales (250, 500, 750 and 1000 m). In 2012, the effect of a four-fold larger area of organic arable fields in simple, homogeneous landscapes on bumblebees and solitary bees was investigated in eight circular landscapes (radius 1000 m). Bumblebees and solitary bees were......Summary: The effects of farming system, flower resources and semi-natural habitats on bumblebees and solitary bees in intensively cultivated landscapes in Denmark were investigated in two sets of studies, in 2011 and 2012. The pan trap colour preferences of bumblebees and solitary bees were also...... assessed. In 2011, bumblebees and solitary bees were trapped in road verges bordering 14 organic (organic sites) and 14 conventional (conventional sites) winter wheat fields. The quantity and quality of local flower resources in the road verge and adjacent field headland were estimated as overall density...

  2. Adrenal scintigraphy with Scintadren

    International Nuclear Information System (INIS)

    Dabasi, G.; Irto, I.; Hernady, T.; Balint, I.

    1983-01-01

    68 patients with various adrenal disorders have been examined using Scintadren /TRC Amersham, England/. The parameters of adrenal imaging under Dexamethason suppression and after its discontinuance were established

  3. Adrenal Gland Disorders: Condition Information

    Science.gov (United States)

    ... About Share Facebook Twitter Pinterest Email Print About Adrenal Gland Disorders The adrenal glands, located on the top of ... as estrogen and testosterone. What are adrenal gland disorders? Adrenal gland disorders occur when the adrenal glands do not ...

  4. Oral gingival metastasis: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Nalini Aswath

    2017-01-01

    Full Text Available Oral cavity is a rare target for metastasis with an incidence of 1% among all oral cancers. In 24% of such cases, oral metastasis is the first indication of an undiagnosed primary. Metastatic oral malignancies have been reported in the mandible, tongue, and gingiva. Although gingival metastasis has been reported from lung, prostate, rectal carcinoma in men and carcinoma of breast, adrenal glands, and genitalia in females, gingival metastasis from carcinoma of the penis has not been reported. Herein, a case of metastatic gingival carcinoma that developed after extraction of teeth from primary carcinoma of the penis is presented. An extensive literature search revealed no such similar case reports.

  5. Solitary mammals provide an animal model for autism spectrum disorders.

    Science.gov (United States)

    Reser, Jared Edward

    2014-02-01

    Species of solitary mammals are known to exhibit specialized, neurological adaptations that prepare them to focus working memory on food procurement and survival rather than on social interaction. Solitary and nonmonogamous mammals, which do not form strong social bonds, have been documented to exhibit behaviors and biomarkers that are similar to endophenotypes in autism. Both individuals on the autism spectrum and certain solitary mammals have been reported to be low on measures of affiliative need, bodily expressiveness, bonding and attachment, direct and shared gazing, emotional engagement, conspecific recognition, partner preference, separation distress, and social approach behavior. Solitary mammals also exhibit certain biomarkers that are characteristic of autism, including diminished oxytocin and vasopressin signaling, dysregulation of the endogenous opioid system, increased Hypothalamic-pituitary-adrenal axis (HPA) activity to social encounters, and reduced HPA activity to separation and isolation. The extent of these similarities suggests that solitary mammals may offer a useful model of autism spectrum disorders and an opportunity for investigating genetic and epigenetic etiological factors. If the brain in autism can be shown to exhibit distinct homologous or homoplastic similarities to the brains of solitary animals, it will reveal that they may be central to the phenotype and should be targeted for further investigation. Research of the neurological, cellular, and molecular basis of these specializations in other mammals may provide insight for behavioral analysis, communication intervention, and psychopharmacology for autism.

  6. The computed tomographic findings of bronchogenic carcinoma presenting as a solitary peripheral pulmonary mass

    International Nuclear Information System (INIS)

    Kim, Hong; Kim, Ok Bae; Woo, Seong Ku; Suh, Soo Jhi; Kim, Sung Soo

    1985-01-01

    It is difficult to distinguish benign from malignant, ulmonary nodule by conventional roentgenologic examination. But CT makes it easier to evaluate adjacent parenchymal invasion, pleural or mediastinal extension, or early metastasis to intra- or extrathoracic lymph node as well as distant organs, although only a solitary peripheral pulmonary nodule is seen on plain radiograph. Authors reviewed CT of 22 cases of histopathologically confirmed primary lung cancer seen as a solitary peripheral pulmonary mass from May 1980 to September 1984 at Dongsan Medical Center, Keimyung University. The results are as follows: 1. The incidence was most common in the 6th decade (36%). Male to female ratio was 10 : 1 and 2 females all had bronchioloalveolar cell carcinoma. 2. The distribution of histologic cell type were as follows: squamous cell carcinoma 40%, adenocarcinoma, small cell carcinoma, bronchioloalveolar cell carcinoma and unclassified carcinoma 14% in each cases, and adenoid cystic carcinoma 4%. 3. The computed tomographic findings were as follows: a) Superior and posterior basal segments of both lower lobes were most frequently involved (68%). b) The mean diameter of the mass was 48 mm, and most common in the range of 30-49 mm in the greatest dimension (46%). c) The mean CT attenuation value was 57 H.U., and most common in the group of 41-70 H. U. (64%). d) Lymph node metastasis was found in 13 (59%) of 22 cases, and the involved nodes were as follows: hilar nodes 10 cases, paratracheal nodes 8 cases, subcarinal nodes 7 cases and extrathoracic nodes 3 cases. In 2 of 3 cases with small cell carcinoma, diffuse multiple lymph nodes were involved. e) Distant metastasis was seen relatively early in 3 cases: cerebral metastasis in 1 cases of squamous cell carcinoma, right adrenal metastasis without intrathoracic lymph node metastasis or invasion of adjacent structure in 1 case of bronchioloalveolar cell carcinoma, and liver and bone metastasis in 1 case of unclassified

  7. Solitary pulmonary nodule

    Science.gov (United States)

    ... Adenocarcinoma - chest x-ray Pulmonary nodule - front view chest x-ray Pulmonary nodule, solitary - CT scan Respiratory system References Gotway MB, Panse PM, Gruden JF, Elicker BM. Thoracic radiology: noninvasive diagnostic imaging. In: Broaddus VC, Mason RJ, ...

  8. Ewing's Sarcoma of the Adrenal Gland.

    Science.gov (United States)

    Pal, Dilip Kumar; Chandra, Vipin; Ranjan, Kumar Rajiv; Chakrabortty, Debasis; Banerjee, Manju

    2016-01-01

    Ewing's sarcoma (ES) or primitive neuro-ectodermal tumor (PNET) typically occurs in long or flat bones, the chest wall, extra-skeletal soft tissue, and rarely in solid organs. Incidence of adrenal Ewing's sarcoma is very rare. Here we report a case of Ewing's sarcoma of the right adrenal gland in an 8-year-old girl who presented with an abdominal mass. The huge tumor was managed by preoperative neo-adjuvant chemotherapy followed by surgical resection. She died due to metastasis after five months of surgery.

  9. Solitary waves in fluids

    CERN Document Server

    Grimshaw, RHJ

    2007-01-01

    After the initial observation by John Scott Russell of a solitary wave in a canal, his insightful laboratory experiments and the subsequent theoretical work of Boussinesq, Rayleigh and Korteweg and de Vries, interest in solitary waves in fluids lapsed until the mid 1960's with the seminal paper of Zabusky and Kruskal describing the discovery of the soliton. This was followed by the rapid development of the theory of solitons and integrable systems. At the same time came the realization that solitary waves occur naturally in many physical systems, and play a fundamental role in many circumstances. The aim of this text is to describe the role that soliton theory plays in fluids in several contexts. After an historical introduction, the book is divided five chapters covering the basic theory of the Korteweg-de Vries equation, and the subsequent application to free-surface solitary waves in water to internal solitary waves in the coastal ocean and the atmospheric boundary layer, solitary waves in rotating flows, ...

  10. A case report of metastatic neuroendocrine carcinoma of the right adrenal gland successfully treated with chemotherapy and surgery.

    Science.gov (United States)

    Ochiai, Toshiya; Komiyama, Sosuke; Ikoma, Hisashi; Kubota, Takeshi; Nakanishi, Masayoshi; Ichikawa, Daisuke; Kikuchi, Shojiro; Fujiwara, Hitoshi; Sakakura, Chohei; Kokuba, Yukihito; Sonoyama, Teruhisa; Otsuji, Eigo

    2010-08-01

    Poorly differentiated neuroendocrine carcinoma has a poor prognosis, especially when associated with distant metastasis. A 60-year-old man was admitted to a private hospital because of dyspnea at work in 2007. Computed tomography revealed lung infarction and a right adrenal tumor sized 12 cm in diameter that was tightly compressed against the inferior vena cava (IVC). Moreover, multiple lymph node metastases around the celiac axis and a solitary liver metastasis at the lateral segment were observed. Thus, we planned chemotherapy without surgery. We selected a combination therapy of irinotecan (CPT-11) and cisplatin (CDDP) (i.e., IP therapy): administration of CDDP [60 mg/m(2) body surface area (BSA)] on day 1 plus CPT-11 (80 mg/m(2)) BSA on days 1 and 8. Thereafter, this protocol was repeated at 3-week intervals. After 15 months of this chemotherapy strategy, the whole lesions showed a partial response by RECIST. The primary tumor had shrunk to 4.2 cm in diameter. In November 2008, we planned surgery to perform resection of the whole lesions. Histological diagnosis of the specimen was a poorly differentiated neuroendocrine carcinoma based on the immunostaining features, i.e., synaptophysin- and chromogranin positive. There were no viable tumor cells at the dissected lymph nodes or at the liver tumor. After surgery, CPT-11 administration was continued. The patient has remained well for 9 months without recurrence.

  11. Functional ectopic adrenal carcinoma in a dog

    OpenAIRE

    Taylor, Jim A.; Lee, Maris S.; Nicholson, Matthew E.; Justin, Robert B.

    2014-01-01

    An 11-year-old spayed female pit bull terrier was presented with a 2-month history of polyuria, polydipsia, polyphagia, and panting. Serum chemistry, blood and urine analysis, and tests for hyperadrenocorticism suggested an adrenal tumor. Abdominal ultrasound identified a mass caudal to the right kidney. The mass was completely excised and histopathology was consistent with endocrine carcinoma. Three years later there was no evidence of recurrence or metastasis.

  12. Functional ectopic adrenal carcinoma in a dog

    Science.gov (United States)

    Taylor, Jim A.; Lee, Maris S.; Nicholson, Matthew E.; Justin, Robert B.

    2014-01-01

    An 11-year-old spayed female pit bull terrier was presented with a 2-month history of polyuria, polydipsia, polyphagia, and panting. Serum chemistry, blood and urine analysis, and tests for hyperadrenocorticism suggested an adrenal tumor. Abdominal ultrasound identified a mass caudal to the right kidney. The mass was completely excised and histopathology was consistent with endocrine carcinoma. Three years later there was no evidence of recurrence or metastasis. PMID:25183891

  13. 131I-19-iodocholesterol adrenal scanning in Cushing's syndrome

    International Nuclear Information System (INIS)

    Charbonnel, B.; Chatal, J.F.; Chupin, M.; Guillon, J.

    1976-01-01

    7 patients were investigated: 2 bilateral hyperplasia due to pituitary ACTH excess showed bilateral adrenal activity. 1 post-surgical remnant with recurrent Cushing's syndrome was detected. 1 adenoma showed unilateral intense activity and absent activity in the controlateral gland, even after ACTH treatment. 2 carcinomas were weakly imaged. In 1 case, hepatic metastasis showed 131 I-19-iodocholesterol uptake. Adrenal imaging with 131 I-19-iodocholesterol is not a good procedure for assessing hormonal function. It is a valuable and safe tool in the localization and diagnosis of adrenal lesions causing Cushing's syndrome, perhaps better than radiologic procedures. Radiation dosimetry is acceptable [fr

  14. Renal Metastasis from Primary Cervical Cancer: A Case Report

    International Nuclear Information System (INIS)

    Jeon, Seong Woo; Kim, See Hyung; Kwon, Sun Young

    2013-01-01

    Metastasis of malignant tumors to the kidney is clinically rare and often discovered by autopsy. Primary lymphoma and lung cancer are known that can metastasize to the kidney. Other malignant tumor metastasis to the kidney is very unusual. Primary cervical cancer metastasis to adjacent pelvic organs and lymph nodes are well known followed by abdominal solid organs such as the liver and adrenal glands. However, reported primary cervical cancer metastasis to the kidney is extremely rare and mostly appeared as bilateral multiple renal masses. We report here on a rare case of unilateral single renal metastasis from primary cervical cancer after concur- rent chemoradiotherapy.

  15. Adrenal Gland Cancer

    Science.gov (United States)

    ... either benign or malignant. Benign tumors aren't cancer. Malignant ones are. Most adrenal gland tumors are ... and may not require treatment. Malignant adrenal gland cancers are uncommon. Types of tumors include Adrenocortical carcinoma - ...

  16. Acute adrenal crisis

    Science.gov (United States)

    ... adrenal gland is damaged due to, for example, Addison disease or other adrenal gland disease, and surgery The ... Call your health care provider if you have Addison disease and are unable to take your glucocorticoid medicine ...

  17. Adrenal Gland Tumors: Statistics

    Science.gov (United States)

    ... Gland Tumor: Statistics Request Permissions Adrenal Gland Tumor: Statistics Approved by the Cancer.Net Editorial Board , 03/ ... primary adrenal gland tumor is very uncommon. Exact statistics are not available for this type of tumor ...

  18. Papillary Thyroid Carcinoma Metastases Presenting as Ipsilateral Adrenal Mass and Renal Cyst.

    Science.gov (United States)

    Ginzburg, Serge; Reddy, Madhu; Veloski, Colleen; Sigurdson, Elin; Ridge, John A; Azrilevich, Mikhail; Kutikov, Alexander

    2015-11-01

    Metastatic spread of differentiated thyroid cancer to genitourinary organs is rare. Synchronous presentation of renal and adrenal thyroid metastasis is even less common, this case being only the 3rd reported. We describe a case of a 60-year-old male with oligometastatic thyroid cancer, where adrenal and renal metastases were the only extracervical sites of disease and triggered the patient's presentation.

  19. Computed tomography in the diagnosis of adrenal disease

    International Nuclear Information System (INIS)

    Hirosawa, Kunihiro

    1980-01-01

    From June 1977 through June 1980, sixty-one patients who were suspected to have adrenal diseases were examined with a CT scanner at Tokyo Women's Medical College. They consist of twenty five primary hyperaldosteronism, eight Cushing's syndrome, twenty pheochromocytoma and eight other adrenal masses. Ten patients were unexpectedly found to have adrenal lesion or mass simulating an adrenal tumor on CT performed for other reasons. CT findings were reviewed and correlated with surgical findings, postmortem studies and with results of other diagnostic modalities. 1. Primary hyperaldosteronism. Fifteen of twenty-five patients underwent surgery. Thirteen were pathologically proved to have aldosteronoma and two hyperplasia. Ten of thirteen patients with aldosteronoma were correctly diagnosed by CT scan. 2. Cushing's syndrome. Unilateral adenoma was correctly diagnosed preoperatively by CT scan on two surgically proved cases. CT showed marked enlargement of the adrenal gland with multiple nodules measuring less than 2 cm in diameter in the patient with nodular hyperplasia. Four patients were found to have normal-appearing adrenals with CT scan. 3. Pheochromocytoma. Three adrenal and one juxta-adrenal pheochromocytomas were detected by CT scan. Pheochromocytoma was considered as very unlikely on the basis of CT scan as well as further clinical investigation in sixteen patients. The value of CT scan for localization of extraadrenal pheochromocytoma remains established. 4. Miscellaneous adrenal disease and extra-adrenal masses simulating adrenal lesions. Two primary carcinoma, two bilateral metastasis, two adrenal neuroblastoma and a cyst were detected by CT scan. In cases with a huge mass, however, the origin and histologic diagnosis could not always be determined by CT scan. (author)

  20. Prolonged survival after resection and radiotherapy for solitary brain metastases from non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Chee, R. J.; Bydder, S.; Cameron, F.

    2007-01-01

    Selected patients with brain metastases from non-small-cell lung cancer benefit from aggressive treatment. This report describes three patients who developed solitary brain metastases after previous resection of primary adenocarcinoma of the lung. Each underwent surgical resection of their brain metastasis followed by cranial irradiation and remain disease free 10 or more years later. Two patients developed cognitive impairment approximately 8 years after treatment of their brain metastasis, which was felt to be due to their previous brain irradiation. Here we discuss the treatment of solitary brain metastasis, particularly the value of combined method approaches in selected patients and dose-volume considerations

  1. CT findings of solitary tuberculoma with a cavity

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Dong Erk; Goo, Hyun Woo; Song, Koun Sik; Lim, Tae Hwan; Kim, Won Dong [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    1994-09-15

    Differential diagnosis of solitary pulmonary nodule with cavity includes lung abscess, tuberculoma, bronchogenic carcinoma, metastasis and trauma, etc. We analyzed the CT appearance of tuberculoma presenting as a solitary pulmonary nodule with cavity and describe the findings which suggest tuberculoma in the differential diagnosis of solitary pulmonary nodule with cavity. 25 patients with solitary pulmonary nodule(diameter less than 4 cm) without surrounding parenchymal consolidation on chest radiograph, who had a cavity within the nodule on CT, were included in our study. Density of the nodule, maximal wall thickness, the character of inner and outer wall margin, location of cavity within nodule, location of the nodule, presence or absence of satellite lesions and calcification were analyzed. Solitary tuberculoma with cavity showed maximal wall thickness more than 15 m in 40%(10/25) and 5-14 mm in 56%(14/25), eccentric cavitation in 84%(21/25) and concentric cavitation in 16%(4/25), spiculated outer wall margin in 56%(14/15) and lobulated margin in 32%(8/25), smooth inner wall margin in 60%(15/25) and nodular margin in 40%(10/25). CT density of the cavity wall compared wth the chest wall muscle was low in 84%(21/25) and isodense in 16%(4/25). Accompanying satellite lesions were seen in 84%(21/25) and calcification was visible in 28%(7/25). The CT findings of solitary tuberculoma with cavity are relative peripheral location, eccentric cavitation, finely spiculated outer wall margin, and mean maximal wall thickness of 13.2 mm, which are also the common features of malignant nodule. However, relative low density of the nodule compared to the chest wall muscle and surrounding satellite lesions can be additional clues favouring solitary tuberculoma with cavity on CT.

  2. Bilateral adrenal masses: a single-centre experience

    Directory of Open Access Journals (Sweden)

    Nilesh Lomte

    2016-05-01

    Full Text Available Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited. Aims To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses. Methods Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002–2015. Results The most common aetiology was pheochromocytoma (40%, followed by tuberculosis (27.1%, primary adrenal lymphoma (PAL (10%, metastases (5.7%, non-functioning adenomas (4.3%, primary bilateral macronodular adrenal hyperplasia (4.3%, and others (8.6%. Age at presentation was less in patients with pheochromocytoma (33 years and tuberculosis (41 years compared with PAL (48 years and metastases (61 years (P<0.001. The presenting symptoms for pheochromocytoma were hyperadrenergic spells (54% and abdominal pain (29%, whereas tuberculosis presented with adrenal insufficiency (AI (95%. The presenting symptoms for PAL were AI (57% and abdominal pain (43%, whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm followed by pheochromocytoma (4.8cm, metastasis (4cm and tuberculosis (2.1cm (P<0.001. Biochemically, most patients with pheochromocytoma (92.8% had catecholamine excess. Hypocortisolism was common in tuberculosis (100% and PAL (71.4% and absent with metastases (P<0.001. Conclusion In evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies.

  3. Bilateral adrenal masses: a single-centre experience

    Science.gov (United States)

    Bandgar, Tushar; Khare, Shruti; Jadhav, Swati; Lila, Anurag; Goroshi, Manjunath; Kasaliwal, Rajeev; Khadilkar, Kranti; Shah, Nalini S

    2016-01-01

    Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited. Aims To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses. Methods Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002–2015). Results The most common aetiology was pheochromocytoma (40%), followed by tuberculosis (27.1%), primary adrenal lymphoma (PAL) (10%), metastases (5.7%), non-functioning adenomas (4.3%), primary bilateral macronodular adrenal hyperplasia (4.3%), and others (8.6%). Age at presentation was less in patients with pheochromocytoma (33 years) and tuberculosis (41 years) compared with PAL (48 years) and metastases (61 years) (P<0.001). The presenting symptoms for pheochromocytoma were hyperadrenergic spells (54%) and abdominal pain (29%), whereas tuberculosis presented with adrenal insufficiency (AI) (95%). The presenting symptoms for PAL were AI (57%) and abdominal pain (43%), whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm) followed by pheochromocytoma (4.8cm), metastasis (4cm) and tuberculosis (2.1cm) (P<0.001). Biochemically, most patients with pheochromocytoma (92.8%) had catecholamine excess. Hypocortisolism was common in tuberculosis (100%) and PAL (71.4%) and absent with metastases (P<0.001). Conclusion In evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies. PMID:27037294

  4. Solitary magnetohydrodynamic vortices

    International Nuclear Information System (INIS)

    Silaev, I.I.; Skvortsov, A.T.

    1990-01-01

    This paper reports on the analytical description of fluid flow by means of localized vortices which is traditional for hydrodynamics, oceanology, plasma physics. Recently it has been widely applied to different structure turbulence models. Considerable results involved have been presented where it was shown that in magnetohydrodynamics alongside with the well-known kinds of localized vortices (e.g. Hill's vortex), which are characterized by quite a weak decrease of disturbed velocity or magnetic field (as a power of the inverse distance from vortex center), the vortices with screening (or solitary vortices) may exist. All disturbed parameters either exponentially vanish or become identically zero in outer region in the latter case. (In a number of papers numerical simulations of such the vortices are presented). Solutions in a form of solitary vortices are of particular interest due to their uniformity and solitonlike behavior. On the basis of these properties one can believe for such structures to occur in real turbulent flows

  5. Computed tomography findings in diseases of the adrenal gland

    International Nuclear Information System (INIS)

    Ozturk, E.; Sildiroglu, H.O.; Sonmez, G.; Basekim, C.C.; Kantarci, M.; Gueven, F.; Doganay, S.; Bozkurt, M.

    2009-01-01

    The adrenal gland is a common site of disease, with an abnormality prevalence as high as 9% in autopsy series. With the increasing use of CT, adrenal lesions are frequently found in the daily practice of radiology and are diagnosed in up to 5% of CT examinations performed for varied reasons. Imaging features on CT can establish a specific diagnosis of many of these lesions, including myelolipoma, hematoma and cysts. Once a diagnostic dilemma, now adenomas can be accurately diagnosed using unenhanced CT, chemical shift magnetic resonance imaging and CT contrast washout analysis. Because the adrenal gland is also a frequent site of metastasis, recent literature has focused on imaging characterization of adrenal masses for differentiation of adenomas from metastases. In patients without known malignancy, most adrenal lesions are benign and a specific diagnosis can now be made on the basis of imaging features. It is important to understand the prevalence of adrenal abnormalities because the gland is a common site of disorders, and the increased use of cross-sectional imaging has increased the frequency of detection of adrenal lesions. The prevalence of disease is important in predicting the risk of malignancy when an adrenal mass is discovered in a patient without known cancer. Detection of adrenal gland diseases has increased substantially with the advent and widespread use of imaging techniques. Although several imaging modalities can be used, CT has a central role in both detection and differential diagnosis of an adrenal lesion. The aim of this article is to review the CT findings of adrenal gland diseases. (author) [de

  6. Feminizing adrenal tumors: Our experience about three cases

    Directory of Open Access Journals (Sweden)

    Chentli Farida

    2013-01-01

    Full Text Available Feminizing adrenal tumors (FATs are very rare as they account for less than 2% of all the adrenal neoplasms. Their prognosis is deemed to be very poor. We aimed to present a mono centre (adult and pediatric experience over a long period of time (January 1980 to Jun 2012. During the study period, we observed only three cases in men aged 22 (2 cases and 45 (1 case. They all consulted for a painful gynecomastia, decreased libido and impotency. Estradiol was high in two cases at presentation, and after a relapsing tumor in the third one. All had big adrenal tumors (5.9, 6, and 17 cm, and a mixed secretion composed by high estradiol and cortisol. The pathological study argued for malignancy in two cases. But, only one had diffuse metastasis and died 4 years after diagnosis; the others diagnosed one and three years ago are still alive without any metastasis or relapsing.

  7. Pinworm infection masquerading as colorectal liver metastasis.

    Science.gov (United States)

    Roberts, K J; Hubscher, S; Mangat, K; Sutcliffe, R; Marudanayagam, R

    2012-09-01

    Enterobius vermicularis is responsible for a variety of diseases but rarely affects the liver. Accurate characterisation of suspected liver metastases is essential to avoid unnecessary surgery. In the presented case, following a diagnosis of rectal cancer, a solitary liver nodule was diagnosed as a liver metastasis due to typical radiological features and subsequently resected. At pathological assessment, however, a necrotic nodule containing E. vermicularis was identified. Solitary necrotic nodules of the liver are usually benign but misdiagnosed frequently as malignant due to radiological features. It is standard practice to diagnose colorectal liver metastases solely on radiological evidence. Without obtaining tissue prior to liver resection, misdiagnosis of solitary necrotic nodules of the liver will continue to occur.

  8. Isolated penile metastasis from bladder carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Demuren, O.A. [Department of Radiology and Imaging, Armed Forces Hospital, Riyadh (Saudi Arabia); Koriech, O. [Department of Oncology, Armed Forces Hospital, Riyadh (Saudi Arabia)

    1999-10-01

    Metastases of the penis are uncommon, with only approximately 300 cases reported since 1870. In up to 70 % of patients, the primary tumour is located in the urogenital tract. Furthermore, isolated metastases of the penis are exceptionally rare. We report a case of solitary squamous cell metastasis of the penis presenting with painful swelling initially thought to be inflammatory in origin. The CT and MR imaging findings are presented with a short review of the literature. (orig.) With 2 figs., 9 refs.

  9. Colonic metastasis from renal cell carcinoma: helical-CT demonstration

    International Nuclear Information System (INIS)

    Diaz-Candamio, M.J.; Pombo, S.; Pombo, F.

    2000-01-01

    Clinically evident colonic metastasis from renal cell carcinoma (RCC) is rare. In the present study a hypervascular sigmoid mass was demonstrated on arterial-phase helical CT using a water enema in a patient who had suffered left nephrectomy 8 years previously for RCC. The intense and early enhancement of the lesion suggested the possibility of a solitary colonic metastasis from RCC, a diagnosis which was pathologically confirmed. (orig.)

  10. A rare adrenal incidentaloma: adrenal schwannoma.

    Science.gov (United States)

    Adas, Mine; Ozulker, Filiz; Adas, Gokhan; Koc, Bora; Ozulker, Tamer; Sahin, Ilknur Mansuroglu

    2013-01-01

    Adrenal schwannoma is an extremely uncommon cause of incidentaloma. It originates from neural sheath Schwann cells of the adrenal gland. We report the case of a left adrenal schwannoma incidentally discovered in a 32-year-old woman during examination of bloated feeling and stomach ache. The patient was incidentally found to have a left adrenal mass of 9 cm on abdominal ultrasonography. Computed tomography (CT) of the abdomen and [(18)F] fluorodeoxyglucose positron emission tomography (PET) were also performed. Metabolic evaluation was unremarkable. Due to the large size of the tumor, left adrenalectomy was performed. The postoperative course was uneventful. Histological examination established the diagnosis of schwannoma. This diagnosis was supported by immunohistochemistry of S-100 and vimentin positivity. In conclusion, adrenal schwannoma is an extremely rare entity and can grow considerably in size. The present case report emphasizes that clinicians should be aware of the possibility of retroperitoneal schwannoma. Total excision of benign schwannoma is associated with a favorable outcome. To our knowledge, there are case reports of schwannoma with CT and magnetic resonance imaging findings in the literature, although this is the first schwannoma case with PET-CT imaging.

  11. Solitary Play: Some Functional Reconsiderations

    Science.gov (United States)

    Moore, Nancy V.; And Others

    1974-01-01

    Solitary play in six kindergarten children was observed and coded for frequency and type in order to resolve iscrepancies in a Sex Birth Order interaction. Several facts concerning solitary play as indicative of independence and maturity are noted. (Author/ED)

  12. Congenital Adrenal Hyperplasia

    Science.gov (United States)

    ... Español NICHD Theme Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning ... Funding Opportunities & Notices Health A to Z List Adrenal Gland Disorders About NICHD Research Information Find a Study More ...

  13. Isolated Late Metastasis of a Renal Cell Cancer Treated by Radical Distal Pancreatectomy

    Directory of Open Access Journals (Sweden)

    J. P. Barras

    1996-01-01

    Full Text Available A 53–year-old man underwent right nephrectomy for a locally advanced renal cell carcinoma with concomitant resection of a solitary metastasis in the right lung. Ten years later, he presented with haematochezia caused by a tumour in the tail of pancreas, invading the transverse colon and the greater curvature of the stomach. The tumour was radically resected, and histological examination revealed a solitary metastasis of the previous renal cell carcinoma. This case illustrates a rare indication for pancreatic resection because of pancreatic metastasis.

  14. Chapter 13. Adrenal glands

    International Nuclear Information System (INIS)

    Roux, H.; Paulin, R.

    1975-01-01

    The condition of isotopic methods to the functional and morphological exploration of the adrenal glands is shown, with emphasis on the fact that althought the cortico-adrenal responds to these methods the same does not apply to the medullo-adrenal, which expresses its morphological changes by producing deformations on the cortical image. Funtional tests, mainly directed at the cortico-adrenal, are described first: study of exchangeable sodium and potassium; determination of the plasma concentration and metabolic clearance of some steroid hormones (cortisol, corticosterone, aldosterone); evaluation of the renin activity. These tests are based on competitive analysis and radioimmunological methods. Morphological tests are examined next. Adrenal scintigraphy uses a simple technique (intraveinous administration of 131 I 19-iodocholesterol with no special preliminary preparation) which gives good images and is only limited now by the need to avoid over exposure of the gonads to ionising radiations [fr

  15. Malignant Giant Cell Tumour of Bone with Axillary Metastasis

    African Journals Online (AJOL)

    2002-06-06

    Jun 6, 2002 ... SUMMARY. Giant Cell Tumour of bone is a typically benign and solitary tumour. However, multiple lesions have been described and 5-10% of lesions may be malignant. We present a case of a malignant giant cell tumour of the distal radius with metastasis to the ipsilateral axilla (an uncommon location).

  16. Hypophyseal metastasis

    International Nuclear Information System (INIS)

    Yanes Quesada, Miguel Angel; Yanes Quesada, Marelys; Lopez Arbolay, Omar; Lima Perez, Mayte; Hernandez Yero, Arturo

    2009-01-01

    Metastatic tumors of hypophyseal gland are infrequent. Most are silent lesions discovered accidentally in necropsy. Appearance of symptomatic metastasis is however, exceptional. We describe here clinical and radiological findings in a female patient aged 69, presenting with a non-differential carcinoma of lung, diagnosed two years a half ago, starting with headache and visual disorders without hypopituitarism and insipidus diabetes. We made a nuclear magnetic resonance and diagnosis was a hypophyseal lesion operated on by trans-esphenoidal route, and Pathological Anatomy Service reports a metastasis of lung carcinoma. (Author)

  17. 131I-cholesterol (19-C) in the diagnosis of adrenal disorders

    International Nuclear Information System (INIS)

    Mueller, C.; Glanzmann, C.; Luetolf, U.M.; Renk, I.W.; Horst, W.

    1976-01-01

    Results are reported of quantitative adrenal scintigraphy with 131 I-cholesterol in 8 patients with normal adrenal function before and after ACTH-stimulation and cortisol-suppression respectively, in one case with an adrenal metastasis from a pulmonary cancer, in two cases with Cushing's disease and in 7 cases with Conn's disease. In normal cases and in patients with M. Cushing a diagnosis of adrenal cortical function is possible with this method but can usually be replaced by more specific biochemical studies of serum and urine. The scintigraphic method is in addition of value in localization studies and can in unequivocal cases replace the selective adrenal phlebography. In patients with M. Conn increased uptake values (bilateral adrenal cortex hyperplasia) as well as reduced or non-detectable uptakes were observed, one of these cases suffering from a cortex carcinoma with M. Conn. (orig.) [de

  18. Solitary Pancreatic Metastasis from Renal Cell Carcinoma: A Case ...

    African Journals Online (AJOL)

    Typically, patients undergo a pancreaticoduodenectomy or distal pancreatectomy depending on the location of the tumor. Atypical resections are done in certain situations. Surgery is carried out in favourable candidates and a thorough evaluation needs to be done intraoperatively for multiple metastases. Histology revealed ...

  19. Ewing?s Sarcoma of the Adrenal Gland

    OpenAIRE

    Pal, Dilip Kumar; Chandra, Vipin; Ranjan, Kumar Rajiv; Chakrabortty, Debasis; Banerjee, Manju

    2016-01-01

    Ewing’s sarcoma (ES) or primitive neuro-ectodermal tumor (PNET) typically occurs in long or flat bones, the chest wall, extra-skeletal soft tissue, and rarely in solid organs. Incidence of adrenal Ewing’s sarcoma is very rare. Here we report a case of Ewing’s sarcoma of the right adrenal gland in an 8-year-old girl who presented with an abdominal mass. The huge tumor was managed by preoperative neo-adjuvant chemotherapy followed by surgical resection. She died due to metastasis after five mon...

  20. Primary adrenal sarcomatoid carcinoma

    Directory of Open Access Journals (Sweden)

    Aftab S. Shaikh

    2014-03-01

    Full Text Available Adrenal sarcomatoid carcinomas are extremely rare tumors presenting with extensive locoregional spread at the time of diagnosis. Patients succumb to metastases within a couple of months. As a result, very few cases are reported in the literature until now. We present a case of a 62-year old female with non-functional sarcomatoid carcinoma of the right adrenal gland. There was no radiological evidence of locoregional metastases. Patient underwent right adrenalectomy. Follow up after 3 months showed para-aortic lymphadenopathy and similar left adrenal mass on computed tomography. Patient refused further treatment and succumbed to the disease. A brief case report with review of literature is presented.

  1. Calcified adrenal cyst

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chung Kyu; Choi, Byung Sook [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1970-10-15

    Calcified hemorrhagic adrenal cysts are rather rare and unusual pathologic entity. Especially, the peripheral curvilinear calcification on roentgenogram is fairly characteristic picture of the cysts. Recently, we have experienced in Severance Hospital one of the classical cases of the benign calcified adrenal cyst in 35 year old white mail patient who has had vague abdominal pain and palpable mass in right abdomen. It has been reviewed several reports for adrenal cysts and hoped that this report may call additional attention of radiological diagnosis on this unusual disease.

  2. Solitary eyelid schwannoma

    Directory of Open Access Journals (Sweden)

    Renu M Magdum

    2014-01-01

    Full Text Available Schwannomas are rare benign tumors arising from Schwann cells of peripheral nerves that form the neural sheath. While there have been reports of such tumors in the orbit, solitary schwannomas arising from the eyelids are very rare. There are reports of schwannomas being erroneously diagnosed as chalazion, inclusion cysts or even eyelid malignancy. We are reporting a case of a 20-year-old female who presented with a painless, non-tender, slow-growing mass in the upper eyelid of the right eye. The external appearance of the mass was suggestive of an implantation cyst of the eyelid and it could be completely excised as it had a well-defined capsule. Histopathological examination showed characteristic hypercellular and hypocellular areas with fusiform nuclei that tended to form palisades. The purpose of reporting this case of schwannoma in a young female is to recommend the inclusion of this entity as a differential diagnosis of well-defined lid tumors.

  3. Adrenal Gland Disorders

    Science.gov (United States)

    ... Cushing's syndrome, there's too much cortisol, while with Addison's disease, there is too little. Some people are born unable to make enough cortisol. Causes of adrenal gland disorders include Genetic mutations Tumors ...

  4. Adrenal imaging agents

    International Nuclear Information System (INIS)

    Davis, M.A.; Hanson, R.N.; Holman, B.L.

    1980-01-01

    The goals of this proposal are the development of selenium-containing analogs of the aromatic amino acids as imaging agents for the pancreas and of the adrenal cortex enzyme inhibitors as imaging agents for adrenal pathology. The objects for this year include (a) the synthesis of methylseleno derivatives of phenylalanine and tryptophan, and (b) the preparation and evaluation of radiolabeled iodobenzoyl derivatives of the selenazole and thiazole analogs of metyrapone and SU-9055

  5. [Addison's disease : Primary adrenal insufficiency].

    Science.gov (United States)

    Pulzer, A; Burger-Stritt, S; Hahner, S

    2016-05-01

    Adrenal insufficiency, a rare disorder which is characterized by the inadequate production or absence of adrenal hormones, may be classified as primary adrenal insufficiency in case of direct affection of the adrenal glands or secondary adrenal insufficiency, which is mostly due to pituitary or hypothalamic disease. Primary adrenal insufficiency affects 11 of 100,000 individuals. Clinical symptoms are mainly nonspecific and include fatigue, weight loss, and hypotension. The diagnostic test of choice is dynamic testing with synthetic ACTH. Patients suffering from chronic adrenal insufficiency require lifelong hormone supplementation. Education in dose adaption during physical and mental stress or emergency situations is essential to prevent life-threatening adrenal crises. Patients with adrenal insufficiency should carry an emergency card and emergency kit with them.

  6. Papillary Thyroid Carcinoma Metastases Presenting as Ipsilateral Adrenal Mass and Renal Cyst

    Directory of Open Access Journals (Sweden)

    Serge Ginzburg

    2015-11-01

    Full Text Available Metastatic spread of differentiated thyroid cancer to genitourinary organs is rare. Synchronous presentation of renal and adrenal thyroid metastasis is even less common, this case being only the 3rd reported. We describe a case of a 60-year-old male with oligometastatic thyroid cancer, where adrenal and renal metastases were the only extracervical sites of disease and triggered the patient's presentation.

  7. CLINICAL CASE OF A MASSIVE ISOLA TED METASTATIC ADRENAL LESION IN COLORECT AL CANCER

    Directory of Open Access Journals (Sweden)

    I. P. Moshurov

    2015-01-01

    Full Text Available AbstractThe liver, lungs, parietal and visceral peritoneum have traditionally been considered to be the main target organs of metastatic colorectal cancer. The isolated adrenal metastasis in colorectal cancer is rare, in the literature there are single observations of clinical cases of successful surgical treatment of such patients. This article presents the clinical observation of successful surgical treatment of patients with colorectal cancer with massive isolated adrenal metastases.

  8. Retroperitoneal extra-adrenal paraganglioma: a rare but important diagnosis.

    LENUS (Irish Health Repository)

    Ahmad, S

    2012-01-31

    BACKGROUND: Extra-adrenal paragangliomas of the retroperitonium are infrequently diagnosed. Their malignant behaviour cannot be predicted on initial clinical and histological assessment. These tumours have higher propensity for subsequent metastasis compared with pargangliomas at other sites. AIM: We aim to describe a case report of an incidental finding of left retroperitoneal paraganglioma in a young man who presented with right flank pain. We also aim to emphasize the importance of diagnosis and the malignant potential of these tumours. METHOD: Patient\\'s clinical notes, operative findings, imaging studies and laboratory investigations including histology results were reviewed. A literature search was done to look into the incidence, presentation, follow-up plan and treatment options for these tumours. CONCLUSION: Surgical resection is the only available curative option for extra-adrenal paragangliomas. Metastasis is observed years after surgery, hence long-term follow-up is required.

  9. Emission tomography for adrenal imaging

    International Nuclear Information System (INIS)

    Britton, K.E.; Shapiro, B.; Hawkins, L.A.

    1980-01-01

    Single photon emission tomography (SPET) of the adrenals was compared to convential gamma camera images. Depths of 19 adrenals were assessed by both the lateral skin-upper kidney pole method and by SPET. Eleven patients with adrenal disorders were also studied. An advantage of using SPET was that the analogue transverse section image showed improvement over the conventional posterior view because the liver activity was well separated from the adrenal. Furthermore, non-adrenal tissue background was virtually eliminated and adrenal depth determination facilitated. (U.K.)

  10. Solitary plasmacytoma of spine with amyloidosis

    Directory of Open Access Journals (Sweden)

    Cui-yun SUN

    2017-01-01

    Full Text Available Objective To report the diagnosis and treatment of one case of solitary plasmacytoma of spine with amyloidosis and investigate the clinicopathological features combined with literatures. Methods and Results The patient was a 46-year-old woman. She suffered from weakness of both lower limbs, unsteady gait and numbness of toes for 20 d. MRI examination revealed an irregular mass behind the spinal cord at T5-7 level and T6-7 vertebral body accessory. The enhanced MRI showed obvious heterogeneous enhancement. The border was clear and spinal dura mater was compressed to shift forward. During operation, T5-7 processus spinosus and vertebral laminae were eroded, and the cortex of bone showed "moth-eaten" erosion. The intraspinal and extradural lesion had rich blood supply, loose bone structure and intact spinal dura mater. Histologically, tumor cells were composed of intensive small cells, and focal plasmacytoid cells were seen. Flake pink staining substance was among them. Artificial cracks were common and multinuclear giant tumor cells were scatteredly distributed. Immunohistochemical analysis showed the cytoplasm of tumor cells were diffusely positive for CD138, CD38 and vimentin (Vim,scatteredly positive for leukocyte common antigen (LCA, and negative for immune globulin κ light chain(IgGκ and λ light chain (IgGλ, CD99, S-100 protein (S-100, pan cytokeratin (PCK, epithelial membrane antigen (EMA, HMB45 and CD34. The Ki-67 labeling index was 1.25%. Congo red staining showed the pink staining substance was brownish red. Hybridization in situ examination showed the DNA content of IgGκ was more than that of IgGλ. The final pathological diagnosis was solitary plasmacytoma of spine with amyloidosis. The patient was treated with postoperative chemotherapy, and there was no recurrence or metastasis during 18-month follow-up period. Conclusions Solitary plasmacytoma of spine with amyloidosis is a rare tumor. The imaging features can offer a few

  11. Genetics Home Reference: primary macronodular adrenal hyperplasia

    Science.gov (United States)

    ... Support and Research Foundation: Genetic Changes Found in Cushing's Disease, Adrenal Tumors, and Adrenal Hyperplasia MalaCards: acth-independent ... macronodular adrenal hyperplasia 2 Merck Manual (Home Edition): Cushing ... Adrenal Diseases Foundation: Cushing's Syndrome Orphanet: Cushing syndrome due to ...

  12. [Adrenal tumours in childhood].

    Science.gov (United States)

    Martos-Moreno, G A; Pozo-Román, J; Argente, J

    2013-09-01

    This special article aims to summarise the current knowledge regarding the two groups of tumours with their origin in the adrenal gland: 1) adrenocortical tumours, derived from the cortex of the adrenal gland and 2) phaeochromocytomas and paragangliomas, neuroendocrine tumours derived from nodes of neural crest derived cells symmetrically distributed at both sides of the entire spine (paragangliomas [PG]). These PGs can be functioning tumors that secrete catecholamines, which confers their typical dark colour after staining with chromium salts (chromaffin tumors). Among these, the term phaeochromocytoma (PC) is restricted to those PGs derived from the chromaffin cells in the adrenal medulla (intra-adrenal PGs), whereas the term PG is used for those sympathetic or parasympathetic ones in an extra-adrenal location. We analyse the state of the art of their pathogenic and genetic bases, as well as their clinical signs and symptoms, the tests currently available for performing their diagnosis (biochemical, hormonal, imaging and molecular studies) and management (surgery, pre- and post-surgical medical treatment), considering the current and developing strategies in chemo- and radiotherapy. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  13. Extra-adrenal malignant paragangliomas presenting as mesenteric and pararectal masses: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Hye [Dept. of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Lee, Jong Mee; Kim, Baek Hui; Kim, Kyeong Ah; Park, Cheol Min [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2017-07-15

    Extra-adrenal paraganglioma is a rare tumor arising from the neural crest cells. Most tumors that develop in the abdomen arise from paraganglia along the paravertebral and para-aortic areas, in particular the organ of Zuckerkandl, which is close to the origin of the inferior mesenteric artery. However, extra-adrenal paraganglioma also occurs in relatively rare places such as the urinary bladder, gallbladder, hepatoduodenal ligament, and gastrointestinal tract. Here, we report imaging findings of extra-adrenal paragangliomas presenting as mesenteric and pararectal masses with lymph node metastasis.

  14. Adrenal Insufficiency and Addison's Disease

    Science.gov (United States)

    ... These conditions can lead to an adrenal crisis. Pregnancy Women with adrenal insufficiency who become pregnant are ... can benefit from following a diet rich in sodium. A health care provider or a dietitian can ...

  15. Radiologic evaluation of adrenal glands

    International Nuclear Information System (INIS)

    Pradel, J.; Bruel, J.M.; Taourel, P.; Garnier, T.; Cyteval, C.; Lamarque, J.L.

    1990-01-01

    When a diagnosis of adrenal disorder is suspected on the basis of clinical manifestations and/or laboratory findings, computed tomography (CT) is generally accepted as the imaging procedure of choice for visualization of adrenal areas and localization of lesions. Sonography keeps an important role in discovering adrenal masses during investigation for other suspected abnormality (incidentaloma). 131 I MIBG scintigraphy provides an efficious mean of pheochromocytoma localization and functional characterization. These non invasive procedures have greatly reduced the need for arteriography and venography; adrenal venous sampling is still an useful method for localizing either a tumor or hyperplasia related to primary aldosteronism. MR imaging and CT are nearly equivalent in the detection of adrenal masses: besides MR imaging has a potential for characterization of adrenal masses which might be useful, especially in distinguishing adrenal adenomas from malignant neoplasms, obviating, in some cases, the need of CT guided adrenal biopsy [fr

  16. Adrenal incidentalomas. Primary hyperaldosteronism

    International Nuclear Information System (INIS)

    Murat, A.; Dupas, B.; Zenatti, M.; Aupetit-Faisant, B.; Tenenbaum, F.; Tabarin, A.; Barrat, J.L.; Gosse, P.; Olivier-Puel, F.; Leprat, F.; Trouette, H.; Laurent, F.; Roger, P.

    1993-01-01

    Adrenal incidentalomas are masses incidentally discovered at X rays, ultrasound or MRI examination of the abdomen. In 100 CT scans, one can expect to find two incidentalomas on average. The article by Murat and Dupas is dealing with the strategy of biological, morphological and scintigraphic examinations to be performed in such patients, to assess whether the tumor is of a benign or a malignant nature. Zenatti et al propose a detailed exploration of the aldosterone pathways, since adrenal carcinoma may be responsible for a specific profile of the serum concentrations of mineralo-steroids, compatible with a blockade of the last step of the aldosterone synthesis. The exploration of primary hyperaldosteronism requires biological and imaging techniques. Tabarin et al summarize the main biological parameters and tests available for the diagnosis of this condition and delineate the indications of imaging techniques, associated to hormonal tests to distinguish between adenoma and bilateral adrenal hyperplasia. (author). 104 refs

  17. Nonclassic Congenital Adrenal Hyperplasia

    Directory of Open Access Journals (Sweden)

    Selma Feldman Witchel

    2010-01-01

    Full Text Available Nonclassic congenital adrenal hyperplasia (NCAH due to P450c21 (21-hydroxylase deficiency is a common autosomal recessive disorder. This disorder is due to mutations in the CYP21A2 gene which is located at chromosome 6p21. The clinical features predominantly reflect androgen excess rather than adrenal insufficiency leading to an ascertainment bias favoring diagnosis in females. Treatment goals include normal linear growth velocity and “on-time” puberty in affected children. For adolescent and adult women, treatment goals include regularization of menses, prevention of progression of hirsutism, and fertility. This paper will review key aspects regarding pathophysiology, diagnosis, and treatment of NCAH.

  18. Laparoscopic adrenal cortex

    International Nuclear Information System (INIS)

    Peyrolou, A.; Salom, A.; Harguindeguy; Taroco, L.; Ardao, G.; Broli, F. . E mail: andresssss@adinet.com.uy

    2005-01-01

    The paper presents the case of a female patient who carried an aldosterone-secreting tumor of adrenal cortex.In the analysis of diagnosis and para clinical examinations there is particular reference to the laparoscopic surgery mode of treatment.Diagnosis should be established on the basis of clinical and laboratory tests (hypopotassemia and hyperaldosteronism).Tumor topography was confirmed through CT scan, MRI and Scintiscan in left adrenal cortex.Resection was consequently made through laparoscopic surgery.The patients evolution was excellent from the surgical viewpoint,with I levels of blood pressure, potassium and aldosterone returned to normal

  19. Imaging of adrenal disorders

    International Nuclear Information System (INIS)

    Fukuchi, Soitsu

    1982-01-01

    Adrenal scintillation scanning, CT and ultrasonography are compared with the conventional imaging methods. The accuracy of retroperitoneal pneumography and adrenal venography are not high, and they detected only large tumors such as Cushing's syndrome and pheochromocytoma. Scintillation scanning is highly effective for the diagnoses of primary aldosteronism and Cushing's syndrome. However, this technique does not visualize pheochromocytoma or hypopituitarism. CT is noninvasive and of high diagnostic value. It is impossible to diagnose tumors by ultrasonography unless the size is more than 3 cm. (Chiba, N.)

  20. Pattern of distant lymph node metastasis in colorectal carcinoma and its correlation with distant organ metastasis: CT evaluation

    International Nuclear Information System (INIS)

    Cha, Sang Hoon; Park, Cheol Min; Cha, In Ho; Chung, Kyoo Byung; Suh, Won Hyuck

    1995-01-01

    To evaluate the pattern of distant lymph node metastasis in colorectal carcinoma and its correlation with distant organ metastasis. We retrospectively reviewed abdominal CT scans of 46 patients with pathologically proven colorectal carcinoma. The incidence of distant lymphadenopathy in colorectal carcinoma was 30.4%(14/46). The most commonly involved distant lymph node was the left paraortic lymph node below the renal hilum(9/25). The most common type of distant lymphadenopathy was solitary type(7/14) and all of these lymphadenopathies were noted in the left paraortic lymph node below the renal hilum. Six cases of left sided colorectal carcinoma showed left paraortic lymphadenopathy with solitary type. The incidence of distant organ metastasis was 17.4%(8/46) and markedly increased if distant lymphadenopathy was multiple and confluent, or confluent type(5/7). The incidence of distant lymphadenopathy in colorectal carcinoma was not high and the most common lymphadenopathy was the left paraortic lymph node with solitary type below the renal hilum. The possibility of distant organ metastasis was high if distant lymphadenopathy was multiple and confluent, or confluent type

  1. Aging and body size in solitary bees

    Science.gov (United States)

    Solitary bees are important pollinators of crops and non-domestic plants. Osmia lignaria is a native, commercially-reared solitary bee used to maximize pollination in orchard crops. In solitary bees, adult body size is extremely variable depending on the nutritional resources available to the develo...

  2. Surgery for adrenal tumors

    International Nuclear Information System (INIS)

    Salamah, S.M.

    2002-01-01

    Objective: To analyze the presentation, localization, pathology, surgical management and outcome of surgery for adrenal gland tumors. Design: Prospective clinico epidemiological study. Place and Duration of Study: The study was conducted at the Department of General Surgery, University Unit, Riyadh medical Complex Kingdom of Saudi Rabia from June, 1991 to may, 2001. Subjects and Methods: A total of 21 cases with adrenal tumors were studied for demographic data, clinical presentation, diagnostic workup, localization, surgical management, pathology and outcome. The outcome of these patients was followed prospectively. Results: The study included 12 female and 9 male patients. The mean age at surgery was 36.7 years. Hypertension (69.%) was the commonest presentation in hypersecretory functional tumors. The localization accuracy for ultrasonography, computerized tomography, MRI and MIBG scan was 95.2%, 98.3% 87.8% and 83.6% respectively. Pheochromocytoma was the most common adrenal pathology observed in 14 (66.6%) cases. The overall morbidity was 19% with no hospital mortality. Complete follow-up of available 19 patients (90.5 %) revealed no tumor recurrence and persistent hypertension in 14.3% cases. Conclusion: surgery on adrenal glands is safe in experienced hands and is recommended in institutes with all backup facilities. (author)

  3. Adrenal pseudocyst. Radiological finds

    International Nuclear Information System (INIS)

    Ortega, E.; Lopez Rasines, G.; Bustos, A.; Otero, M.; Rodriguez, M.I.; Pagola, M.A.

    1991-01-01

    Adrenal cysts are infrequent, the pseudocysts being those that most often produce clinical symptoms. A case of pseudocyst in right suprarenal gland is presented in a young woman with no clinical history, who was studied by means of ultrasound (US) and computerized tomography (CT). (author)

  4. Experience of treating late cerebral lungcancer metastasis using photodynamic therapy

    Directory of Open Access Journals (Sweden)

    A. I. Ryabova

    2013-01-01

    Full Text Available Treatment outcomes for a patient with solitary brain metastasis after long-term relapse-free follow-up of invasive lung carcinoma were presented. Brain metastasis without other signs of disease progression was diagnosed 10 years after combined modality treatment for stage II lung cancer. Removal of intracerebral metastasis with intraoperative photodynamic therapy was performed. Histology microspecimens of the primary tumor and metastasis were similar. No signs of disease progression in the brain 9 months after surgery were found. This case demonstrates that it is important to increase cancer suspicion for patients with long-term relapse-free follow-up. The use of intraoperative photodynamic therapy with photoditazine as a sensitizer in the treatment of cerebral metastases results in a favorable anti-tumor effect, thus improving life quality of patients

  5. Solitary waves and homoclinic orbits

    International Nuclear Information System (INIS)

    Balmforth, N.J.

    1994-03-01

    The notion that fluid motion often organizes itself into coherent structures has increasingly permeated modern fluid dynamics. Such localized objects appear in laminar flows and persist in turbulent states; from the water on windows on rainy days, to the circulations in planetary atmospheres. This review concerns solitary waves in fluids. More specifically, it centres around the mathematical description of solitary waves in a single spatial dimension. Moreover, it concentrates on strongly dissipative dynamics, rather than integrable systems like the KdV equation. One-dimensional solitary waves, or pulses and fronts as they are also called, are the simplest kinds of coherent structure (at least from a geometrical point of view). Nevertheless, their dynamics can be rich and complicated. In some circumstances this leads to the formation of spatio-temporal chaos in the systems giving birth to the solitary waves, and understanding that phenomenon is one of the major goals in the theory outlined in this review. Unfortunately, such a goal is far from achieved to date, and the author assess its current status and incompleteness

  6. Aggressive solitary intracranial metastatic malignant melanoma from a primary mediastinal tumour.

    Science.gov (United States)

    Sivaraju, Laxminadh; Aryan, Saritha; Hegde, Vinay S; Ghosal, Nandita; Hegde, Alangar S

    2016-08-01

    Malignant melanoma is the third most common tumour to cause cerebral metastases, following breast and lung cancer. Central nervous system metastases occur in 10-40% of patients with melanoma. Intracranial metastasis from a primary malignant melanoma of the anterior mediastinum is uncommon. We report a case of solitary intracranial metastatic melanoma arising from a primary mediastinal tumour. We then discuss the clinico-radiological features and treatment options. © The Author(s) 2016.

  7. New and superior adrenal imaging agent, 131I-6β-iodomethyl-19-nor-cholesterol (NP-59): evaluation in humans

    International Nuclear Information System (INIS)

    Sarkar, S.D.; Cohen, E.L.; Beierwaltes, W.H.; Ice, R.D.; Cooper, R.; Gold, E.N.

    1977-01-01

    We have reported tissue distribution studies in rats and dogs with a new adrenal imaging agent, 131 I-6β-iodomethyl-19-nor-cholesterol (NP-59). This agent concentrated five times higher in the adrenal cortex than 131 I-19-iodocholesterol without increased concentration in non-adrenal tissues. We now report in 34 patients, the findings on scintigraphy with NP-59 compared with angiograms and/or adrenal vein hormone levels and histopathology, including 13 patients with hypercortisolism, 12 with primary aldosteronism, 2 with low renin hypertension, 5 with catecholamine excess, 1 with a liver metastasis from an aldosterone producing adrenal cortical carcinoma, and 1 with anaplastic adrenal cortical carcinoma. NP-59 adrenal cortical uptake was more rapid and intense and background activity was less prominent, allowing earlier and more definite interpretation of images than was possible with 131 I-19-iodocholesterol

  8. [Cranial metastasis of thyroid follicular carcinoma. Report of a case].

    Science.gov (United States)

    Calderón-Garcidueñas, A L; González-Schaffinni, M A; Farías-García, R; Rey-Laborde, R

    2001-01-01

    Thyroid follicular carcinoma is able to produce metastatic lesions before the vanishing of the primary lesion. We present a case of a woman with a lytic, solitary, asymptomatic parietal bone lesion of 2 years of evolution. Autopsy revealed a thyroid gland with two small cystic areas and renal metastasis. Thyroid carcinoma should be included in the differential diagnosis in cases of lytic bone lesions with long evolution in patients 60 years of age or older.

  9. Isolated adrenal paracoccidioidomycosis: Case report

    International Nuclear Information System (INIS)

    Uribe Castro, Jorge Ricardo; Quintana, Humberto; Puentes, Alix Sofia and others

    2011-01-01

    Even though paracoccidioidomycosis has a relatively high prevalence in Latin America in a systemic form, isolated cases, especially compromising the adrenal glands, are uncommon, with only two reported cases. In this article, we report the case of a 55 year-old male with clinical manifestations of adrenal insufficiency. The only imaging finding was the presence of bilateral adrenal masses. The biopsy showed Paracoccidioides brasiliensis infection.

  10. Nonlinear positron acoustic solitary waves

    International Nuclear Information System (INIS)

    Tribeche, Mouloud; Aoutou, Kamel; Younsi, Smain; Amour, Rabia

    2009-01-01

    The problem of nonlinear positron acoustic solitary waves involving the dynamics of mobile cold positrons is addressed. A theoretical work is presented to show their existence and possible realization in a simple four-component plasma model. The results should be useful for the understanding of the localized structures that may occur in space and laboratory plasmas as new sources of cold positrons are now well developed.

  11. [Solitary hyperfunctioning thyroid gland carcinomas].

    Science.gov (United States)

    Zivaljevic, V; Zivic, R; Diklic, A; Krgovic, K; Kalezic, N; Vekic, B; Stevanovic, D; Paunovic, I

    2011-08-01

    Thyroid gland carcinomas usually appear as afunctional and hypofunctional lesions on thyroid scintigrams, but some rare cases of thyroid carcinoma with scintigraphic hyperfunctional lesions have also been reported. The aim of our retrospective study was to elucidate the frequency of carcinomas in patients operated for solitary hyperfunctional thyroid nodules and to represent their demographic and clinical features. During one decade (1997/2006), 308 patients were operated for solitary hyperfunctional thyroid nodules in the Centre for Endocrine Surgery in Belgrade. Malignancy was revealed in 9 cases (about 3 %) by histopathological examination. In 6 cases papillary microcarcinomas were found adjacent to dominant hyperfunctional adenomas, while in 3 cases (about 1 %) real hyperfunctional carcinomas were confirmed. Follicular carcinoma was diagnosed in 2 cases and papillary carcinoma in one. All 3 patients were preoperatively hyperthyroid. In both patients with follicular carcinoma we performed lobectomies. In the third case we carried out a total thyroidectomy considering the intraoperative frozen section finding of a papillary carcinoma. According to our results the frequency of solitary hyperfunctioning thyroid carcinomas is about 1 %, so that the possibility that a hyperfunctional nodule is malignant should be considered in the treatment of such lesions. © Georg Thieme Verlag KG Stuttgart ˙ New York.

  12. Primary adrenal leiomyosarcoma: A case report with immunohistochemical study and review of literature

    Directory of Open Access Journals (Sweden)

    Sanjay D Deshmukh

    2013-01-01

    Full Text Available Primary adrenal mesenchymal tumors are exceptionally rare. Diagnosis is based entirely on histological and immunohistochemical evaluation which is indispensable not only for determining tumor type but also for predicting biological behavior. We report a rare case of primary leiomyosarcoma of the left adrenal gland, in a 60 year old woman who presented with flank pain. Computed tomography revealed a well defined left adrenal tumor which was surgically resected. Histological examination of the tumor showed malignant spindle cells in interlacing fascicles and whorls. Nuclear pleomorphism, tumor giant cells and abnormal mitotic figures were seen. On immunohistochemistry, the tumor cells showed reactivity for smooth muscle actin, vimentin and desmin; and were negative for cytokeratin, S100 protein, CD117 and HMB-45. A diagnosis of primary adrenal leiomyosarcoma was offered. Postoperative recovery of the patient was uneventful and the patient was symptom free with no evidence of tumor metastasis or recurrence 21 months after surgery.

  13. Surf similarity and solitary wave runup

    DEFF Research Database (Denmark)

    Fuhrman, David R.; Madsen, Per A.

    2008-01-01

    The notion of surf similarity in the runup of solitary waves is revisited. We show that the surf similarity parameter for solitary waves may be effectively reduced to the beach slope divided by the offshore wave height to depth ratio. This clarifies its physical interpretation relative to a previ...... functional dependence on their respective surf similarity parameters. Important equivalencies in the runup of sinusoidal and solitary waves are thus revealed.......The notion of surf similarity in the runup of solitary waves is revisited. We show that the surf similarity parameter for solitary waves may be effectively reduced to the beach slope divided by the offshore wave height to depth ratio. This clarifies its physical interpretation relative...... to a previous parameterization, which was not given in an explicit form. Good coherency with experimental (breaking) runup data is preserved with this simpler parameter. A recasting of analytical (nonbreaking) runup expressions for sinusoidal and solitary waves additionally shows that they contain identical...

  14. Bladder Metastasis of non-Small Cell Lung Cancer : an Unusual Cause of Hematuria

    NARCIS (Netherlands)

    Karatas, O. Faruk; Bayrak, Reyhan; Yildirim, M. Erol; Bayrak, Omer; Cimentepe, Ersin; Unal, Dogan

    2009-01-01

    Approximately 2% of bladder malignancies are metastatic. The lung cancer makes metastasis sporadically to the bladder. A-69-year-old female patient presented with a history of pain in kidneys, vomiting and hematuria. Cystoscopic examination of the patient revealed small bladder capacity and solitary

  15. Primitive neuroectodermal tumor of adrenal: Clinical presentation and outcomes

    Directory of Open Access Journals (Sweden)

    Deep Dutta

    2013-01-01

    Full Text Available Primitive neuroectodermal tumor (PNET of adrenal is an extremely rare tumor of neural crest origin. A nonfunctional left adrenal mass (14.6 × 10.5 × 10.0 cm on computed tomography (CT was detected in a 40-year-old lady with abdominal pain, swelling, and left pleural effusion. She underwent left adrenalectomy and left nephrectomy with retroperitoneal resection. Histopathology revealed sheets and nest of oval tumor cells with hyperchromatic nuclei, prominent nucleoli, scanty cytoplasm, brisk mitotic activity, necrosis, lymphovascular invasion, capsular invasion, and extension to the surrounding muscles; staining positive for Mic-2 (CD-99 antigen, vimentin, synaptophysin, and Melan-A. Thoracocentesis, pleural fluid study, and pleural biopsy did not show metastasis. She responded well to vincristine, adriamycin, and cyclophosphamide followed by ifosfamide and etoposide (IE. This is the first report of adrenal peripheral PNET (pPNET from India. This report intends to highlight that pPNET should be suspected in a patient presenting with huge nonfunctional adrenal mass which may be confused with adrenocortical carcinoma.

  16. An Unusual Presentation of Lung Cancer Metastasis: Perianal Abscess

    OpenAIRE

    Murat Kilic

    2014-01-01

    Lung cancer is one of the most commonly diagnosed cancers in both men and women. Although the most frequent sites of distant metastasis of lung cancers are the pleura, liver, adrenal glands, skeletal system and brain, perianal region has been rarely reported as a metastasis site. A male patient was admitted to our emergency room with a long standing perianal abscess. During abscess drainage, a mass was noticed at the base of the abscess pouch, and thus a biopsy was taken. Pathologically, it w...

  17. Multi-component optical solitary waves

    DEFF Research Database (Denmark)

    Kivshar, Y. S.; Sukhorukov, A. A.; Ostrovskaya, E. A.

    2000-01-01

    We discuss several novel types of multi-component (temporal and spatial) envelope solitary waves that appear in fiber and waveguide nonlinear optics. In particular, we describe multi-channel solitary waves in bit-parallel-wavelength fiber transmission systems for highperformance computer networks......, multi-color parametric spatial solitary waves due to cascaded nonlinearities of quadratic materials, and quasiperiodic envelope solitons due to quasi-phase-matching in Fibonacci optical superlattices. (C) 2000 Elsevier Science B.V. All rights reserved....

  18. Prolactin induces adrenal hypertrophy

    Directory of Open Access Journals (Sweden)

    E.J. Silva

    2004-02-01

    Full Text Available Although adrenocorticotropic hormone is generally considered to play a major role in the regulation of adrenal glucocorticoid secretion, several reports have suggested that other pituitary hormones (e.g., prolactin also play a significant role in the regulation of adrenal function. The aim of the present study was to measure the adrenocortical cell area and to determine the effects of the transition from the prepubertal to the postpubertal period on the hyperprolactinemic state induced by domperidone (4.0 mg kg-1 day-1, sc. In hyperprolactinemic adult and young rats, the adrenals were heavier, as determined at necropsy, than in the respective controls: adults (30 days: 0.16 ± 0.008 and 0.11 ± 0.007; 46 days: 0.17 ± 0.006 and 0.12 ± 0.008, and 61 days: 0.17 ± 0.008 and 0.10 ± 0.004 mg for treated and control animals, respectively; P < 0.05, and young rats (30 days: 0.19 ± 0.003 and 0.16 ± 0.007, and 60 days: 0.16 ± 0.006 and 0.13 ± 0.009 mg; P < 0.05. We selected randomly a circular area in which we counted the nuclei of adrenocortical cells. The area of zona fasciculata cells was increased in hyperprolactinemic adult and young rats compared to controls: adults: (61 days: 524.90 ± 47.85 and 244.84 ± 9.03 µm² for treated and control animals, respectively; P < 0.05, and young rats: (15 days: 462.30 ± 16.24 and 414.28 ± 18.19; 60 days: 640.51 ± 12.91 and 480.24 ± 22.79 µm²; P < 0.05. Based on these data we conclude that the increase in adrenal weight observed in the hyperprolactinemic animals may be due to prolactin-induced adrenocortical cell hypertrophy.

  19. A metastatic adrenal tumor from a hepatocellular carcinoma: combination therapy with transarterial chemoembolization and radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyun Jin; Cho, Yun Ku; Ahn, Yong Sik; Kim, Mi Young [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2007-07-15

    The adrenal gland is the second most common site of metastasis from a hepatocellular carcinoma (HCC). Radiofrequency ablation (RFA) for these tumors has been reported to be a potentially effective alternative to an adrenalectomy, especially for inoperable patients. However, for intermediate or large adrenal tumors, combination therapy of transarterial chemoembolization (TACE) and RFA can be attempted as it may reduce the heat sink effect. A 74-year-old patient presented with abdominal discomfort. Abdominal CT images revealed a 5.0 cm sized right adrenal mass. A percutaneous biopsy of the adrenal mass revealed a metastatic hepatocellular carcinoma. TACE was performed on the adrenal mass. However, a one-month follow-up CT image revealed a residual viable tumor. RFA was performed for the adrenal tumor six weeks after the TACE. No procedure-related major complications were noted. The serum alpha-fetoprotein level had also been normalized after the treatment, and 10-month follow-up CT images showed no definite evidence of viable adrenal tumor.

  20. [Adrenal insufficiency of the adult].

    Science.gov (United States)

    Jublanc, C; Bruckert, E

    2016-12-01

    Adrenal insufficiency is a rare but life-threatening disorder. Clinical manifestations include fatigue, weight loss, gastrointestinal manifestations and skin hyperpigmentation, the latter being specific of primary adrenal failure. Because of non-specific clinical features of this rare disorder, diagnosis can be delayed and adrenal failure be revealed by an acute crisis. Adrenal insufficiency can be primary (Addison disease), most frequently autoimmune, or secondary, resulting from long term administration of exogenous glucocorticoids or more rarely from pituitary disorders. Monitoring of substitutive treatment is now well codified. Patient education is very important in this chronic disease that remains associated with a persistent high risk of adrenal crisis. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  1. Solitary circumscribed neurofibroma of the vulva

    International Nuclear Information System (INIS)

    Lau Serrano, Dalgis; Millan Vega, Maria Margarita; Fajardo Tornes, Yarine Leonell

    2012-01-01

    Neurofibroma is a benign tumor that originates from cells of peripheral nerve sheath. It may occur as solitary or multiple lesions as part of Von Recklinghausen disease or neurofibromatosis. The solitary lesions are rare and usually they are not associated with systemic symptoms

  2. Metastasis features of 546 patients with stage IV non-small cell lung cancer at first visit and the significance in radiotherapy

    International Nuclear Information System (INIS)

    Li Fenghu; Lu Bing; Fu Heyi; Han Lei; Li Qingsong; Li Huiqin

    2012-01-01

    Objective: To investigate the clinical metastasis features and the possibility of 3 dimensional radiotherapy of stage IV non-small cell lung cancer (NSCLC). Methods: The clinical materials of 546 patients with stage IV NSCLC and the relationship b T and N stage and metastasis were retrospectively analyzed. Results In 546 patients with stage IV NSCLC, the number with bone metastasis was 294, the number with brain metastasis was 167, the number with lung metastasis was 137, the number with liver metastasis was 79, the number with adrenal gland metastasis was 66, 37 with lymph node metastasis, 35 with subcutaneous metastasis and 10 with other organ metastasis. The number with single organ metastasis was 379 (69.4%) ,in which 37.7% with bone metastasis, 19.8% with brain metastasis, 16.9% with lung metastasis, 7.4% with liver metastasis, 7.4% with adrenal gland metastasis, 4.5% with lymph node metastasis, 5.5% with subcutaneous metastasis and 0.8% with other organ metastasis. The bone metastasis probability of T 3+4 patient was similar with T 1+2 (69.4%, 30.6%, χ 2 = 7.65, P = 0.067), but N 2+3 patient was more than N 0+1 (69.7%, 30.3%, χ 2 = 7.89, P = 0.044). The brain metastasis probability of T 3+4 patient was more than T 1+2 (70.7%, 29.3%, χ 2 = 10.64, P = 0.018), but N 2+3 patient was similar with N 0+1 (54.5%, 45.5%, χ 2 = 7.14, P = 0.079), and N 1+3+3 patient was more than N 0 (86.8%, 13.2%, χ 2 = 10.26, P = 0.024). Conclusions: In 546 patients with stage IV NSCLC, the most common metastatic organ is bone, the second is brain, the third is lung, the forth is liver, followed by adrenal gland; single organ metastasis is more common than multiple organ metastasis. The later the T stage is, the more severe is the metastasis. Through 3 dimensional radiotherapy, not only the quality of life of some stage IV patients is improved, but also the survival time was prolonged observably. (authors)

  3. Imaging findings of neonatal adrenal disorders

    International Nuclear Information System (INIS)

    Yoon, Hye Kyung; Han, Bo Kyung; Lee, Min Hee

    1999-01-01

    In newborn infants, normal adrenal glands are characterized by a relatively thin echogenic center surrounded by a thick, hypoechoic cortical rim as seen on ultrasound (US). Various disorders involving the neonatal adrenal gland include adrenal hemorrhage, hyperplasia, cyst, Wolman's disease, and congenital neuroblastoma. Adrenal hemorrhage is the most common cause of an adrenal mass in the neonate, though differentiation between adrenal hemorrhage and neuroblastoma is in many cases difficult. We describe characteristic US, CT and MR imaging findings in neonates with various adrenal disorders

  4. Imaging findings of neonatal adrenal disorders

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung; Han, Bo Kyung; Lee, Min Hee [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-01-01

    In newborn infants, normal adrenal glands are characterized by a relatively thin echogenic center surrounded by a thick, hypoechoic cortical rim as seen on ultrasound (US). Various disorders involving the neonatal adrenal gland include adrenal hemorrhage, hyperplasia, cyst, Wolman's disease, and congenital neuroblastoma. Adrenal hemorrhage is the most common cause of an adrenal mass in the neonate, though differentiation between adrenal hemorrhage and neuroblastoma is in many cases difficult. We describe characteristic US, CT and MR imaging findings in neonates with various adrenal disorders.

  5. Diagnosis of adrenal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Richter, E.I.; Loesch, H.

    1987-09-01

    Of 155 patients with adrenal disorders, 120 (77%) were correctly diagnosed as negative. There were no correlations between the results of computer tomography and phlebography or between computer tomography and laboratory tests. In 31 patients (20%) a correct diagnosis was obtained and these patients were sent to surgery. Four cases (3%) were shown to be false positive. In these cases (with one exception), both the computer tomography and phlebography results had been overinterpreted. Computer tomography was shown to be a method of high sensitivity and almost as great specificity. Tumors cannot be distinguished by phlebography; only pheochromocytoma shows a characteristic alteration of vessels in arteriograms. In general, an accurate diagnosis requires positive angiography (arterio- or phlebography) results and clear evidence of elevated hormone levels. Only then is surgery indicated.

  6. Diagnosis of adrenal tumors

    International Nuclear Information System (INIS)

    Richter, E.I.; Loesch, H.

    1987-01-01

    Of 155 patients with adrenal disorders, 120 (77%) were correctly diagnosed as negative. There were no correlations between the results of computer tomography and phlebography or between computer tomography and laboratory tests. In 31 patients (20%) a correct diagnosis was obtained and these patients were sent to surgery. Four cases (3%) were shown to be false positive. In these cases (with one exception), both the computer tomography and phlebography results had been overinterpreted. Computer tomography was shown to be a method of high sensitivity and almost as great specificity. Tumors cannot be distinguished by phlebography; only pheochromocytoma shows a characteristic alteration of vessels in arteriograms. In general, an accurate diagnosis requires positive angiography (arterio- or phlebography) results and clear evidence of elevated hormone levels. Only then is surgery indicated. (orig.) [de

  7. Adrenal vein catheterization. Anatomic considerations

    Energy Technology Data Exchange (ETDEWEB)

    El-Sherief, M.A. (Akademiska Sjukhuset, Uppsala (Sweden))

    1982-01-01

    Twenty post-mortem specimens and 93 phlebographies (56 right side, 37 left side) from 44 patients were investigated with respect to the adrenal venous anatomy. At autopsy, the venous orifices displayed in the area of adrenal drainage were injected bilaterally to identify the adrenal vein(s), the surrounding channels and the presence of interconnections. The findings were correlated with those at clinical phlebography, and the different sources of error were elicited. These were mainly found on the right side. Some guidelines are suggested in the hope that these will contribute to eliminate misconceptions.

  8. A case of adrenal Cushing's syndrome with bilateral adrenal masses.

    Science.gov (United States)

    Guo, Ya-Wun; Hwu, Chii-Min; Won, Justin Ging-Shing; Chu, Chia-Huei; Lin, Liang-Yu

    2016-01-01

    A functional lesion in corticotrophin (ACTH)-independent Cushing's syndrome is difficult to distinguish from lesions of bilateral adrenal masses. Methods for distinguishing these lesions include adrenal venous sampling and (131)I-6β-iodomethyl-19-norcholesterol ((131)I-NP-59) scintigraphy. We present a case of a 29-year-old Han Chinese female patient with a history of hypercholesterolaemia and polycystic ovary syndrome. She presented with a 6month history of an 8kg body weight gain and gradual rounding of the face. Serial examinations revealed loss of circadian rhythm of cortisol, elevated urinary free-cortisol level and undetectable ACTH level (Cushing's syndrome presenting with bilateral adrenal masses. The clinical presentation of Cushing' syndrome includes symptoms and signs of fat redistribution and protein-wasting features.The diagnosis of patients with ACTH-independent Cushing's syndrome with bilateral adrenal masses is challenging for localisation of the lesion.Both adrenal venous sampling and (131)I-NP-59 scintigraphy are good methods to use in these patients with Cushing's syndrome presenting with bilateral adrenal masses.

  9. MR imaging in adrenal diseases

    International Nuclear Information System (INIS)

    Juliani, G.; Avateneo, T.; Potenzoni, F.

    1988-01-01

    Twenty-five patients affected by adrenal glands pathology underwent CT and MRI: 6 nonfuctioning adenomas, 2 Cushing's adenomas, 2 Conn's adenomas, 6 metastases, 3 cystis, 2 carcinomas (Cushing's syndrome), 1 Lymphoma and 3 pheochromocytomas. Diagnosis was subsequently confirmed either at surgery, or autopsy, or with needle biopsy. In all cases normal adrenal glands and pathological lesions were showed by MRI. T1 signal intensity and mass diameter were compared with T2 signal intensity, represented by the intensity ratio between the adrenal mass vs normal hepatic parenchyma. MRI signal intensity, usually high in case of malignancy and low in adenomas, shows a mean value which is much wider than that referred to mass diameter evaluation (carcinoma is larger than adenoma); for this reason those findings have proved to be insufficiently accurate for adrenal tissue characterization, even for the evaluation of cysts and pheochromocytomas. In the same cases CT showed higher accuracy

  10. An Unusual Presentation of Lung Cancer Metastasis: Perianal Abscess

    Directory of Open Access Journals (Sweden)

    Murat Kilic

    2014-06-01

    Full Text Available Lung cancer is one of the most commonly diagnosed cancers in both men and women. Although the most frequent sites of distant metastasis of lung cancers are the pleura, liver, adrenal glands, skeletal system and brain, perianal region has been rarely reported as a metastasis site. A male patient was admitted to our emergency room with a long standing perianal abscess. During abscess drainage, a mass was noticed at the base of the abscess pouch, and thus a biopsy was taken. Pathologically, it was reported as a metastasis of squamous cell carcinoma, therefore some radiological  investigations and endoscopic procedures were performed to determine the primary focus of cancer. A pulmonary mass was revealed in PET/CT, and was considered as primary tumor. Both primary and metastatic perianal tumors can be rarely presented as an abscess formation. In this situation, a biopsy should be performed from the lesion to avoid misdiagnosis.

  11. CT findings of adrenal schwannoma

    International Nuclear Information System (INIS)

    Zhang, Y.-M.; Lei, P.-F.; Chen, M.-N.; Lv, X.-F.; Ling, Y.-H.; Cai, P.-Q.; Gao, J.-M.

    2016-01-01

    Aim: To analyse the computed tomography (CT) imaging features of patients with adrenal schwannoma. Materials and methods: Eight cases of adrenal schwannoma confirmed by histopathology were included in this study. All eight patients had undergone multiphase CT examinations. The features of the adrenal schwannoma in the CT images were analysed retrospectively in detail, including size, shape, margin, radiodensity, calcification, and enhancement pattern. Results: There were six male and two female patients, with a median age of 44.5 years (range, 25–52 years). Two patients complained of right flank pain, and two with left upper abdominal discomfort, while the remaining patients were diagnosed by routine ultrasound examinations. On unenhanced CT images, all cases of adrenal schwannoma were well circumscribed, rounded or oval, heterogeneous masses with cystic components, with two cases exhibiting calcification, and three cases with septa. On enhanced CT images, all cases displayed mild heterogeneous enhancement of the tumour during the arterial phase, and progressive enhancement during the portal venous phase and equilibrium phase. Conclusion: Adrenal schwannoma commonly presents as a well-defined unilateral mass with cystic degeneration, septa, and a characteristic progressive contrast-enhancement pattern on multiphase enhanced scans. - Highlights: • Adrenal schwannomas were extremely rare, and eight cases' medical data of this disease were collected in this study. • They usually presented a well-defined unilateral mass with cystic degeneration and sepations. • They manifested characteristic progressive contrast enhancement pattern on enhanced CT images.

  12. Management of a solitary thyroid nodule

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    Solitary nodule in the thyroid is a common clinical entity. A careful clinical assessment is the crucial first step in deciding the modality of treatment. The only worthwhile investigation is FNAC. Other investigations are done merely for the sake of a complete academic work up and can usually be dispensed with in most of the cases. Not every solitary nodule requires surgery. The optimum surgery for a solitary nodule is a total lobectomy. The specimen should be subjected to histological examination before recommending further treatment

  13. Pain relief by Cyberknife radiosurgery for spinal metastasis.

    Science.gov (United States)

    Lee, Sunyoung; Chun, Mison

    2012-01-01

    To report pain relief effect in patients with spinal metastases treated with Cyberknife® and to analyze the factors associated with pain relapse after initial pain relief. We retrospectively analyzed patients with spinal metastasis treated with stereotactic body radiosurgery between April 2007 and June 2009. A total of 57 patients with 73 lesions were available for analysis with a median follow-up of 6.8 months (range, 1-30). Pain was assessed by a verbal/visual analogue scale at each visit: from 0 to 10. Pain relief was defined as a decrease of at least three levels of the pain score without an increase in analgesic use. Complete relief was defined as no analgesics or a score 0 or 1. Pain relief was achieved in 88% of the lesions, with complete relief in 51% within 7 days from the start of radiosurgery. The median duration of pain relief was 3.2 months (range, 1-30). Pain reappeared in 16 patients (27%). Spinal cord compression (P = 0.001) and performance status (P = 0.01) were predictive of pain relapse by multivariate Cox analysis. All 6 patients treated with solitary spinal metastasis experienced pain relief; 5 of them were alive without evidence of disease at a median of 16 months (range, 7-30). As previous studies have shown, our study confirms that pain relief with spinal radiosurgery is around 90%. In particular, long-term pain relief and disease control was observed in patients with solitary spinal metastasis.

  14. A rare case of thyroid metastasis from pancreatic adenocarcinoma.

    LENUS (Irish Health Repository)

    Kelly, Michael E

    2012-02-01

    CONTEXT: Thyroid metastasis from pancreatic adenocarcinoma is extremely rare, with only two previous cases in the literature. We report a case of pancreatic adenocarcinoma metastasising to the thyroid. We review the incidence, diagnosis, and management of this rare occurrence. CASE REPORT: A 38-year-old man with a synchronous 6-month history of thyroid swelling, presented with epigastric pain and signs of obstructive jaundice. He was investigated by abdominal computerised tomography and endoscopic retrograde cholangiopancreatography. The diagnosis of pancreatic neoplasm was made. His thyroid neoplasm was investigated at another tertiary centre and thought to be a papillary neoplasm. He underwent a pancreaticoduodenectomy and recovered well post-operatively. Eight weeks later he had a total thyroidectomy. Histology confirmed that the thyroid mass was both morphologically and immunophenotypically similar to the pancreatic neoplasm. CONCLUSION: This case demonstrates the importance of a full investigation when a patient with suspected neoplastic history presents with a thyroid nodule. We outline the crucial role that immunohistochemistry plays in detecting and classifying primary and secondary thyroid neoplasms. The detection of a solitary thyroid metastasis from pancreatic adenocarcinoma may indicate a poor prognosis, and it is debatable whether resection of the primary should be undertaken when it presents with a solitary metastasis.

  15. Solitary Fibrous Tumor of the Uterus

    Directory of Open Access Journals (Sweden)

    Po-Wei Chu

    2006-12-01

    Conclusion: The behavior of solitary fibrous tumors arising from the uterus is difficult to evaluate; therefore, complete surgical excision featuring clear margins and comprehensive follow-up is recommended.

  16. Exact solitary waves of the Fisher equation

    International Nuclear Information System (INIS)

    Kudryashov, Nikolai A.

    2005-01-01

    New method is presented to search exact solutions of nonlinear differential equations. This approach is used to look for exact solutions of the Fisher equation. New exact solitary waves of the Fisher equation are given

  17. Papillary thyroid carcinoma with tuberculous cervical lymphadenopathy mimicking metastasis

    International Nuclear Information System (INIS)

    Iqbal, M; Subhan, A.; Aslam, A.

    2011-01-01

    To determine the frequency of tuberculous cervical lymphadenopathy mimicking metastasis from papillary thyroid cancer. Study Design: Case series. Place and Duration of Study: Surgical Unit-I, Ward-3 of Jinnah Postgraduate Medical Centre, Karachi, from March 2005 to March 2010. Methodology: All patients above 12 years of age of either gender diagnosed on investigations as papillary thyroid cancer (PTC) were included in the study. Ultrasound and fine needle aspiration cytology (FNAC), neck of solitary thyroid nodules (STN) and cervical lymph nodes were done. Total thyroidectomy and excision biopsy of cervical lymph nodes was performed, histopathological results were recorded and patients were managed accordingly. Results: A total of 55 patients had PTC and 25 had cervical lymphadenopathy. Eighteen patients of PTC with cervical lymphadenopathy were diagnosed after investigations as cases of tuberculous cervical lymphadenopathy (TCL) initially considered as metastasis from PTC; 5 patients had metastasis from PTC. Two patients proved to be of reactive hyperplasia which initially showed tuberculous cervical lymphadenopathy on FNAC. So 80% patients of cervical lymphadenopathy with PTC were due to benign disease and 20% had metastasis in lymph node due to PTC. Conclusion: PTC with cervical lymphadenopathy due to co-existent tuberculosis is common. Metastasis from PTC in lymph nodes were less common than tuberculous lymphodenitis in this study. Tuberculosis should be considered before deciding for neck dissection in cases of PTC. (author)

  18. Perforated Solitary Diverticulitis of the Ascending Colon

    Science.gov (United States)

    2005-06-01

    postoperative day 6. DISCUSSION Diverticuli of the right colon exist in approximately 1% to 5% of patients with diverticular disease .1-3 They are...ORIGINAL REPORTS Perforated Solitary Diverticulitis of the Ascending Colon CPT David S. Kauvar, MC, USA, MAJ, Jayson Aydelotte, MC, USA, and MAJ...Michael Harnisch, MC, USA Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas KEY WORDS: solitary colon diverticulum

  19. Conservative numerical methods for solitary wave interactions

    Energy Technology Data Exchange (ETDEWEB)

    Duran, A; Lopez-Marcos, M A [Departamento de Matematica Aplicada y Computacion, Facultad de Ciencias, Universidad de Valladolid, Paseo del Prado de la Magdalena s/n, 47005 Valladolid (Spain)

    2003-07-18

    The purpose of this paper is to show the advantages that represent the use of numerical methods that preserve invariant quantities in the study of solitary wave interactions for the regularized long wave equation. It is shown that the so-called conservative methods are more appropriate to study the phenomenon and provide a dynamic point of view that allows us to estimate the changes in the parameters of the solitary waves after the collision.

  20. Bilateral adrenal cystic neuroblastoma with superior vena cava syndrome and massive intracystic haemorrhage

    International Nuclear Information System (INIS)

    Pinarli, Faruk Guclu; Danaci, Murat; Diren, Baris; Tander, Burak; Rizalar, Riza; Dagdemir, Ayhan; Acar, Sabri

    2004-01-01

    Bilateral cystic adrenal tumours are a rare presentation of neuroblastoma. Intratumoural haemorrhage is a frequent finding in neuroblastoma, but is rarely symptomatic. We present an 11-month-old girl with predominantly cystic bilateral neuroblastomas and distant lymph-node metastasis. Massive intracystic haemorrhage and superior vena cava (SVC) syndrome were ominous prognostic factors, leading to death. Large tumours with intracystic haemorrhage might require a conservative approach. (orig.)

  1. [Hemorrhagic adrenal pseudocyst: case report].

    Science.gov (United States)

    Basile, G; Buffone, A; Cicciarella, G; di Mari, P; Cirino, E

    2004-01-01

    Adrenal cysts are usually asymptomatic; they are usually identified occasionally during ultrasound or C.T. scans (incidentaloma). Among adrenal cysts the most common types are epithelial cysts and pseudocysts. Intracystic haemorrhage is one of the possible complications of adrenal pseudocysts. We report a case of a young woman with right superior abdominal pain, fever and acute anemia. A C.T. scan showed a 10 cm. mass between the liver and the right kidney. To be sure of the nature of this mass also M.R., urography and C.T.-guided biopsy were carried out. This latter only let us make the final diagnosis of hemorrhagic adrenal pseudocyst. Thereafter, a laparotomic right adrenalectomy was performed, with full recovery of the patient. Adrenal cysts may cause differential diagnostic problems with masses of contiguous organs like kidney, liver and gallbladder. For this reason, ultrasound and C.T. scans may not be sufficient and must be completed by M.R., urography and/or C.T.-guided biopsy. Intracystic hamorrhage, spontaneous or post-traumatic, may cause to the patient acute anemia which, as soon as the diagnosis is confirmed, indicates surgery. The operation usually is a laparotomic adrenalectomy, since the laparoscopic approach is not sufficient to control large masses with active bleeding inside.

  2. Chemotherapy-Induced Regression of an Adrenocorticotropin-Secreting Pituitary Carcinoma Accompanied by Secondary Adrenal Insufficiency

    Directory of Open Access Journals (Sweden)

    Robert Frank Cornell

    2013-01-01

    Full Text Available Purpose. Adrenocorticotropin- (ACTH- secreting pituitary carcinomas are rare and require multimodality treatment. The aim of this study was to report the response to various therapies and discuss the potential development of secondary adrenal insufficiency with cytotoxic chemotherapy. Methods. This report describes a man with a large silent corticotroph adenoma progressing to endogenous hypercortisolism and metastatic ACTH-secreting pituitary carcinoma over a period of 14 years. Results. Seven years after initial presentation, progressive tumor enlargement associated with the development of hypercortisolism mandated multiple pituitary tumor debulking procedures and radiotherapy. Testing of the Ki-67 proliferation index was markedly high and he developed a hepatic metastasis. Combination therapy with cisplatin and etoposide resulted in a substantial reduction in tumor size, near-complete regression of his liver metastasis, and dramatic decrease in ACTH secretion. This unexpectedly resulted in symptomatic secondary adrenal insufficiency. Conclusions. This is the first reported case of secondary adrenal insufficiency after use of cytotoxic chemotherapy for metastatic ACTH-secreting pituitary carcinoma. High proliferative indices may be predictive of dramatic responses to chemotherapy. Given the potential for such responses, the development of secondary adrenal insufficiency may occur and patients should be monitored accordingly.

  3. Polycystic ovarian disease: the adrenal connection.

    Science.gov (United States)

    Marouliss, George B; Triantafillidis, Ioannis K

    2006-01-01

    Polycystic ovarian disease (PCOD) is characterized by hyperandrogenemia, ovulatory dysfunction and polycystic ovaries (PCO). The increased androgen production in PCOD comes primarily from the ovaries. However, in about 40% of patients there is excessive adrenal androgen production (DHEA, DHEA-Sulfate, Androstenedione, Testosterone and Dihydrotestosterone). The contribution of the adrenal in the PCOD is suggested by the presence of adrenal androgen excess in PCO, the presence of PCO in women with enzymatic adrenal hyperplasia as well as in women with adrenal tumors. However, the cause of adrenal androgen hypersecretion is not yet fully understood but it may include endogenous hypersecretion of the zona reticularis of unclear cause, hypersecretion of cortical-androgen-stimulating hormone (CASH), stress, hyperprolactinemia, adrenal enzymatic defects etc. This short review covers the aspects of adrenal androgen hypersecretion in PCOD.

  4. Bone Health in Adrenal Disorders

    Directory of Open Access Journals (Sweden)

    Beom-Jun Kim

    2018-03-01

    Full Text Available Secondary osteoporosis resulting from specific clinical disorders may be potentially reversible, and thus continuous efforts to find and adequately treat the secondary causes of skeletal fragility are critical to ameliorate fracture risk and to avoid unnecessary treatment with anti-osteoporotic drugs. Among the hyperfunctional adrenal masses, Cushing's syndrome, pheochromocytoma, and primary aldosteronism are receiving particularly great attention due to their high morbidity and mortality mainly by increasing cardiovascular risk. Interestingly, there is accumulating experimental and clinical evidence that adrenal hormones may have direct detrimental effects on bone metabolism as well. Thus, the present review discusses the possibility of adrenal disorders, especially focusing on pheochromocytoma and primary aldosteronism, as secondary causes of osteoporosis.

  5. [Immunoendocrine associations in adrenal glands].

    Science.gov (United States)

    Sterzl, I; Hrdá, P

    2010-12-01

    Immune and endocrine systems are basic regulatory mechanisms of organism and, including the nervous system, maintain the organism's homeostasis. The main immune system representatives are mononuclear cells, T- and B-cells and their products, in the endocrine system the main representatives are cells of the glands with inner secretion and their products. One of the most important glands for maintaining homeostasis are adrenal glands. It has been proven that either cells of the immune system, either endocrine cells can, although in trace amounts, produce mutually mediators of both systems (hormones, cytokines). Disorders in one system can lead to pathological symptoms in the other system. Also here represent adrenals an important model.

  6. Differential diagnosis of adrenal gland masses

    International Nuclear Information System (INIS)

    Szolar, D.H.M.; Unger, B.; Preidler, K.; Ranner, G.; Heinz-Peer, G.

    1999-01-01

    Computed tomography (CT) and magnetic resonance (MR) imaging are first line modalities in the evaluation of patients with adrenal gland masses, and have the potential to be very accurate for the localization of adrenal gland masses in patients with diseases associated with hyperfunctioning conditions of the adrenal gland. Both CT and MR imaging allow a specific diagnosis of acute adrenal hemorrhage, adrenal myelolipoma, and adrenal cysts. CT is also helpful in the assessment of patients with Addision's disease, particularly the subacute from secondary to granulomatous diseases. Quantitative evaluation of adrenal masses on unenhanced CT scans and/or qualitative analysis on chemical-shift MR imaging have been shown to be accurate in distinguishing adrenal adenomas from non-adenomas. Attenuation of 11 HE or less on unenhanced CT scans and/or signal loss on opposed phase MR images indicate adenoma with a high specificity and acceptable sensitivity. More recently, delayed-enhanced CT has yielded higher sensitivity and specificity values in distinguishing between adrenal adenomas and non-adenomas than both unenhanced CT and chemical-shift MR imaging do. On delayed-enhanced CT scans, adrenal adenomas exhibit a greater washout of contrast material than do adrenal non-adenomas. Therefore, adrenal non-adenomas have significantly higher attenuation than adenomas on delayed-enhanced CT scans obtained at several arbitrarily chosen time points (3-60 min) after the initiation of contrast material administration. (orig.) [de

  7. Spontaneous Retroperitoneal Hemorrhage from Adrenal Artery Aneurysm

    International Nuclear Information System (INIS)

    Gonzalez Valverde, F.M.; Balsalobre, M.; Torregrosa, N.; Molto, M.; Gomez Ramos, M.J.; Vazquez Rojas, J.L.

    2007-01-01

    Spontaneous adrenal hemorrhage is a very rare but serious disorder of the adrenal gland that can require emergent treatment. We report on a 42-year-old man who underwent selective angiography for diagnosis and treatment of retroperitoneal hemorrhage from small adrenal artery aneurysm. This case gives further details about the value of transluminal artery embolization in the management of visceral aneurysm rupture

  8. Principles and management of adrenal cancer

    International Nuclear Information System (INIS)

    Javadpour, N.

    1987-01-01

    Principles and Management of Adrenal Cancer is a comprehensive presentation of the medical and surgical management of neoplastic diseases of the adrenal glands. It consists of two parts. The first provides an overview of the embryology, anatomy, physiology, pathology, and advances in methods of diagnosis and imaging techniques. The second deals with specific diseases of the adrenal cortex and medulla. (orig./MG)

  9. Neonatal adrenal hemorrhage presenting as acute scrotum

    African Journals Online (AJOL)

    Introduction. In newborns, adrenal hemorrhage is not an uncommon event. The large size of the adrenal cortex contributes to an increased vulnerability to trauma during a difficult delivery [1]. However, the neonatal adrenal hemorrhage may rarely present as inguinoscrotal swelling [2,3]. This condition can simulate torsion of ...

  10. Asymptomatic myelolipoma of the adrenal.

    Science.gov (United States)

    Hadjigeorgi, C; Lafoyianni, S; Pontikis, Y; Van Vliet-Constantinidou, C

    1992-01-01

    Myelolipoma of the adrenal gland is a rare benign tumour which seldom produces symptoms unless it attains considerable size or hemorrhages into itself. Histologically the tumor is composed of varying proportions of fat and bone marrow elements. We present a case of a male child, with homozygous beta thalassemia and asymptomatic myelolipoma.

  11. Blood sampling from adrenal gland vein

    International Nuclear Information System (INIS)

    Sun Yong; Ni Caifang

    2009-01-01

    Adrenal gland vein sampling is an interventional method to get the blood samples from the adrenal gland vein. The blood is obtained via a catheter which is selectively inserted in the adrenal gland vein. This technique is mainly used to be diagnostic for primary hyperaldosteronism. A full knowledge of the anatomy and variations of the adrenal gland vein, serious preoperative preparation and skilled catheterization manipulation are necessary for obtaining sufficient blood sample and for reducing the occurrence of complications. Providing the physicians with definite diagnostic evidence and being technically feasible, adrenal gland vein sampling should become one of the routine examinations for clarifying the cause of primary hyperaldosteronism. (authors)

  12. The Diagnosis and Surgical Treatment for Solitary Pulmonary Metastases: A Report of 156 Cases

    Directory of Open Access Journals (Sweden)

    Hui ZHANG

    2012-04-01

    Full Text Available Background and objective In recent years, it has been proven that surgical treatment for solitary pulmonary metastases has achieved satisfactory results. Consequently, the study aims to investigate the diagnosis, indications for surgery, operative techniques, and prognostic factors of the surgical resection for solitary pulmonary metastases, and to improve the survival rate of patients with pulmonary metastases. Methods The medical records of 156 patients with surgical procedures at our institution were retrospectively reviewed. Results The primary tumors were verified as cancer in 134 cases, sarcoma in 21, and 1 contained unknown tissue. There was no perioperative mortality. A total of 153 patients returned for follow up. Follow-up time was 1 yr to 10 yr. The 5-year survival rates were 31.2%. The median survival time was 35.8 months. Systematic lymph node dissection was performed in 113 patients. The 5-year survival rates were 12.5% for lymph node-positive patients and 37.3% for lymph node–negative patients. The patients who underwent lobectomies had better survival rates, with a 5-year survival rate of 38.5%. Conclusion Surgery is recommended for patients with solitary pulmonary metastasis if they fulfill the surgical indications and favorable outcomes can be achieved. VATS can be chosen for the patients. Hilar and mediastinal lymph node involvement and the surgical approach are potentially important prognostic factors.

  13. Clinical and laboratory evaluation of adrenal dysfunction

    International Nuclear Information System (INIS)

    Ashkar, F.S.; Fishman, L.M.

    1983-01-01

    Because of their special physical and chemical properties, the adrenal secretory products were among the first hormonal substances to be measured by methods other than bioassay. Over the past several years, the development of sensitive and specific methods of hormone assay dependent on the use of radionuclides has revolutionized investigative and clinical endocrinology. While the capacity of defining most abnormalities of adrenal function antedates hormone measurement and adrenal imaging utilizing radioisotopes, the availability of such methods has greatly facilitated and made more precise the diagnostic approach to patients with suspected adrenal dysfunction. As an example of how clinical and laboratory considerations can be integrated into a rational approach to the diagnosis of adrenal disease, the problem of suspected adrenal hyperfunction is analyzed in light of current understanding of its pathophysiology. Reflection demonstrates that suspected primary aldosteronism and adrenal insufficiency are equally amenable to such an approach

  14. Diffractons: Solitary Waves Created by Diffraction in Periodic Media

    KAUST Repository

    Ketcheson, David I.; Quezada de Luna, Manuel

    2015-01-01

    A new class of solitary waves arises in the solution of nonlinear wave equations with constant impedance and no dispersive terms. These solitary waves depend on a balance between nonlinearity and a dispersion-like effect due to spatial variation

  15. Interaction dynamics of electrostatic solitary waves

    Directory of Open Access Journals (Sweden)

    V. L. Krasovsky

    1999-01-01

    Full Text Available Interaction of nonlinear electrostatic pulses associated with electron phase density holes moving in a collisionless plasma is studied. An elementary event of the interaction is analyzed on the basis of the energy balance in the system consisting of two electrostatic solitary waves. It is established that an intrinsic property of the system is a specific irreversibility caused by a nonadiabatic modification of the internal structure of the holes and their effective heating in the process of the interaction. This dynamical irreversibility is closely connected with phase mixing of the trapped electrons comprising the holes and oscillating in the varying self-consistent potential wells. As a consequence of the irreversibility, the "collisions" of the solitary waves should be treated as "inelastic" ones. This explains the general tendency to the merging of the phase density holes frequently observed in numerical simulation and to corresponding coupling of the solitary waves.

  16. Solitary Wave Interactions in Granular Media

    Institute of Scientific and Technical Information of China (English)

    WEN Zhen-Ying; WANG Shun-Jin; ZHANG Xiu-Ming; LI Lei

    2007-01-01

    We numerically study the interactions of solitary waves in granular media, by considering a chain of beads, which repel upon contact via the Hertz-type potential, V ∝δn, with 5/2 ≤n≤3 and δ≥0,δbeing the bead-bead overlap. There are two collision types of solitary waves, overtaking collision and head-on collision, in the chain of beads. Our quantitative results show that after collision the large solitary wave gains energy and the small one loses energy for overtaking type while the large one loses energy, and the small one gains energy for head-on type. The scattering effects decrease with n for overtaking collision whereas increase with n for head-on collision.

  17. Solitary waves on nonlinear elastic rods. I

    DEFF Research Database (Denmark)

    Sørensen, Mads Peter; Christiansen, Peter Leth; Lomdahl, P. S.

    1984-01-01

    Acoustic waves on elastic rods with circular cross section are governed by improved Boussinesq equations when transverse motion and nonlinearity in the elastic medium are taken into account. Solitary wave solutions to these equations have been found. The present paper treats the interaction betwe...... nonlinearity. The balance between dispersion and nonlinearity in the equation is investigated.......Acoustic waves on elastic rods with circular cross section are governed by improved Boussinesq equations when transverse motion and nonlinearity in the elastic medium are taken into account. Solitary wave solutions to these equations have been found. The present paper treats the interaction between...... the solitary waves numerically. It is demonstrated that the waves behave almost like solitons in agreement with the fact that the improved Boussinesq equations are nearly integrable. Thus three conservation theorems can be derived from the equations. A new subsonic quasibreather is found in the case of a cubic...

  18. [Etiologic spectrum of solitary constitutional syndrome].

    Science.gov (United States)

    Hernández Hernández, J L; Matorras Galán, P; Riancho Moral, J A; González-Macías, J

    2002-07-01

    To know the spectrum of diseases responsible for the solitary constitutional syndrome in our setting. This syndrome was defined as a clinical picture characterized by the presence of asthenia, anorexia, and weight loss of at least 5% of body weight in the last six months, not associated with any other symptom or sign suggesting the diagnosis of an organ or system disease. All patients diagnosed of the solitary constitutional syndrome (328) in a tertiary-care level teaching hospital between January 1991 and December 1996. Fifty-two (170) percent of patients with solitary constitutional syndrome were males and 48% (158) females. The mean age was 65.4%, ranging from 15 to 97 years. The average of the monthly estimated weight loss was 3 to 4 kilograms. A total of 115 (35%) malignant neoplasms and 5 (1.5%) benign tumors were diagnosed. The most common malignant tumors corresponded to the digestive tract (51.3% of the total malignant tumors). The second cause in frequency of the solitary constitutional syndrome corresponded to psychiatric diseases, with a total of 80 patients (24.3%). A total of 116 non-neoplastic organic diseases were detected, with digestive tract diseases --mainly peptic disease-- being the most common cause in this group. After follow-up, only in twenty cases were we unable to detect the underlying disease responsible for the syndrome. In nine of these, the solitary constitutional syndrome was self-limited. Forty-four percent of patients had at least another concomitant disease and in 24% of patients more than one associated condition was found. The most common diseases responsible for the solitary constitutional syndrome were, by decreasing frequency, malignant tumors, psychiatric disorders, and non-malignant organic diseases located in the digestive tract. A better knowledge of the etiological spectrum of this syndrome might be useful for a more efficient management of these patients.

  19. High grade gilomas and solitary metastases: differentiation using perfusion MR imaging and spectroscopic MR imaging

    International Nuclear Information System (INIS)

    Law, M.; Cha, S.; Knopp, E.A.; Johnson, G.; Litt, A.W.

    2002-01-01

    Full text: To determine whether perfusion MRI (pMRI) and spectroscopic MR imaging (sMRI) can be used to differentiate high grade primary gliomas and solitary metastases on the basis of differences in vascularity and metabolite levels in the peritumoral. Fifty-one patients with a solitary brain tumor (33 gliomas, 18 metastases) underwent conventional MRI, contrast enhanced pMRI and sMRI before surgical resection or stereotactic biopsy. The peri-tumoral region is defined as the area within the white matter, immediately adjacent to the enhancing portion of the tumor (hyperintense on T2- weighted imaging but no enhancement on post-contrast T1-weighted imaging). Relative cerebral blood volume (rCBV) measurements were made in these regions from the pMRI data. Spectra from the enhancing tumor, the peritumoral region and normal brain, were obtained from the 2D multi-voxel CSI acquisition (TE = 135ms). The measured rCBV within the abnormal peritumoral region in highgrade gliomas and metastasis were 1.31 ± 0.97 (mean ± standard deviation) and 0.39 ± 0.19, respectively. The difference was statistically significant (p<0.0001). Spectroscopic imaging demonstrated elevated choline (Cho/Cr 2.28 ± 1.24) in the peritumoral region of gliomas but not in metastasis (Cho/Cr = 0.76 ± 0.23). The difference was again statistically significant (p 0.001), with Student's t-test. Although conventional imaging characteristics of solitary metastases and primary high grade gliomas may sometimes be similar, pMRI and sMRI are able to distinguish between the two, based on the rCBV and metabolite ratios within the peri-tumoral region. Copyright (2002) Blackwell Science Pty Ltd

  20. Solitary extramedullary plasmacytoma of the sinonasal region.

    Science.gov (United States)

    Hazarika, Produl; Balakrishnan, R; Singh, Rohit; Pujary, Kailesh; Aziz, Benazim

    2011-07-01

    Less than 10% of the patients with plasma cell neoplasms present with a solitary plasmacytoma. Though the nasal cavity is a common extramedullary site, the occurrence is extremely rare. Two cases of solitary extramedullary plasmacytoma of the sinonasal region are reported. The first of which is sinonasal plasmacytoma with concomitant HIV, an association that has been reported rarely in literature to date and is matter of much debate. In the second case report, we present an instance of surgical excision of the tumor using KTP 532 laser. The diagnosis was established using immunohistochemical techniques and multiple myeloma workups were negative in all cases.

  1. A radiographic study of solitary bone cysts

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Rak; Hwang, Eui Hwan; Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, Division of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    1994-02-15

    The aim of this study was to evaluate the clinical, radiographic and histopathologic features of 23 cases of solitary bone cyst by means of the analysis of radiographs and biopsy specimens in 23 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chunbuk National University. The obtained results were as follows; 1. The incidence of solitary bone cyst was almost equal in males (52.2%) and in females(42.8%) and the prevalent age of the solitary bone cyst were the second decade (47.8%) and the third decade (21.7%). 2. In the signs and symptoms of solitary bone cyst, pain or tenderness revealed in 17.4%, swelling revealed in 13.0%, pain and swelling revealed in 21.7%, paresthesia revealed in 4.4% and 43.5% were a symptom and the tooth vitality involved in the solitary bone cyst, 76.5% were posterior and 23.5% were either positive or negative. 3. In the location of the solitary bone cyst, 47.8% present posterior region, 21.7% present anterior region, 21.6% present anterior and posterior region, 4.4% present condylar process area. 4. In the hyperostotic border of the solitary bone cyst, 47.8% were seen entirely, 21.8% were seen partially, and 30.4% were not seen. 5. In the change of tooth, 59.1% were loss of the alveolar lamina dura, 13.6% were root resorption 4.55% were tooth displacement, 4.55% were root resorption and tooth displacement. 6. In the change of cortical bone of the solitary bone cyst, 39.1% were intact and 60.9% were thinning and expansion of cortical bone. 7. In the histopathologic findings of 9 cases, 33.3% were thin connective tissue wall, 11.1% were thickened myxo-fibromatous wall, 55.6% were thickened myxofibromatous wall with dysplastic bone formation.

  2. A radiographic study of solitary bone cysts

    International Nuclear Information System (INIS)

    Kim, Kyung Rak; Hwang, Eui Hwan; Lee, Sang Rae

    1994-01-01

    The aim of this study was to evaluate the clinical, radiographic and histopathologic features of 23 cases of solitary bone cyst by means of the analysis of radiographs and biopsy specimens in 23 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chunbuk National University. The obtained results were as follows; 1. The incidence of solitary bone cyst was almost equal in males (52.2%) and in females(42.8%) and the prevalent age of the solitary bone cyst were the second decade (47.8%) and the third decade (21.7%). 2. In the signs and symptoms of solitary bone cyst, pain or tenderness revealed in 17.4%, swelling revealed in 13.0%, pain and swelling revealed in 21.7%, paresthesia revealed in 4.4% and 43.5% were a symptom and the tooth vitality involved in the solitary bone cyst, 76.5% were posterior and 23.5% were either positive or negative. 3. In the location of the solitary bone cyst, 47.8% present posterior region, 21.7% present anterior region, 21.6% present anterior and posterior region, 4.4% present condylar process area. 4. In the hyperostotic border of the solitary bone cyst, 47.8% were seen entirely, 21.8% were seen partially, and 30.4% were not seen. 5. In the change of tooth, 59.1% were loss of the alveolar lamina dura, 13.6% were root resorption 4.55% were tooth displacement, 4.55% were root resorption and tooth displacement. 6. In the change of cortical bone of the solitary bone cyst, 39.1% were intact and 60.9% were thinning and expansion of cortical bone. 7. In the histopathologic findings of 9 cases, 33.3% were thin connective tissue wall, 11.1% were thickened myxo-fibromatous wall, 55.6% were thickened myxofibromatous wall with dysplastic bone formation.

  3. Rare Case of Duodenal Metastasis From Pulmonary Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Zain Memon DO

    2017-10-01

    Full Text Available Pulmonary squamous cell carcinoma is the second most common non–small cell malignancy of the lung. It commonly metastasizes to the adrenal glands, bone, liver, brain, and kidneys. Most occurrences of metastatic squamous cell carcinoma involving the gastrointestinal tract originate from primary lung tumors. Metastasis to the duodenum, however, is exceedingly rare, with very few cases of stomach or duodenal involvement described in the literature. We report the case of a patient with stage IV pulmonary squamous cell carcinoma metastasizing to the duodenum with an uncommon presentation to add to the paucity of literature available regarding this rare finding.

  4. A prenatally detected adrenal cyst treated by adrenal-sparing ...

    African Journals Online (AJOL)

    Ahmet Dursun and Munevver Ho ¸sgo¨ r. A neonatal case of left adrenal cyst detected in utero and ... Correspondence to Munevver Ho ¸sgör, MD, PhD, Department II of Pediatric. Surgery, Dr Behcet Uz Children's Hospital, Koruturk Mh. ..... Radiology 1986; 161:631–633. 13 Erbil Y, Salmasliog˘lu A, Barbaros U, Bozbora A, ...

  5. Diagnostic dilemma of degenerative joint disease, chronic avascular necrosis or metastasis in planar Tc-99m-methylene diphosphonate planar skeletal scintigraphy excluded by single positron emission computed tomography/computed tomography

    International Nuclear Information System (INIS)

    Jain, Tarun Kumar; Phulsunga, Rohit Kumar; Basher, Rajender Kumar; Kumar, Narendra; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2005-01-01

    We present a 71-year-old male patient subjected to skeletal scintigraphy for metastasis work up of prostate cancer. Whole body planar images revealed a solitary focal tracer uptake in left femoral head mimicking as solitary metastatic focus. Single positron emission computed tomography/computed tomography images localized this increased tracer uptake to the subchondral cysts with minimal sclerosis in left femur head with no decrease in size of femur head and was reported as (degenerative joint disease)

  6. Formation and Coalescence of Electron Solitary Holes

    DEFF Research Database (Denmark)

    Saeki, K.; Michelsen, Poul; Pécseli, H. L.

    1979-01-01

    Electron solitary holes were observed in a magnetized collisionless plasma. These holes were identified as Bernstein-Green-Kruskal equilibria, thus being purely kinetic phenomena. The electron hole does not damp even though its velocity is close to the electron thermal velocity. Two holes attract...

  7. Histoplasmosis presenting with solitary pulmonary nodule: Two ...

    African Journals Online (AJOL)

    Pulmonary histoplasmosis is a granulomatous disease, whose diagnosis is not always easy, as it may simulate metastatic lesions due to similar radiographic findings. We herein report two cases of histoplasmosis with solitary pulmonary nodule in asymptomatic patients with histories of cancer surgeries, whose diagnoses ...

  8. Solitary waves on nonlinear elastic rods. II

    DEFF Research Database (Denmark)

    Sørensen, Mads Peter; Christiansen, Peter Leth; Lomdahl, P. S.

    1987-01-01

    In continuation of an earlier study of propagation of solitary waves on nonlinear elastic rods, numerical investigations of blowup, reflection, and fission at continuous and discontinuous variation of the cross section for the rod and reflection at the end of the rod are presented. The results ar...... are compared with predictions of conservation theorems for energy and momentum....

  9. Is percutaneous nephrolithotomy in solitary kidneys safe?

    Science.gov (United States)

    Wong, Kathie Alexina; Sahai, Arun; Patel, Amit; Thomas, Kay; Bultitude, Matthew; Glass, Jonathan

    2013-11-01

    To review our experience from a high volume stone center with a focus on efficacy, safety, and renal function. Stones requiring percutaneous nephrolithotomy (PCNL) in patients with solitary kidneys can pose significant anxiety to the urologist. Limited data are available in published reports in this setting. A comprehensive retrospective review of medical records was performed on patients who underwent PCNL and had a solitary kidney or a single functioning renal unit. Data were collected on patient demographics, stone burden, outcomes, complications, and renal function. Of 378 PCNLs performed between January 2003 and September 2011, 22 were performed in 17 patients with a single functioning kidney. Three procedures were performed in a transplanted kidney. In those with solitary calculus, the longest mean length and stone surface area were 37 mm and 825 mm(2), respectively. Stone-free rate was 59%. Auxiliary procedures were required in 6 cases, resulting in a stone-free rate of 77%. Median inpatient stay was 4 days. Serum creatinine values improved from 144 to 126 umol/L before and after the procedure and mean estimated glomerular filtration rate improved similarly from 51 to 59 mls/minute, respectively. Blood transfusion was required in 1 patient, sepsis developed in 3, and 2 patients required a stent for obstruction. PCNL in solitary kidneys is safe with an acceptable complication rate if performed in a high volume center. Outcomes are good, although auxiliary procedures may be necessary. Renal function remains stable or improves after procedure. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Position of solitary thyroid nodules by gammagraphy

    International Nuclear Information System (INIS)

    Basteris M, J.; Gomez D, R.

    2007-01-01

    In this work it is presented which it is the position more frequent of the solitary thyroid nodules. It was used the method of retrospective longitudinal observational investigation in 125 patients that went to the laboratory for realization of detection of thyroid nodules in the years 2004 and 2005 through gammagraphy. (Author)

  11. On the solitary wave paradigm for tsunamis

    DEFF Research Database (Denmark)

    Madsen, Per A.; Fuhrman, David R.; Schäffer, Hemming Andreas

    2008-01-01

    Since the 1970s, solitary waves have commonly been used to model tsunamis especially in experimental and mathematical studies. Unfortunately, the link to geophysical scales is not well established, and in this work we question the geophysical relevance of this paradigm. In part 1, we simulate...

  12. On solitary surface waves in cold plasmas

    International Nuclear Information System (INIS)

    Vladimirov, S.V.; Yu, M.Y.; Stenflo, L.

    1993-01-01

    A new type of nonlinear electromagnetic solitary surface waves propagating along the boundary of a cold plasma is discussed. These waves are described by a novel nonlinear evolution equation, obtained when the nonlinear surface currents at the boundary are taken into consideration. (Author)

  13. CFD Analysis of Water Solitary Wave Reflection

    Directory of Open Access Journals (Sweden)

    K. Smida

    2011-12-01

    Full Text Available A new numerical wave generation method is used to investigate the head-on collision of two solitary waves. The reflection at vertical wall of a solitary wave is also presented. The originality of this model, based on the Navier-Stokes equations, is the specification of an internal inlet velocity, defined as a source line within the computational domain for the generation of these non linear waves. This model was successfully implemented in the PHOENICS (Parabolic Hyperbolic Or Elliptic Numerical Integration Code Series code. The collision of two counter-propagating solitary waves is similar to the interaction of a soliton with a vertical wall. This wave generation method allows the saving of considerable time for this collision process since the counter-propagating wave is generated directly without reflection at vertical wall. For the collision of two solitary waves, numerical results show that the run-up phenomenon can be well explained, the solution of the maximum wave run-up is almost equal to experimental measurement. The simulated wave profiles during the collision are in good agreement with experimental results. For the reflection at vertical wall, the spatial profiles of the wave at fixed instants show that this problem is equivalent to the collision process.

  14. The radiology in the solitary bone lesions

    International Nuclear Information System (INIS)

    Veloso, G.A.; Cardoso, V.M.

    1985-01-01

    Three methods of radiologic analysis of the solitary bone lesions are reviewed. 1. Radiological analysis of the lesions with the objective to suppose the histologic type; 2. To appreciate the velocity of growth and aggressiveness of the lesions. 3. To appreciate the biological behaviour of the bone lesions, making the diagnosis necessary for the treatment. (M.A.C.) [pt

  15. Congenital adrenal hyperplasia: Case report.

    OpenAIRE

    Jaime Avaria E.; María José Vargas F.; Loreto Triviño F.; Andrea Gleisner E.

    2013-01-01

    INTRODUCTION: Congenital adrenal hyperplasia (CAH) is an autosomal recessive disease whose main cause is the deficiency of 21-hydroxylase, an enzyme involved in the synthesis of cortisol and aldosterone. There are two forms of CAH, a classical and nonclassical form, being the first objective of analysis in the clinical case. Its clinical manifestations vary in severity, depending on the level of hormone deficiency. Within the classic is described the salt-wasting form, whose consequences are ...

  16. Functional paraganglioma extra-adrenal

    International Nuclear Information System (INIS)

    Arroyo-Martinez, Laura; Alvarez-Pertuz, Humberto; Acuna-Calvo, Jorge; Montoya-Calles, Juan Diego

    2006-01-01

    Functioning paragangliomas are rare tumours that produce catecholamines.They originate from extra-adrenal chromaffin cells. They are frequently malignant and are associated with high incidence of persistent or recurrent disease after their primary treatment. They are known as glomus, chemodectomas, chromaffin paragangliomas and glomerulocytomas. The location is diverse and reflects the paragangliomar distribution in the body from the base of the skull to the pelvic floor. The paragangliomas are found where there are nodes of the autonomous system, however, approximately 90% of these tumours appear in the adrenal glands (and they constitute the pheochromocytomas) and the remaining 10% is a location extra adrenal, but it has been said that its impact can be underestimated, ranging from 18% to 22% in adults and children up to 30%. The extra-adrenal are originated more frequently in the abdomen (85%), other in the chest (12%) and more rarely in the head and neck (3%). Imaging studies and measurement of non-physiological production of catecholamines may aid in the diagnosis of this entity. Surgery is the treatment of choice. It is presented the case of a primigravidas patient aged 32 with HTAIE requiring caesarean section, who had a postpartum torpid and despite to multiple antihypertensive treatments their pathology was difficult to deal, with ophthalmic complications. Some time later, the patient is studied by hyperhidrosis, laboratory tests and images are requested and it is documented incidentally, a left retroperitoneal tumour, the studies are expanded and reach the correct diagnosis. The tumour required surgical resection. The patient had a satisfactory postoperative period and she discharged with control in the external consultation. (author) [es

  17. Schwannoma of the adrenal gland

    Directory of Open Access Journals (Sweden)

    Anunayi Jeshtadi

    2014-07-01

    Full Text Available Visceral schwannomas are extremely rare and are usually discov-ered incidentally on USG/CT-Scan. Primary schwannomas of the adrenal gland are extremely uncommon. It has been theorized that they originate from Schwann cells that insulate the nerve fi-bers innervating the adrenal medulla. Histopathological examina-tion coupled with immunohistochemistry provides the definitive diagnosis. A 55 year old normotensive female presented with pain in the right loin since 5 months. Her renal parameters were normal. Contrast enhanced computed tomography of abdomen showed a well delineated 6.5 x 5cms mass at upper pole of her right kidney. 24-hour urinary metanephrine was slightly elevated (3.07mg/24hrs. A decline in Serum cortisol levels was observed following a dexamethasone suppression test (18.89nmol/l. Histopathological examination revealed a spindle cell tumor. Immunohistochemistry showed strong and diffuse positive staining for S-100 with negative expression for CD-117, desmin, CD-34, HMB-45, synaptophysin, chromogranin, cytokeratin, and SMA. Ki-67 index was 2%.A diagnosis of cellular schwannoma of adrenal gland was confirmed.

  18. Solitary pulmonary metastases in high-risk melanoma patients: a prospective comparison of conventional and computed tomography

    International Nuclear Information System (INIS)

    Heaston, D.K.; Putman, C.E.; Rodan, B.A.; Nicholson, E.; Ravin, C.E.; Korobkin, M.; Chen, J.T.; Seigler, H.F.

    1983-01-01

    A prospective comparison of chest radiography, conventional tomography, and computed tomography (CT) in the detection or confirmation of solitary pulmonary nodules was made in 42 patients with high propensity for pulmonary metastases due to advanced local (Clark level IV or V) or regional malignant melanoma. Unequivocal nodules were revealed by chest radiography in 11 patients, conventional tomograhy in 16, and computed tomography in 20 patients. Both plain films and tomography in three of these 20 were normal, but follow-up verified pulmonary metastases. Computed tomography detected more pulmonary nodules than conventional tomography in 11 patients in addition to identifying lesions in extrapulmonary sites. Therefore, chest CT is recommended before institution of immunotherapy or surgical removal of a solitary pulmonary melanoma metastasis. Once chemotherapy had been instituted for bulky regional or cutaneous involvement, however, the findings of either conventional or computed tomography were comparable in this study

  19. Colonic Metastasis with Anemia Leading to a Diagnosis of Primary Lung Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Vasa Jevremovic

    2016-01-01

    Full Text Available Metastasis occurs with 50% of lung carcinomas, most commonly to lymph nodes, adrenal glands, liver, bone, and brain. It is extremely rare for lung cancer to present with symptoms of a gastrointestinal metastasis and even more so pertaining to the colon. To the best of our knowledge, only 12 such cases have been reported in the literature. We describe a case of a 71-year-old female presenting with refractory iron deficiency anemia that was found to have a lesion in the transverse colon. Pathology revealed adenocarcinoma of the lung and a subsequent lung lesion was discovered in a retrograde fashion.

  20. Optimal glucocorticoid replacement in adrenal insufficiency.

    Science.gov (United States)

    Øksnes, Marianne; Ross, Richard; Løvås, Kristian

    2015-01-01

    Adrenal insufficiency (glucocorticoid deficiency) comprises a group of rare diseases, including primary adrenal insufficiency, secondary adrenal insufficiency and congenital adrenal hyperplasia. Lifesaving glucocorticoid therapy was introduced over 60 years ago, but since then a number of advances in treatment have taken place. Specifically, little is known about short- and long-term treatment effects, and morbidity and mortality. Over the past decade, systematic cohort and registry studies have described reduced health-related quality of life, an unfavourable metabolic profile and increased mortality in patients with adrenal insufficiency, which may relate to unphysiological glucocorticoid replacement. This has led to the development of new modes of replacement that aim to mimic normal glucocorticoid physiology. Here, evidence for the inadequacy of conventional glucocorticoid therapy and recent developments in treatment are reviewed, with an emphasis on primary adrenal insufficiency. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Electro-acoustic solitary waves in dusty plasmas

    International Nuclear Information System (INIS)

    Mamun, A.A.; Sayed, F.

    2005-10-01

    present a rigorous theoretical investigation of electro- acoustic [particularly, dust-ion acoustic (DIA) and dust-acoustic (DA)] solitary waves in dusty plasmas. We employ the reductive perturbation method for small but finite amplitude solitary waves as well as the pseudo-potential approach for arbitrary amplitude ones. We also analyze the effects of non-planar geometry and dust charge fluctuations on both DIA and DA solitary waves, the effect of finite ion-temperature on DIA solitary waves, and the effects of dust-fluid temperature and non-isothermal ion distributions on DA solitary waves. It has been reported that these effects do not only significantly modify the basic features of DIA or DA solitary waves, but also introduce some important new features. The basic features and the underlying physics of DIA and DA solitary waves, which are relevant to space and laboratory dusty plasmas, are briefly discussed. (author)

  2. A Rare Case of Metastasis to the Thyroid Gland from Renal Clear Cell Carcinoma 11 Years after Nephrectomy and Concurrent Primary Esophageal Carcinoma

    Directory of Open Access Journals (Sweden)

    Mohammad Saud Khan

    2018-01-01

    Full Text Available Renal cell carcinoma is known to cause metastasis to unusual sites, which can be both synchronous or metachronous. Thyroid gland is a rare site for metastasis, but when it occurs, renal cell carcinoma is the most common primary neoplasm. We report the case of a 81-year-old female patient who had a significant medical history of right clear cell renal carcinoma with adrenal metastasis. She underwent right radical nephrectomy and adrenalectomy followed by radiofrequency ablation of left adrenal metastasis and systemic chemotherapy with sunitinib. Eleven years later, she presented with dysphagia and was found to have distal esophageal adenocarcinoma. On imaging, there was incidental detection of a left renal mass lesion and a right thyroid nodule, which on histopathology and immunohistochemistry were confirmed to be clear cell carcinoma of renal origin.

  3. Lung Metastasis Mimicking Fingertip Infection

    Science.gov (United States)

    Soylemez, Salih; Demiroglu, Murat; Yayla, Mehmet Ali; Ozkan, Korhan; Alpan, Bugra; Ozger, Harzem

    2015-01-01

    Metastasis fingers (acral metastasis) are finding a poor prognosis. Past medical history should be questioned and metastasis from primary tumor should be kept in mind in patients with pain, swelling, and hyperemia in fingers. Successful surgical treatment on acral metastasis does not extend the life expectancy; however, it reduces the patient's pain during his terminal period, saves the functions of the limb, and increases life comfort. PMID:26236517

  4. Lung Metastasis Mimicking Fingertip Infection

    Directory of Open Access Journals (Sweden)

    Salih Soylemez

    2015-01-01

    Full Text Available Metastasis fingers (acral metastasis are finding a poor prognosis. Past medical history should be questioned and metastasis from primary tumor should be kept in mind in patients with pain, swelling, and hyperemia in fingers. Successful surgical treatment on acral metastasis does not extend the life expectancy; however, it reduces the patient’s pain during his terminal period, saves the functions of the limb, and increases life comfort.

  5. Severe bilateral adrenal hemorrhages in a newborn complicated by persistent adrenal insufficiency

    OpenAIRE

    Zessis, Nicholas R; Nicholas, Jennifer L; Stone, Stephen I

    2018-01-01

    Summary Bilateral adrenal hemorrhages rarely occur during the neonatal period and are often associated with traumatic vaginal deliveries. However, the adrenal gland has highly regenerative capabilities and adrenal insufficiency typically resolves over time. We evaluated a newborn female after experiencing fetal macrosomia and a traumatic vaginal delivery. She developed acidosis and acute renal injury. Large adrenal hemorrhages were noted bilaterally on ultrasound, and she was diagnosed with a...

  6. Insuficiencia suprarrenal primaria por adrenalitis autoimnume

    OpenAIRE

    Muzzo B,Santiago; Izquierdo C,Gianina; Verbeke P,Sandra

    2002-01-01

    We report a 10 years old boy, admitted with a history of asthenia, anorexia and weight loss of 4 kg. Initial laboratory work up showed metabolic acidosis and hyponatremia. The patient had no circadian rhythm of serum cortisol and an adrenal stimulation test confirmed the presence of adrenal insufficiency. Anti-adrenal antibodies were positive. Treatment with cortisol and fluorocortisone resulted in a complete remission of symptoms (Rev Méd Chile 2002; 130: 901-6).

  7. Radiological diagnosis of the adrenal glands

    International Nuclear Information System (INIS)

    Engelbrecht, V.

    2005-01-01

    The adrenal gland is a common site of disease involving hormonal dysfunction as well as benign and malignant masses. Radiology, especially computed tomography (CT) and magnetic resonance (MR), plays a critical role in detecting and characterizing diseases affecting the adrenal gland. This paper contains a summary of the most important diseases of the adrenal gland and presents criteria for differentiating between benign and malignant masses as well as an algorithm for the diagnostic steps in incidentaloma. (orig.)

  8. Ultrasonographi assessment of congenital adrenal masses

    International Nuclear Information System (INIS)

    Muro Velilla, D.; Sanguesa, C.; Alberto, C.; Lopez, A., Benlloch, C.

    1996-01-01

    The demonstrate the utility of ultrasound (US) in the initial assessment and follow-up of newborns with adrenal masses. A series of 21 newborns presenting adrenal mass studied on the basis of US findings, clinical assessment and biochemical data. Seven patients had congenital neuroblastoma, two had a benign tumor and twelve presented adrenal hemorrhage. Postnatal US study of the course of these patients is essential for the differential diagnosis of their lesions when not diagnosed prenatally. (Author) 20 refs

  9. Isolated splenic metastasis of endometrial adenocarcinoma--a case report.

    Science.gov (United States)

    Andrei, S; Preda, C; Andrei, A; Becheanu, G; Herlea, V; Lupescu, I; Popescu, I

    2011-01-01

    The spleen in rarely the place for solid, non-haematological tumors, isolated splenic metastases from adenocarcinomas being extremely rare findings, regardless of the origin and the histological type of the primary tumor. We present the case of a female patient with isolated splenic metastasis diagnosed by abdominal computer tomography at only 20 months after curative surgery for endometrial adenocarcinoma, in which the final diagnosis has been established by histological and immunohistochemical examination of the splenectomy piece. The haematogenous dissemination of the endometrial cancer occurs most commonly in the lungs, liver or bones, the spleen being rarely affected. In the medical literature there are cited up to date only 12 cases of solitary splenic metastasis from endometrial adenocarcinoma. The particularity of the case presented by us is the early appearance of an isolated splenic metastasis, at less than two years after curative surgery (compared to an average of 4-5 years cited in the literature), from an endometrial cancer which was classified histologicaly in the group with low-risk for relapse (well differentiated endometrioid adenocarcinoma). In conclusion, although solitary splenic secondary determinations are very rare, the incidence of the reported cases in the medical literature is increasing, their late appearance (a few years after the primary tumor's resection) and the lack of symptoms until the tumor reaches appreciable size or it complicates with necrosis, justifies the periodic abdominal imaging examination, on long-term, for postoperative monitorisation after the initial curative surgery. Their treatment of choice is open, classical splenectomy that must be followed by chemotherapy in order to prevent the development of other possible micrometastases.

  10. An Unusual Case of Adrenal Incidentaloma

    Directory of Open Access Journals (Sweden)

    Turker Tasliyurt

    2014-09-01

    Full Text Available Adrenal incidentalomas are masses accidentally discovered while conducting radiological examinations for other purposes. A major part of adrenal incidentalomas are non-functional adenomas. Silently developing Cushing's syndrome or pheochromocytoma can be observed in adrenal incidentalomas. However, coexistence of Cushing's syndrome and pheochromocytoma at the same time in the same case is quite rare. In the present study, an atypical adrenal incidentaloma case is presented, whose laboratory examinations were compatible with Subclinical Cushing's syndrome, urinary catecholamine metabolites were normal, but who histopathologically had pheochromocytoma diagnosis. [J Contemp Med 2014; 4(3.000: 160-163

  11. The Lateralizing Asymmetry of Adrenal Adenomas

    Science.gov (United States)

    Hao, Meng; Lopez, Diana; Luque-Fernandez, Miguel Angel; Cote, Kathryn; Newfield, Jessica; Connors, Molly; Vaidya, Anand

    2018-01-01

    Abstract Context It is presumed that the incidence of adrenal adenomas is symmetric between the left and right adrenal gland; however, anecdotal observations suggest a potential lateralizing asymmetry. Objective To investigate the symmetry in detection of adrenal adenomas and relevance to patient care. Design Cross-sectional and longitudinal studies. Population and Setting One thousand three hundred seventy-six patients with abdominal computed tomography or magnetic resonance imaging demonstrating benign-appearing adrenal adenomas. Main Outcome Location and size of adrenal adenomas. Results Left-sided adenomas were discovered in 65% of patients, right-sided in 21%, and bilateral adenomas in 14%. Among unilateral adenomas, 75% were left-sided. Left-sided adenomas were more prevalent than right-sided adenomas in each size category except the largest: Adrenal adenomas are substantially more likely to be identified on the left adrenal than the right. This observation may be due to detection bias attributed to the location of the right adrenal, which may preclude identification of right-sided adenomas until they are substantially larger. These findings suggest the potential for an underrecognition of right-sided adenomas that may also impair the accurate detection of bilateral adrenal diseases. PMID:29644340

  12. A prenatally detected adrenal cyst treated by adrenal-sparing surgery

    African Journals Online (AJOL)

    A neonatal case of left adrenal cyst detected in utero and successfully treated by adrenal-sparing surgery is presented and discussed with review of the literature. Incidentally discovered prenatal adrenal masses present a diagnostic dilemma. Benign and malignant conditions can present as a fetal suprarenal mass. There is ...

  13. Adrenal scan in 17-alpha-hydroxylase deficiency: false indication of adrenal adenoma

    International Nuclear Information System (INIS)

    Shore, R.M.; Lieberman, L.M.; Newman, T.J.; Friedman, A.; Bargman, G.J.

    1981-01-01

    A patient who was thought to have testicular feminization syndrome and primary aldosteronism had an adrenal scan that suggested an adrenal adenoma. After later diagnosis of 17-alpha-hydroxylase deficiency, she was treated with glucocorticoids rather than surgery. Her clinical course and a repeat adrenal scan confirmed she did not have a tumor

  14. Rare adrenal gland incidentaloma: an unusual Ewing's sarcoma family of tumor presentation and literature review.

    Science.gov (United States)

    Guo, Hui; Chen, Shuaiqi; Liu, Shukun; Wang, Kaixuan; Liu, Erpeng; Li, Faping; Hou, Yuchuan

    2017-04-04

    Members of the Ewing's sarcoma family of tumor (ESFT) are malignant neoplasms and rarely observed in the adrenal gland. We report an extremely exceptional case of ESFT rising from the adrenal gland in a 57-year-old Chinese man. The patient was hospitalized with abdominal swelling for 2 months. Computed tomography (CT) scan revealed a nearly-circular mass measuring about 8.1 × 10.6 cm in the right adrenal region. The patient underwent right adrenal resection. Histopathologic examination found the tumor was composed of small round blue cells forming typical Homer-Wright rosettes in focal area. The immunohistochemical analysis confirmed the case to be ESFT, which was positive for membranous CD99 and nuclear FLI-1. The patient was scheduled for four courses of large doses of chemotherapy and died for cancer metastasis one year later after surgery. Histopathological evidence of Homer-Wright rosettes and immunohistochemical markers positivity, such as CD99 and FLI-1, are valuable factors for ESFT diagnosis, although cytogenetic analysis is considered as the gold standard. Complete surgery is the treatment of choice for ESFT and adjuvant radiotherapy and combination chemotherapy can significantly improve the survival rate of postoperative patients.

  15. [A Distal Bile Duct Carcinoma Patient Who Underwent Surgical Resection for Liver Metastasis].

    Science.gov (United States)

    Komiyama, Sosuke; Izumiya, Yasuhito; Kimura, Yu; Nakashima, Shingo; Kin, Syuichi; Kawakami, Sadao

    2018-03-01

    A 70-year-old man with distal bile duct carcinoma underwent a subtotal stomach-preserving pancreaticoduodenectomy without adjuvant chemotherapy. One and a half years after the surgery, elevated levels of serum SPan-1(38.1 U/mL)were observed and CT scans demonstrated a solitary metastasis, 25mm in size, in segment 8 of the liver. The patient received 2 courses of gemcitabine-cisplatin combination chemotherapy. No new lesions were detected after chemotherapy and the patient underwent a partial liver resection of segment 8. The pathological examination revealed a metachronous distant metastasis originating from the bile duct carcinoma. Subsequently, the patient received S-1 adjuvant chemotherapy for 6 months. Following completion of all therapies, the patient survived without tumor recurrence for 3 years and 10 months after the initial operation. Thus, surgical interventions might be effective in improving prognosis among selected patients with postoperative liver metastasis of bile duct carcinoma.

  16. Bronchogenic adenocarcinoma presenting as a synchronous solitary lytic skull lesion with ischaemic stroke--case report and literature review.

    LENUS (Irish Health Repository)

    O'Connell, David

    2011-01-01

    The authors describe a rare case of metastatic bronchogenic adenocarcinoma in a 55-year-old man presenting with concomittant solitary lytic skull lesion and ischaemic stroke. Metastatic bronchogenic carcinoma is known to present as lytic skull lesions. Primary brain tumours are also known to cause ischaemic brain injury. An underlying stroke risk may be exagerated by cranial tumour surgery. Patients with brain tumours are well known to be predisposed to an increased risk of developing thromboembolic disease. It is unusual to see metastatic bronchogenic adenocarcinoma presenting as ischaemic stroke with a background of concomittant cerebral metastasis. The aetio-pathogenesis of this rare occurrence is discussed with a review of literature.

  17. Adrenal Castleman's disease mimicking other adrenal neoplasms: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Seung Baek; Lee, Nam Kyung; Kim, Suk; Han, Ga Jin; Ha, Hong Koo; Ku, Ja Yoon; Ahn, Sang Jeong; Lee, Chang Hun [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of)

    2017-01-15

    We present a rare case of adrenal Castleman's disease with hyaline vascular type mimicking other adrenal neoplasms in a 65-year-old woman. Although rare, the hyaline vascular type of adrenal Castleman's disease should be included in the differential diagnosis if an adrenal mass shows a well-defined, highly enhancing solid adrenal mass with peripheral rim enhancement, multiple satellite lymph nodes, and peritoneal thickening around the dominant mass on computed tomography as shown in this patient.

  18. Testicular Adrenal Rest Tumors (TARTS With Unusual Histological Features in Congenital Adrenal Hyperplasia (CAH

    Directory of Open Access Journals (Sweden)

    Valeri Marianovsky

    2015-07-01

    Full Text Available Congenital adrenal hyperplasia (CAH patients with testicular adrenal rest tumors (TARTs with testicular enlargement present a serious diagnostic challenge. According to the data TARTs are usually benign. They are rare, resulting in paucity in the medical literature regarding their pathological features. We report a case of bilateral synchronous mass-forming TARTs with marked cytological and nuclear atypia misinterpreted as malignant testicular tumors in a 40-years-old man with CAH and CT and MRI data for pheochromocytoma of the right adrenal gland and paraaortal and paracaval lymphadenomegaly. He was previously diagnosed with adrenal cortical carcinoma of the left adrenal gland.

  19. Image characteristics of adrenal ganglioneuroma

    International Nuclear Information System (INIS)

    Ohishi, Yukihiko; Machida, Toyohei; Tashiro, Kazuya

    1994-01-01

    The image characteristics of adrenal ganglioneuroma observed in various types of imaging were examined. The subjects of the study were 6 cases of adrenal ganglioneuroma which had been histologically confirmed: the ages of the subjects ranged from 25 to 54 (mean age 41), and the maximum diameter of the tumors were 4 to 7 cm. The diagnostic methods employed in their detection were ultrasonography (US) and computed tomography (CT) in all 6 cases, magnetic resonance imaging (MRI) in 5 cases, and arteriography in 3 cases. On US and CT images, all 6 tumors had clear and smooth boundaries, and were homogeneous. They were hypoechoic on US images and low density on CT images. Of the 5 cases for which contrast CT images had been obtained, one showed a slightly heterogeneous staining. On MRI, the tumors were of lower intensity in comparison to the liver in 4 of 5 cases on the T 1 -weighted images, and the internal structure was homogeneous in 3 cases and heterogeneous in one case. The remaining one case was of isointensity and homogeneous. On the T 2 -weighted images, all 5 cases were of high intensity and heterogeneous. The blood flow distribution in the 3 tumors which were examined by Gd-DTPA dynamic MRI was low and of isointensity to the liver: 2 were heterogeneous and one was homogeneous. T 1 -enhanced images were obtained in 4 cases: 2 were of high intensity and heterogeneous, one was of isointensity and homogeneous, and one was of heterogeneously isointensity. Arteriography indicated that all 3 cases were hypovascular and no vascularization or ruptures were evident. It appeared that the imaging characteristics of adrenal ganglioneuroma were as follows: (1) homogeneous on US and CT images; (2) hypoechoic on US images, low density on CT images and little enhancement on contrast CT images; (3) of low intensity homogeneous on T 1 -weighted images and of high intensity heterogeneous on T 2 -weighted images and little blood flow distribution on dynamic MRI. (author)

  20. Partial Differential Equations and Solitary Waves Theory

    CERN Document Server

    Wazwaz, Abdul-Majid

    2009-01-01

    "Partial Differential Equations and Solitary Waves Theory" is a self-contained book divided into two parts: Part I is a coherent survey bringing together newly developed methods for solving PDEs. While some traditional techniques are presented, this part does not require thorough understanding of abstract theories or compact concepts. Well-selected worked examples and exercises shall guide the reader through the text. Part II provides an extensive exposition of the solitary waves theory. This part handles nonlinear evolution equations by methods such as Hirota’s bilinear method or the tanh-coth method. A self-contained treatment is presented to discuss complete integrability of a wide class of nonlinear equations. This part presents in an accessible manner a systematic presentation of solitons, multi-soliton solutions, kinks, peakons, cuspons, and compactons. While the whole book can be used as a text for advanced undergraduate and graduate students in applied mathematics, physics and engineering, Part II w...

  1. Laparoscopic resection of gastric gastrointestinal stromal tumors presenting as left adrenal tumors

    Institute of Scientific and Technical Information of China (English)

    Shiu-Dong Chung; Jeff Shih-chieh Chueh; Hong-Jeng Yu

    2012-01-01

    Gastrointestinal stromal tumors (GISTs) are rare gastrointestinal malignancies. They are rarely seen near the urinary tract. In a literature review, only one case of GIST presenting as a left adrenal tumor was reported. We report two documented cases of gastric GISTs mimicking left adrenal tumors which were successfully treated with pure laparoscopic adrenalectomy and wedge resection of the stomach by excising the tumor from the stomach with serial firing of endoscopic gastrointestinal staplers. The surgical margins were clear, and the patients recovered smoothly. No adjuvant therapy with imatinib was prescribed. During the surveillance for 9 mo and 44 mo respectively, no tumor recurrence and metastasis were documented. Laparoscopic tumor excision, when adhering to the principles of surgical oncology, seems feasible and the prognosis is favorable for such tumors.

  2. Two-color walking Peregrine solitary waves.

    Science.gov (United States)

    Baronio, Fabio; Chen, Shihua; Mihalache, Dumitru

    2017-09-15

    We study the extreme localization of light, evolving upon a non-zero background, in two-color parametric wave interaction in nonlinear quadratic media. We report the existence of quadratic Peregrine solitary waves, in the presence of significant group-velocity mismatch between the waves (or Poynting vector beam walk-off), in the regime of cascading second-harmonic generation. This finding opens a novel path for the experimental demonstration of extreme rogue waves in ultrafast quadratic nonlinear optics.

  3. Radiotherapy in the treatment of solitary plasmacytoma.

    Science.gov (United States)

    Jyothirmayi, R; Gangadharan, V P; Nair, M K; Rajan, B

    1997-05-01

    Solitary plasmacytoma of bone (SPB) and extramedullary plasmacytoma (EMP) are rare. High local control rates are reported with radiotherapy, although the optimal dose and extent of radiotherapy portals remains controversial. Between 1983 and 1993, 30 patients with solitary plasmacytoma were seen at the Regional Cancer Centre, Trivandrum, India. 23 patients had SPB and seven EMP. The mean age was 52 years and the male to female ratio 3.2:1. Diagnosis of SPB was confirmed by biopsy in 16 patients and tumour excision in seven. 20 patients received megavoltage radiotherapy to the bone lesion with limited margins, and one received chemotherapy. Two patients who underwent complete tumour excision received no further treatment. All seven patients with EMP received megavoltage radiotherapy, four following biopsy and three after tumour excision. Local control was achieved in all patients with SPB. Nine progressed to multiple myeloma and one developed a solitary plasmacytoma in another bone. Six patients with EMP achieved local control. Three later progressed to multiple myeloma and one had local relapse. Median time to relapse was 28 months in SPB and 30 months in EMP. 5-year overall survival rates were 82% and 57% for patients with SPB and EMP, respectively. The corresponding progression free survival rates were 55% and 50%, respectively. Age, sex, site of tumour, serum M protein and haemoglobin levels did not significantly influence progression free survival. The extent of surgery, radiotherapy dose or time to relapse were not significant prognostic factors. Radiotherapy appears to be an effective modality of treatment of solitary plasmacytoma. No dose-response relationship is observed, and high local control rates are achieved with limited portals. Progression to multiple myeloma is the commonest pattern of failure, although no prognostic factors for progression are identified. The role of chemotherapy in preventing disease progression needs further evaluation.

  4. Negative ion sound solitary waves revisited

    Science.gov (United States)

    Cairns, R. A.; Cairns

    2013-12-01

    Some years ago, a group including the present author and Padma Shukla showed that a suitable non-thermal electron distribution allows the formation of ion sound solitary waves with either positive or negative density perturbations, whereas with Maxwellian electrons only a positive density perturbation is possible. The present paper discusses the qualitative features of this distribution allowing the negative waves and shared with suitable two-temperature distributions.

  5. Frustrated Brownian Motion of Nonlocal Solitary Waves

    International Nuclear Information System (INIS)

    Folli, V.; Conti, C.

    2010-01-01

    We investigate the evolution of solitary waves in a nonlocal medium in the presence of disorder. By using a perturbational approach, we show that an increasing degree of nonlocality may largely hamper the Brownian motion of self-trapped wave packets. The result is valid for any kind of nonlocality and in the presence of nonparaxial effects. Analytical predictions are compared with numerical simulations based on stochastic partial differential equations.

  6. Rare primary retroperitoneal teratoma masquerading as adrenal ...

    African Journals Online (AJOL)

    J.M. Ratkal

    Abstract. Objectives: To present a rare case of Primary mature cystic teratoma of right adrenal gland in adult female with an aim to review the published literature. Materials and Methods: The case details of a lady presenting with vague upper abdominal pain and on investigation was found to have a right adrenal mass were ...

  7. Neonatal adrenal hemorrhage mimicking an acute scrotum.

    Science.gov (United States)

    Adorisio, O; Mattei, R; Ciardini, E; Centonze, N; Noccioli, B

    2007-02-01

    Twenty-two cases of scrotal hematoma caused by neonatal adrenal hemorrhage are reported in the literature and unnecessary surgical exploration was performed in nine (41%), suspecting testicular torsion. In this paper, we present a newborn male with right adrenal gland hemorrhage causing right scrotal swelling and discoloration of groin managed conservatively.

  8. Bilateral spontaneous adrenal haemorrhage complicating acute pancreatitis

    International Nuclear Information System (INIS)

    Pianta, M.; Varma, D. K.

    2007-01-01

    Bilateral adrenal haemorrhage is an event that mandates prompt diagnosis and treatment to prevent primary adrenocortical insufficiency and potential death. Presentation can be non-specific and incidentally diagnosed with imaging alone, primarily CT. We present a case of acute pancreatitis with spontaneous bilateral adrenal haemorrhage and briefly discuss imaging and treatment implications

  9. Hypoadrenia following adrenal venography in Cushing's disease

    International Nuclear Information System (INIS)

    Goth, M.; Szilagy, G.; Irsy, G.; Szabolcs, I.; Berentey, E.; Molnar, F.; Magyar, E.

    1984-01-01

    Three patients with Cushing's disease are reported. In two patients the hyperfunction of the adrenal glands creased following selective adrenal venography, moreover hypoadrenia has developed. In the third case necrosis following venography was proved by surgery and confirmed by histology. Regarding the therapeutic possibilities of Cushing's diesease the use of this diagnostic procedure is taken into consideration but not recommended. (orig.)

  10. Intrinsic electromagnetic solitary vortices in magnetized plasma

    International Nuclear Information System (INIS)

    Liu, J.; Horton, W.

    1986-01-01

    Several Rossby type vortex solutions constructed for electromagnetic perturbations in magnetized plasma encounter the difficulty that the perturbed magnetic field and the parallel current are not continuous on the boundary between two regions. We find that fourth order differential equations must be solved to remove this discontinuity. Special solutions for two types of boundary value problems for the fourth order partial differential equations are presented. By applying these solutions to different nonlinear equations in magnetized plasma, the intrinsic electromagnetic solitary drift-Alfven vortex (along with solitary Alfven vortex) and the intrinsic electromagnetic solitary electron vortex (along with short-wavelength drift vortex) are constructed. While still keeping a localized dipole structure, these new vortices have more complicated radial structures in the inner and outer regions than the usual Rossby wave vortex. The new type of vortices guarantees the continuity of the perturbed magnetic field deltaB/sub perpendicular/ and the parallel current j/sub parallel/ on the boundary between inner and outer regions of the vortex. The allowed regions of propagation speeds for these vortices are analyzed, and we find that the complementary relation between the vortex propagating speeds and the corresponding phase velocities of the linear modes no longer exists

  11. Staging Lung Cancer: Metastasis.

    Science.gov (United States)

    Shroff, Girish S; Viswanathan, Chitra; Carter, Brett W; Benveniste, Marcelo F; Truong, Mylene T; Sabloff, Bradley S

    2018-05-01

    The updated eighth edition of the tumor, node, metastasis (TNM) classification for lung cancer includes revisions to T and M descriptors. In terms of the M descriptor, the classification of intrathoracic metastatic disease as M1a is unchanged from TNM-7. Extrathoracic metastatic disease, which was classified as M1b in TNM-7, is now subdivided into M1b (single metastasis, single organ) and M1c (multiple metastases in one or multiple organs) descriptors. In this article, the rationale for changes in the M descriptors, the utility of preoperative staging with PET/computed tomography, and the treatment options available for patients with oligometastatic disease are discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Meta-iodobenzylguanidine adrenal medulla localization

    International Nuclear Information System (INIS)

    Guilloteau, D.; Baulieu, J.L.; Chambon, C.; Valat, C.; Baulieu, F.; Itti, R.; Pourcelot, L.; Besnard, J.C.; Huguet, F.; Narcisse, G.; Viel, C.

    1984-01-01

    In order to investigate the mechanism of uptake of meta-iodobenzylguanidine (mIBG) by the adrenal glands, autoradiographic and pharmacologic studies were performed in mice and dogs receiving radioiodinated mIBG. In mice, on macroautoradiography of whole body section 48 h after 125 I-mIBG, most of the radioactivity was focused in the adrenal glands. On microautoradiography, silver grains were exclusively located in the adrenal medulla. Time counting after phenoxybenzamine, cocaine, and desipramine treatment resulted in 45%, 35%, and 0% inhibition of mIBG uptake, respectively. Tissue counting and scintigraphic studies demonstrated a more than 50% mIBG release from the adrenal glands. These data indicate the high affinity of mIBG for adrenal medulla and suggest that the mIBG and catecholamine uptake mechanisms are onlt partially the same. (orig.)

  13. [Neonatal adrenal hematoma: various modes of presentation].

    Science.gov (United States)

    Fadil, F-Z; Lehlimi, M; Chemsi, M; Habzi, A; Benomar, S

    2014-09-01

    Neonatal adrenal hematoma is a rare condition, most frequently caused by trauma. We report three cases of adrenal hematoma admitted to the Neonatology and Neonatal Intensive Care Unit in the A. Harouchi Children's Hospital, the Ibn Rushd University Hospital in Casablanca, Morocco, over a 2-year period from January 2011 to December 2012. The average age of these patients was 5 days. The clinical presentations were diverse; the most common manifestations were intense jaundice in one case, acute adrenal insufficiency in one case, and severe anemia in the other case. Abdominal ultrasonography was used to confirm the diagnosis and monitor adrenal hemorrhage in all the patients. Analysis of clinical, laboratory, and ultrasonography data showed a favorable prognosis in all the patients. Based on these observations, we discuss the risk factors, clinical presentations, progression and management of neonatal adrenal hemorrhage. Copyright © 2014. Published by Elsevier SAS.

  14. Case report on the role of radiofrequency-assisted spleen-preserving surgery for splenic metastasis in the era of check-point inhibitors.

    Science.gov (United States)

    Mudan, Satvinder; Kumar, Jayant; Mafalda, Neves C; Kusano, Tomokazu; Reccia, Isabella; Zanallato, Artur; Dalgleish, Angus; Habib, Nagy

    2017-12-01

    An isolated splenic metastasis is a rare phenomenon noted in advanced stage melanoma. We report the role of radiofrequency (RF) -based splenic-preserving splenectomy in a patient with a solitary splenic metastasis from advanced stage melanoma that was managed with checkpoint inhibitors. We report a case of a 60-year-old man who presented with multiple lung metastases and a solitary splenic metastasis with advanced stage melanoma following excision of primary from his trunk 2.3 years back. Considering the diagnosis of advanced stage melanoma with multiple lung metastases and a solitary splenic metastasis, and its ongoing progressive nature. This case was discussed in the tumour board meeting. A decision was made to commence treatment with immunotherapy in the form of PD-1 inhibitor (programmed cell death 1 receptor) pembrolizumab. Follow-up restaging computer tomography (CT) scan of the abdomen and chest showed a significant reduction in the lung and chest wall lesions, but the splenic lesion remained unchanged. Given the lack of response to treatment in the splenic metastasis and the significant decrease in lung metastases, the multidisciplinary team decided that a partial splenectomy combined with continued immunotherapy treatment would be appropriate as the success of immunotherapy was imminent within the splenic preservation. The postoperative recovery was smooth and the patient was discharged from hospital on the sixth postoperative day with normal platelets and white blood cells. The histopathological analysis of the resected specimen showed a metastatic melanoma with negative margins.At 10-month follow-up after the splenic resection the patient had not experienced further tumour recurrences. Spleen-preserving resection for an isolated, solitary splenic metastasis of melanoma is a feasible approach as it not only preserves the ongoing efficacy of checkpoint inhibitors by preserving the physiological T cell milieu, but the immunomodulation properties of RF can

  15. Adrenal Mass Causing Secondary Hypertension.

    Science.gov (United States)

    Robinson, Darlene Y

    2015-11-01

    Most hypertensive patients have essential (primary) hypertension; only 5% to 10% have a secondary cause. Two clinical characteristics suggestive of secondary hypertension are early onset (hypertension (>180/110 mm Hg). When faced with these findings, clinicians should consider a secondary cause of hypertension. A 22-year-old woman being evaluated for asthma exacerbation in the emergency department was noted to have severe persistent hypertension. Additional evaluation revealed severe hypokalemia, metabolic alkalosis, and hypernatremia. The patient was admitted to the hospital for blood pressure management, electrolyte replacement, and further evaluation of presumed hyperaldosteronism. Diagnostic imaging revealed a large adrenal mass. Surgical resection was performed, leading to a diagnosis of hyperaldosteronism caused by adrenal carcinoma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Secondary hypertension is far less common than essential hypertension; however, considering the large volume of patients seen in emergency departments, it is likely that some will have secondary hypertension. Emergency physicians should be aware of the clinical characteristics that suggest secondary hypertension so that the appropriate diagnostic and treatment pathways can be pursued. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Congenital Adrenal Hyperplasia: Unresolved Issues.

    Science.gov (United States)

    Yau, Mabel; Khattab, Ahmed; Poppas, Dix; Ghizzoni, Lucia; New, Maria

    2016-01-01

    Congenital adrenal hyperplasia (CAH) describes a family of disorders that comes from enzymatic deficiencies in cortisol production, with 21-hydroxylase deficiency causing ∼90% of cases. Distinction is made between the severe classical form and milder nonclassical form of CAH. Molecular genetic analysis is used to confirm the hormonal diagnosis. A high rate of genotype-phenotype disconcordance has been found in 21-hydroxylase deficiency. The goal of treatment is to replace with synthetic glucocorticoids and mineralocorticoids and suppress adrenal androgen production. The treatment of patients affected with nonclassical CAH, particularly males, remains controversial. Variable synthetic glucocorticoids are used and new modes of glucocorticoid delivery are under investigation. To improve height, growth hormone and other adjuvant therapies are employed. Long-term outcomes of genital surgery using modern techniques in females affected with classical CAH continue to be investigated. Prenatal treatment with dexamethasone is available to avoid ambiguous genitalia in these females. Although studies have shown its safety to mother and fetus, prenatal treatment is still regarded as experimental. Currently, prenatal diagnosis of CAH can only be obtained through invasive methods. Recently, the detection of cell-free fetal DNA in maternal plasma has made it possible to make this diagnosis earlier and noninvasively. © 2016 S. Karger AG, Basel.

  17. Brain metastasis from colorectal cancer

    International Nuclear Information System (INIS)

    Bamba, Yoshiko; Itabashi, Michio; Hirosawa, Tomoichiro; Ogawa, Shinpei; Noguchi, Eiichiro; Takemoto, Kaori; Shirotani, Noriyasu; Kameoka, Shingo

    2007-01-01

    The present study was performed to clarify the clinical characteristics of brain metastasis from colorectal cancer. Five patients with brain metastasis from colorectal cancer treated at our institute between 2001 and 2005 were included in the study. Clinical findings and survival time were determined and an appropriate system for follow-up in such cases was considered. Brain metastasis was found after surgery for colorectal cancer in 4 cases. In addition, colorectal cancer was found after diagnosis of brain metastasis in 1 case. At the time of diagnosis of brain metastasis, all patients had lung metastasis and 3 had liver metastasis. The mean periods between surgery for colorectal cancer and lung and brain metastases were 19.5 and 38.2 months, respectively. In all cases, brain metastasis was diagnosed by imaging after the appearance of neurological symptoms. Brain metastases were multiple in 1 case and focal in 4 cases. We performed gamma knife radiation therapy, and the symptoms disappeared or decreased in all cases. Mean survival time after brain metastasis was 3.0 months. Prognosis after brain metastasis is poor, but gamma knife radiation therapy contributed to patients' quality of life. (author)

  18. The cruel and unusual phenomenology of solitary confinement

    OpenAIRE

    Shaun eGallagher; Shaun eGallagher; Shaun eGallagher

    2014-01-01

    What happens when subjects are deprived of intersubjective contact? This paper looks closely at the phenomenology and psychology of one example of that deprivation: solitary confinement. It also puts the phenomenology and psychology of solitary confinement to use in the legal context. Not only is there no consensus on whether solitary confinement is a cruel and unusual punishment, there is no consensus on the definition of the term ‘cruel’ in the use of that legal phrase. I argue that we ...

  19. The cruel and unusual phenomenology of solitary confinement.

    Science.gov (United States)

    Gallagher, Shaun

    2014-01-01

    What happens when subjects are deprived of intersubjective contact? This paper looks closely at the phenomenology and psychology of one example of that deprivation: solitary confinement. It also puts the phenomenology and psychology of solitary confinement to use in the legal context. Not only is there no consensus on whether solitary confinement is a "cruel and unusual punishment," there is no consensus on the definition of the term "cruel" in the use of that legal phrase. I argue that we can find a moral consensus on the meaning of "cruelty" by looking specifically at the phenomenology and psychology of solitary confinement.

  20. The cruel and unusual phenomenology of solitary confinement

    Directory of Open Access Journals (Sweden)

    Shaun eGallagher

    2014-06-01

    Full Text Available What happens when subjects are deprived of intersubjective contact? This paper looks closely at the phenomenology and psychology of one example of that deprivation: solitary confinement. It also puts the phenomenology and psychology of solitary confinement to use in the legal context. Not only is there no consensus on whether solitary confinement is a cruel and unusual punishment, there is no consensus on the definition of the term ‘cruel’ in the use of that legal phrase. I argue that we can find a moral consensus on the meaning of ‘cruelty’ by looking specifically at the phenomenology and psychology of solitary confinement.

  1. Interaction for solitary waves in coasting charged particle beams

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Shi-Wei; Hong, Xue-Ren; Shi, Yu-Ren; Duan, Wen-shan, E-mail: duanws@nwnu.edu.cn [College of Physics and Electronic Engineering and Joint Laboratory of Atomic an Molecular Physics of NWNU and IMPCAS, Northwest Normal University, Lanzhou 730070 (China); Qi, Xin; Yang, Lei, E-mail: lyang@impcas.ac.cn [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Han, Jiu-Ning [College of Physics and Electromechanical Engineering, Hexi University, Zhangye 734000 (China)

    2014-03-15

    By using the extended Poincare-Lighthill-Kuo perturbation method, the collision of solitary waves in a coasting charged particle beams is studied. The results show that the system admits a solution with two solitary waves, which move in opposite directions and can be described by two Korteweg-deVries equation in small-amplitude limit. The collision of two solitary waves is elastic, and after the interaction they preserve their original properties. Then the weak phase shift in traveling direction of collision between two solitary waves is derived explicitly.

  2. Solitary Fibrous Tumor Arising from Stomach: CT Findings

    Science.gov (United States)

    Park, Sung Hee; Kwon, Jieun; Park, Jong-pil; Park, Mi-Suk; Lim, Joon Seok; Kim, Joo Hee; Kim, Ki Whang

    2007-01-01

    Solitary fibrous tumors are spindle-cell neoplasms that usually develop in the pleura and peritoneum, and rarely arise in the stomach. To our knowledge, there is only one case reporting a solitary fibrous tumor arising from stomach in the English literature. Here we report the case of a 26-year-old man with a large solitary fibrous tumor arising from the stomach which involved the submucosa and muscular layer and resembled a gastrointestinal stromal tumor in the stomach, based on what was seen during abdominal computed tomography. A solitary fibrous tumor arising from the stomach, although rare, could be considered as a diagnostic possibility for gastric submucosal tumors. PMID:18159603

  3. Adrenal incidentaloma and the Janus Kinase 2 V617F mutation: A case-based review of the literature

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    Mustafa Unubol

    2013-01-01

    Full Text Available Adrenal incidentaloma was detected in an 81-year-old male patient and a 37-year-old female patient who had been diagnosed with essential thrombocytosis. Each patient′s Janus Kinase 2 (JAK2 V617F mutation was positive, and they were evaluated as having non-functional adrenal incidentaloma. The JAK2 activates the signal transducers and activators of transcription (STAT proteins which then activate the phosphoinositol-3 kinases, Ras, mitogen-activated protein (MAP kinases, and transcription. Constitutive activation causes cell proliferation and dysregulation of apoptosis. It is thought that STAT3 activation-mediated JAK family kinases have a central role in the solid tumor cell series. Permanent activation of STAT3 and STAT5 causes tumor cell proliferation, survival, metastasis, and an increase in tumor-mediated inflammation in solid and hematologic tumors. According to our literature screening, irregular JAK signaling, seen at the pathogenesis of many solid and hematologic tumors, has not been previously evaluated with regard to adrenal tumors. As a result, our cases are the first coexistence of JAK V617F mutation with adrenal incidentaloma in the literature. Because of this, we think that JAK2 mutation must be evaluated to clarify the etiology of adrenal incidentalomas.

  4. Normal liver tissue sparing by intensity-modulated proton stereotactic body radiotherapy for solitary liver tumours

    International Nuclear Information System (INIS)

    Petersen, Joergen B. B.; Hansen, Anders T.; Lassen, Yasmin; Grau, Cai; Hoeyer, Morten; Muren, Ludvig P.

    2011-01-01

    Background. Stereotactic body radiotherapy (SBRT) is often the preferred treatment for the advanced liver tumours which owing to tumour distribution, size and multi-focality are out of range of surgical resection or radiofrequency ablation. However, only a minority of patients with liver tumours may be candidates for conventional SBRT because of the limited radiation tolerance of normal liver, intestine and other normal tissues. Due to the favourable depth-dose characteristics of protons, intensity-modulated proton therapy (IMPT) may be a superior alternative to photon-based SBRT. The purpose of this treatment planning study was therefore to investigate the potential sparing of normal liver by IMPT compared to photon-based intensity-modulated radiotherapy (IMRT) for solitary liver tumours. Material and methods. Ten patients with solitary liver metastasis treated at our institution with multi-field SBRT were retrospectively re-planned with IMRT and proton pencil beam scanning techniques. For the proton plans, two to three coplanar fields were used in contrast to five to six coplanar and non-coplanar photon fields. The same planning objectives were used for both techniques. A risk adapted dose prescription to the PTV surface of 12.5-16.75 Gy x 3 was used. Results. The spared liver volume for IMPT was higher compared to IMRT in all 10 patients. At the highest prescription dose level, the median liver volume receiving less than 15 Gy was 1411 cm 3 for IMPT and 955 cm 3 for IMRT (p D 15 Gy > 700 cm 3 constraint. For the D mean = 15 Gy constraint, nine of 10 cases could be treated at the highest dose level using IMPT whereas with IMRT, only two cases met this constraint at the highest dose level and six at the lowest dose level. Conclusion. A considerable sparing of normal liver tissue can be obtained using proton-based SBRT for solitary liver tumours

  5. Role of endoscopic ultrasound-guided fine-needle aspiration in adrenal lesions: analysis of 32 patients

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    Rakesh K Gupta

    2018-01-01

    Full Text Available Objective: Endoscopic ultrasound-guided fine-needle aspiration cytology (EUS-FNAC is a precise and safe technique that provides both radiological and pathological diagnosis with a better diagnostic yield and minimal adverse events. EUS-FNAC led to the remarkable increase in the detection rate of incidentaloma found during radiologic staging or follow-up in various malignancy or unrelated conditions. Aims: We did this preliminary study with an aim to evaluate the role of EUS-FNA in diagnosing and classifying adrenal lesions, clinical impact, and compare the outcome with the previously published literature. Materials and Methods: We included 32 consecutive cases (both retrospective and prospective of EUS-guided adrenal aspirate performed over a period of 3.3 years. The indications for the aspirate in decreasing order were metastasis (most common carcinoma gall bladder > primary adrenal mass > disseminated tuberculosis > pyrexia of unknown origin. On EUS, 28 cases revealed space occupying lesion or mass (two cases bilateral and four cases revealed diffuse enlargement (two cases bilateral with a mean size of 21 mm. Results: The cytology reports were benign adrenal aspirate (43.8%, metastatic adenocarcinoma (15.6%, histoplasmosis (9.4%, tuberculosis (9.4%, round cell tumor (6.2%, adrenocortical carcinoma (3.1%, and descriptive (3.1%. Three cases (9.4% yielded inadequate sample. The TNM staging was altered in 22.23% of the cases by result of adrenal aspirate. Conclusions: EUS-FNA of the adrenal gland is a safe, quick, and sensitive and real-time diagnostic technique, which requires an integrated approach of clinician, endoscopist, and cytopathologist for high precision in diagnosis. Although the role of EUS-FNA for right adrenal is not much described, we found adequate sample yield in all the four patients that underwent the procedure.

  6. Tongue metastasis mimicking an abscess.

    Science.gov (United States)

    Mavili, Ertuğrul; Oztürk, Mustafa; Yücel, Tuba; Yüce, Imdat; Cağli, Sedat

    2010-03-01

    Primary tumors metastasizing to the oral cavity are extremely rare. Lung is one of the most common primary sources of metastases to the tongue. Although the incidence of lung cancer is increasing, tongue metastasis as the initial presentation of the tumor remains uncommon. Due to the rarity of tongue metastasis, little is known about its imaging findings. Herein we report the magnetic resonance imaging and clinical findings of a lingual metastasis, mimicking an abscess, from a primary lung cancer.

  7. The role of radiation therapy in the treatment of solitary plasmacytomas

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    Mayr, N.A.; B-Chen Wen; Hussey, D.H.; Staples, J.J.; Doornbos, J.F.; Vigliotti, A.P. (Iowa University College of Medicine, Iowa City (USA). Division of Radiation Oncology, Department of Radiology); Burns, C.P. (Iowa University College of Medicine, Iowa City (USA). Division of Hematology-Oncology, Department of Internal Medicine)

    1990-03-01

    Between 1960 and 1985, 30 patients with solitary plasmacytomas wee treated with radiotherapy at the University of Iowa: 13 patients with extramedullary plasmacytomas (EMP) and 17 with solitary plasmacytomas of bone (SPB). The local control rats were 92% for patients with EMP and 88% for those with SPB. Two of nine patients (22%) with EMP treated to the primary tumor only developed regional lymph node metastasis, indicating the need for elective irradiation of this area. The most common pattern of failure in both groups was progression to multiple myeloma. This occurred in 23% of the patients with EMP and 53% of those with SPB. The time course of progression to multiple myeloma differed for the two groups. All of those who progressed to multiple myeloma in the EMP group did so within 2 years, whereas a significant number of those in the SPB group progressed more than 5 years after initial therapy. None of five patients who received adjuvant chemotherapy in the SPB group progressed to multiple myeloma, compared to 75% (9/12) of the patients who did not receive chemotherapy. (author). 20 refs.; 3 figs.; 5 tabs.

  8. The role of radiation therapy in the treatment of solitary plasmacytomas

    International Nuclear Information System (INIS)

    Mayr, N.A.; B-Chen Wen; Hussey, D.H.; Staples, J.J.; Doornbos, J.F.; Vigliotti, A.P.; Burns, C.P.

    1990-01-01

    Between 1960 and 1985, 30 patients with solitary plasmacytomas wee treated with radiotherapy at the University of Iowa: 13 patients with extramedullary plasmacytomas (EMP) and 17 with solitary plasmacytomas of bone (SPB). The local control rats were 92% for patients with EMP and 88% for those with SPB. Two of nine patients (22%) with EMP treated to the primary tumor only developed regional lymph node metastasis, indicating the need for elective irradiation of this area. The most common pattern of failure in both groups was progression to multiple myeloma. This occurred in 23% of the patients with EMP and 53% of those with SPB. The time course of progression to multiple myeloma differed for the two groups. All of those who progressed to multiple myeloma in the EMP group did so within 2 years, whereas a significant number of those in the SPB group progressed more than 5 years after initial therapy. None of five patients who received adjuvant chemotherapy in the SPB group progressed to multiple myeloma, compared to 75% (9/12) of the patients who did not receive chemotherapy. (author). 20 refs.; 3 figs.; 5 tabs

  9. The role of radiation therapy in the treatment of solitary plasmacytomas.

    Science.gov (United States)

    Mayr, N A; Wen, B C; Hussey, D H; Burns, C P; Staples, J J; Doornbos, J F; Vigliotti, A P

    1990-04-01

    Between 1960 and 1985, 30 patients with solitary plasmacytomas were treated with radiotherapy at the University of Iowa: 13 patients with extramedullary plasmacytomas (EMP) and 17 with solitary plasmacytomas of bone (SPB). The local control rates were 92% for patients with EMP and 88% for those with SPB. Two of nine patients (22%) with EMP treated to the primary tumor only developed regional lymph node metastasis, indicating the need for elective irradiation of this area. The most common pattern of failure in both groups was progression to multiple myeloma. This occurred in 23% of the patients with EMP and 53% of those with SPB. The time course of progression to multiple myeloma differed for the two groups. All of those who progressed to multiple myeloma in the EMP group did so within 2 years, whereas a significant number of those in the SPB group progressed more than 5 years after initial therapy. None of five patients who received adjuvant chemotherapy in the SPB group progressed to multiple myeloma, compared to 75% (9/12) of the patients who did not receive chemotherapy.

  10. Neonatal adrenal hemorrhage presenting as late onset neonatal jaundice

    OpenAIRE

    Qureshi, Umar Amin; Ahmad, Nisar; Rasool, Akhter; Choh, Suhail

    2009-01-01

    Clinical manifestations of adrenal hemorrhage vary depending on the degree and rate of hemorrhage, as well as the amount of adrenal cortex compromised by hemorrhage. We report here a case of neonatal adrenal hemorrhage that presented with late onset neonatal jaundice. The cause of adrenal hemorrhage was birth asphyxia.

  11. Patient-specific workup of adrenal incidentalomas

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    Romy R. de Haan

    Full Text Available Purpose: : To develop a clinical prediction model to predict a clinically relevant adrenal disorder for patients with adrenal incidentaloma. Materials and methods: : This retrospective study is approved by the institutional review board, with waiver of informed consent. Natural language processing is used for filtering of adrenal incidentaloma cases in all thoracic and abdominal CT reports from 2010 till 2012. A total of 635 patients are identified. Stepwise logistic regression is used to construct the prediction model. The model predicts if a patient is at risk for malignancy or hormonal hyperfunction of the adrenal gland at the moment of initial presentation, thus generates a predicted probability for every individual patient. The prediction model is evaluated on its usefulness in clinical practice using decision curve analysis (DCA based on different threshold probabilities. For patients whose predicted probability is lower than the predetermined threshold probability, further workup could be omitted. Results: : A prediction model is successfully developed, with an area under the curve (AUC of 0.78. Results of the DCA indicate that up to 11% of patients with an adrenal incidentaloma can be avoided from unnecessary workup, with a sensitivity of 100% and specificity of 11%. Conclusion: : A prediction model can accurately predict if an adrenal incidentaloma patient is at risk for malignancy or hormonal hyperfunction of the adrenal gland based on initial imaging features and patient demographics. However, with most adrenal incidentalomas labeled as nonfunctional adrenocortical adenomas requiring no further treatment, it is likely that more patients could be omitting from unnecessary diagnostics. Keywords: Adrenal incidentaloma, Patient-specific workup, Prediction model

  12. Leptomeningeal metastasis from hepatocellular carcinoma with other unusual metastases: a case report

    International Nuclear Information System (INIS)

    Pan, Zhenyu; Yang, Guozi; Yuan, Tingting; Pang, Xiaochuan; Wang, Yongxiang; Qu, Limei; Dong, Lihua

    2014-01-01

    Leptomeningeal metastasis, which results from metastasis of tumors to the arachnoid and pia mater, can lead to the dissemination of tumor cells throughout the subarachnoid space via the cerebral spinal fluid, and frequently with a poor prognosis. The primary tumor in adults is most often breast cancer, lung cancer, or melanoma. Although leptomeningeal metastasis due to cholangiocarcinoma has been reported, to the best of our knowledge there is no cytologically confirmed report of leptomeningeal metastasis from hepatocellular carcinoma. We herein report a case of leptomeningeal metastasis from hepatocellular carcinoma in a 53-year-old woman with concomitant systemic metastases to the lung, bone, brain, kidney, adrenal gland, subcutaneous tissues, and abdominal pelvis. The neurological symptoms of the patient were relieved after treatment with methotrexate intra-cerebral spinal fluid chemotherapy concurrent with whole brain radiotherapy. To our knowledge this is the first report of leptomeningeal metastasis from hepatocellular carcinoma confirmed by cytology. Treatment with methotrexate intra-cerebral spinal fluid chemotherapy concurrent with whole brain radiotherapy was effective

  13. A case of treatment in a patient with synchronous bilateral renal cell carcinoma and simultaneous metastatic involvement of both adrenal glands: Clinical observation

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    V. R. Latypov

    2014-11-01

    Full Text Available Synchronous bilateral renal cell carcinoma occurs in 1.4 % of cases. The probability of bilateral adrenal metastases from renal cell carcinoma is less than 0.5 %. The clinical observation presents a case of synchronous bilateral renal cell carcinoma and simultaneous metastatic involvement of both adrenal glands. A 55‑year-old male patient was adm tted with the signs of hematuria and anemia to the Unit of Urology, Clinic of General Surgery, Siberian State Medical University. He was found to have synchronous bilateral renal cell carcinoma and simultaneous bilateral adrenal involvement. Sequential surgical treatment – radical nephrectomy (with adrenal gland removal on the right side and, after 3 months, adrenalectomy and kidney resection on the left side were performed. All the organs removed displayed tumors that proved to be renal cell carcinomas (a clear cell variant. There were lymph node metastases in the right-sided renal portal. Postoperatively, the investigators performed hormone replacement therapy for adrenal insufficiency, an immunotherapy cycle, three cycles of targeted therapy withsorafenib and sunitinib (at an interval of 0.5–2 years, and insulin therapy for new-onset diabetes mellitus. The duration of a follow-up was 6.2 years. When describing the case, the patient was alive and showed a generalized tumorous process with extensive tumor involvement of the solitary kidney. Sunitinib therapy was used.

  14. A case of treatment in a patient with synchronous bilateral renal cell carcinoma and simultaneous metastatic involvement of both adrenal glands: Clinical observation

    Directory of Open Access Journals (Sweden)

    V. R. Latypov

    2014-01-01

    Full Text Available Synchronous bilateral renal cell carcinoma occurs in 1.4 % of cases. The probability of bilateral adrenal metastases from renal cell carcinoma is less than 0.5 %. The clinical observation presents a case of synchronous bilateral renal cell carcinoma and simultaneous metastatic involvement of both adrenal glands. A 55‑year-old male patient was adm tted with the signs of hematuria and anemia to the Unit of Urology, Clinic of General Surgery, Siberian State Medical University. He was found to have synchronous bilateral renal cell carcinoma and simultaneous bilateral adrenal involvement. Sequential surgical treatment – radical nephrectomy (with adrenal gland removal on the right side and, after 3 months, adrenalectomy and kidney resection on the left side were performed. All the organs removed displayed tumors that proved to be renal cell carcinomas (a clear cell variant. There were lymph node metastases in the right-sided renal portal. Postoperatively, the investigators performed hormone replacement therapy for adrenal insufficiency, an immunotherapy cycle, three cycles of targeted therapy withsorafenib and sunitinib (at an interval of 0.5–2 years, and insulin therapy for new-onset diabetes mellitus. The duration of a follow-up was 6.2 years. When describing the case, the patient was alive and showed a generalized tumorous process with extensive tumor involvement of the solitary kidney. Sunitinib therapy was used.

  15. Bulk solitary waves in elastic solids

    Science.gov (United States)

    Samsonov, A. M.; Dreiden, G. V.; Semenova, I. V.; Shvartz, A. G.

    2015-10-01

    A short and object oriented conspectus of bulk solitary wave theory, numerical simulations and real experiments in condensed matter is given. Upon a brief description of the soliton history and development we focus on bulk solitary waves of strain, also known as waves of density and, sometimes, as elastic and/or acoustic solitons. We consider the problem of nonlinear bulk wave generation and detection in basic structural elements, rods, plates and shells, that are exhaustively studied and widely used in physics and engineering. However, it is mostly valid for linear elasticity, whereas dynamic nonlinear theory of these elements is still far from being completed. In order to show how the nonlinear waves can be used in various applications, we studied the solitary elastic wave propagation along lengthy wave guides, and remarkably small attenuation of elastic solitons was proven in physical experiments. Both theory and generation for strain soliton in a shell, however, remained unsolved problems until recently, and we consider in more details the nonlinear bulk wave propagation in a shell. We studied an axially symmetric deformation of an infinite nonlinearly elastic cylindrical shell without torsion. The problem for bulk longitudinal waves is shown to be reducible to the one equation, if a relation between transversal displacement and the longitudinal strain is found. It is found that both the 1+1D and even the 1+2D problems for long travelling waves in nonlinear solids can be reduced to the Weierstrass equation for elliptic functions, which provide the solitary wave solutions as appropriate limits. We show that the accuracy in the boundary conditions on free lateral surfaces is of crucial importance for solution, derive the only equation for longitudinal nonlinear strain wave and show, that the equation has, amongst others, a bidirectional solitary wave solution, which lead us to successful physical experiments. We observed first the compression solitary wave in the

  16. Adrenal medullary hyperplasia. Hyperplasia-pheochromocytoma sequence.

    Science.gov (United States)

    Kurihara, K; Mizuseki, K; Kondo, T; Ohoka, H; Mannami, M; Kawai, K

    1990-09-01

    We present a case of unilateral adrenal medullary hyperplasia in a 63-year-old woman with clinical signs and symptoms of pheochromocytoma unassociated with multiple endocrine neoplasia. The surgically removed adrenal gland revealed diffuse medullary hyperplasia with multiple micronodules measuring up to 2 mm. The micronodules were composed of enlarged chromaffin cells with atypia, histologically similar to those of pheochromocytoma, forming small solid alveolar patterns separated by a fibrovascular stroma. Removal of the hyperplastic adrenal gland resulted in disappearance of paroxysmal nocturnal hypertension and palpitation. These results suggest that diffuse and nodular medullary hyperplasia is the precursor of pheochromocytoma.

  17. Adrenal Ewing's Sarcoma in an Elderly Man.

    Science.gov (United States)

    Toda, Kazuyoshi; Ishii, Sumiyasu; Yasuoka, Hidetoshi; Nishioka, Masaki; Kobayashi, Takayuki; Horiguchi, Kazuhiko; Tomaru, Takuya; Ozawa, Atsushi; Shibusawa, Nobuyuki; Satoh, Tetsurou; Koshi, Hiromi; Segawa, Atsuki; Shimizu, Shin-Ichi; Oyama, Tetsunari; Yamada, Masanobu

    2018-02-15

    Ewing's sarcoma usually arises in the bones of children and adolescents. We herein report a 74-year-old man with Ewing's sarcoma in the adrenal gland. The diagnosis was confirmed by a genetic test, pathological studies, and several imaging studies. He already had multiple liver metastases when he was transferred to our hospital and died on the 37th day. The diagnosis was further confirmed by autopsy studies. Adrenal Ewing's sarcoma is very rare, and our patient was older than other reported cases. Ewing's sarcoma should be considered even in elderly patients with adrenal tumors.

  18. Severe bilateral adrenal hemorrhages in  a  newborn complicated by persistent adrenal insufficiency

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    Nicholas R Zessis

    2018-02-01

    Full Text Available Bilateral adrenal hemorrhages rarely occur during the neonatal period and are often associated with traumatic vaginal deliveries. However, the adrenal gland has highly regenerative capabilities and adrenal insufficiency typically resolves over time. We evaluated a newborn female after experiencing fetal macrosomia and a traumatic vaginal delivery. She developed acidosis and acute renal injury. Large adrenal hemorrhages were noted bilaterally on ultrasound, and she was diagnosed with adrenal insufficiency based on characteristic electrolyte changes and a low cortisol (4.2 μg/dL. On follow-up testing, this patient was unable to be weaned off of hydrocortisone or fludrocortisone despite resolution of hemorrhages on ultrasound. Providers should consider bilateral adrenal hemorrhage when evaluating critically ill neonates after a traumatic delivery. In extreme cases, this may be a persistent process.

  19. Coexistence of Cushing syndrome from functional adrenal adenoma and Addison disease from immune-mediated adrenalitis.

    Science.gov (United States)

    Colucci, Randall; Jimenez, Rafael E; Farrar, William; Malgor, Ramiro; Kohn, Leonard; Schwartz, Frank L

    2012-06-01

    A 56-year-old woman presented with an incidental adrenal adenoma and physical examination findings that included moderate obesity, a slight cervicothoracic fat pad ("buffalo hump"), increased supraclavicular fat pads, and white abdominal striae. Biochemical workup revealed elevated levels of 24-hour urinary free cortisol but normal serum morning cortisol and suppressed levels of corticotropin, suggestive of adrenal-dependent Cushing syndrome. The resected adrenal gland revealed macronodular cortical hyperplasia with a dominant nodule. Other findings included an absent cortisol response to corticotropin stimulation, presence of serum anti-21-hydroxylase antibodies, and mononuclear cell infiltration--consistent with adrenalitis. The findings represent, to the authors' knowledge, the first known case of a patient with coexistent functional cortisol-secreting macronodular adrenal tumor resulting in Cushing syndrome and immune-mediated adrenalitis resulting in Addison disease.

  20. Isolated metachronous splenic metastasis from synchronous colon cancer

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    Aker Fugen

    2006-07-01

    Full Text Available Abstract Background Isolated splenic metastases from colorectal cancer are very rare and there are only 13 cases reported in the English literature so far. Most cases are asymptomatic and the diagnosis is usually made by imaging studies during the evaluation of rising CEA level postoperatively. Case presentation A 76-year-old man underwent an extended left hemicolectomy for synchronous colon cancers located at the left flexure and the sigmoid colon. The tumors were staged as IIIC (T3N2M0 clinically and the patient received adjuvant chemotherapy. During the first year follow-up period, the patient remained asymptomatic with normal levels of laboratory tests including CEA measurement. However, a gradually rising CEA level after the 14th postoperative month necessitated further imaging studies including computed tomography of the abdomen which revealed a mass in the spleen that was subsequently confirmed by 18FDG- PET scanning to be an isolated metastasis. The patient underwent splenectomy 17 months after his previous cancer surgery. Histological diagnosis confirmed a metastatic adenocarcinoma with no capsule invasion. After an uneventful postoperative period, the patient has been symptom-free during the one-year of follow-up with normal blood CEA levels, although he did not accept to receive any further adjuvant therapy. To the best of our knowledge, this 14th case of isolated splenic metastasis from colorectal carcinoma is also the first reported case of splenic metastasis demonstrated preoperatively by 18FDG PET-CT fusion scanning which revealed its solitary nature as well. Conclusion Isolated splenic metastasis is a rare finding in the follow-up of colorectal cancer patients and long-term survival can be achieved with splenectomy.

  1. Social interactions in a solitary carnivore

    Institute of Scientific and Technical Information of China (English)

    L.Mark ELBROCH; Howard QUIGLEY

    2017-01-01

    In total,177 of 245 terrestrial carnivores are described as solitary,and much of carnivore ecology is built on the assumptions that interactions between adult solitary carnivores are rare.We employed Global Positioning System (GPS) technology and motion-triggered cameras to test predictions of land-tenure territoriality and the resource dispersion hypothesis in a territorial carnivore,the puma Puma concolor.We documented 89 independent GPS interactions,60% of which occurred at puma kills (n=53),59 camera interactions,11 (17%) of which captured courtship behaviors,and 5 other interactions (1 F-F,3 M-F,and 1 M-M).Mean minimum weekly contact rates were 5.5 times higher in winter,the season when elk Cervus elaphus were aggregated at lower elevations and during which puma courtship primarily occurred.In winter,contacts rates were 0.6± 0.3 (standard deviation (SD)) interactions/week vs.0.1 ± 0.1 (SD) interactions/week during summer.The preponderance of interactions at food sources supported the resource dispersion hypothesis,which predicts that resource fluxes can explain temporary social behaviors that do not result in any apparent benefits for the individuals involved.Conspecific tolerance is logical when a prey is so large that the predator that killed it cannot consume it entirely,and thus,the costs of tolerating a conspecific sharing the kill are less than the potential costs associated with defending it and being injured.Puma aggregations at kills numbered as high as 9,emphasizing the need for future research on what explains tolerance among solitary carnivores.

  2. Localization and solitary waves in solid mechanics

    CERN Document Server

    Champneys, A R; Thompson, J M T

    1999-01-01

    This book is a collection of recent reprints and new material on fundamentally nonlinear problems in structural systems which demonstrate localized responses to continuous inputs. It has two intended audiences. For mathematicians and physicists it should provide useful new insights into a classical yet rapidly developing area of application of the rich subject of dynamical systems theory. For workers in structural and solid mechanics it introduces a new methodology for dealing with structural localization and the related topic of the generation of solitary waves. Applications range from classi

  3. Radiotherapy for solitary plasmacytoma and multiple myeloma

    International Nuclear Information System (INIS)

    Schmaus, M.C.; Neuhof, D.

    2014-01-01

    Solitary plasmacytoma and multiple myeloma require a differentiated radiotherapy. The irradiation for plasmacytoma with an adequate total dose (medullary 40-50 Gy or extramedullary 50-60 Gy) leads to a high degree of local control with a low rate of side effects. In cases of multiple myeloma radiotherapy will achieve effective palliation, both in terms of recalcification as well as reduction of neurological symptoms and analgesia. In terms of analgesia the rule is the higher the single dose fraction the faster the reduction of pain. As part of a conditioning treatment prior to stem cell transplantation radiotherapy contributes to the establishment of a graft versus myeloma effect (GVM). (orig.) [de

  4. Solitary lucent epiphyseal lesions in children

    Energy Technology Data Exchange (ETDEWEB)

    Gardner, D.J.; Azouz, E.M.

    1988-10-01

    We evaluated retrospectively the varying radiographic appearances of 15 solitary lucent epiphyseal lesions occurring in children. Imaging modalities used included plain films, conventional tomography, nuclear scintigraphy, and computed tomography. 40% of the lesions (6) were due to osteomyelitis. The remaining lesions included tuberculosis (1), foreign body granuloma (1), chondroblastoma (2), chondromyoxid fibroma (1), enchondroma (1), osteoid osteoma (2), and eosinophilic granuloma (1). Although the radiographic appearances of such lesions may be particularly characteristic, pathologic correlation is frequently necessary. The high incidence of osteomyelitis in our cases emphasizes its importance as a cause for a lucent epiphyseal lesion.

  5. Gravitational bags and solitary cosmological evolution

    International Nuclear Information System (INIS)

    Davidson, A.; Guendelman, E.I.

    1989-01-01

    The role played by the sophisticated scalar potential, dictated by spontaneous compactification, is analyzed. A fine-tuning is mandatory for achieving asymptotic flatness. Two main aspects are studied. 1. The three-fold spherically symmetric case exhibits localized four-dimensional objects, to be referred to as ''gravitational bags''. These are cores of scalar fields confined by means of a cosmic domain wall, whose size only slightly exceeds equal-mass black holes. 2. The cosmological case introduces a novel scenario of ''solitary evolution''. Triggered by the collapse of the extra dimensions, the universe undergoes an inflationary stage before settling in an oscillating fashion, in its ground state. (orig.)

  6. Microtubules: A network for solitary waves

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    Zdravković Slobodan

    2017-01-01

    Full Text Available In the present paper we deal with nonlinear dynamics of microtubules. The structure and role of microtubules in cells are explained as well as one of models explaining their dynamics. Solutions of the crucial nonlinear differential equation depend on used mathematical methods. Two commonly used procedures, continuum and semi-discrete approximations, are explained. These solutions are solitary waves usually called as kink solitons, breathers and bell-type solitons. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III45010

  7. Persistent Primary Aldosteronism Despite Iatrogenic Adrenal Hemorrhage After Adrenal Vein Sampling.

    Science.gov (United States)

    Okamura, Keisuke; Okuda, Tetsu; Shirai, Kazuyuki; Abe, Ichiro; Kobayashi, Kunihisa; Ishii, Tatsu; Haraoka, Seiji; Urata, Hidenori

    2018-01-01

    Before surgery for primary aldosteronism (PA), localization is evaluated with adrenal vein sampling (AVS). A 56-year-old Japanese woman had a right adrenal mass, hypokalemia, and a high aldosterone/renin ratio. Stress tests confirmed the diagnosis of PA. Subsequently, preoperative AVS was performed and right adrenal hemorrhage (AH) occurred unexpectedly. Because hypertension persisted, laparoscopic right adrenalectomy was performed. Postoperatively, the blood pressure was normalized. Pathological examination revealed an adrenal cortical adenoma largely unaffected by necrosis and hemorrhage. Previous reports have also indicated that AH may not ameliorate PA. We discussed the clinical progress of AH and the measures to prevent causing AH.

  8. A case of adrenal Cushing’s syndrome with bilateral adrenal masses

    Directory of Open Access Journals (Sweden)

    Ya-Wun Guo

    2016-05-01

    Full Text Available A functional lesion in corticotrophin (ACTH-independent Cushing’s syndrome is difficult to distinguish from lesions of bilateral adrenal masses. Methods for distinguishing these lesions include adrenal venous sampling and 131I-6β-iodomethyl-19-norcholesterol (131I-NP-59 scintigraphy. We present a case of a 29-year-old Han Chinese female patient with a history of hypercholesterolaemia and polycystic ovary syndrome. She presented with a 6month history of an 8kg body weight gain and gradual rounding of the face. Serial examinations revealed loss of circadian rhythm of cortisol, elevated urinary free-cortisol level and undetectable ACTH level (<5pg/mL. No suppression was observed in both the low- and high-dose dexamethasone suppression tests. Adrenal computed tomography revealed bilateral adrenal masses. Adrenal venous sampling was performed, and the right-to-left lateralisation ratio was 14.29. The finding from adrenal scintigraphy with NP-59 was consistent with right adrenal adenoma. The patient underwent laparoscopic right adrenalectomy, and the pathology report showed adrenocortical adenoma. Her postoperative cortisol level was 3.2μg/dL, and her Cushingoid appearance improved. In sum, both adrenal venous sampling and 131I-NP-59 scintigraphy are good diagnostic methods for Cushing’s syndrome presenting with bilateral adrenal masses.

  9. Persistent Primary Aldosteronism Despite Iatrogenic Adrenal Hemorrhage After Adrenal Vein Sampling

    Science.gov (United States)

    Okamura, Keisuke; Okuda, Tetsu; Shirai, Kazuyuki; Abe, Ichiro; Kobayashi, Kunihisa; Ishii, Tatsu; Haraoka, Seiji; Urata, Hidenori

    2018-01-01

    Before surgery for primary aldosteronism (PA), localization is evaluated with adrenal vein sampling (AVS). A 56-year-old Japanese woman had a right adrenal mass, hypokalemia, and a high aldosterone/renin ratio. Stress tests confirmed the diagnosis of PA. Subsequently, preoperative AVS was performed and right adrenal hemorrhage (AH) occurred unexpectedly. Because hypertension persisted, laparoscopic right adrenalectomy was performed. Postoperatively, the blood pressure was normalized. Pathological examination revealed an adrenal cortical adenoma largely unaffected by necrosis and hemorrhage. Previous reports have also indicated that AH may not ameliorate PA. We discussed the clinical progress of AH and the measures to prevent causing AH. PMID:29238437

  10. ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography for the evaluation of bone metastasis in patients with gastric cancer.

    Science.gov (United States)

    Ma, Dae Won; Kim, Jie-Hyun; Jeon, Tae Joo; Lee, Yong Chan; Yun, Mijin; Youn, Young Hoon; Park, Hyojin; Lee, Sang In

    2013-09-01

    The roles of positron emission tomography and bone scanning in identifying bone metastasis in gastric cancer are unclear. We compared the usefulness of positron emission tomography-computed tomography and scanning in detecting bone metastasis in gastric cancer. Data from 1485 patients diagnosed with gastric cancer who had undergone positron emission tomography-computed tomography and scanning were reviewed. Of 170 enrolled patients who were suspected of bone metastasis in either positron emission tomography or scanning, 81.2% were confirmed to have bone metastasis. The sensitivity, specificity, and accuracy were 93.5%, 25.0%, and 80.6%, respectively, for positron emission tomography and 93.5%, 37.5%, and 82.9%, respectively, for scanning. 87.7% of patients with bone metastasis showed positive findings on two modalities. 15.0% of solitary bone metastases were positive on positron emission tomography only. Positron emission tomography was superior to scanning for the detection of synchronous bone metastasis, but the two modalities were similar for the detection of metachronous bone metastasis. The concordance rate of response assessment after treatment between two modalities was moderate. Positron emission tomography-computed tomography may be more effective for the diagnosis of bone metastasis in the initial staging workup. Conversely, bone scanning and positron emission tomography-computed tomography may be similarly effective for the detection of metachronous bone metastasis. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  11. Solitary drift waves in the presence of magnetic shear

    International Nuclear Information System (INIS)

    Meiss, J.D.; Horton, W.

    1982-07-01

    The two-component fluid equations describing electron drift and ion acoustic waves in a nonuniform magnetized plasma are shown to possess nonlinear two-dimensional solitary wave solutions. In the presence of magnetic shear, radiative shear damping is exponentially small in L/sub s//L/sub n/ for solitary drift waves, in contrast to linear waves

  12. Solitary Plasmacytoma: A Review Of Clinical, Ocular, Neurological ...

    African Journals Online (AJOL)

    Solitary plasmacytomas are defined as proliferation of monoclonal plasma cells without evidence of significant bone-marrow plasma-cell infiltration. They are classified according to location into solitary plasmacytoma of bone if they occur in bone, and extramedullary plasmacytoma if they arise in soft tissues. They are more ...

  13. Ion-acoustic solitary waves near double layers

    International Nuclear Information System (INIS)

    Kuehl, H.H.; Imen, K.

    1985-01-01

    The possibility of ion-acoustic solitary-wave solutions in the uniform plasma on the high-potential side of double layer is investigated. Based on a fluid model of the double layer, it is found that both compressive and rarefactive solitary waves are allowed. Curves are presented which show the regions in parameter space in which these solutions exist

  14. Giant adrenal incidentaloma in young patient

    International Nuclear Information System (INIS)

    Andrade, Cristiano Feijo; Espirito Santo, Paulo Rogerio Quieregatto do; Teixeira, Antonio Roberto Franchi

    2000-01-01

    Incidental adrenal tumors are lesions occasionally observed during abdominal US or CT scans. These tumors have been observed in patients without clinical or laboratorial signs of adrenal disease. The authors report a case of a 18 - years - old young man who was admitted to the Franco da Rocha Hospital, Sao Paulo, with abdominal pain and a palpated mass in the epigastrium which began one month ago. These findings were preceded by a blunt trauma at the epigastrium three months earlier. First clinical hypothesis was of a traumatic pancreatic pseudocyst. However, investigation and laparotomy showed a large left adrenal solid mass, weighting 700 g. The mass was removed and histology was performed. There was no evidence of malignant neoplasm, then the diagnostic of incidental adenoma of adrenal was confirmed. The authors hope to stimulate surgeons for early detection of these lesions in order to prevent the complications and improve the prognosis. (author)

  15. Lateral retroperitoneoscopic adrenalectomy for complicated adrenal ...

    African Journals Online (AJOL)

    sected completely, a self-made bag was used to dress up the adrenal ... were stable, and the patients had regained consciousness ... diet and normal ambulation as regards to the requirement ..... The Malaysian Journal of Medical Scienc-.

  16. Vulvar Metastasis from Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-01-01

    Full Text Available Vulvar metastasis of urothelial carcinoma of the bladder is a very rare entity; few cases are reported in the English literature. In this paper, we describe the clinical and pathological characteristics, evolution, and treatment of a patient with vulvar metastasis of urothelial carcinoma of the bladder followed by a brief review of the reported cases in the literature.

  17. Giant Adrenal Myelolipoma Masquerading as Heart Failure

    Directory of Open Access Journals (Sweden)

    Parijat S. Joy

    2014-03-01

    Full Text Available Adrenal myelolipomas are rare benign tumors of the adrenal cortex composed of adipose and hematopoietic cells. They have been postulated to arise from repeated stimulation by stress, inflammation and ACTH oversecretion. Myelolipomas are usually detected incidentally on imaging and do not require any active intervention besides regular follow-up by imaging. However, myelolipomas may insidiously grow to large sizes and cause mass effects and hemorrhage. Timely diagnosis and surgical resection are curative and lifesaving.

  18. Immunologic, hemodynamic, and adrenal incompetence in cirrhosis

    DEFF Research Database (Denmark)

    Risør, Louise Madeleine; Bendtsen, Flemming; Møller, Søren

    2015-01-01

    dysfunction, but is not responsive to volume expansion. Recent research indicates that development of hepatic nephropathy represents a continuous spectrum of functional and structural dysfunction and may be precipitated by the inherent immunologic, adrenal, and hemodynamic incompetence in cirrhosis. New...... research explores several new markers of renal dysfunction that may replace serum creatinine in the future and give new insight on the hepatic nephropathy. Our understanding of the pathophysiological mechanisms causing the immunologic, adrenal, and hemodynamic incompetence, and the impact on renal...

  19. Ultrasound diagnosis of adrenal hemorrhage in meningococcemia

    International Nuclear Information System (INIS)

    Sarnaik, A.P.; Sanfilippo, D.J.K.; Slovis, T.L.; Children's Hospital of Michigan, Detroit; Wayne State Univ., Detroit, MI

    1988-01-01

    Adrenal hemorrhage (AH) is a well-described complication of the neonatal period, anticoagulant therapy, and overwhelming bacterial infection especially with N. meningitis. Until recently the diagnosis of acute AH was based predominantly on autopsy findings. Ultrasound and computed tomography examinations have been successfully used for antemortem detection of AH in neonates and anticoagulated patients. We report two patients with fulminant meningococcal infection who demonstrated bilateral adrenal hemorrhages on ultrasonography. (orig.)

  20. Chronic Heroin Dependence Leading to Adrenal Insufficiency

    Directory of Open Access Journals (Sweden)

    Gautam Das

    2014-01-01

    Full Text Available Opioids have been the mainstay for pain relief and palliation over a long period of time. They are commonly abused by drug addicts and such dependence usually imparts severe physiologic effects on multiple organ systems. The negative impact of opioids on the endocrine system is poorly understood and often underestimated. We describe a patient who developed severe suppression of the hypothalamic-pituitary adrenal (HPA axis leading to secondary adrenal insufficiency due to long standing abuse of opioids.

  1. Radiation therapy for the solitary plasmacytoma

    Directory of Open Access Journals (Sweden)

    Esengül Koçak

    2010-06-01

    Full Text Available Plasma-cell neoplasms are classically categorized into four groups as: multiple myeloma (MM, plasma-cell leukemias, solitary plasmacytomas (SP of the bone (SPB, and extramedullary plasmacytomas (EMP. These tumors may be described as localized or diffuse in presentation. Localized plasma-cell neoplasms are rare, and include SP of the skeletal system, accounting for 2-5% of all plasma-cell neoplasms, and EMP of soft tissue, accounting for approximately 3% of all such neoplasms. SP is defined as a solitary mass of neoplastic plasma cells either in the bone marrow or in various soft tissue sites. There appears to be a continuum in which SP often progresses to MM. The main treatment modality for SP is radiation therapy (RT. However, there are no conclusive data in the literature on the optimal RT dose for SP. This review describes the interrelationship of plasma-cell neoplasms, and attempts to determine the minimal RT dose required to obtain local control.

  2. Electromagnetic solitary vortices in rotating plasma

    International Nuclear Information System (INIS)

    Liu, J.; Horton, W.

    1985-12-01

    The nonlinear equations describing drift-Alfven solitary vortices in a low β, rotating plasma are derived. Two types of solitary vortex solutions along with their corresponding nonlinear dispersion relations are obtained. Both solutions have the localized coherent dilopar structure. The first type of solution belongs to the family of the usual Rossby or drift wave vortex, while the second type of solution is intrinsic to the electromagnetic perturbation in a magnetized plasma and is a complicated structure. While the first type of vortex is a solution to a second order differential equation the second one is the solution of a fourth order differential equation intrinsic to the electromagnetic problem. The fourth order vortex solution has two intrinsic space scales in contrast to the single space scale of the previous drift vortex solution. With the second short scale length the parallel current density at the vortex interface becomes continuous. As special cases the rotational electron drift vortex and the rotational ballooning vortex also are given. 10 refs

  3. The lifecycle of axisymmetric internal solitary waves

    Directory of Open Access Journals (Sweden)

    J. M. McMillan

    2010-09-01

    Full Text Available The generation and evolution of solitary waves by intrusive gravity currents in an approximate two-layer fluid with equal upper- and lower-layer depths is examined in a cylindrical geometry by way of theory and numerical simulations. The study is limited to vertically symmetric cases in which the density of the intruding fluid is equal to the average density of the ambient. We show that even though the head height of the intrusion decreases, it propagates at a constant speed well beyond 3 lock radii. This is because the strong stratification at the interface supports the formation of a mode-2 solitary wave that surrounds the intrusion head and carries it outwards at a constant speed. The wave and intrusion propagate faster than a linear long wave; therefore, there is strong supporting evidence that the wave is indeed nonlinear. Rectilinear Korteweg-de Vries theory is extended to allow the wave amplitude to decay as r-p with p=½ and the theory is compared to the observed waves to demonstrate that the width of the wave scales with its amplitude. After propagating beyond 7 lock radii the intrusion runs out of fluid. Thereafter, the wave continues to spread radially at a constant speed, however, the amplitude decreases sufficiently so that linear dispersion dominates and the amplitude decays with distance as r-1.

  4. Air-space pattern in lung metastasis from adenocarcinoma of the GI tract

    Energy Technology Data Exchange (ETDEWEB)

    Gaeta, M.; Volta, S.; Scribano, E. [Univ. of Messina (Italy)] [and others

    1996-03-01

    We retrospectively reviewed a series of proven lung metastasis to evaluate the frequency and CT features of metastases showing an air-space (lepidic) pattern of growth. CT examinations of 65 patients with proven lung metastasis from GI carcinomas were reviewed by three observers. Four CT features were used to classify lesions as air-space metastases: (a) air-space nodules; (b) parenchymal consolidation containing air bronchogram and/or showing angiogram sign; (c) focal or extensive ground-glass opacities; and (d) nodule(s) with a {open_quotes}halo{close_quotes} sign. Six of 65 patients showed air-space metastases: three from pancreatic carcinoma. two from colonic carcinoma, and one from jejunal carcinoma. In one case, metastasis appeared as extensive parenchymal consolidation associated with ground-glass opacities; in one as an area of ground-glass opacity; in one as an extensive parenchymal consolidation with air bronchogram; in one as parenchymal consolidations with angiogram sign and multiple nodules, some of these with halo sign; in one as air-space nodules and patchy air-space consolidations; and in one as a solitary nodule with halo sign. Our study shows that air-space lung metastasis from GI carcinomas is uncommon but not rare. On CT as well as microscopically, differential diagnosis between air-space metastasis and bronchioloalveolar carcinoma may be impossible. 13 refs., 5 figs., 1 tab.

  5. Classic congenital adrenal hyperplasia and puberty.

    Science.gov (United States)

    Charmandari, Evangelia; Brook, Charles G D; Hindmarsh, Peter C

    2004-11-01

    Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders resulting from deficiency of one of the five enzymes required for synthesis of cortisol in the adrenal cortex. The most common form of the disease is classic 21-hydroxylase deficiency, which is characterized by decreased synthesis of glucocorticoids and often mineralocorticoids, adrenal hyperandrogenism and impaired development and function of the adrenal medulla. The clinical management of classic 21-hydroxylase deficiency is often suboptimal, and patients are at risk of developing in tandem iatrogenic hypercortisolism and/or hyperandogenism. Limitations of current medical therapy include the inability to control hyperandrogenism without employing supraphysiologic doses of glucocorticoid, hyperresponsiveness of the hypertrophied adrenal glands to adrenocorticotropic hormone (ACTH) and difficulty in suppressing ACTH secretion from the anterior pituitary. Puberty imposes increased difficulty in attaining adrenocortical suppression despite optimal substitution therapy and adherence to medical treatment. Alterations in the endocrine milieu at puberty may influence cortisol pharmacokinetics and, consequently, the handling of hydrocortisone used as replacement therapy. Recent studies have demonstrated a significant increase in cortisol clearance at puberty and a shorter half-life of free cortisol in pubertal females compared with males. Furthermore, children with classic CAH have elevated fasting serum insulin concentrations and insulin resistance. The latter may further enhance adrenal and/or ovarian androgen secretion, decrease the therapeutic efficacy of glucocorticoids and contribute to later development of the metabolic syndrome and its complications.

  6. Clinical and Radiological Discrimination of Solitary Pulmonary Lesions in Colorectal Cancer Patients.

    Science.gov (United States)

    Ohtaki, Yoichi; Shimizu, Kimihiro; Nagashima, Toshiteru; Nakazawa, Seshiru; Obayashi, Kai; Azuma, Yoko; Iijima, Misaki; Kosaka, Takayuki; Yajima, Toshiki; Ogawa, Hiroomi; Tsutsumi, Soichi; Arai, Motohiro; Mogi, Akira; Kuwano, Hiroyuki

    2018-04-01

    The lung is one of the most common organs of metastasis from colorectal cancer (CRC), and we have encountered lung cancer patients with a history of CRC. There have been few studies regarding methods used to discriminate between primary lung cancer (PLC) and pulmonary metastasis from CRC (PM-CRC) based only on preoperative findings. We retrospectively investigated predictive factors discriminating between these lesions in patients with a history of CRC. Between 2006 and 2015, 117 patients with a history of CRC (44 patients with 47 PLC and 73 patients with 102 PM-CRC) underwent subsequent or concurrent resection of pulmonary lesions. We compared the clinical and radiological characteristics of 100 patients with solitary lesions (43 PLC and 57 PM-CRC). Using univariate and multivariate analyses, we examined predictive factors for discrimination of these two lesions. All tumors with findings of ground-glass opacity (GGO) were PLC (n = 19). In a multivariate analysis of 81 radiologically solid tumors, two factors were found to be significant independent predictors of PLC: a history of stage I CRC and presence of pleural indentation. All tumors in 26 patients with either GGO or both a stage I CRC history and pleural indentation were PLC, while most tumors in patients without all three factors were PM-CRC (43/44; 97.7%). The presence or absence of GGO, pathological CRC stage, and pleural indentation could be useful factors to distinguish between PLC and PM-CRC.

  7. Determination of adrenal volume by MRI in healthy children

    DEFF Research Database (Denmark)

    Mouritsen, Annette; Johansen, Marie Lindhardt; Wohlfahrt-Veje, Christine

    2014-01-01

    , to estimate adrenal size in healthy children and to evaluate determinants of adrenal volume such as age, gender, body size, pubic hair stage and serum levels of adrenal androgens. DESIGN: Two hundred and thirty-five healthy children (116 girls and 119 boys) (age range 10.0-14.8 years) were examined by MRI......% of healthy children aged 10-15 years. Adrenal volume increased with age and Tanner stage of pubic hair. Future studies will unravel whether adrenal MRI is useful when evaluating children with adrenal diseases....... (estimate B = 0.34 ml/year, P = 0.03), age (estimate B = 0.05 ml/year, P = 0.021) and pubic hair stage (estimate B = 0.05 ml/stage, P = 0.075). No associations between adrenal size and serum levels of adrenal androgens were observed. CONCLUSION: It was possible to determine adrenal volume by MRI in only 50...

  8. Ewing's sarcoma arising from the adrenal gland in a young male: a case report.

    Science.gov (United States)

    Zahir, Muhammad Nauman; Ansari, Tayyaba Zehra; Moatter, Tariq; Memon, Wasim; Pervez, Shahid

    2013-12-13

    Ewing's sarcoma uncommonly arises from extraosseous soft tissue or parenchymal organs. Primary adrenal Ewing's Sarcoma, although very rare, is extremely aggressive and commonly fatal. A 17 year old Pakistani male was referred to the outpatient oncology clinic at our center with a three month history of concomitant pain, swelling and dragging sensation in the right hypochondrium. Abdominal examination revealed a large, firm mass in the right hypochondrium extending into the right lumbar region and epigastrium. His genital exam was unremarkable and there were no stigmata of hepatic or adrenal disease.Computed tomography scans revealed a large peripherally enhancing mass in the hepatorenal area, biopsy of which showed a neoplastic lesion composed of small round blue cells which exhibited abundance of glycogen and stained diffusely positive for CD99 (MIC2 antigen). Fluorescence in situ hybridization demonstrated gene rearrangement at chromosome 22q12 which confirmed the diagnosis of Ewing's sarcoma. Staging scans revealed pulmonary metastasis and hence he was commenced on systemic chemotherapy. This case report highlights the importance of keeping Ewing's sarcoma in mind when a young patient presents with a large non-functional adrenal mass.

  9. Urinary bladder metastasis from lung adenocarcinoma: A rare cause of hematuria

    Directory of Open Access Journals (Sweden)

    Kan Wai Man Raymond

    2014-01-01

    Full Text Available We presented an unusual case of hematuria caused by a solitary bladder metastasis from lung adenocarcinoma. A confident diagnosis of secondary adenocarcinoma of the bladder was made by clinical suspicion based on patient′s past history, careful examination of tumor morphology, and a directed panel (cytokeratin [CK] 7/CK20/thyroid transcription factor 1 of immunohistochemistry. We sought, through sharing our experience in the investigative and diagnostic process, to contribute to the better understanding of this unusual cause of hematuria.

  10. Failure to visualize adrenal glands in a patient with bilateral adrenal hyperplasia

    International Nuclear Information System (INIS)

    Gordon, L.; Mayfield, R.K.; Levine, J.H.; Lopes-Virella, M.F.; Sagel, J.; Buse, M.G.

    1980-01-01

    A patient with clinical and biochemical evidence of Cushing's disease and severe hyperlipidemia underwent an adrenal imaging procedure with NP-59 (6β-[ 131 I]iodomethyl-19-norcholesterol), without visualization of either gland. Correction of the hyperlipidemia followed by repeated adrenal imaging resulted in bilateral visualization. A pituitary tumor was removed at surgery, confirming the diagnosis of Cushing's disease

  11. Adrenomegaly and septic adrenal hemorrhage (Waterhouse-Friderichsen syndrome) in the setting of congenital adrenal hyperplasia

    OpenAIRE

    Saad, Amin F.; Ford, Kenneth L.; dePrisco, Gregory; Smerud, Michael J.

    2013-01-01

    Congenital adrenal hyperplasia refers to a spectrum of autosomal recessive inherited disorders of steroidogenesis most commonly identified on newborn screenings. We describe a young woman who presented with abdominal pain and on subsequent imaging was found to have features of congenital adrenal hyperplasia. Imaging findings, treatment, and potential complications are discussed.

  12. Adrenomegaly and septic adrenal hemorrhage (Waterhouse-Friderichsen syndrome) in the setting of congenital adrenal hyperplasia.

    Science.gov (United States)

    Saad, Amin F; Ford, Kenneth L; Deprisco, Gregory; Smerud, Michael J

    2013-07-01

    Congenital adrenal hyperplasia refers to a spectrum of autosomal recessive inherited disorders of steroidogenesis most commonly identified on newborn screenings. We describe a young woman who presented with abdominal pain and on subsequent imaging was found to have features of congenital adrenal hyperplasia. Imaging findings, treatment, and potential complications are discussed.

  13. Solitary plasmacytoma of bone and soft tissue

    International Nuclear Information System (INIS)

    Bolek, Timothy W.; Marcus, Robert B.; Mendenhall, Nancy Price

    1996-01-01

    Purpose: This retrospective review evaluates the results of radiotherapy used for curative intent in the management of solitary plasmacytoma. Methods and Materials: Between August 1963 and January 1993, 37 patients with a solitary plasmacytoma were treated with curative intent at the University of Florida. Criteria for inclusion in the study were (a) a biopsy-proven plasmacytoma, (b) no tumor in the bone marrow on biopsy, and (c) no evidence of disseminated disease on skeletal survey. The primary site was osseous in 27 patients and extramedullary in 10 patients; 9 of the 10 extramedullary lesions were located in the upper respiratory passages. Treatment consisted of primary radio-therapy. in all but one patient, who received surgical resection alone. Two patients also received adjuvant chemotherapy. The median radiation dose was 43.2 Gy in 1.8-Gy fractions. Absolute survival, progression to myeloma, and local control rates were calculated using the Kaplan-Meier method. A multivariate analysis was performed for prognostic factors predictive of absolute survival. Results: Multivariate analysis revealed tumor type (osseous vs. extramedullary) to be predictive of absolute survival (p = 0.12). Factors not predictive of survival were age, sex, use of chemotherapy, immunoglobulin level, and type of immunoglobulin elevated. Patients with osseous tumors had a lower survival rate than those with extramedullary tumors (55% vs. 80% at 10 years, p = 0.06). Multiple myeloma was more likely to develop in patients with osseous tumors (54% vs. 11% at 10 years, 100% vs. 33% at 15 years, p = 0.03). Of patients in whom multiple myeloma developed, those with osseous tumors had a poorer survival rate after development of myeloma (32% vs. 100% at 5 years, p = 0.11). Local relapse developed in 1 patient with an osseous tumor 10 months after treatment with 28.3 Gy in 14 fractions; this was controlled with an additional 28.3 Gy in 10 fractions. Local failure did not develop in any patient

  14. Ampullary carcinoma with cutaneous metastasis

    Directory of Open Access Journals (Sweden)

    I-Ting Liu

    2016-06-01

    Full Text Available Carcinoma of the ampulla of Vater is a rare gastrointestinal tumor. Additionally, cutaneous metastasis from such an internal malignancy is also uncommon. We reported the case of a 55-year-old man afflicted with ampullary carcinoma with cutaneous metastasis. The patient did not undergo the standard Whipple procedure but received chemotherapy due to apparent left neck lymph node metastasis noted by initial PET/CT imaging. The skin metastasis presented as a left neck infiltrating purpuric lesion, which was confirmed by skin biopsy approximately one year after the patient's disease was first diagnosed. Thereafter, the patient received further chemotherapy pursuant to his course of medical management. Skin metastasis usually represents a poor patient prognosis. In these cases, treatment of cutaneous metastasis typically includes systemic chemotherapy and local management such as radiation therapy or tumor excision. And when choosing a chemotherapy regimen for the ampullary cancer, the histological subtypes (intestinal or pancreatobiliary should be comprehensively considered. In our review of the literature, the intestinal type seems to have less distant lymph node metastasis, advanced local invasion, as well as recurrence than pancreatobiliary type of ampullary cancer.

  15. Impact induced solitary wave propagation through a woodpile structure

    International Nuclear Information System (INIS)

    Kore, R; Waychal, A; Yadav, P; Shelke, A; Agarwal, S; Sahoo, N; Uddin, Ahsan

    2016-01-01

    In this paper, we investigate solitary wave propagation through a one-dimensional woodpile structure excited by low and high velocity impact. Woodpile structures are a sub-class of granular metamaterial, which supports propagation of nonlinear waves. Hertz contact law governs the behavior of the solitary wave propagation through the granular media. Towards an experimental study, a woodpile structure was fabricated by orthogonally stacking cylindrical rods. A shock tube facility has been developed to launch an impactor on the woodpile structure at a velocity of 30 m s −1 . Embedded granular chain sensors were fabricated to study the behavior of the solitary wave. The impact induced stress wave is studied to investigate solitary wave parameters, i.e. contact force, contact time, and solitary wave velocity. With the aid of the experimental setup, numerical simulations, and a theoretical solution based on the long wavelength approximation, formation of the solitary wave in the woodpile structure is validated to a reasonable degree of accuracy. The nondispersive and compact supported solitary waves traveling at sonic wave velocity offer unique properties that could be leveraged for application in nondestructive testing and structural health monitoring. (paper)

  16. Computed tomography of the adrenal glands in Addision's disease

    International Nuclear Information System (INIS)

    Rzymski, K.; Sobieszczyk, S.; Kosowicz, J.; Akademia Medyczna, Poznan

    1984-01-01

    In 30 cases of chronic adrenal insufficiency (Addison's disease) CT of the adrenal glands was performed using a fourth generation scanner and a 2 mm slice thickness. Adrenal glands were visualized in all the cases. In 26 patients the adrenals were atrophied; the adrenal shape was abnormal in 21 patients. In 15 patients CT disclosed calcifications in one or both glands, which were particularly frequent in patients over the age of 50. Atrophy of adrenal glands was of high occurrence in cases of autoimmune origin. (orig.) [de

  17. Clinicopathological correlates of adrenal Cushing's syndrome.

    Science.gov (United States)

    Duan, Kai; Gomez Hernandez, Karen; Mete, Ozgur

    2015-03-01

    Endogenous Cushing's syndrome is a rare endocrine disorder that incurs significant cardiovascular morbidity and mortality, due to glucocorticoid excess. It comprises adrenal (20%) and non-adrenal (80%) aetiologies. While the majority of cases are attributed to pituitary or ectopic corticotropin (ACTH) overproduction, primary cortisol-producing adrenal cortical lesions are increasingly recognised in the pathophysiology of Cushing's syndrome. Our understanding of this disease has progressed substantially over the past decade. Recently, important mechanisms underlying the pathogenesis of adrenal hypercortisolism have been elucidated with the discovery of mutations in cyclic AMP signalling (PRKACA, PRKAR1A, GNAS, PDE11A, PDE8B), armadillo repeat containing 5 gene (ARMC5) a putative tumour suppressor gene, aberrant G-protein-coupled receptors, and intra-adrenal secretion of ACTH. Accurate subtyping of Cushing's syndrome is crucial for treatment decision-making and requires a complete integration of clinical, biochemical, imaging and pathology findings. Pathological correlates in the adrenal glands include hyperplasia, adenoma and carcinoma. While the most common presentation is diffuse adrenocortical hyperplasia secondary to excess ACTH production, this entity is usually treated with pituitary or ectopic tumour resection. Therefore, when confronted with adrenalectomy specimens in the setting of Cushing's syndrome, surgical pathologists are most commonly exposed to adrenocortical adenomas, carcinomas and primary macronodular or micronodular hyperplasia. This review provides an update on the rapidly evolving knowledge of adrenal Cushing's syndrome and discusses the clinicopathological correlations of this important disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Assessment of adrenal function in liver diseases

    Directory of Open Access Journals (Sweden)

    Sandeep Kharb

    2013-01-01

    Full Text Available Background: In recent times, there are reports of adrenal dysfunction in whole spectrum of liver disease. Adrenal insufficiency (AI has been shown to correlate with progression of liver disease. Hence this study was conducted to assess adrenal function in subjects with acute liver disease (ALD, chronic liver disease (CLD and post liver transplantation (LT. Material and Methods: This study included 25 healthy controls, 25 patients of ALD, 20 subjects of CLD with Child-Pugh stage A (CLD-1 and 30 with Child-Pugh stage B or C (CLD-2, and 10 subjects with LT. All subjects were assessed clinically, biochemically and for adrenal functions. Results: AI was present in 9 (34.6% patients with ALD, 20 (40% patients with CLD and 4 (40% in subjects with LT. AI was more common in CLD-2 (18 patients - 60% than CLD-1 (2 patients - 10%. All patients with chronic liver disease had significantly lower basal cortisol (8.8±4.8, P=0.01, stimulated cortisol (18.2±6.3, P <0.00001 and incremental cortisol (9.4±4.6, P <0.00001 as compared to controls. There was increase in percentage of subjects with adrenal dysfunction with progression of liver disease as assessed by Child-Pugh staging. AI was predicted by lower levels of serum protein, serum albumin, total cholesterol and HDL cholesterol and higher levels of serum bilirubin and INR. Adrenal functions showed recovery following liver transplantation. Conclusions: AI forms important part of spectrum of acute and chronic liver disease. Deterioration of synthetic functions of liver disease predicts presence of AI, and these patients should be evaluated for adrenal dysfunction periodically.

  19. Nasopharyngeal carcinoma with pericardial metastasis

    Directory of Open Access Journals (Sweden)

    Shang-Wen Chen

    2011-07-01

    Full Text Available Nasopharyngeal carcinoma (NPC is prevalent in Taiwan and is characterized by a high frequency of nodal metastasis. The most common organs with distal metastases are the bones, lungs, and liver, with extremely rare cases to the pericardium. Herein, we report a rare case with NPC who presented with dyspnea and orthopnea. Serial studies, including pericardial biopsy, revealed NPC with pericardial metastasis and pericardial effusion. The tumor cells of both the original and metastatic tumors were positive for Epstein–Barr virus by in situ hybridization. This is the first histologically confirmed case of NPC with pericardial metastasis.

  20. Analytical study of dissipative solitary waves

    Energy Technology Data Exchange (ETDEWEB)

    Dini, Fatemeh [Department of Physics, Amirkabir University of Technology, Tehran (Iran, Islamic Republic of); Emamzadeh, Mehdi Molaie [Department of Physics, Amirkabir University of Technology, Tehran (Iran, Islamic Republic of); Khorasani, Sina [School of Electrical Engineering, Sharif University of Technology, PO Box 11365-363, Tehran (Iran, Islamic Republic of); Bobin, Jean Louis [Universite Pierre et Marie Curie, Paris (France); Amrollahi, Reza [Department of Physics, Amirkabir University of Technology, Tehran (Iran, Islamic Republic of); Sodagar, Majid [School of Electrical Engineering, Sharif University of Technology, PO Box 11365-363, Tehran (Iran, Islamic Republic of); Khoshnegar, Milad [School of Electrical Engineering, Sharif University of Technology, PO Box 11365-363, Tehran (Iran, Islamic Republic of)

    2008-02-15

    In this paper, the analytical solution to a new class of nonlinear solitons is presented with cubic nonlinearity, subject to a dissipation term arising as a result of a first-order derivative with respect to time, in the weakly nonlinear regime. Exact solutions are found using the combination of the perturbation and Green's function methods up to the third order. We present an example and discuss the asymptotic behavior of the Green's function. The dissipative solitary equation is also studied in the phase space in the non-dissipative and dissipative forms. Bounded and unbounded solutions of this equation are characterized, yielding an energy conversation law for non-dissipative waves. Applications of the model include weakly nonlinear solutions of terahertz Josephson plasma waves in layered superconductors and ablative Rayleigh-Taylor instability.

  1. A solitary fibrous tumor of the kidney

    Directory of Open Access Journals (Sweden)

    Anuruddha M Abeygunasekera

    2015-01-01

    Full Text Available A solitary fibrous tumor (SFT is an uncommon spindle cell neoplasm that usually occurs in the pleura, but may occur in extrapleural sites. Its occurrence in the kidney is rare. We report a SFT, clinically thought to be a renal cell carcinoma arising in the kidney of a 68-year-old female. The tumor was well-circumscribed and composed of a mixture of spindle cells and dense collagenous bands. Immunohistochemical studies revealed reactivity for CD34, CD99, and Bcl-2 protein, with no staining for keratin or muscle markers, confirming the diagnosis. The immunohistochemical study was the key to diagnosis. Several younger members of her family had colorectal and lung cancers suggesting the possibility of a familial or genetic susceptibility.

  2. Electromagnetic solitary waves in magnetized plasmas

    International Nuclear Information System (INIS)

    Hazeltine, R.D.; Holm, D.D.; Morrison, P.J.

    1985-03-01

    A Hamiltonian formulation, in terms of noncanonical Poisson bracket, is presented for a nonlinear fluid system that includes reduced magnetohydrodynamics and the Hasegawa-Mima equation as limiting cases. The single-helicity and axisymmetric versions possess three nonlinear Casimir invariants, from which a generalized potential can be constructed. Variation of the generalized potential yields a description of exact nonlinear stationary states. The new equilibria, allowing for plasma flow as well as partial electron adiabaticity, are distinct from those found in conventional magnetohydrodynamic theory. They differ from electrostatic stationary states in containing plasma current and magnetic field excitation. One class of steady-state solutions is shown to provide a simple electromagnetic generalization of drift-solitary waves

  3. Diagnosis and management of solitary pulmonary nodules.

    Science.gov (United States)

    Jeong, Yeon Joo; Lee, Kyung Soo; Kwon, O Jung

    2008-12-01

    The advent of computed tomography (CT) screening with or without the help of computer-aided detection systems has increased the detection rate of solitary pulmonary nodules (SPNs), including that of early peripheral lung cancer. Helical dynamic (HD)CT, providing the information on morphologic and hemodynamic characteristics with high specificity and reasonably high accuracy, can be used for the initial assessment of SPNs. (18)F-fluorodeoxyglucose PET/CT is more sensitive at detecting malignancy than HDCT. Therefore, PET/CT may be selectively performed to characterize SPNs when HDCT gives an inconclusive diagnosis. Serial volume measurements are currently the most reliable methods for the tissue characterization of subcentimeter nodules. When malignant nodule is highly suspected for subcentimeter nodules, video-assisted thoracoscopic surgery nodule removal after nodule localization using the pulmonary nodule-marker system may be performed for diagnosis and treatment.

  4. Solitary Rectal Ulcer Syndrome: A Biopsychosocial Assessment

    Directory of Open Access Journals (Sweden)

    Hamed Daghaghzadeh

    2016-06-01

    Full Text Available Background: Solitary rectal ulcer syndrome (SRUS is a chronic disorder of the gastrointestinal tract and its etiology is not well understood. There is no specific treatment for this syndrome and patients with SRUS may, for years, experience many complications. The aim of the present research was the biopsychosocial study of patients with SRUS.Methods: The study participants consisted of 16 patients with SRUS (7 men and 9 women. Their medical records were reviewed retrospectively to evaluate the clinical spectrum of the patients along with the endoscopic and histological findings. Moreover, psychiatric and personality disorders [based on Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Text Revision (DSM IV-TR], psychosocial stressors, early life traumas, and coping mechanisms were assessed through structured interviews.Results: At presentation, mean age of the patients was 39 years (16 to 70. Common symptoms reported included rectal bleeding (93.8%, rectal self-digitations (81.2%, passage of mucous (75%, anal pain (75%, and straining (75%. Endoscopically, solitary and multiple lesions were present in 9 (60% and 4 (26.7% patients, respectively, and 87% of lesions were ulcerative and 13.3% polypoidal. The most common histological findings were superficial ulceration (92.85% and intercryptic fibromuscular obliteration (87.71%. Common psychosocial findings included anxiety disorders (50%, depression (37.5%, obsessive-compulsive personality disorder (OCPD or traits (62.5%, interpersonal problems (43.75%, marital conflicts (43.75%, occupational stress (37.5%, early life traumas, physical abuse (31.25%, sexual abuse (31.25%, dysfunctional coping mechanisms, emotional inhibition (50%, and non-assertiveness (37.5%.Conclusion: Given the evidence in this study, we cannot ignore the psychosocial problems of patients with SRUS and biopsychosocial assessment of SRUS is more appropriate than biomedical evaluation alone.

  5. Ambipolarons: Solitary wave solutions for the radial electric field in a plasma

    International Nuclear Information System (INIS)

    Hastings, D.E.; Hazeltine, R.D.; Morrison, P.J.

    1986-01-01

    The ambipolar radial electric field in a nonaxisymmetric plasma can be described by a nonlinear diffusion equation. This equation is shown to possess solitary wave solutions. A model nonlinear diffusion equation with a cubic nonlinearity is studied. An explicit analytic step-like form for the solitary wave is found. It is shown that the solitary wave solutions are linearly stable against all but translational perturbations. Collisions of these solitary waves are studied and three possible final states are found: two diverging solitary waves, two stationary solitary waves, or two converging solitary waves leading to annihilation

  6. The cruel and unusual phenomenology of solitary confinement

    OpenAIRE

    Gallagher, Shaun

    2014-01-01

    What happens when subjects are deprived of intersubjective contact? This paper looks closely at the phenomenology and psychology of one example of that deprivation: solitary confinement. It also puts the phenomenology and psychology of solitary confinement to use in the legal context. Not only is there no consensus on whether solitary confinement is a “cruel and unusual punishment,” there is no consensus on the definition of the term “cruel” in the use of that legal phrase. I argue that we ca...

  7. Solitary Fibrous Tumor Arising from Stomach: CT Findings

    OpenAIRE

    Park, Sung Hee; Kim, Myeong-Jin; Kwon, Jieun; Park, Jong-pil; Park, Mi-Suk; Lim, Joon Seok; Kim, Joo Hee; Kim, Ki Whang

    2007-01-01

    Solitary fibrous tumors are spindle-cell neoplasms that usually develop in the pleura and peritoneum, and rarely arise in the stomach. To our knowledge, there is only one case reporting a solitary fibrous tumor arising from stomach in the English literature. Here we report the case of a 26-year-old man with a large solitary fibrous tumor arising from the stomach which involved the submucosa and muscular layer and resembled a gastrointestinal stromal tumor in the stomach, based on what was see...

  8. Widespread occurrence of honey bee pathogens in solitary bees.

    Science.gov (United States)

    Ravoet, Jorgen; De Smet, Lina; Meeus, Ivan; Smagghe, Guy; Wenseleers, Tom; de Graaf, Dirk C

    2014-10-01

    Solitary bees and honey bees from a neighbouring apiary were screened for a broad set of putative pathogens including protists, fungi, spiroplasmas and viruses. Most sampled bees appeared to be infected with multiple parasites. Interestingly, viruses exclusively known from honey bees such as Apis mellifera Filamentous Virus and Varroa destructor Macula-like Virus were also discovered in solitary bees. A microsporidium found in Andrena vaga showed most resemblance to Nosema thomsoni. Our results suggest that bee hives represent a putative source of pathogens for other pollinators. Similarly, solitary bees may act as a reservoir of honey bee pathogens. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Cyberknife fractionated radiotherapy for adrenal metastases: Preliminary report from a multispecialty Indian cancer care center

    Directory of Open Access Journals (Sweden)

    Trinanjan Basu

    2015-03-01

    Full Text Available Purpose: Metastasis to adrenal gland from lung, breast, and kidney malignancies are quite common. Historically radiotherapy was intended for pain palliation. Recent studies with stereotactic body radiotherapy (SBRT including Cyberknife robotic radiosurgery aiming at disease control brings about encouraging results. Here we represent the early clinical experience with Cyberknife stereotactic system from an Indian cancer care center. The main purpose of this retrospective review is to serve as a stepping stone for future prospective studies with non- invasive yet effective technique compared to surgery. Methods: We retrospectively reviewed four cases of adrenal metastases (three: lung and one: renal cell carcinoma treated with Cyberknife SBRT. X sight spine tracking was employed for planning and treatment delivery. Patients were evaluated for local response clinically as well as with PETCT based response criteria.Results: With a median gross tumor volume of 20.5 cc and median dose per fraction of 10 Gy, two patients had complete response (CR and two had partial response (PR when assessed 8-12 weeks post treatment as per RECIST. There was no RTOG grade 2 or more acute adverse events and organs at risk dosage were acceptable. Till last follow up all the patients were locally controlled and alive. Conclusion: Cyberknife SBRT with its unique advantages like non- invasive, short duration outpatient treatment technique culminating in similar local control rates in comparison to surgery is an attractive option. World literature of linear accelerator based SBRT and our data with Cyberknife SBRT with small sample size and early follow up are similar in terms of local control in adrenal metastases. Future prospective data would reveal more information on the management of adrenal metastases.

  10. Cutaneous metastasis in anorectal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Krishnendra Varma

    2015-01-01

    Full Text Available Cutaneous metastasis in anorectal adenocarcinoma is a rare entity. Here, we report the case of a 40-year-old female who presented with yellowish-brown, irregular, solid, elevated rashes over the pubis with a recent history off palliative colostomy for anorectal adenocarcinoma. Clinically, we suspected metastasis that was proved on biopsy. We report this case due to the rare presenting site (i.e., perineum of a metastatic adenocarcinoma.

  11. Factors predicting the duration of adrenal insufficiency in patients successfully treated for Cushing disease and nonmalignant primary adrenal Cushing syndrome.

    Science.gov (United States)

    Prete, Alessandro; Paragliola, Rosa Maria; Bottiglieri, Filomena; Rota, Carlo Antonio; Pontecorvi, Alfredo; Salvatori, Roberto; Corsello, Salvatore Maria

    2017-03-01

    Successful treatment of Cushing syndrome causes transient or permanent adrenal insufficiency deriving from endogenous hypercortisolism-induced hypothalamus-pituitary-adrenal-axis suppression. We analyzed pre-treatment factors potentially affecting the duration of adrenal insufficiency. We conducted a retrospective analysis on patients successfully treated for Cushing disease (15 patients) who underwent transsphenoidal surgery, and nonmalignant primary adrenal Cushing syndrome (31 patients) who underwent unilateral adrenalectomy, divided into patients with overt primary adrenal Cushing syndrome (14 patients) and subclinical primary adrenal Cushing syndrome (17 patients). Epidemiological data, medical history, and hormonal parameters depending on the etiology of hypercortisolism were collected and compared to the duration of adrenal insufficiency. The median duration of follow-up after surgery for Cushing disease and primary adrenal Cushing syndrome was 70 and 48 months, respectively. In the Cushing disease group, the median duration of adrenal insufficiency after transsphenoidal surgery was 15 months: younger age at diagnosis and longer duration of signs and symptoms of hypercortisolism before diagnosis and surgery were associated with longer duration of adrenal insufficiency. The median duration of adrenal insufficiency was 6 months for subclinical primary adrenal Cushing syndrome and 18.5 months for overt primary adrenal Cushing syndrome. The biochemical severity of hypercortisolism, the grade of hypothalamus-pituitary-adrenal-axis suppression, and treatment with ketoconazole before surgery accounted for longer duration of adrenal insufficiency. In patients with Cushing disease, younger age and delayed diagnosis and treatment predict longer need for glucocorticoid replacement therapy after successful transsphenoidal surgery. In patients with primary adrenal Cushing syndrome, the severity of hypercortisolism plays a primary role in influencing the duration of

  12. Adrenal hypoplasia congenita: a rare cause of primary adrenal insufficiency and hypogonadotropic hypogonadism

    Directory of Open Access Journals (Sweden)

    Marta Loureiro

    2015-09-01

    Full Text Available Primary adrenal insufficiency is defined by the impaired synthesis of adrenocortical hormones due to an intrinsic disease of the adrenal cortex. Determining its etiology is crucial to allow adequate long-term management and genetic counseling. We report the case of a male adolescent that presented in the neonatal period with adrenal crisis and received replacement therapy for primary adrenal insufficiency. During follow-up, adrenal hypoplasia congenita (AHC was suspected given his persistently raised adrenocorticotropic hormone levels, with markedly low 17-OH progesterone and androstenedione levels. DNA sequence analysis revealed a mutation in NR0B1 gene (c.1292delG, confirming the diagnosis. Delayed puberty and persistent low levels of gonadotropins led to testosterone replacement therapy. X-linked AHC is a rare cause of primary adrenal insufficiency and hypogonadotropic hypogonadism, related to mutations in NR0B1 gene. Despite its rarity, AHC should be considered in patients who present with primary adrenal failure, low levels of 17-OH progesterone and hypogonadotropic hypogonadism.

  13. What Are Some Types of Adrenal Gland Disorders?

    Science.gov (United States)

    ... until the adrenal glands start functioning normally again. Addison's Disease This rare disorder develops when the adrenal glands ... not make enough cortisol. In most cases of Addison's disease, the body also doesn't make enough of ...

  14. REVIEW ARTICLE Adrenal lesions encountered in current medical ...

    African Journals Online (AJOL)

    help to characterise an adrenal mass and guide diagnosis. .... Longitudinal ultrasound image demonstrating a well- defined, solid ... Adrenal metastases in a 56-year-old woman with advanced breast carcinoma. ..... of cancer patients.[3].

  15. Neurologic complications of disorders of the adrenal glands.

    Science.gov (United States)

    Bertorini, Tulio E; Perez, Angel

    2014-01-01

    Disorders of the adrenal glands frequently have secondary neurological manifestations, while some diseases that involve the central nervous system are accompanied by adrenal gland dysfunction. Excessive corticosteroid secretions in primary or secondary Cushing's syndrome causes muscle weakness and behavioral disturbances, such as emotional lability and sometimes depression, while adrenal insufficiency may cause fatigue, weakness, and depression. Adrenoleukodystrophy and adrenoneuromyelopathy are X-linked recessive disorders of the metabolism of very long chain fatty acids that manifest with white matter abnormalities of the brain, myelopathy and/or neuropathy, as well as adrenal insufficiency. Other disorders of the adrenal glands include hyperaldosteroidism, which may cause weakness from hypokalemia. Dysfunction of the adrenal medulla causes excessive or deficient secretion of catecholamines, primarily causing cardiovascular symptoms. This chapter reviews the clinical manifestations and diagnostic aspects and treatment of the various disorders of the adrenal glands. Some of the congenital adrenal diseases are also discussed. © 2014 Elsevier B.V. All rights reserved.

  16. Clinical significance of adrenal computed tomography in Addison's disease

    International Nuclear Information System (INIS)

    Sun, Zhong-Hua; Nomura, Kaoru; Toraya, Shohzoh; Ujihara, Makoto; Horiba, Nobuo; Suda, Toshihiro; Tsushima, Toshio; Demura, Hiroshi; Kono, Atsushi

    1992-01-01

    Adrenal computed tomographic (CT) scanning was conducted in twelve patients with Addison's disease during the clinical course. In tuberculous Addison's disease (n=8), three of four patients examined during the first two years after disease onset had bilaterally enlarged adrenals, while one of four had a unilaterally enlarged one. At least one adrenal gland was enlarged after onset in all six patients examined during the first four years. Thereafter, the adrenal glands was atrophied bilaterally, in contrast to adrenal glands in idiopathic Addison's disease which was atrophied bilaterally from disease onset (n=2). Adrenal calcification was a less sensitive clue in tracing pathogenesis, i.e., adrenal calcification was observed in five of eight patients with tuberculous Addison's disease, but not idiopathic patients. Thus, adrenal CT scanning could show the etiology of Addison's disease (infection or autoimmunity) and the phase of Addison's disease secondary to tuberculosis, which may be clinically important for initiating antituberculous treatment. (author)

  17. Magnetic resonance appearance of adrenal hemorrhage in a neonate

    International Nuclear Information System (INIS)

    Willemse, A.P.P.; Feldberg, M.A.M.; Witkamp, T.D.; Coppes, M.J.; Kramer, P.P.G.

    1989-01-01

    The Magnetic Resonance (MR) appearance of adrenal hemorrhage in a neonate is described and compared with Ultrasound (US). The value of US studies in adrenal neonatal hemorrhage is well known. We present the MR appearance of this common condition. (orig.)

  18. Principles and management of adrenal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Javadpour, N.

    1987-01-01

    This book provides information on adrenal diseases of latest developments and guides the clinicians in the care of their patients. The book is divided into two parts. The first section gives an overview of the embryology, anatomy, physiology, markers, pathology, imaging and the current progress in the field. The second edition covers specific diseases of the adrenal cortex and medulla. The increasingly significant roles played by steroids, catecholamines, blockers, computed tomography and magnetic resonance are elucidated and discussed. The contents include: Overview of progress; current problems, and perspectives - embryology anatomy, physiology, and biologic markers; pathology; advances in diagnosis; imaging techniques; adrenal disorders in childhood; primary aldosteronism; Cushing's syndrome; carcinoma; pheochromocytoma; neuroblastoma; metastatic disease; surgical management; and subject index.

  19. Imaging of the adrenal gland lesions

    Directory of Open Access Journals (Sweden)

    Keith Herr

    2014-08-01

    Full Text Available With the steep increase in the use of cross-sectional imaging in recent years, the incidentally detected adrenal lesion, or "incidentaloma", has become an increasingly common diagnostic problem for the radiologist, and a need for an approach to classifying these lesions as benign, malignant or indeterminate with imaging has spurred an explosion of research. While most incidentalomas represent benign disease, typically an adenoma, the possibility of malignant involvement of the adrenal gland necessitates a reliance on imaging to inform management decisions. In this article, we review the literature on adrenal gland imaging, with particular emphasis on computed tomography, magnetic resonance imaging, and photon-emission tomography, and discuss how these findings relate to clinical practice. Emerging technologies, such as contrast-enhanced ultrasonography, dual-energy computed tomography, and magnetic resonance spectroscopic imaging will also be briefly addressed.

  20. Computed tomography of the adrenal glands

    International Nuclear Information System (INIS)

    Buck, J.; Reiser, U.; Heuck, F.

    1982-01-01

    Whole body CT opens a third dimension - in addition with the advantage of being a non-invasive method with relatively negligible risk. Both, the normal CT findings of the adrenal gland and the normal variants in shape and position are described. With help of morphometry and image processing measurements of the size of the adrenal gland of 20 healthy patients were made and are listed; not only the respective normal variants but also hypo-hyperplasia are pointed out. Some examples are suitable for the illustration of pathologic conditions, such as inflammation and benign and malignant primary and secondary neoplasis. Finally, the value of adrenal gland CT is discussed with reference to the other radiologic methods. (orig.)

  1. Bilateral adrenal hemorrhage in polycythemia vera

    Directory of Open Access Journals (Sweden)

    Shruti Bhandari

    2016-09-01

    Full Text Available Bilateral adrenal hemorrhage (BAH is a rare complication typically seen in critically ill patients, which can lead to acute adrenal insufficiency and death unless it is recognized promptly and treated appropriately. We describe the case of a 64-year-old man with polycythemia vera found to be unresponsive with fever, hypotension, tachycardia, and hypoglycemia. Electrocardiogram showed ST-elevation with elevated troponin, hemoglobin, prothrombin time, and partial thromboplastin time. He required aggressive ventilator and vasopressor support. Despite primary coronary intervention, he remained hypotensive. Random cortisol level was low. He received stress dose hydrocortisone with immediate hemodynamic stability. BAH was highly suspected and was confirmed by non-contrast abdominal computed tomography. Prompt recognition and timely initiated treatment remain crucial to impact the mortality associated with acute adrenal insufficiency.

  2. Imaging of the adrenal gland lesions

    Energy Technology Data Exchange (ETDEWEB)

    Herr, Keith [Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA (United States); Muglia, Valdair F. [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina; Koff, Walter Jose [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Faculdade de Medicina. Dept. de Cirurgia; Westphalen, Antonio Carlos, E-mail: antonio.westphalen@ucsf.edu [Departments of Radiology and Biomedical Imaging and Urology, School of Medicine, University of California, San Francisco, CA (United States)

    2014-07-15

    With the steep increase in the use of cross-sectional imaging in recent years, the incidentally detected adrenal lesion, or 'incidentaloma', has become an increasingly common diagnostic problem for the radiologist, and a need for an approach to classifying these lesions as benign, malignant or indeterminate with imaging has spurred an explosion of research. While most incidentalomas represent benign disease, typically an adenoma, the possibility of m alignant involvement of the adrenal gland necessitates a reliance on imaging to inform management decisions. In this article, we review the literature on adrenal gland imaging, with particular emphasis on computed tomography, magnetic resonance imaging, and photon-emission tomography, and discuss how these findings relate to clinical practice. Emerging technologies, such as contrast-enhanced ultrasonography, dual-energy computed tomography, and magnetic resonance spectroscopic imaging will also be briefly addressed. (author)

  3. Principles and management of adrenal cancer

    International Nuclear Information System (INIS)

    Javadpour, N.

    1987-01-01

    This book provides information on adrenal diseases of latest developments and guides the clinicians in the care of their patients. The book is divided into two parts. The first section gives an overview of the embryology, anatomy, physiology, markers, pathology, imaging and the current progress in the field. The second edition covers specific diseases of the adrenal cortex and medulla. The increasingly significant roles played by steroids, catecholamines, blockers, computed tomography and magnetic resonance are elucidated and discussed. The contents include: Overview of progress; current problems, and perspectives - embryology anatomy, physiology, and biologic markers; pathology; advances in diagnosis; imaging techniques; adrenal disorders in childhood; primary aldosteronism; Cushing's syndrome; carcinoma; pheochromocytoma; neuroblastoma; metastatic disease; surgical management; and subject index

  4. Rotating solitary wave at the wall of a cylindrical container

    KAUST Repository

    Amaouche, Mustapha; Ait Abderrahmane, Hamid; Vatistas, Georgios H.

    2013-01-01

    This paper deals with the theoretical modeling of a rotating solitary surface wave that was observed during water drainage from a cylindrical reservoir, when shallow water conditions were reached. It represents an improvement of our previous study

  5. Is DNA a nonlinear dynamical system where solitary conformational ...

    Indian Academy of Sciences (India)

    Unknown

    DNA is considered as a nonlinear dynamical system in which solitary conformational waves can be excited. The ... nonlinear differential equations and their soliton-like solu- .... structure and dynamics can be added till the most accurate.

  6. Adrenal insufficiency in pakistani hiv infected patients

    International Nuclear Information System (INIS)

    Afreen, B.; Khan, K.A.; Riaz, A.

    2017-01-01

    Background: Adrenal insufficiency (AI) is the most common endocrine complication among patients with AIDS/HIV infection and there are number of causes of AI in HIV patients. Human immunodeficiency virus directly as well as indirectly destroys adrenal glands. The estimates of its prevalence and severity vary. AI is the most life threatening but readily correctable endocrine complication that occurs in persons with HIV infection. This study was carried out to determine the frequency of Adrenal Insufficiency in HIV patients and their clinical features as proper diagnosis and timely treatment have been shown to improve quality of life and long-term mortality in AIDS patients. Methods: It was a cross sectional survey conducted at HIV clinic and Jinnah Allama Iqbal Institute of Diabetes and Endocrinology, Jinnah Hospital Lahore. Sixty-four HIV positive patients, both male and female, aged above 15 years were included in the study. HIV patients who had recently taken steroids, ketoconazole or rifampicin, determined on history, were excluded from the study. The data was collected on a structured proforma and analysis was performed in SPSS-21.0. Frequency and percentages for adrenal insufficiency and its characteristics were calculated. Chi-square test was used with p<0.05 as statistically significant. Results: In this study, 9 (14.06%) HIV patients were diagnosed with adrenal insufficiency, male to female ratio was 3.5:1 and AI was found statistically significantly associated with fatigue (p<0.008) and weight loss (p<0.001). Conclusion: Adrenal insufficiency was high among the patients with HIV, it was not gender specific but it was found to be associated with fatigue and weight loss. (author)

  7. Bilateral adrenal hemorrhage and primary antiphospholipid antibody syndrome

    International Nuclear Information System (INIS)

    Garcia de Iturrospe, C.; Quilez, I.J.; Echevarria, J.J.

    1996-01-01

    Bilateral adrenal hemorrhage is an uncommon entity that is difficult to diagnose given the ambiquity of the clinical signs. Computerized tomography plays a major role in the diagnosis, disclosing enlarged adrenal glands presenting the hyperdense aspect that characterizes this disorders. We present a case of bilateral adrenal hemoorrhage in a patient diagnosed as having primary antiphospholipid antibody syndrome, which is a less common cause of adrenal hemorrhage than those classically reported, such as anticoagulant therapy, sepsis, shock and abdominal injury. (Author) 8 refs

  8. Two cases of neonatal adrenal hemorrhage presenting with persistent jaundice.

    Science.gov (United States)

    Ruffini, E; De Petris, L; Zorzi, G; Paoletti, P; Mambelli, G; Carlucci, A

    2013-01-01

    The adrenal hemorrhage is a relatively rare event in newborns but must be considered in the presence of a persistent unexplained jaundice, especially in presence of predisposing factors. Serial ultrasonography is the modality of choice for initial diagnosis and follow-up of neonatal adrenal hemorrhage. We report two cases of neonatal adrenal hemorrhage presenting with persistent jaundice. The causes of the neonatal adrenal hemorrhages were a difficult vaginal delivery in macrosomic infant and a neonatal infection.

  9. Adult adrenal haemorrhage: an unrecognised complication of renal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Loke, T.K.L. E-mail: lokekl@ha.org.hk

    2001-07-01

    There are many predisposing factors for neonatal adrenal haemorrhage but the causative factors are different in adults. Several cases of neonatal adrenal haemorrhage have been reported in association with renal vein thrombosis. This complication has not been documented in the adults. The presence of an adrenal mass in the setting of renal vein thrombosis should raise the possibility of adrenal haemorrhage even though this is extremely uncommon in adults.

  10. The solitary electromagnetic waves in the graphene superlattice

    International Nuclear Information System (INIS)

    Kryuchkov, Sergey V.; Kukhar', Egor I.

    2013-01-01

    d’Alembert equation written for the electromagnetic waves propagating in the graphene superlattice is analyzed. The possibility of the propagation of the solitary electromagnetic waves in the graphene superlattice is discussed. The amplitude and the width of the electromagnetic pulse are calculated. The drag current induced by such wave across the superlattice axis is investigated. The numerical estimate of the charge dragged by the solitary wave is made.

  11. Solitary Fibrous Tumor of the Pancreas: Imaging Findings

    International Nuclear Information System (INIS)

    Kwon, Heon Ju; Byun, Jae Ho; Kang, Jun; Park, Seong Ho; Lee, Moon Gyu

    2008-01-01

    We report here a case of a pathologically proven solitary fibrous tumor of the pancreas. A 54-year-old man was referred to our hospital for further evaluation of a pancreatic mass that was found incidentally. CT, MR imaging, and endoscopic ultrasonography showed a well-defined, enhancing mass with cystic portions of the pancreas body. MR cholangiopancreatography showed no pancreatic duct dilatation. A solitary fibrous tumor of the pancreas is a very rare lesion

  12. Immunohistochemical Localization of AT1a, AT1b, and AT2 Angiotensin II Receptor Subtypes in the Rat Adrenal, Pituitary, and Brain with a Perspective Commentary

    Directory of Open Access Journals (Sweden)

    Courtney Premer

    2013-01-01

    Full Text Available Angiotensin II increases blood pressure and stimulates thirst and sodium appetite in the brain. It also stimulates secretion of aldosterone from the adrenal zona glomerulosa and epinephrine from the adrenal medulla. The rat has 3 subtypes of angiotensin II receptors: AT1a, AT1b, and AT2. mRNAs for all three subtypes occur in the adrenal and brain. To immunohistochemically differentiate these receptor subtypes, rabbits were immunized with C-terminal fragments of these subtypes to generate receptor subtype-specific antibodies. Immunofluorescence revealed AT1a and AT2 receptors in adrenal zona glomerulosa and medulla. AT1b immunofluorescence was present in the zona glomerulosa, but not the medulla. Ultrastructural immunogold labeling for the AT1a receptor in glomerulosa and medullary cells localized it to plasma membrane, endocytic vesicles, multivesicular bodies, and the nucleus. AT1b and AT2, but not AT1a, immunofluorescence was observed in the anterior pituitary. Stellate cells were AT1b positive while ovoid cells were AT2 positive. In the brain, neurons were AT1a, AT1b, and AT2 positive, but glia was only AT1b positive. Highest levels of AT1a, AT1b, and AT2 receptor immunofluorescence were in the subfornical organ, median eminence, area postrema, paraventricular nucleus, and solitary tract nucleus. These studies complement those employing different techniques to characterize Ang II receptors.

  13. [Association between Williams syndrome and adrenal insufficiency].

    Science.gov (United States)

    Rchachi, Meryem; Larwanou, Maazou Mahamane; El Ouahabi, Hanan; Ajdi, Farida

    2017-01-01

    Williams syndrome is a developmental disorder including dysmorphia, cardiovascular malformations and a specific neuropsychological profile together with other associated disorders. We report the case of a 17-year old girl, born of a non-inbred marriage, with Williams syndrome discovered during an assessment of degree of failure to thrive. Its association with primary adrenal insufficiency makes it unique. Diagnosis is confirmed by cytogenetic and molecular analysis. Its management consists of the implementation of treatment for adrenal insufficiency associated with a clinico-biological monitoring.

  14. Prenatal Diagnosis of Congenital Adrenal Hyperplasia.

    Science.gov (United States)

    Yau, Mabel; Khattab, Ahmed; New, Maria I

    2016-06-01

    Congenital adrenal hyperplasia (CAH) owing to 21-hydroxylase deficiency is a monogenic disorder of adrenal steroidogenesis. To prevent genital ambiguity, in girls, prenatal dexamethasone treatment is administered early in the first trimester. Prenatal genetic diagnosis of CAH and fetal sex determination identify affected female fetuses at risk for genital virilization. Advancements in prenatal diagnosis are owing to improved understanding of the genetic basis of CAH and improved technology. Cloning of the CYP21A2 gene ushered in molecular genetic analysis as the current standard of care. Noninvasive prenatal diagnosis allows for targeted treatment and avoids unnecessary treatment of males and unaffected females. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Plasma metanephrine for assessing the selectivity of adrenal venous sampling

    NARCIS (Netherlands)

    Dekkers, T.; Deinum, J.; Schultze Kool, L.J.; Blondin, D.; Vonend, O.; Hermus, A.R.M.M.; Peitzsch, M.; Rump, L.C.; Antoch, G.; Sweep, F.C.; Bornstein, S.R.; Lenders, J.W.M.; Willenberg, H.S.; Eisenhofer, G.

    2013-01-01

    Adrenal vein sampling is used to establish the origins of excess production of adrenal hormones in primary aldosteronism. Correct catheter positioning is confirmed using adrenal vein measurements of cortisol, but this parameter is not always reliable. Plasma metanephrine represents an alternative

  16. [Adrenal tumors. Principles of diagnostics and operative treatment].

    Science.gov (United States)

    Gonsior, A; Pfeiffer, H; Führer, D; Liatsikos, E; Schwalenberg, T; Stolzenburg, J-U

    2010-05-01

    Adrenal masses are very heterogeneous and comprise benign or malignant tumors, unilateral or bilateral masses and variable endocrine activity. Because of these attributes adrenal gland masses are a clinical challenge. This article gives a summary of diagnostic steps and indications for adrenal surgery including perioperative management.

  17. Radiological findings of congenital lipoid adrenal hyperplasia: a case report

    International Nuclear Information System (INIS)

    Kim, Mi Jeong; Shin, Joo Yong; Lee, Hee Jung; Lee, Jin Hee; Sohn, Cheol Ho; Lee, Sung Moon; Kim, Hong; Woo, Seong Ku; Suh, Soo Ji

    2001-01-01

    Congenital lipoid adrenal hyperplasia (CLAH) is a rare autosomal recessive disorder characterized by the marked accumulation of lipids and cholesterol in the adrenal cortex, and the failure of adrenal steroids to synthesise. We report the ultrasound (US), computed tomographic (CT), and magnetic resonance (MR) imaging findings in a four-day-old female neonate with CLAH

  18. Radiofrequency ablation of hepatic metastasis: Results of treatment in forty patients

    Directory of Open Access Journals (Sweden)

    Rath G

    2008-01-01

    Full Text Available Aim: To evaluate the local control of hepatic metastasis with radiofrequency ablation treatment. Materials and Methods: We did a retrospective analysis in 40 patients treated with radiofrequency ablation for hepatic metastasis. The tumors ablated included up to two metastatic liver lesions, with primaries in breast, gastrointestinal tract, cervix, etc. Radiofrequency ablation was performed under general anesthesia in all cases, using ultrasound guidance. Radionics Cool-Tip RF System was used to deliver the treatment. Results: The median age of patients treated was 49 years. There were 13 female and 27 male patients. The median tumor size ablated was 1.5 cm (0.75-4.0 cm. A total of 52 radiofrequency ablation cycles were delivered. Successful ablation was achieved in all patients with hepatic metastasis less than 3 cm in size. Pain was the most common complication seen (75%. One patients developed skin burns. At 2-year follow-up 7.5% of patients had locally recurrent disease. Conclusions: Radiofrequency ablation is a minimally invasive treatment modality. It can be useful in a select group of patients with solitary liver metastasis of less than 3 cm size.

  19. Uterine cervical cancer with brain metastasis as the initial site of presentation.

    Science.gov (United States)

    Sato, Yumi; Tanaka, Kei; Kobayashi, Yoichi; Shibuya, Hiromi; Nishigaya, Yoshiko; Momomura, Mai; Matsumoto, Hironori; Iwashita, Mitsutoshi

    2015-07-01

    Brain metastasis from uterine cervical cancer is rare, with an incidence of 0.5%, and usually occurs late in the course of the disease. We report a case of uterine cervical cancer with brain metastasis as the initial site of presentation. A 50-year-old woman with headache, vertigo, amnesia and loss of appetite was admitted for persistent vomiting. Contrast enhanced computed tomography showed a solitary right frontal cerebral lesion with ring enhancement and uterine cervical tumor. She was diagnosed with uterine cervical squamous cell carcinoma with parametrium invasion and no other distant affected organs were detected. The cerebral lesion was surgically removed and pathologically proved to be metastasis of uterine cervical squamous cell carcinoma. The patient underwent concurrent chemoradiotherapy, followed by cerebral radiation therapy, but multiple metastases to the liver and lung developed and the patient died 7 months after diagnosis of brain metastasis. © 2015 The Authors. Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.

  20. Physiological Basis for the Etiology, Diagnosis, and Treatment of Adrenal Disorders: Cushing’s Syndrome, Adrenal Insufficiency, and Congenital Adrenal Hyperplasia

    Science.gov (United States)

    Raff, Hershel; Sharma, Susmeeta T.; Nieman, Lynnette K.

    2014-01-01

    The hypothalamic-pituitary-adrenal (HPA) axis is a classic neuroendocrine system. One of the best ways to understand the HPA axis is to appreciate its dynamics in the variety of diseases and syndromes that affect it. Excess glucocorticoid activity can be due to endogenous cortisol overproduction (spontaneous Cushing’s syndrome) or exogenous glucocorticoid therapy (iatrogenic Cushing’s syndrome). Endogenous Cushing’s syndrome can be subdivided into ACTH-dependent and ACTH-independent, the latter of which is usually due to autonomous adrenal overproduction. The former can be due to a pituitary corticotroph tumor (usually benign) or ectopic ACTH production from tumors outside the pituitary; both of these tumor types overexpress the proopiomelanocortin gene. The converse of Cushing’s syndrome is the lack of normal cortisol secretion and is usually due to adrenal destruction (primary adrenal insufficiency) or hypopituitarism (secondary adrenal insufficiency). Secondary adrenal insufficiency can also result from a rapid discontinuation of long-term, pharmacological glucocorticoid therapy because of HPA axis suppression and adrenal atrophy. Finally, mutations in the steroidogenic enzymes of the adrenal cortex can lead to congenital adrenal hyperplasia and an increase in precursor steroids, particularly androgens. When present in utero, this can lead to masculinization of a female fetus. An understanding of the dynamics of the HPA axis is necessary to master the diagnosis and differential diagnosis of pituitary-adrenal diseases. Furthermore, understanding the pathophysiology of the HPA axis gives great insight into its normal control. PMID:24715566

  1. Unusual metachronous isolated inguinal lymph node metastasis from adenocarcinoma of the sigmoid colon

    Directory of Open Access Journals (Sweden)

    Parodo Giuseppina

    2011-10-01

    Full Text Available Abstract This study aimed to describe an unusual case of metachronous isolated inguinal lymph nodes metastasis from sigmoid carcinoma. A 62-year-old man was referred to our department because of an obstructing sigmoid carcinoma. Colonoscopy showed the obstructing lesion at 30 cm from the anal verge and abdominal CT revealed a sigmoid lesion infiltrating the left lateral abdominal wall. The patient underwent a colonic resection extended to the abdominal wall. Histology showed an adenocarcinoma of the colon infiltrating the abdominal wall with iuxtacolic nodal involvement. Thirty three months after surgery abdominal CT and PET scan revealed a metastatic left inguinal lymph node involvement. The metastatic lymph node was found strictly adherent to the left iliac-femoral artery and encompassing the origin of the left inferior epigastric artery. Histology showed a metachronous nodal metastasis from colonic adenocarcinoma. Despite metastastic involvement of inguinal lymph node from rectal cancer is a rare but well known clinical entity, to the best of our knowledge, this is the first report of inguinal metastasis from a carcinoma of the left colon. Literature review shows only three other similar reported cases: two cases of inguinal metastasis secondary to adenocarcinoma of the cecum and one case of axillary metastasis from left colonic carcinoma. A metastatic pathway through superficial abdominal wall lymphatic vessels could be possible through the route along the left inferior epigastric artery. The solitary inguinal nodal involvement from rectal carcinoma could have a more favorable prognosis. In the case of nodal metastasis to the body surface lymph nodes from colonic carcinoma, following the small number of such cases reported in the literature, no definitive conclusions can be drawn.

  2. Ultrasound follow up of testicular adrenal rest tumors with congenital adrenal hyperplasia: Report of three cases

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jeong Yeon; Kim, Dong Won; Yoon, Seong Kuk; Nam, Kyung Jin [Dept. of Radiology, Dong-A University Hospital, Busan (Korea, Republic of)

    2014-12-15

    While testicular adrenal rest tumor is generally a rare intratesticular tumor, it is frequent in patients with congenital adrenal hyperplasia. The tumors are diagnosed and followed up by ultrasound examination because these tumors are non-palpable and symptomless in most cases and always benign. Ultrasound imaging features change depending on how congenital adrenal hyperplasia is controlled. We herein report three cases of testicular adrenal rest tumors with different usual and unusual imaging findings and follow-up imaging. Patient 1 was a 14-year-old boy who presented with poor compliance to medication. Patient 2 and 3 were a 10-year-old and 13-year-old boy who presented with precocious puberty and short stature, respectively. Ultrasound examinations demonstrated oval hypoechoic masses and irregular speculated hyperechoic masses in the testes and different serial imaging findings.

  3. Ultrasound follow up of testicular adrenal rest tumors with congenital adrenal hyperplasia: Report of three cases

    International Nuclear Information System (INIS)

    Cho, Jeong Yeon; Kim, Dong Won; Yoon, Seong Kuk; Nam, Kyung Jin

    2014-01-01

    While testicular adrenal rest tumor is generally a rare intratesticular tumor, it is frequent in patients with congenital adrenal hyperplasia. The tumors are diagnosed and followed up by ultrasound examination because these tumors are non-palpable and symptomless in most cases and always benign. Ultrasound imaging features change depending on how congenital adrenal hyperplasia is controlled. We herein report three cases of testicular adrenal rest tumors with different usual and unusual imaging findings and follow-up imaging. Patient 1 was a 14-year-old boy who presented with poor compliance to medication. Patient 2 and 3 were a 10-year-old and 13-year-old boy who presented with precocious puberty and short stature, respectively. Ultrasound examinations demonstrated oval hypoechoic masses and irregular speculated hyperechoic masses in the testes and different serial imaging findings

  4. Intraparenchymal Hemorrhage due to Brain Metastasis of Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Rafael Sartori Balbinot

    2017-09-01

    Full Text Available Although extrahepatic metastases from hepatocellular carcinoma (HCC are present in only 5–15% of cases, they are certainly factors associated with poor prognosis. The main sites include lung, lymph nodes, bones, and adrenal glands, in descending order. Metastasis in the central nervous system is extremely rare, and the incidences vary from 0.6 to 1.7%. We report a case of a 54-year-old man previously diagnosed with alcohol-induced cirrhosis of the liver and HCC. The patient was admitted presenting progressive left hemiparesis and headache which started 2 days earlier, with no history of cranioencephalic trauma. After admission, cranial computed tomography revealed an intraparenchymal hemorrhage area with surrounding edema in the right frontal lobe. An angioresonance requested showed a large extra-axial mass lesion located in the right frontal region with well-defined contours and predominantly hypointense signal on T2 sequence. At first, the radiological findings suggested meningioma as the first diagnostic hypothesis. However, the patient underwent surgery. The tumor was completely removed, and the morphological and immunohistochemical findings were consistent with metastatic hepatocarcinoma associated with meningioma. In postoperative care, the patient did not recover from the left hemiparesis and manifested Broca’s aphasia. He had a survival time of 24 weeks, presenting acute liver failure as his cause of death. There is a lack of evidence supporting a specific management of patients with brain metastasis from HCC. Furthermore, there are no studies that evaluate different modalities of therapeutics in brain metastasis of HCC due to the rarity of this condition. Therefore, management must be individualized depending on probable prognostic factors in these patients.

  5. Solid solitary hamartoma of the spleen

    Directory of Open Access Journals (Sweden)

    Grubor Nikica

    2013-01-01

    Full Text Available Introduction. Hamartoma of the spleen is a rare, sometimes asymptomatic similar to hemangioma benign tumor of the spleen, which, owing to the new diagnostic imaging methods, is discovered with increasing frequency. It appears as solitary or multiple tumorous lesions. Case Outline. We present a 48-year-old woman in whom, during the investigation for Helicobacter pylori gastric infection and rectal bleeding, with ultrasonography, a mass 6.5×6.5 cm in diameter was discovered by chance within the spleen. Splenectomy was performed due to suspected lymphoma of the spleen. On histology, tumor showed to be of mixed cellular structure, with areas without white pulp, at places with marked dilatation of sinusoids and capillaries to the formation of „blood lakes“ between which broad hypercellular Billroth’s zones were present. Extramedullary hematopoiesis was found focally. The cells that covered vascular spaces were CD34+ and CD31+ and CD8- and CD21-. Conclusion. Hamartoma has to be taken into consideration always when well circumscribed hypervascular tumor within the spleen is found, particularly in children. Although the diagnosis of hamartoma may be suspected preoperatively, the exact diagnosis is established based on histological and immunohystochemistry examinations. Treatment is most often splenectomy and rarely a partial splenectomy is possible, which is recommended particularly in children.

  6. Diagnostic procedures of the solitary pulmonary nodule

    International Nuclear Information System (INIS)

    Aoe, Keisuke; Hiraki, Akio; Kohara, Hiroyuki

    2003-01-01

    The spread of computed tomography (CT) brought the frequent further examinations of the solitary pulmonary nodules (SPN). To aim the evaluation of initial data on examinations of SPN for differential diagnosis, we studied retrospective cases. Thirty-one cases of SPN less than 20 mm in diameter were compared in clinical findings and CT image findings and were examined the diagnostic procedures in recent three years in National Sanyo Hospital. The 31 patients consisted of 14 males and 17 females ranging 44 to 79 years old, median 65 years old. The causes of SPN were lung cancer (11 patients), cryptococcosis (4 patients), tuberculoma (3 patients), non-tuberculous mycobacteria (2 patients), pneumoconiosis (2 patients), pneumonia scar (one patient), hamartoma (one patient), and unknown (7 patients). There were no significant differences in laboratory findings between lung cancer and the others. CT findings showed significant differences in four categories. All patients underwent fiberoptic bronchoscopy (FB) examinations and 12 patients were determined the diagnosis initial FB. Five patients were established their diagnosis using videoassociated thoracoscopic surgeries. (author)

  7. Intracranial solitary fibrous tumor: Imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Clarencon, Frederic, E-mail: fredclare5@msn.com [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France); Bonneville, Fabrice [Department of Neuroradiology, Hopital Rangueil, Toulouse University Hospital, 31000 Toulouse (France); Rousseau, Audrey [Department of Neuropathology, Pitie-Salpetriere Hospital (France); Galanaud, Damien [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France); Kujas, Michele [Department of Neuropathology, Pitie-Salpetriere Hospital (France); Naggara, Olivier [Department of Neuroradiology, St Anne Hospital, 75014 Paris (France); Cornu, Philippe [Department of Neurosurgery, Pitie-Salpetriere Hospital (France); Chiras, Jacques [Department of Neuroradiology, Pitie-Salpetriere Hospital, APHP, 75013 Paris (France)

    2011-11-15

    Objective: To study the neuroimaging features of intracranial solitary fibrous tumors (ISFTs). Materials and methods: Retrospective study of neuroimaging features of 9 consecutive histopathologically proven ISFT cases. Location, size, shape, density, signal intensity and gadolinium uptake were studied at CT and MRI. Data collected from diffusion-weighted imaging (DWI) (3 patients), perfusion imaging and MR spectroscopy (2 patients), and DSA (4 patients) were also analyzed. Results: The tumors most frequently arose from the intracranial meninges (7/9), while the other lesions were intraventricular. Tumor size ranged from 2.5 to 10 cm (mean = 6.6 cm). They presented multilobular shape in 6/9 patients. Most ISFTs were heterogeneous (7/9) with areas of low T2 signal intensity that strongly enhanced after gadolinium administration (6/8). Erosion of the skull was present in about half of the cases (4/9). Components with decreased apparent diffusion coefficient were seen in 2/3 ISFTs on DWI. Spectroscopy revealed elevated peaks of choline and myo-inositol. MR perfusion showed features of hyperperfusion. Conclusion: ISFT should be considered in cases of extra-axial, supratentorial, heterogeneous, hypervascular tumor. Areas of low T2 signal intensity that strongly enhance after gadolinium injection are suggestive of this diagnosis. Restricted diffusion and elevated peak of myo-inositol may be additional valuable features.

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

    International Nuclear Information System (INIS)

    Miura, Kentaro; Itami, Jun; Nawano, Shigeru; Okada, Junichi; Ogino, Takashi; Uno, Koichi; Arimizu, Noboru

    1985-01-01

    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)

  9. Microenvironment Determinants of Brain Metastasis

    Directory of Open Access Journals (Sweden)

    Zhang Chenyu

    2011-02-01

    Full Text Available Abstract Metastasis accounts for 90% of cancer-related mortality. Brain metastases generally present during the late stages in the natural history of cancer progression. Recent advances in cancer treatment and management have resulted in better control of systemic disease metastatic to organs other than the brain and improved patient survival. However, patients who experience recurrent disease manifest an increasing number of brain metastases, which are usually refractory to therapies. To meet the new challenges of controlling brain metastasis, the research community has been tackling the problem with novel experimental models and research tools, which have led to an improved understanding of brain metastasis. The time-tested "seed-and-soil" hypothesis of metastasis indicates that successful outgrowth of deadly metastatic tumors depends on permissible interactions between the metastatic cancer cells and the site-specific microenvironment in the host organs. Consistently, recent studies indicate that the brain, the major component of the central nervous system, has unique physiological features that can determine the outcome of metastatic tumor growth. The current review summarizes recent discoveries on these tumor-brain interactions, and the potential clinical implications these novel findings could have for the better treatment of patients with brain metastasis.

  10. Reactive Astrocytes in Brain Metastasis

    Directory of Open Access Journals (Sweden)

    David Wasilewski

    2017-12-01

    Full Text Available Brain metastasis, the secondary growth of malignant cells within the central nervous system (CNS, exceeds the incidence of primary brain tumors (i.e., gliomas by tenfold and are seemingly on the rise owing to the emergence of novel targeted therapies that are more effective in controlling extracranial disease relatively to intracranial lesions. Despite the fact that metastasis to the brain poses a unmet clinical problem, with afflicted patients carrying significant morbidity and a fatal prognosis, our knowledge as to how metastatic cells manage to adapt to the tissue environment of the CNS remains limited. Answering this question could pave the way for novel and more specific therapeutic modalities in brain metastasis by targeting the specific makeup of the brain metastatic niche. In regard to this, astrocytes have emerged as the major host cell type that cancer cells encounter and interact with during brain metastasis formation. Similarly to other CNS disorders, astrocytes become reactive and respond to the presence of cancer cells by changing their phenotype and significantly influencing the outcome of disseminated cancer cells within the CNS. Here, we summarize the current knowledge on the contribution of reactive astrocytes in brain metastasis by focusing on the signaling pathways and types of interactions that play a crucial part in the communication with cancer cells and how these could be translated into innovative therapies.

  11. Adrenal Steroids: Biphasic Effects on Neurons

    NARCIS (Netherlands)

    Joels, M.; Karst, H.; Squire, L.R.

    2009-01-01

    Corticosteroid hormones are released from the adrenal gland after stress. They enter the brain and bind to high-affinity mineralocorticoid and lower affinity glucocorticoid receptors. Through these nuclear receptors, corticosteroids exert long-lasting effects on essential properties of neurons, such

  12. Total Body Opacification 'Technique Neonatal Adrenal Haemorrhage

    African Journals Online (AJOL)

    1971-12-11

    Dec 11, 1971 ... A case is reported illustrating the possible usefulness of total body opacification in the diagnosis of neonatal adrenal haemorrhage. To derive maximum benefit from this principle, the routine use of an early film coupled with high dosage is urged whenever an intravenous pyelogram is performed for ...

  13. Adrenal metabolism of mitotane and related compounds

    International Nuclear Information System (INIS)

    Djanegara, T.K.S.

    1989-01-01

    Mitotane (o,p'-DDD; 1-[2-chlorophenyl]-1-[4-chlorophenyl]-2,2-dichloroethane) has been used in the treatment of Cushing's syndrome due to adrenal hyperfunction and it the drug of choice for adrenocortical carcinoma. The object of this investigation is to study the biotransformation of o,p'-DDD and p,p'-DDD in dogs and bovine adrenal cortex to explain its selective toxicity and mechanism of action. The in vitro biotransformation of 14 C-labeled o,p'-DDD and p,p'-DDD by dog and bovine adrenal cortex as studied. Of the cortex subcellular fractions, the cytosol fraction was found to be the most active in metabolizing the substrates, followed by the mitochondrial fraction. This metabolism including that in cytosolic fractions, did not take place with boiled enzyme preparations and required an NADPH generating system. This study has been directed towards establishing the metabolic activation mechanism which may account for the adrenocorticolytic effect of mitotane in contrast to detoxication by the liver. HPLC and TLC metabolic profiles have been generated from incubations of bovine and dog adrenal cortex homogenates and their subfractions for 14 C-labeled p,p'-DDD, o,p'-DDD and its monochloroethylene derivative, o,p'-DDMU

  14. Unilateral nodular adrenal hyperplasia: Case series

    African Journals Online (AJOL)

    A.F. Kotb

    2016-07-26

    Jul 26, 2016 ... Abstract. Introduction: Nodular adrenal hyperplasia is one of rare causes of adrenocortical hyperplasia. The disease usually presents bilaterally. Few publications discussed the possibility of unilateral disease, in association with hyperaldosteronism or Cushing syndrome. Case series: We are reporting 3 ...

  15. Imaging features of benign adrenal cysts

    International Nuclear Information System (INIS)

    Sanal, Hatice Tuba; Kocaoglu, Murat; Yildirim, Duzgun; Bulakbasi, Nail; Guvenc, Inanc; Tayfun, Cem; Ucoz, Taner

    2006-01-01

    Benign adrenal gland cysts (BACs) are rare lesions with a variable histological spectrum and may mimic not only each other but also malignant ones. We aimed to review imaging features of BACs which can be helpful in distinguishing each entity and determining the subsequent appropriate management

  16. Diagnosis and classification of Addison's disease (autoimmune adrenalitis).

    Science.gov (United States)

    Brandão Neto, Rodrigo Antonio; de Carvalho, Jozélio Freire

    2014-01-01

    Autoimmune adrenalitis, or autoimmune Addison disease (AAD), is the most prevalent cause of primary adrenal insufficiency in the developed world. AAD is rare and can easily be misdiagnosed as other conditions. The diagnosis depends on demonstrating inappropriately low cortisol production and the presence of high titers of adrenal cortex autoantibodies (ACAs), along with excluding other causes of adrenal failure using other tests as necessary. The treatment corticosteroid replacement, and the prognosis following the treatment is the same as the normal population. Spontaneous recovery of adrenal function has been described but is rare. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. [Neonatal adrenal hemorrhage revealed by jaundice: a case report].

    Science.gov (United States)

    Oulmaati, A; Hays, S; Mory-Thomas, N; Bretones, P; Bensaid, M; Jordan, I; Bonfils, M; Godbert, I; Picaud, J-C

    2012-04-01

    The clinical presentation of adrenal hemorrhage varies, depending on the extent of hemorrhage as well as the amount of adrenal cortex involved by the hemorrhage. We report here a case of neonatal adrenal hemorrhage revealed by late onset of neonatal jaundice. This adrenal hemorrhage most probably resulted from shoulder dystocia. The aim of this work was to focus on the fact that jaundice can be caused by adrenal hemorrhage and to emphasize the crucial importance of abdominal ultrasound in cases of persistent jaundice. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  18. Functioning adrenal myelolipoma: A rare cause of hypertension

    Directory of Open Access Journals (Sweden)

    Nagendar Jakka

    2013-01-01

    Full Text Available Co-occurrence of adrenal incidentaloma with hypertension calls for evaluation of endocrine causes including pheochromocytoma, Cushing′s disease, and primary aldosteronism. We are reporting 40-years-old man who presented with hypertension and adrenal mass. He had elevated metanephrines, histology of resected adrenal mass revealed adrenal myelolipoma, and immuno-histochemistry was positive for chromogranin A. Both his blood pressure and urinary metanephrines returned to normal after surgery. The association of hypertension and adrenal myelolipoma may not be entirely coincidental, as it may be associated with secreting catecholamine. Literature on such an uncommon association is reviewed briefly as well.

  19. Modeling Congenital Adrenal Hyperplasia and Testing Interventions for Adrenal Insufficiency Using Donor-Specific Reprogrammed Cells

    Directory of Open Access Journals (Sweden)

    Gerard Ruiz-Babot

    2018-01-01

    Full Text Available Adrenal insufficiency is managed by hormone replacement therapy, which is far from optimal; the ability to generate functional steroidogenic cells would offer a unique opportunity for a curative approach to restoring the complex feedback regulation of the hypothalamic-pituitary-adrenal axis. Here, we generated human induced steroidogenic cells (hiSCs from fibroblasts, blood-, and urine-derived cells through forced expression of steroidogenic factor-1 and activation of the PKA and LHRH pathways. hiSCs had ultrastructural features resembling steroid-secreting cells, expressed steroidogenic enzymes, and secreted steroid hormones in response to stimuli. hiSCs were viable when transplanted into the mouse kidney capsule and intra-adrenal. Importantly, the hypocortisolism of hiSCs derived from patients with adrenal insufficiency due to congenital adrenal hyperplasia was rescued by expressing the wild-type version of the defective disease-causing enzymes. Our study provides an effective tool with many potential applications for studying adrenal pathobiology in a personalized manner and opens venues for the development of precision therapies.

  20. Modeling Congenital Adrenal Hyperplasia and Testing Interventions for Adrenal Insufficiency Using Donor-Specific Reprogrammed Cells.

    Science.gov (United States)

    Ruiz-Babot, Gerard; Balyura, Mariya; Hadjidemetriou, Irene; Ajodha, Sharon J; Taylor, David R; Ghataore, Lea; Taylor, Norman F; Schubert, Undine; Ziegler, Christian G; Storr, Helen L; Druce, Maralyn R; Gevers, Evelien F; Drake, William M; Srirangalingam, Umasuthan; Conway, Gerard S; King, Peter J; Metherell, Louise A; Bornstein, Stefan R; Guasti, Leonardo

    2018-01-30

    Adrenal insufficiency is managed by hormone replacement therapy, which is far from optimal; the ability to generate functional steroidogenic cells would offer a unique opportunity for a curative approach to restoring the complex feedback regulation of the hypothalamic-pituitary-adrenal axis. Here, we generated human induced steroidogenic cells (hiSCs) from fibroblasts, blood-, and urine-derived cells through forced expression of steroidogenic factor-1 and activation of the PKA and LHRH pathways. hiSCs had ultrastructural features resembling steroid-secreting cells, expressed steroidogenic enzymes, and secreted steroid hormones in response to stimuli. hiSCs were viable when transplanted into the mouse kidney capsule and intra-adrenal. Importantly, the hypocortisolism of hiSCs derived from patients with adrenal insufficiency due to congenital adrenal hyperplasia was rescued by expressing the wild-type version of the defective disease-causing enzymes. Our study provides an effective tool with many potential applications for studying adrenal pathobiology in a personalized manner and opens venues for the development of precision therapies. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Adrenal hormones before and after venography during adrenal venous sampling: a self-controlled study.

    Science.gov (United States)

    Koike, Yuya; Matsui, Seishi; Omura, Masao; Makita, Kohzoh; Obara, Alfonso W D; Moriya, Nobukazu; Nishikawa, Tetsuo

    2017-03-01

    A stress reaction involving increased adrenal hormone release occurs when starting adrenal venous sampling (AVS). The purpose of the present study was to investigate the effect of single shot venography on adrenal hormone production during AVS. This was a prospective self-controlled study. We enrolled 54 consecutive patients (21 men, 33 women; mean age 52 ± 11 years) with primary aldosteronism who underwent AVS from May 2014 to February 2015. Under non-stimulated conditions, blood samples were obtained from a common trunk of the left adrenal vein before and after single shot venography. The initial plasma aldosterone and cortisol concentration (PAC and PCC) were compared with those measured after venography for each patient. PAC and PCC were slightly but significantly decreased between before and after venography (after log transformation 2.12 ± 0.73 vs 2.07 ± 0.72, P = 0.00066, 1.89 ± 0.52 vs 1.83 ± 0.53, P = 0.00031, respectively). During non-stimulated left AVS, adrenal hormone secretion was slightly but significantly decreased after venography, similar to the normal time-related stress reaction. Venography did not increase the adrenal hormone secretion.

  2. A radioimmunoassay for the detection of adrenal autoantibodies

    International Nuclear Information System (INIS)

    Kosowicz, J.; Gryczynska, M.; Bottazzo, G.F.

    1986-01-01

    A solid phase radioimmunoassay for adrenal antibodies is described. In the assay plastic tubes coated with adrenal microsomes (100 μg/ml) were incubated with human sera diluted from 1:50 to 1:5000 and the retained antibodies detected by subsequent incubation with 125 I-labelled protein A. The method was precise over the range of serum dilution of 1:250 to 1:5000. In the group of 30 patients with Addison's disease 19 had positive results in adrenal antibody radioimmunoassay (RIA). Comparative studies of RIA and immunofluorescence (IFL) revealed that there was partial correlation of adrenal antibody results in patients with high titre antibodies whereas RIA usually was more sensitive than IFL in patients with low titre antibodies. Computerized tomography (CT) displayed bilateral adrenal atrophy in most patients who had adrenal antibodies. On the other hand, patients with low RIA results and negative IFL antibodies had predominantly adrenal calcifications on scans. (author)

  3. Computed tomography of the adrenals in patients with tuberculosis

    International Nuclear Information System (INIS)

    Yamashita, Seizo; Machado, Jussara Marcondes; Morceli, Jose

    2004-01-01

    We evaluated the adrenals of individuals without tuberculosis (group 1 - G1) and with tuberculosis (group 2 - G2) using computed tomography. The antero-posterior length, the thickness, and the longitudinal length of the adrenals were compared in G1 and G2. The duration of the disease, the occurrence of morphologic abnormalities in G2, the distribution according to sex, age and skin color were also studied. There was difference in the antero-posterior length and thickness of right adrenal between G1 and G2. A higher prevalence of white skin male individuals was observed in G2. There was no association between duration of the disease and the occurrence of morphologic abnormalities in G2. A higher occurrence of adrenal enlargement was observed in G2. The main computed tomography findings in patients with tuberculosis were enlargement of the adrenal without calcification, enlargement of the adrenal with punctiform calcifications, and residual calcification of the adrenal. (author)

  4. Nodal metastasis in thyroid cancer

    International Nuclear Information System (INIS)

    Samuel, A.M.

    1999-01-01

    The biological behavior and hence the prognosis of thyroid cancer (TC) depends among other factors on the extent of spread of the disease outside the thyroid bed. This effect is controversial, especially for nodal metastasis of well differentiated thyroid carcinoma (WDC). Nodal metastasis at the time of initial diagnosis behaves differently depending on the histology, age of the patient, presence of extrathyroidal extension, and the sex of the individual. The type of the surgery, administration of 131 I and thyroxin suppression also to some extent influence the rate of recurrence and mortality. Experience has shown that it is not as innocuous as a small intrathyroidal tumor without any invasion outside the thyroid bed and due consideration should be accorded to the management strategies for handling patients with nodal metastasis

  5. Intracardiac metastasis originated from chondrosarcoma.

    Science.gov (United States)

    Maurea, Nicola; Ragone, Gianluca; Coppola, Carmela; Caronna, Antonietta; Tocchetti, Carlo G; Agozzino, Lucio; Apice, Gaetano; Iaffaioli, Rosario V

    2017-05-01

    Primary cardiac tumors are extremely rare. By comparison, metastatic involvement of the heart is over 20 times more common and has been reported in autopsy series in up to one in five patients dying of cancer. Cardiac metastasis of chondrosarcoma is absolutely not frequent. In the recent literature, a cardiac metastasis from chondrosarcoma has never been described. We report the case of an 18-year-old man with a diagnosis of cardiac metastasis that originated from a left scapular chondrosarcoma. Chondrosarcoma is a skeletal tumor with various grades of malignancy, rapidly evolving, and with a strong tendency to metastasize, with low responsiveness to chemotherapy. The onset of characteristic systemic symptoms in the late stage of the disease led to the diagnosis of a mass localized in the right atrium. Management and differential diagnosis of infective heart lesions were also very complex in a rapidly evolving life-threatening condition.

  6. The evaluation of computed tomography of the normal adrenal glands

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Seung Yon; Kook, Shin Ho; Lee, Cho Hye; Choi, Kyung Hee; Rhee, Chung Sik [Ewha Womens University College of Medicine, Seoul (Korea, Republic of)

    1986-08-15

    Radiology plays an important role in evaluating patients with suspected adrenal gland pathology. Morphologic delineation of adrenal gland is especially valuable in patients with clinical and/or biochemical evidence of a disturbance in adrenal function. Many diagnostic radiologic methods are available for demonstrating adrenal lesions. Computed tomography overcomes many of the disadvantages of these other radiologic techniques. The high degree of spatial and density resolution allows precise demonstration of the normal adrenal glands as well as detection of both small and large tumors in almost all patients. So CT of adrenal gland is an excellent noninvasive screening method and definitive imaging technique. The anthers have investigated the capability of CT to image the normal size, location and shape of both glands. Knowledge of the range of normal is useful for optimal interpretation of CT scans in patients with suspected adrenal pathology. We reviewed CT scan of 150 cases without evidence of adrenal disease. The following results were obtained; 1. There were 90 male and 60 female patients. 2. Their ages ranged from 20 to 60 years. 3. On CT, both glands were shown in 135 (90.0%), the right in 143 (95.3%), the left in 142 (94.6%). 4. In the shape of adrenal glands, most of right adrenal gland was linear or comet shaped; 68 (47.6%), most of left adrenal gland was inverted-Y shaped; 103 (72.6%). 5. In the length of adrenal glands, the right was 2.5{+-}0.77cm, the left was 2.9{+-}0.75cm. 6. In the width of adrenal glands, the right was 3.2{+-}0.74cm, the left was 2.7{+-}0.57cm. 7. In the thickness of adrenal glands, the right was 0.5{+-}0.14cm, the left was 0.6{+-}0.16cm.

  7. Results of Three-Dimensional Conformal Radiation Therapy for the Treatment of a Solitary Sternal Relapse of Breast Cancer

    International Nuclear Information System (INIS)

    Kim, Hae Young; Huh, Seung Jae; Park, Won; Choi, Do Ho; Kang, Min Kyu; Yang, Jung Hyun; Nam, Seok Jin; Im, Young Hyuck

    2008-01-01

    To evaluate the response and survival rate after three-dimensional conformal radiation therapy (3D-CRT) of patients with a solitary sternal relapse of breast cancer. Seventeen patients between May 1996 and June 2005 were evaluated with the salvage 3D-CRT treatment of a solitary sternal relapse of breast cancer. The treatment fields included the gross tumor volume with 2 cm margins. The total radiation dose was 35.0 ∼61.5 Gy (biologic effective dose of 43.7 ∼76.9 Gy10 using an α/β ratio of 10 Gy), with a daily dose of 1.8∼3.0 Gy. The tumor response was evaluated by the change in maximum tumor size via follow up CT scans 1∼3 months after the completion of treatment. An objective tumor response was achieved in all patients, with a complete response in 5 patients and a partial response in 12 patients. The 5-year overall survival rate was 51.9% (median survival time: 27 months), and the most important factor affecting overall survival was the disease-free interval (interval from primary surgery of breast cancer to the development of sternal metastasis): The 5-year overall survival rate was 61.8% for patients with a disease-free interval ≥12 months and 0.0% for patients < with disease-free interval <12 months (p=0.03). The response to 3D-CRT was good in patients with solitary sternal relapse of breast cancer. Particularly, patients with long disease-free interval from primary surgery survived significantly longer than patients with short disease-free interval from primary surgery

  8. Solitary pancreas retransplant: Study of 22 cases

    Directory of Open Access Journals (Sweden)

    Tércio Genzini

    2006-03-01

    Full Text Available Objective: To present our experience with pancreas retransplantin patients previously submitted to simultaneous pancreas-kidneytransplant, pancreas after kidney transplant and pancreastransplant alone. Methods: Between January/1996 and December/2005, 330 pancreas transplants were performed: 308 primarytransplants and 22 (6% retransplants of solitary pancreas. Thefollowing variables were analyzed: patient age; time elapsedbetween the first and the second transplant; causes of loss of thefirst graft; technical characteristics of the transplant andretransplant and the criteria for selecting donors for retransplant.These clinical data were submitted to statistical analysis. Results:The mean age of patients was 34.3 years and the mean elapsedtime between the first and second transplant was 19.3 months.The causes of the first graft loss were venous (8; 35% and arterial(5; 23% thrombosis, chronic rejection (4; 18%, ischemia/reperfusion injury (2, reflux pancreatitis (1, primary non-function(1 and sepsis (1. A second transplant was performed in thesame iliac fossa in 16 patients (72%. Venous drainage wasperformed in the iliac vein in 16 patients (72%, in the inferior venacava in 5 patients (22% and in the portal vein in one patient. 6 allbladder drainage was the technique used in 18 (82% cases andenteric drainage, in 4 patients (18%. Immunosuppressive regimenapplied to all cases was quadruple therapy with antilymphocyteinduction, tacrolimus, mycophenolate mofetil and steroids. Therewas one early death due to sepsis. One-year patient and pancreasgraft survival rates for retransplants were, respectively, 95% and85%. There was no additional risk for removing the pancreas graftat retransplant. Conclusion: Pancreas retransplant was technicallyfeasible in all cases and results similar to those described in theliterature were found for primary pancreas transplant.

  9. Acute solitary localized pneumonia: CT diagnosis

    International Nuclear Information System (INIS)

    Li Tieyi

    1999-01-01

    Objective: To evaluate CT in the differential diagnosis of solitary localized pneumonia. Method: Only plain CT without contrast study was done because of different types of CT scanners weed. There were 25 cases with localized pneumonia with initial diagnosis as suspected peripheral bronchogenic carcinoma. All patients were over forty years of age, 84% 50-80 years, 13(52%) patients were asymptomatic, 5(20%) patients had bloody sputum. Results: The CT features were divided into three patterns: (1) irregular nodule with relatively well-defined margin, ground-glass opacity and a few punctuate high densities. (2) irregular nodule with sharply circumscribed, spiculate border and homogeneous density. (3) regular nodule with relatively well-defined margin, and homogeneous density. The third type was most frequent (60%) with predilection for the dorsal segments of the lower lobes, or the posterior basal segments. Of the 25 patients 3 had operation, the remaining cases were treated as pneumonia, the lesions were resolved in 18(82%) patients in 2-3 weeks. Conclusions: Sometimes it is very difficult to differentiate localized pneumonia from peripheral lung cancer on the basis of clinical presentation and imaging. The spiculate margins of irregular nodule shown on CT could be indeterminate on chest radiography, and as a result chest radiograph is helpful in differential diagnosis of localized pneumonia. Change in size of the lesion as observed at the same cross-section scan, smaller at mediastinal window than at lung window is in favor of localized pneumonia, however, with the exception of alveolar carcinoma, treatment with antibiotic therapy for a period of 2-3 weeks, helps differentiate these diseases

  10. Imaging features of intracranial solitary fibrous tumors

    International Nuclear Information System (INIS)

    Yu Shuilian; Man Yuping; Ma Longbai; Liu Ying; Wei Qiang; Zhu Youkai

    2012-01-01

    Objective: To summarize the imaging features of intracranial solitary fibrous tumors (ISFT). Methods: Ten patients with ISFT proven histopathologically were collected. Four cases had CT data and all cases had MR data. The imaging features and pathological results were retrospectively analyzed. Results: All cases were misdiagnosed as meningioma at pre-operation. All lesions arose from intracranial meninges including 5 lesions above the tentorium, 4 lesions beneath the tentorium and 1 lesion growing around the tentorium. The margins of all the masses were well defined, and 8 lesions presented multilobular shape. CT demonstrated hyerattenuated masses in all 4 lesions, smooth erosion of the basicranial skull in 1 lesion, and punctiform calcification of the capsule in 1 lesion. T 1 WI showed most lesions with isointense or slight hyperintense signals including homogeneous in 4 lesions and heterogeneous in 6 lesions. T 2 WI demonstrated isointense or slight hyperintense in 2 lesions, mixed hypointense and hyperintense signals in 4, cystic portion in 2, and two distinct portion of hyperintense and hypointense signal, so called 'yin-yang' pattern, in 2. Strong enhanced was found in all lesions, especially in 8 lesion with heterogeneous with the low T 2 signal. 'Dural tail' was found in 4 lesions. Conclusions: ISFI has some specific CT and MR features including heterogeneous signal intensity on T 2 WI, strong enhancement of areas with low T 2 signal intensity, slight or no 'dural tail', without skull thickening, and the typical 'yin-yang' pattern. (authors)

  11. Orbital stability of solitary waves for Kundu equation

    Science.gov (United States)

    Zhang, Weiguo; Qin, Yinghao; Zhao, Yan; Guo, Boling

    In this paper, we consider the Kundu equation which is not a standard Hamiltonian system. The abstract orbital stability theory proposed by Grillakis et al. (1987, 1990) cannot be applied directly to study orbital stability of solitary waves for this equation. Motivated by the idea of Guo and Wu (1995), we construct three invariants of motion and use detailed spectral analysis to obtain orbital stability of solitary waves for Kundu equation. Since Kundu equation is more complex than the derivative Schrödinger equation, we utilize some techniques to overcome some difficulties in this paper. It should be pointed out that the results obtained in this paper are more general than those obtained by Guo and Wu (1995). We present a sufficient condition under which solitary waves are orbitally stable for 2c+sυ1995) only considered the case 2c+sυ>0. We obtain the results on orbital stability of solitary waves for the derivative Schrödinger equation given by Colin and Ohta (2006) as a corollary in this paper. Furthermore, we obtain orbital stability of solitary waves for Chen-Lee-Lin equation and Gerdjikov-Ivanov equation, respectively.

  12. Brain metastasis from melanoma: the prognostic value of varying sites of extracranial disease.

    Science.gov (United States)

    Bates, James E; Youn, Paul; Usuki, Kenneth Y; Walter, Kevin A; Huggins, Christine F; Okunieff, Paul; Milano, Michael T

    2015-11-01

    Patients with brain metastasis from melanoma have poor outcomes. Radiation is used both for prognostic and symptomatic value. We aimed to further clarify the role of stereotactic radiosurgery (SRS) and whole brain radiotherapy (WBRT) as well as the prognostic implication of various sites of extracranial disease. The records of 73 consecutive patients treated at the University of Rochester Medical Center for brain-metastatic melanoma from January 2004 to October 2013 were reviewed. The median overall survival (OS) was 3.0 months. Patients treated with WBRT alone had decreased OS compared to those treated with SRS alone (HR = 0.38, p = 0.001) or WBRT and SRS (HR = 0.51, p = 0.039). The mean number of brain metastasis differed (p = 0.002) in patients in patients who received WBRT (4.0) compared to those who did not (2.0). Among patients with extracranial disease (n = 63), bone metastasis (HR = 1.86, p = 0.047, n = 15) was a negative prognostic factor; liver (HR = 1.59, p = 0.113, n = 17), lung (HR = 1.51, p = 0.23, n = 51) and adrenal metastasis (HR = 1.70, p = 0.15, n = 10) were not. In patients with concurrent brain and lung metastasis, those with disease limited to those two sites (OS = 8.7 mo, n = 13) had improved OS (HR = 0.44, p = 0.014) compared to those with additional disease (OS = 1.8 mo, n = 50). Based on this hypothesis-generating retrospective analysis, SRS may offer survival benefit compared to WBRT alone in patients with brain metastatic melanoma. Bone metastasis appears to confer a particularly poor prognosis. Those with disease confined to the lung and brain may represent a population with improved prognosis.

  13. Cutaneous metastasis of bilateral renal cell carcinoma.

    Science.gov (United States)

    Abbasi, Fariba; Alizadeh, Mansur; Noroozinia, Farahnaz; Moradi, Amin

    2013-01-01

    Renal cell carcinoma (RCC) is a malignant lethal tumour with high potential of metastasis. However, metastasis from RCC to the skin is much less common. It is virtually a sign of poor prognosis. We represent a 42 years old man with bilateral RCC of clear cell type followed by metastasis to the scalp one month later. In this case the relatively young age of the patient, bilaterality of RCC and occurance of skin metastasis in the absence of recurrent kidney tumour are interesting.

  14. Incidental detection of prostate-specific antigen-negative metastatic prostate cancer initially presented with solitary pulmonary nodule on fluorodeoxyglucose positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Erdogan, Ezgi Basak; Buyukpinarbasili, Nur; Ziyade, Sedat; Akman, Tolga; Turk, Haci Mehmet; Aydin, Mehmet

    2005-01-01

    A 71-year-old male patient with solitary pulmonary nodule underwent fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) showing slightly increased FDG uptake in this nodule. In addition, PET/CT detected hypermetabolic sclerotic bone lesions in the right second rib and 7 th thoracic vertebrae, which were interpreted as possible metastases, and mildly increased FDG uptake in the prostate gland highly suspicious of malignancy. The patient's prostate-specific antigen (PSA) level was within normal range (3.8 ng/dL). The histopathological examination of the lung nodule and right second rib lesion proved metastases from prostate cancer, then the prostate biopsy-confirmed prostate adenocarcinoma. The unique feature of this case is to emphasize the importance of performing PET/CT for solitary pulmonary nodule in detecting PSA-negative metastatic prostate cancer. This case indicated that it should be kept in mind that, even if the PSA is negative, a lung metastasis of prostate cancer may be an underlying cause in patients evaluated for solitary pulmonary nodule by FDG PET/CT

  15. Metastasis genetics, epigenetics, and the tumor microenvironment

    Science.gov (United States)

    KISS1 is a member of a family of genes known as metastasis suppressors, defined by their ability to block metastasis without blocking primary tumor development and growth. KISS1 re-expression in multiple metastatic cell lines of diverse cellular origin suppresses metastasis; yet, still allows comple...

  16. Gut metastasis from breast carcinoma.

    Science.gov (United States)

    Al-Qahtani, Mohammed S

    2007-10-01

    Breast cancer is the second most common malignancy in women. Common sites of metastases include the liver, lung, bone, and the brain. Metastases to the gastrointestinal tract are rare with patients presenting with small-bowel perforation, intestinal obstruction, and gastrointestinal bleeding. Here we report a case of a Saudi female presenting with invasive lobular carcinoma and ileo-cecal junction metastasis.

  17. Gut metastasis from breast carcinoma

    International Nuclear Information System (INIS)

    Al-Qahtani, Mohammad S.

    2007-01-01

    Breast cancer is the second most common malignancy in women. Common sites of metastases include the liver, lung, bone and the brain. Metastases to the gastrointestinal tract are with patients presenting with small-bowel perforation, intestinal obstruction and gastrointestinal bleeding. Here we report a case of Saudi female presenting with invasive lobular carcinoma and i leo-junction metastasis. (author)

  18. Pulmonary Metastasis from Pseudomyxoma Peritonei

    Directory of Open Access Journals (Sweden)

    Toshiyuki Kitai

    2012-01-01

    Full Text Available Pseudomyxoma peritonei (PMP is a rare clinical condition, where copious mucinous ascites accumulate in the peritoneal cavity due to dissemination of mucin-producing tumor. Because of this disseminating, yet nonmetastasizing, behavior, PMP attracts much interest from surgical oncologists in that aggressive locoregional therapy can give the opportunity of long survival and even cure. Although extra-abdominal metastasis is exceptionally rare, the lung is the most likely site in such a case. In this paper, the clinical findings and treatment of eleven cases with pulmonary metastasis from PMP were reviewed, including ten cases in the literature and one case which we experienced. The clinical features of PMP cases with pulmonary metastasis were similar to cases without pulmonary metastasis. The histological type was low-grade mucinous neoplasm in most cases. Pulmonary lesions were resected in seven cases in which abdominal lesions were controlled by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy or another therapeutic modality. Disease-free state was maintained in five cases at the end of the follow-up period. However, it should be noted that rapid progression after resection was seen in two cases, suggesting that biological features may have changed by surgical intervention.

  19. Sexual Differentiation of Circadian Clock Function in the Adrenal Gland.

    Science.gov (United States)

    Kloehn, Ian; Pillai, Savin B; Officer, Laurel; Klement, Claire; Gasser, Paul J; Evans, Jennifer A

    2016-05-01

    Sex differences in glucocorticoid production are associated with increased responsiveness of the adrenal gland in females. However, the adrenal-intrinsic mechanisms that establish sexual dimorphic function remain ill defined. Glucocorticoid production is gated at the molecular level by the circadian clock, which may contribute to sexual dimorphic adrenal function. Here we examine sex differences in the adrenal gland using an optical reporter of circadian clock function. Adrenal glands were cultured from male and female Period2::Luciferase (PER2::LUC) mice to assess clock function in vitro in real time. We confirm that there is a pronounced sex difference in the intrinsic capacity to sustain PER2::LUC rhythms in vitro, with higher amplitude rhythms in adrenal glands collected from males than from females. Changes in adrenal PER2::LUC rhythms over the reproductive life span implicate T as an important factor in driving sex differences in adrenal clock function. By directly manipulating hormone levels in adult mice in vivo, we demonstrate that T increases the amplitude of PER2::LUC rhythms in adrenal glands of both male and female mice. In contrast, we find little evidence that ovarian hormones modify adrenal clock function. Lastly, we find that T in vitro can increase the amplitude of PER2::LUC rhythms in male adrenals but not female adrenals, which suggests the existence of sex differences in the mechanisms of T action in vivo. Collectively these results reveal that activational effects of T alter circadian timekeeping in the adrenal gland, which may have implications for sex differences in stress reactivity and stress-related disorders.

  20. Public Health and Solitary Confinement in the United States.

    Science.gov (United States)

    Cloud, David H; Drucker, Ernest; Browne, Angela; Parsons, Jim

    2015-01-01

    The history of solitary confinement in the United States stretches from the silent prisons of 200 years ago to today's supermax prisons, mechanized panopticons that isolate tens of thousands, sometimes for decades. We examined the living conditions and characteristics of the populations in solitary confinement. As part of the growing movement for reform, public health agencies have an ethical obligation to help address the excessive use of solitary confinement in jails and prisons in accordance with established public health functions (e.g., violence prevention, health equity, surveillance, and minimizing of occupational and psychological hazards for correctional staff). Public health professionals should lead efforts to replace reliance on this overly punitive correctional policy with models based on rehabilitation and restorative justice.

  1. Diffractons: Solitary Waves Created by Diffraction in Periodic Media

    KAUST Repository

    Ketcheson, David I.

    2015-03-31

    A new class of solitary waves arises in the solution of nonlinear wave equations with constant impedance and no dispersive terms. These solitary waves depend on a balance between nonlinearity and a dispersion-like effect due to spatial variation in the sound speed of the medium. A high-order homogenized model confirms this effective dispersive behavior, and its solutions agree well with those obtained by direct simulation of the variable-coefficient system. These waves are observed to be long-time stable, globally attracting solutions that arise in general as solutions to nonlinear wave problems with periodically varying sound speed. They share some properties with known classes of solitary waves but possess important differences as well.

  2. Ulcerative giant solitary trichoepithelioma of scalp: a rare presentation

    Directory of Open Access Journals (Sweden)

    Sundeep Chowdhry

    2016-07-01

    Full Text Available Trichoepithelioma is a trichogenic tumor which arises from the inferior segment of hair follicle epithelium as hamartoma. Giant solitary trichoepithelioma (GST has been defined as a solitary trichoepithelioma with a diameter greater than 2 cm. A 49-year-old female presented with a slow growing skin coloured swelling on the scalp of 8 years duration with recent history of ulceration and occasional bleeding. The local examination revealed a single well defined nodular swelling which was irregular in shape measuring approximately 2 × 2.5 cm. Histopathology from biopsy specimen revealed dark basaloid cells with scanty cytoplasm and darkly stained nucleus arranged in nests with horn cysts lacking high-grade atypia and mitosis, which was consistent with features of trichoepithelioma. Giant solitary trichoepithelioma of scalp is itself a rare entity and the present case is being reported with the additional component of ulceration in the lesion.

  3. Numerical Simulation of Cylindrical Solitary Waves in Periodic Media

    KAUST Repository

    Quezada de Luna, Manuel; Ketcheson, David I.

    2013-01-01

    We study the behavior of nonlinear waves in a two-dimensional medium with density and stress relation that vary periodically in space. Efficient approximate Riemann solvers are developed for the corresponding variable-coefficient first-order hyperbolic system. We present direct numerical simulations of this multiscale problem, focused on the propagation of a single localized perturbation in media with strongly varying impedance. For the conditions studied, we find little evidence of shock formation. Instead, solutions consist primarily of solitary waves. These solitary waves are observed to be stable over long times and to interact in a manner approximately like solitons. The system considered has no dispersive terms; these solitary waves arise due to the material heterogeneity, which leads to strong reflections and effective dispersion.

  4. Solitary plasmacytoma of the mandible - a rare entity.

    Science.gov (United States)

    Baad, Rajendra; Kapse, Sonam C; Rathod, Nanita; Sonawane, Kishor; Thete, Sanjay Gangadhar; Kumar, M Naveen

    2013-06-01

    Plasma cell dyscrasias (multiple myeloma, solitary plasmocytoma of bone and extra medullary plasmocytoma) are cha¬racterized by a monoclonal neoplastic proliferation of plasma cells of which Solitary plasmocytoma of bone (SPB) is a localized form. SPB is most frequently seen in vertebrae and secondarily in long bones. Its presence in jaws is extremely rare. The malignant plasma cells express monotypic cytoplasmic immunoglobulins and plasma cell-associated antigens, with an absence of immature B-cell antigens. Here we report a unique case of plasmacytoma in the right side of mandible, a chronology for diagnosis of the lesion is also reviewed along with clinical, radiographic, histopathological and immunohistochemical evidence. How to cite this article: Baad R, Kapse S C, Rathod N, Sonawane K, Thete S G, Naveen M K. Solitary Plasmacytoma of the Mandible - A Rare Entity. J Int Oral Health 2013; 5(3):97-101.

  5. Public Health and Solitary Confinement in the United States

    Science.gov (United States)

    Drucker, Ernest; Browne, Angela; Parsons, Jim

    2015-01-01

    The history of solitary confinement in the United States stretches from the silent prisons of 200 years ago to today’s supermax prisons, mechanized panopticons that isolate tens of thousands, sometimes for decades. We examined the living conditions and characteristics of the populations in solitary confinement. As part of the growing movement for reform, public health agencies have an ethical obligation to help address the excessive use of solitary confinement in jails and prisons in accordance with established public health functions (e.g., violence prevention, health equity, surveillance, and minimizing of occupational and psychological hazards for correctional staff). Public health professionals should lead efforts to replace reliance on this overly punitive correctional policy with models based on rehabilitation and restorative justice. PMID:25393185

  6. Reconstructive surgery in eight children with solitary kidneys

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens

    1989-01-01

    Within a 10-year period reconstructive urinary tract surgery has been carried out in eight children with solitary kidneys. The children were 0-5 years old. Six had unilateral renal agenesis and two had unilateral multicystic kidney. In five children ureteroneocystostomy was performed, in two of t...... months of age. Postoperatively, the renal function was subnormal (although improved) in two children; in six it was normal. The most important prognostic factors in solitary kidneys with urinary tract obstruction are infection and developmental injury.......Within a 10-year period reconstructive urinary tract surgery has been carried out in eight children with solitary kidneys. The children were 0-5 years old. Six had unilateral renal agenesis and two had unilateral multicystic kidney. In five children ureteroneocystostomy was performed, in two...

  7. Numerical Simulation of Cylindrical Solitary Waves in Periodic Media

    KAUST Repository

    Quezada de Luna, Manuel

    2013-07-14

    We study the behavior of nonlinear waves in a two-dimensional medium with density and stress relation that vary periodically in space. Efficient approximate Riemann solvers are developed for the corresponding variable-coefficient first-order hyperbolic system. We present direct numerical simulations of this multiscale problem, focused on the propagation of a single localized perturbation in media with strongly varying impedance. For the conditions studied, we find little evidence of shock formation. Instead, solutions consist primarily of solitary waves. These solitary waves are observed to be stable over long times and to interact in a manner approximately like solitons. The system considered has no dispersive terms; these solitary waves arise due to the material heterogeneity, which leads to strong reflections and effective dispersion.

  8. CT manifestation of peritoneal metastasis

    International Nuclear Information System (INIS)

    Cha, Soon Joo; Kang, Eun Young; Suh, Won Hyuck

    1989-01-01

    Peritoneal metastasis is frequent mode of dissemination of intraabdominal malignancies. Radiologic diagnosis of peritoneal metastasis has relied on indirect evidence on a barium UGI series and small bowel examination. With the advent of CT scanning, CT is capable of direct imaging of peritoneum. The sensitivity of CT in detecting peritoneal metastasis and CT manifestation of peritoneal metastatic lesions had reported occasionally, but rarely in Korea. So, authors illustrated the CT manifestation of peritoneal metastatic lesions in 32 cases of macroscopically proven cases in laparoscopy or laparotomy in Korea University Hae Wha Hospital during recent 4 years. The results are as follows. 1. Of total 32 cases, 18 cases were male and 14 cases were female. Age incidence was the most common in 6th decade. 2. The most common type of malignancy that cause peritoneal metastasis was the stomach cancer and next common type of malignancies were pancreas cancer in men and ovarian cancer in women. 3. Of total 32 cases of peritoneal metastasis which was confirmed by laparoscopy or laparotomy macroscopically, 23 cases (72%) were detected peritoneal thickening and/or omental pathology by CT, and the remaining 9 cases (28%) were not detected by CT. 4. Ascites was present in 19 cases (59%). 5. Parietal peritoneal thickening was present in 16 cases (50%) by CT and sheetlike pattern was the most common findings. The patterns of peritoneal thickening was relatively nonspecific and was not correlated with primary tumor type. 6. Tumor involvement of greater omentum by CT was present in 19 cases (59%). There were 7 cases of smudged appearance pattern, 6 cases of nodular pattern, 6 cases of omental cake pattern and no cystic mass pattern. The patterns of omental pathology was relatively nonspecific and was nor correlated with primary tumor type

  9. Validity of computerized tomography in adrenal diseases

    International Nuclear Information System (INIS)

    Galanski, M.; Cramer, B.M.; Vetter, H.

    1981-01-01

    For diagnosis of adenomas in primary aldosteronism CT proved to be helpful. Although microadenomas have to be ruled out by selective venous sampling from both adrenal glands adenomas down to 8 mm in diameter can be visualized. Scintigraphy does not always permit reliable differentiation of unilateral adenoma from bilateral hyperplasia. - In endogenous Cushing's syndrome adrenal carcinomas are underlying etiologically in about 10% of the cases. Since carcinomas are detected easily by CT it should be performed in the first place. Whereas adenomas and hyperplasia are easily diagnosed by scintigraphy carcinomas may escape scintigraphy. - Pheochromocytomas, if situated in the vicinity of the kidneys, can be localiced safely by CT. Contrary to adenomas, carcinomas and pheochromocytomas may be detected by CT without difficulty because of their size. (orig.) [de

  10. Adrenal scintigraphy using 131I-Adosterol

    International Nuclear Information System (INIS)

    Fukunaga, Masao; Dokoh, Shigeharu; Yamamoto, Itsuo; Morita, Rikushi; Torizuka, Kanji

    1977-01-01

    131 I-Adosterol (6β-iodomethyl-19-norcholest-5(10)-3β-ol) was administered to evaluate adrenal grand in 20 patients including 9 patients with primary aldosteronism, 5 with Cushing's syndrome, one with pheochromocytoma, one with retroperitoneal tumor, 3 with essential hypertension and one with obesity. Standard scintigraphies were performed at 3rd day and again 6th day after administration of 131 I-adosterol (1-1.5 mCi). Suppression scintigraphies were obtained while the patients were taking dexamethasone 2 to 3 mg daily from 3 days prior to injection of the tracer until adrenal imaging. In the cases with essential hypertension and obesity, both adrenal glands were delineated equally by standard scintigraphy, and in one patient, undergone suppression scintigraphy, the uptake of 131 I-adosterol by both glands were completely inhibited by dexamethasone administration. In primary aldosteronism, six of the 9 patients demonstrated the increased radioactivity in one side, and were diagnosed as aldosteronoma. In 3 cases, failed to show the lesions on standard scintigraphy, the lesions could be detected by suppression scintigraphy, and aldosteronomas measuring 1 x 1 x 0.7, 2 x 2 x 1 and 1.7 x 1.5 x 0.8 cm were confirmed by operation. In Cushing's syndrome, standard scintigraphy could easily distinguish between adenoma (one case) and bilateral hyperplasia (4 cases). Adrenal scintigraphy was also a useful method in order to assess the effect of pituitary irradiation therapy in the case of hyperplasia. In pheochromocytoma and retroperitoneal tumor, the side of the lesion was identified by the absence of a functioning gland. Suppression scintigraphy was particularly useful in detecting the localization of the small tumor in primary aldosteronism. (auth.)

  11. Adrenal Hyperandrogenism: Multidisciplinary Approach to Solving Problemss

    Directory of Open Access Journals (Sweden)

    L.A. Lutsenko

    2016-11-01

    Full Text Available Prevalence and possible consequences of the hyperandrogenic states in women of reproductive age stipulate the importance of timely differential diagnosis of hyperandrogenism. Taking into account the level of the development of radiological and laboratory methods of researches, an accurate diagnosis is possible, especially when diagnosing adrenal hyperandrogenism, which often occurs without significant clinical symptoms, but is associated with menstrual disorders, infertility, miscarriage.

  12. Subclinical hypercortisolism in patients with adrenal incidentaloma

    International Nuclear Information System (INIS)

    Fernández, B.; Betancourt, V.C.; Padilla, P.; De la Barca, M.

    2016-01-01

    Subclinical hypercortisolism (HS) is diagnosed in a patient with no Cushing's syndrome manifest phenotype but with autonomic cortisol secretion. Harmful effects of chronic subtle excess of cortisol have been demonstrated, such as hypertension (AHT), type 2 diabetes mellitus (DM2) or glucose intolerance, obesity, osteoporosis, vertebral fractures and dyslipidemia. It has been suggested that subclinical hypercortisolism may itself be a vascular risk factor. In order to identify the presence of subclinical hypercortisolism and its main clinical manifestations in patients with adrenal incidentalomas treated at the endocrinology service of the 'Arnaldo Milian Castro' Clinical Surgical Hospital, a descriptive cross-sectional investigation was carried out from 2012 to 2015 The sample of intentional type was made up of 34 patients older than 18 years and diagnosis of adrenal incidentalomas. Age, sex, toxic habits, questioning results, physical examination and the necessary diagnostic investigations were analyzed. The results showed a predominance of females, over 60 years old, with toxic habits and family and personal history of hypertension and DM2. Palpitations, low back pain, asthenia and obesity with pigmentation of the skin were the most frequent clinical manifestations. Hyperglycemia, dyslipidemia, and elevated levels of cortisol occurred in the majority of patients. Imaging diagnosis showed left lesions and less than 4.0 cm and adrenal adenoma was the most frequent histopathological diagnosis. It was demonstrated that subclinical hypercortisolism is present in an important group of patients with adrenal incidentalomas, is not as asymptomatic, and is related to the presence of vascular risk factors, and other comorbidities

  13. Solitary Fibrous Tumor of Retromolar Pad; a Rare Challenging Case

    Science.gov (United States)

    Lotfi, Ali; Mokhtari, Sepideh; Moshref, Mohammad; Shahla, Maryam; Atarbashi Moghadam, Saede

    2017-01-01

    Solitary fibrous tumor has a wide spectrum of histopathologic features and many tumors show similar microscopic features. This similarity poses diagnostic challenges to the pathologists and immunohistochemical analysis is required in many cases. Moreover, it is a rare entity in orofacial region which consequently would make its diagnosis more challenging in oral cavity. The knowledge of various microscopic patterns of this tumor contributes to a proper diagnosis and prevents unnecessary treatment. This study reports a case of solitary fibrous tumor in the retromolar pad area and discusses its various histological features and differential diagnoses. PMID:28620640

  14. Statistical Thermodynamic Approach to Vibrational Solitary Waves in Acetanilide

    Science.gov (United States)

    Vasconcellos, Áurea R.; Mesquita, Marcus V.; Luzzi, Roberto

    1998-03-01

    We analyze the behavior of the macroscopic thermodynamic state of polymers, centering on acetanilide. The nonlinear equations of evolution for the populations and the statistically averaged field amplitudes of CO-stretching modes are derived. The existence of excitations of the solitary wave type is evidenced. The infrared spectrum is calculated and compared with the experimental data of Careri et al. [Phys. Rev. Lett. 51, 104 (1983)], resulting in a good agreement. We also consider the situation of a nonthermally highly excited sample, predicting the occurrence of a large increase in the lifetime of the solitary wave excitation.

  15. CT-guided percutaneous treatment of solitary pyogenic splenic abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Pombo, F. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Suarez, I. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Marini, M. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Arrojo, L. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Echaniz, A. [Dept. of Internal Medicine, Hospital Juan Canalejo, La Coruna (Spain)

    1991-08-01

    Six patients with solitary pyogenic splenic abscesses treated by CT-guided percutaneous drainage (by catheter or needle), are presented. There were 3 unilocular, purely intrasplenic abscesses and 3 complex lesions with loculations and perisplenic involvement. Percutaneous drainage and intravenous antibiotics were curative in 4 patients. In the other 2, who had multiloculated abscesses, despite initially successful drainage, splenectomy was performed because of intractable left upper quadrant pain in one case and persistent fever and drainage of pus after 30 days in the other. These patients also developed large, sterile left pleural effusions. Solitary pyogenic splenic abscesses - particularly if uniloculated - can be effectively treated by CT-guided percutaneous drainage. (orig.)

  16. A Solitary Fibrous Tumor of the Pleura Revealed by Hiccups

    Directory of Open Access Journals (Sweden)

    A. Chafik

    2011-01-01

    Full Text Available Solitary fibrous tumors of the pleura are rare and benign primary localized tumors; they possess a malignant potential and thus should be excised. We report a case of a 43-year-old woman, who had suffered for 5 years from right basithoracic pain associated with progressive dyspnea and persistent hiccups during the last 6 months. We have not found any similar case in the literature. Further testing after excision by thoracotomy revealed a solitary fibrous pleural tumor. A brief discussion of the clinical presentation and incidence of these tumors is included.

  17. Coherent structures in wave boundary layers. Part 2. Solitary motion

    DEFF Research Database (Denmark)

    Sumer, B. Mutlu; Jensen, Palle Martin; Sørensen, Lone B.

    2010-01-01

    This study continues the investigation of wave boundary layers reported by Carstensen, Sumer & Fredsøe (J. Fluid Mech., 2010, part 1 of this paper). The present paper summarizes the results of an experimental investigation of turbulent solitary wave boundary layers, simulated by solitary motion...... the boundary-layer flow experiences a regular array of vortex tubes near the bed over a short period of time during the deceleration stage; and (iii) transitional regime characterized with turbulent spots, revealed by single/multiple, or, sometimes, quite dense spikes in the bed shear stress traces...

  18. A case of congenital solitary Langerhans cell histiocytoma.

    LENUS (Irish Health Repository)

    Ricciardo, Bernadette

    2012-02-01

    A newborn baby boy was referred to the Paediatric Dermatology Unit with a solitary asymptomatic nodule overlying his right nasolabial fold. Complete physical examination, full blood count, serum chemistry, liver function tests and baseline imaging were unremarkable. Histopathological examination showed an atypical dermal infiltrate of mononuclear cells that stained positive with CD1a and S100. A diagnosis of congenital solitary Langerhans cell histiocytoma was made. The lesion completely resolved by 4 months of age. The baby is now 15 months old and repeat systemic evaluation has remained normal.

  19. Solitary tuberculous brain lesions: 24 new cases and a review of the literature.

    Science.gov (United States)

    Psimaras, D; Bonnet, C; Heinzmann, A; Cárdenas, G; Hernández José Luis, S; Tungaria, A; Behari, S; Lacrois, D; Mokhtari, K; Karantoni, E; Sokrab Tag, E; Idris Mohamed, N; Sönmez, G; Caumes, E; Roze, E

    2014-01-01

    A solitary tuberculous brain lesion (STBL) can be difficult to distinguish from a glioma, metastasis or other infectious disease, especially from a pyogenic brain abscess. We analyzed the clinical characteristics, diagnostic procedures and outcomes of 24 patients with STBL diagnosed in three centers from France, India and Mexico. We also reviewed 92 STBL cases previously reported in the literature. General symptoms were found in 54% of our patients, including enlarged lymph nodes in 20%. Cerebrospinal fluid was typically abnormal, with lymphocytic pleocytosis and a high protein level. The lung CT scan was abnormal in 56% of patients, showing lymphadenopathy or pachipleuritis. Brain MRI or CT was always abnormal, showing contrast-enhanced lesions. Typically, MRI abnormalities were hypointense on T1-weighted sequences, while T2-weighted sequences showed both a peripheral hypersignal and a central hyposignal. The diagnosis was documented microbiologically or supported histologically in 71% of cases. Clinical outcome was good in 83% of cases. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules.

    Science.gov (United States)

    Schwarz, Carsten; Schönfeld, Nicolas; Bittner, Roland C; Mairinger, Thomas; Rüssmann, Holger; Bauer, Torsten T; Kaiser, Dirk; Loddenkemper, Robert

    2013-01-01

    The diagnostic value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules (SPN) is still under debate among pneumologists, radiologists and thoracic surgeons. In a prospective observational manner, flexible bronchoscopy was routinely performed in 225 patients with SPN of unknown origin. Of the 225 patients, 80.5% had lung cancer, 7.6% had metastasis of an extrapulmonary primary tumour and 12% had benign aetiology. Unsuspected endobronchial involvement was found in 4.4% of all 225 patients (or in 5.5% of patients with lung cancer). In addition, flexible bronchoscopy clarified the underlying aetiology in 41% of the cases. The bronchoscopic biopsy results from the SPN were positive in 84 (46.5%) patients with lung cancer. Surgery was cancelled due to the results of flexible bronchoscopy in four cases (involvement of the right main bronchus (impaired pulmonary function did not allow pneumonectomy) n=1, small cell lung cancer n=1, bacterial pneumonia n=2), and the surgical strategy had to be modified to bilobectomy in one patient. Flexible bronchoscopy changed the planned surgical approach in five cases substantially. These results suggest that routine flexible bronchoscopy should be included in the regular pre-operative work-up of patients with SPN.

  1. Genitourinary MR: Kidneys and adrenal glands

    International Nuclear Information System (INIS)

    Krestin, G.P.

    1999-01-01

    Due to its high tissue contrast and multiplanar imaging capabilites, MRI provides a detailed display of renal and adrenal anatomy. Recent technical developments overcoming the problem of respiration induced motion artifacts and the use of paramagnetic contrast agents have further improved the performance of MRI which has now evolved as an alternative or complementary imaging modality to ultrasound, excretory urography and computed tomography. Dynamic contrast-enhanced studies will usually allow to detect even small enhancing solid areas within the cyst wall. Use of a fast (turbo) spoiled gradient echo sequence allows for assessment of contrast enhancement dynamics in renal and adrenal masses. For tumor staging, the multiplanar imaging capabilities of MRI are advantageous. Perinephric extent is best detected using opposed-phase GRE images resulting in an artifical accentuation of renal contours. Extension into venous structures is best diagnosed by using a GRE sequence allowing for distinction between flowing blood and tumor thrombus. Noninvasive differentiation of adrenal lesions can be performed with an unprecedented accuracy using chemical-shift imaging. (orig.)

  2. Morphometric study of the avian adrenal gland.

    Science.gov (United States)

    Aire, T A

    1980-01-01

    The interrenal and medullary cords as well as the blood vessels and connective tissue proportions in the adrenal glands of the male Nigerian fowl (Gallus domesticus) and guinea-fowl (Numida meleagris) were studied by microstereological techniques. Laying domestic fowl of the Rhode Island Red breed were entirely defeathered and maintained in a hot, humid pen for a period of three months, after which the adrenal glands were also studied microstereologically. Interrenal cord width was also measured in all the birds studied. The interrenal cords of the subscapular zone were consistently wider than those cords in the inner zone of the adrenal glands. This clearly suggested morphological zoning. The proportion of interrenal tissue was significantly greater in the guinea-fowl than in the Nigerian fowl, but the medullary tissue and the blood vessels and connective tissue were not significantly different. Interrenal hypoplasia or medullary hyperplasia occurred in the defeathered Rhode Island Red fowl as compared to the control birds of the same breed and sex. The significance of these findings is discussed. PMID:7440402

  3. Adrenal Hemangioma: A Case of Retroperitoneal Tumor

    Directory of Open Access Journals (Sweden)

    Genta Iwamoto

    2018-01-01

    Full Text Available Introduction. Adrenal hemangioma is a rare disease, with only some 60 cases reported previously. Due to the difficulty of the preoperative diagnosis of adrenal hemangioma, almost all of the cases were diagnosed by a histopathological analysis of surgical specimens. Case Presentation. A 52-year-old man was referred to our department for further examination of his left retroperitoneal tumor. He had received hemodialysis due to chronic renal failure resulting from membranous nephropathy. Computed tomography revealed a mass around his left hilum. Magnetic resonance imaging (MRI and positron-emission tomography (PET-CT were unable to confirm or deny malignancy, and tumor markers, including CEA and CA19-9, showed slight elevation. His tumor grew from 38 mm to 54 mm in diameter in 7 months of follow-up. We therefore planned retroperitoneal tumor resection with left nephrectomy. Histopathologically, hyperplastic small vessels with hemorrhaging and denaturation were seen. The endothelial cells showed no variants or division of the nucleus. Based on this diagnosis, no further therapy was performed. He has had no recurrence in the eight months since the surgery. Conclusion. We herein report a rare case of adrenal hemangioma.

  4. The kidney, adrenal gland, and retroperitoneum

    International Nuclear Information System (INIS)

    Demas, B.; Thurnher, S.; Hricak, H.

    1987-01-01

    Although its unparalleled tissue contrast resolution and multiplanar imaging capability, and the fact that it does not require exogeneous contrast agents, allow very detailed anatomic delineation of retroperitoneal anatomy in a safe and completely noninvasive fashion, magnetic resonance imaging (MRI) cannot at this time be used a screening procedure for evaluation of the adrenal glands and kidneys. At present, MRI remains time-consuming and expensive when compared with conventional X-ray computed tomography (X-ray CT), sonography, and quantitative scintigraphy. It is recommended, rather, that MRI can be reserved for situations in which its particular advantages can be expected to resolve questions raised by other imaging modalities. For example, MRI can be used t characterize an adrenal mass detected by CT, to evaluate extension of renal or adrenal neoplasms into adjacent organs when CT findings are equivocal, to assess vascular patency when intravenous contrast material is contraindicated or CT findings are equivocal, and to evaluate the cause of renal allograft failure when findings with other radiologic modalities are inconclusive and biopsy is medically contraindicated. Evaluation of the cause of ureteral obstruction and detection of calculi or lesional calcification are more reliably achieved with CT

  5. Percutaneous needle-biopsy of the adrenal glands

    International Nuclear Information System (INIS)

    Wernecke, K.; Galanski, M.

    1986-01-01

    This account of techniques, range of indications and results of percutaneous adrenal biopsy refers to communications in the literature and to the authors' own experience. Lateral, transhepatic aspiration of adrenal material guided by sonographic control is more easy in the right adrenal gland. Punctation of the left adrenal gland ought to be done from the back and guided by computerized tomography, also in order to leave spleen, kidney, pancreas and stomach as unaffected as possible. The most frequent problem indicating adrenal biopsy still is differentiation between metastases or encretorily non-active adenomas in tumor patients. Experienced examiners will achieve an 80 to 90% sensitivity of adrenal biopsy. Clinically established, suspected phaeochromocytoma is an absolute contra-indication to fine-needle biopsy. (orig./MG) [de

  6. [Primary hyperaldosteronism due to unilateral adrenal hyperplasia with surgical resolution].

    Science.gov (United States)

    Rubio-Puchol, O; Garzón-Pastor, S; Salom-Vendrell, C; Hernández-Mijares, A

    Unilateral adrenal hyperplasia is a rare cause of primary hyperaldosteronism (around a 3%) that has surgical treatment. A case of a patient with hypertension resistant to conventional therapy in treatment with 7 drugs who presented with primary hyperaldosteronism due to unilateral adrenal hyperplasia is presented. A left adrenalectomy was performed, and the patient had a good clinical response, with no need of any drug after 2 years of surgery. Unilateral adrenal hyperplasia is a different entity and it is not an asymmetric variant of the bilateral adrenal hyperplasia. In the study of patients with primary hyperaldosteronism and imaging tests with absence of adenoma is a diagnosis that must be considered before cataloguing patients with bilateral adrenal hyperplasia and start a medical treatment, because unilateral adrenal hyperplasia would have a surgical resolution. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. New and superior adrenal scanning agent, NP-59

    International Nuclear Information System (INIS)

    Sarkar, S.D.; Beierwaltes, W.H.; Ice, R.D.; Basmadjian, G.P.; Hertzel, K.R.; Kennedy, W.P.; Mason, M.M.

    1975-01-01

    The first synthesis of 131 I-19-iodocholesterol had a 10 to 25 percent radiochemical impurity that was not iodide ion. This impurity has been identified as 6β- 131 I-iodomethyl-19-nor cholest-5(10)-en-3β-ol (NP-59) and has been synthesized. Tissue distribution studies with 131 I-NP-59 in rats and dogs revealed a higher adrenal uptake and adrenal-to-tissue ratios compared to 131 I 19-iodocholesterol, probably less in vivo deiodination, and superior adrenal images. A high uptake was seen in the adrenal medulla in addition to that in the cortex. Iodine-131-NP-59 is being evaluated for the early detection of adrenal--cortical disorders and as a potential scanning agent for detecting structural abnormalities of the adrenal medulla

  8. Mismatch repair protein deficient endometrioid adenocarcinomas, metastasizing to adrenal gland and lymph nodes: Unusual cases with diagnostic implications

    Directory of Open Access Journals (Sweden)

    Bharat Rekhi

    2015-01-01

    Full Text Available Recently, certain endometrial carcinomas have been found to be associated with mismatch repair (MMR protein defects/deficiency. A 39-year-old female presented with cough, decreased appetite and significant weight loss since 2 months. Earlier, she had undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO for endometrioid adenocarcinoma. Imaging disclosed an 8 cm-sized adrenal mass that was surgically excised. Histopathology of the adrenal tumor, endocervical tumor, and endometrial biopsy revealed Federation of Gynecology and Obstetrics (FIGO Grade II to III endometrioid adenocarcinoma. By immunohistochemistry, tumor cells were positive for cytokeratin 7, epithelial membrane antigen, PAX8, MLH1 and PMS2 while negative for estrogen receptor (ER, progesterone receptor (PR, MSH2 and MSH6. She underwent adjuvant radiotherapy and chemotherapy. A 34-year-old lady presented with vaginal bleeding since 9 months. She underwent TAH-BSO, reported as FIGO Grade III endometrioid adenocarcinoma. By immunohistochemistry, tumor cells were negative for ER, PR, MLH1, and PMS2 while positive for MSH2 and MSH6. She underwent adjuvant radiotherapy and chemotherapy. However, she developed multiple nodal and pericardial metastases and succumbed to the disease within a year post-diagnosis. Certain high-grade endometrioid adenocarcinomas occurring in younger women are MMR protein deficient and display an aggressive clinical course. Adrenal metastasis in endometrial carcinomas is rare.

  9. Biosynthesis and metabolism of steroid hormones by human adrenal carcinomas

    OpenAIRE

    Brown, J.W.; Fishman, L.M.

    2000-01-01

    Over a 15-year period, our university-based laboratory obtained 125 adrenal tumors, of which 15 (12%) were adrenal cortical carcinomas. Of these, 6 (40% of the carcinomas) occurred in patients with clear clinical manifestations of steroid hormone excess. Adrenal cortical carcinoma cells derived from the surgically resected tumors in 4 of these patients were isolated and established in primary culture. Radiotracer steroid interconversion studies were carried out with these cultures and also on...

  10. Posterior retroperitoneoscopic adrenal surgery for clinical and subclinical Cushing's syndrome in patients with bilateral adrenal disease.

    Science.gov (United States)

    Lowery, Aoife J; Seeliger, Barbara; Alesina, Pier F; Walz, Martin K

    2017-08-01

    The treatment of hypercortisolism for patients with bilateral adrenal disease (BAD) is controversial. Bilateral total adrenalectomy results in permanent hypocortisolaemia requiring lifelong steroid replacement. A more conservative surgical approach, with less than bilateral total adrenalectomy (leaving functional adrenal tissue either unilaterally or bilaterally), represents an alternative option; however, long-term outcome or recurrence data are limited. We report our experience with the surgical management of hypercortisolism caused by BAD. Between 2004 and 2016, 42 patients (12 male, 30 female; mean age 58 ± 10 years) with clinical or subclinical Cushing's syndrome (CS/sCS) caused by BAD underwent adrenal surgery via the posterior retroperitoneoscopic approach. Adrenal surgery was defined as "adrenalectomy" when total gland excision was performed or "resection" when a partial or subtotal adrenal resection was performed. Clinical, radiological and biochemical parameters were evaluated preoperatively and postoperatively. Seventy adrenal operations performed in total included unilateral resection (n = 3), unilateral adrenalectomy (n = 15), bilateral resection (n = 9), adrenalectomy and contralateral resection (n = 14) and bilateral total adrenalectomy (n = 3). Median operating time was 47.5 min (30-150) with no difference between unilateral and bilateral (synchronous included) procedures (p = 0.15). Mortality was zero. Clavien-Dindo grade of postoperative complications was I (n = 5) and IV (n = 3). All but one patient with CS and 17/31 patients with sCS received postoperative steroid supplementation for a median duration of 20 (1.5-129) months. After median follow-up of 40 months (3-129), the remission rate was 92%; 11 patients required ongoing steroid supplementation. There were three biochemical recurrences (two underwent contralateral resection); two patients with new/progressive radiological nodularity are biochemically eucortisolaemic. A

  11. Diagnostic performance of a computer-assisted diagnosis system for bone scintigraphy of newly developed skeletal metastasis in prostate cancer patients: search for low-sensitivity subgroups.

    Science.gov (United States)

    Koizumi, Mitsuru; Motegi, Kazuki; Koyama, Masamichi; Terauchi, Takashi; Yuasa, Takeshi; Yonese, Junji

    2017-08-01

    The computer-assisted diagnostic system for bone scintigraphy (BS) BONENAVI is used to evaluate skeletal metastasis. We investigated its diagnostic performance in prostate cancer patients with and without skeletal metastasis and searched for the problems. An artificial neural network (ANN) value was calculated in 226 prostate cancer patients (124 with skeletal metastasis and 101 without) using BS. Receiver operating characteristic curve analysis was performed and the sensitivity and specificity determined (cutoff ANN = 0.5). Patient's situation at the time of diagnosis of skeletal metastasis, computed tomography (CT) type, extent of disease (EOD), and BS uptake grade were analyzed. False-negative and false-positive results were recorded. BONENAVI showed 82% (102/124) of sensitivity and 83% (84/101) specificity for metastasis detection. There were no significant differences among CT types, although low EOD and faint BS uptake were associated with low ANN values and low sensitivity. Patients showed lower sensitivity during the follow-up period than staging work-up. False-negative lesions were often located in the pelvis or adjacent to it. They comprised not only solitary, faint BS lesions but also overlaying to urinary excretion. BONENAVI with BS has good sensitivity and specificity for detecting prostate cancer's osseous metastasis. Low EOD and faint BS uptake are associated with low sensitivity but not the CT type. Prostate cancer patients likely to have false-negative results during the follow-up period had a solitary lesion in the pelvis with faint BS uptake or lesions overlaying to urinary excretion.

  12. Development of Cerebral Metastasis after Medical and Surgical Treatment of Anal Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Andrew Austin Gassman

    2012-01-01

    Full Text Available Squamous cell carcinoma of the anus is a relatively uncommon GI malignancy. When it does occur, it metastasizes in only a small minority of patients. Spread of anal squamous cell carcinoma to the brain is exceedingly rare, and has been previously reported only three times in the medical literature. We report the case of a 67 year old male who was diagnosed on presentation with a poorly differentiated anal squamous cell carcinoma that already had a solitary metastasis to the liver. While the tumors were initially responsive to chemoradiotherapy, the patient’s primary and liver lesions recurred. The patient then underwent synchronous abdominoperineal resection for the primary lesion and a liver lobectomy for the metastasis. Soon thereafter, the patient developed focal neurologic symptoms and was found to have an intracranial lesion that on biopsy demonstrated metastatic squamous cell carcinoma. This case highlights the fact that patients with a previous history of anal squamous cell carcinoma can occasionally develop cerebral metastasis. Furthermore, cerebral metastases from anal squamous cell carcinoma portend a dismal prognosis even in the face of aggressive medical and surgical therapy.

  13. Unusual Upper Gastrointestinal Bleeding due to Late Metastasis from Renal Cell Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Wen-Tsan Chang

    2004-03-01

    Full Text Available A case of recurrent massive upper gastrointestinal bleeding originating from metastatic renal cell carcinoma is reported. A 63-year-old woman underwent right nephrectomy 9 years previously and experienced no recurrence during follow-up. A gradually enlarging ulcerative tumor over the bulb of the duodenum and four subsequent episodes of massive bleeding from this tumor occurred between June 2001 and March 2002. The patient underwent surgery in April 2002 for intractable bleeding from the tumor. Renal cell carcinoma metastasis to the duodenum was confirmed from the surgical specimen. Upper gastrointestinal bleeding due to malignancy is very rare and the duodenum is the least frequently involved site. Furthermore, a solitary late renal cell carcinoma metastasis 9 years after a nephrectomy is extremely uncommon. This case suggests that life-long follow-up of renal cell carcinoma patients is necessary, owing to unpredictable behavior and the possibility of long disease-free intervals. In nephrectomized patients suffering from gastrointestinal bleeding, complete evaluation, especially endoscopic examination, is indicated. The possibility of late recurrent renal cell carcinoma metastasis to the gastrointestinal tract should be kept in mind, although it is rare. If the patient is fit for surgery, metastatectomy is the first choice of treatment.

  14. Addison's disease with adrenal enlargement on sonography and computed toimography

    International Nuclear Information System (INIS)

    Renner, F.; Graninger, W.

    1986-01-01

    One of the major causes of chronic adrenal insufficiency (Addison's disease) is tuberculous adrenalopathy. Since sonography and computed tomography have become generally available in recent years and are of potential help in the diagnosis of this disease the merits of these methods are discussed in the light of 2 cases of adrenal tuberculosis, followed by a review of the literature. Adrenal calcification is the most significant, although not specific sign of adrenal insufficiency due to tuberculosis. Computed tomography has proven to be the method of choice in the non-invasive diagnosis of tuberculous adrenalopathy and in the monitoring of tuberculostatic treatment in this disease. Sonography is helpful as a preliminary investigation. (Author)

  15. How Do I Find an Experienced Adrenal Surgeon?

    Science.gov (United States)

    ... List Adrenal Gland Disorders About NICHD Research Information Find a Study More Information Amenorrhea About NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) ...

  16. Clinical evaluation of adrenal computed tomography and scintigraphy

    International Nuclear Information System (INIS)

    Hayasaka, Kazumasa; Yoshikawa, Hiroyuki; Asano, Akira; Kikuchi, Yuzo; Amo, Kazuo

    1983-01-01

    In 15 cases with adrenal lesion, we studied the clinical usefulness of computed tomography (CT) and scintigram. CT and RI have been successfully to locate adrenal funtioning cortical tumors (6/6) as small as 10 mm in diameter. In 5 adrenal non-funtioning cortical and medullary disorders, RI finding only shows RI activity is decreasing, but CT may be helpful in differential diagnosis. At present, CT is a reliable technique for locating adrenal disorders, and we should suggest that it should be the initial radiographic investigation. (author)

  17. Adrenal scintiscanning with NP-59: a new radioiodinated cholesterol agent

    International Nuclear Information System (INIS)

    Miles, J.M.; Wahner, H.W.; Carpenter, P.C.; Salassa, R.M.; Northcutt, R.C.

    1979-01-01

    Adrenal imaging in the past has been limited in its clinical application by the long interval between administration of dose and visualization of adrenal glands. We review our experience with the use of a newer labeling agent, NP-59, in 29 patients with various adrenal disorders and in 4 normal subjects. With this agent, identification of adrenal lesions is possible with a high degree of accuracy, and diagnostic information is usually available within 48 hrs. NP-59 is particularly useful in evaluating primary aldosteronism and selected cases of Cushing's syndrome

  18. Detailed examination of the adrenal glands by angiography and radioimmunologic measurement of hormones in adrenal venous blood

    International Nuclear Information System (INIS)

    Yugrinov, O.G.; Slavnov, V.N.; Komissarenko, I.V.; Olejnik, V.A.; Benikova, E.A.

    1984-01-01

    In 222 patients the adrenal glands were examined in detail by arteriography and venography, and if indicated also the ovaries, kidneys, bladder and other organs were checked up. Blood samples were taken from the adrenal glands, renal veins and the vena cava inferior in the bifurcational and subdiaphragmatic region. According to the clinical requirements cortisol, corticotropine, aldosterone, adrenaline, noradrenaline and renine activity were determined. Comprehensive angiographic and radioimmunologic studies revealed in 54 patients tumors of the adrenal cortex. Tumors of the adrenal medulla were detected in 43 of the cases. In 103 cases a morbus Icenko-Cushing was found. The basic examination of the diagnostic schedule was selective adrenal venography. Adrenal arteriography and measurement of venous hormone levels were complementary investigations and were rarely used as independent methods. (author)

  19. Pericytes limit tumor cell metastasis

    DEFF Research Database (Denmark)

    Xian, Xiaojie; Håkansson, Joakim; Ståhlberg, Anders

    2006-01-01

    Previously we observed that neural cell adhesion molecule (NCAM) deficiency in beta tumor cells facilitates metastasis into distant organs and local lymph nodes. Here, we show that NCAM-deficient beta cell tumors grew leaky blood vessels with perturbed pericyte-endothelial cell-cell interactions...... the microvessel wall. To directly address whether pericyte dysfunction increases the metastatic potential of solid tumors, we studied beta cell tumorigenesis in primary pericyte-deficient Pdgfb(ret/ret) mice. This resulted in beta tumor cell metastases in distant organs and local lymph nodes, demonstrating a role...... and deficient perivascular deposition of ECM components. Conversely, tumor cell expression of NCAM in a fibrosarcoma model (T241) improved pericyte recruitment and increased perivascular deposition of ECM molecules. Together, these findings suggest that NCAM may limit tumor cell metastasis by stabilizing...

  20. Relativistic solitary waves modulating long laser pulses in plasmas

    International Nuclear Information System (INIS)

    Sanchez-Arriaga, G; Siminos, E; Lefebvre, E

    2011-01-01

    This paper discusses the existence of solitary electromagnetic waves trapped in a self-generated Langmuir wave and embedded in an infinitely long circularly polarized electromagnetic wave propagating through a plasma. From a mathematical point of view they are exact solutions of the one-dimensional relativistic cold fluid plasma model with nonvanishing boundary conditions. Under the assumption of travelling wave solutions with velocity V and vector potential frequency ω, the fluid model is reduced to a Hamiltonian system. The solitary waves are homoclinic (grey solitons) or heteroclinic (dark solitons) orbits to fixed points. Using a dynamical systems description of the Hamiltonian system and a spectral method, we identify a large variety of solitary waves, including asymmetric ones, discuss their disappearance for certain parameter values and classify them according to (i) grey or dark character, (ii) the number of humps of the vector potential envelope and (iii) their symmetries. The solutions come in continuous families in the parametric V-ω plane and extend up to velocities that approach the speed of light. The stability of certain types of grey solitary waves is investigated with the aid of particle-in-cell simulations that demonstrate their propagation for a few tens of the inverse of the plasma frequency.

  1. Solitary extramedullary plasmacytoma of the colon, rectum and anus ...

    African Journals Online (AJOL)

    Solitary extramedullary plasmacytoma (SEP) is a neoplastic proliferation of a single clone of plasma cells that occur outside of the bone and bone marrow. It is rare, commonly occurring in the head and neck region, followed by the gastrointestinal tract. The aetiology, risk factors, natural history and consequent treatment are ...

  2. Solitary ionizing surface waves on low-temperature plasmas

    International Nuclear Information System (INIS)

    Vladimirov, S.V.; Yu, M.Y.

    1993-01-01

    It is demonstrated that at the boundary of semi-infinite low-temperature plasma new types of localized ionizing surface wave structures can propagate. The solitary waves are described by an evolution equation similar to the KdV equation, but the solutions differ considerably from that of the latter

  3. Periodic and solitary wave solutions of cubic–quintic nonlinear ...

    Indian Academy of Sciences (India)

    Home; Journals; Pramana – Journal of Physics; Volume 86; Issue 6. Periodic and solitary wave solutions of cubic–quintic nonlinear reaction-diffusion equation with variable convection coefficients. BHARDWAJ S B SINGH RAM MEHAR SHARMA KUSHAL MISHRA S C. Regular Volume 86 Issue 6 June 2016 pp 1253-1258 ...

  4. Juvenile Solitary Confinement as a Form of Child Abuse.

    Science.gov (United States)

    Clark, Andrew B

    2017-09-01

    Placing incarcerated juveniles into solitary confinement continues to occur in certain states of the United States, despite the accumulating evidence that it may cause substantial psychological damage to the teenagers who must endure it. The practice has been widely condemned by professional and human rights organizations, amid a growing appreciation of the immaturity and vulnerability of the adolescent brain. Although several states and the federal government have been successful in abolishing or dramatically reducing the use of juvenile solitary confinement, it remains common practice in many facilities. Clinicians working in correctional facilities where juvenile solitary confinement is employed are therefore faced with difficult questions of ethics, as to how best to balance their competing duties, and how to respond to such state-sanctioned ill treatment of their patients. Given the emerging consensus around the psychological damage wrought by sustained solitary confinement, clinicians may well reach the difficult conclusion that they are both legally mandated and ethically bound to file a report of suspected child abuse. Such a report would be unlikely to be investigated for administrative reasons, but it would allow clinicians to communicate the gravity of their concern effectively. © 2017 American Academy of Psychiatry and the Law.

  5. Electron-acoustic solitary waves in the Earth's inner magnetosphere

    Science.gov (United States)

    Dillard, C. S.; Vasko, I. Y.; Mozer, F. S.; Agapitov, O. V.; Bonnell, J. W.

    2018-02-01

    The broadband electrostatic turbulence observed in the inner magnetosphere is produced by large-amplitude electrostatic solitary waves of generally two types. The solitary waves with symmetric bipolar parallel (magnetic field-aligned) electric field are electron phase space holes. The solitary waves with highly asymmetric bipolar parallel electric field have been recently shown to correspond to the electron-acoustic plasma mode (existing due to two-temperature electron population). Through theoretical and numerical analysis of hydrodynamic and modified Korteweg-de Vries equations, we demonstrate that the asymmetric solitary waves appear due to the steepening of initially quasi-monochromatic electron-acoustic perturbation arrested at some moment by collisionless dissipation (Landau damping). The typical steepening time is found to be from a few to tens of milliseconds. The steepening of the electron-acoustic waves has not been reproduced in self-consistent kinetic simulations yet, and factors controlling the formation of steepened electron-acoustic waves, rather than electron phase space holes, remain unclear.

  6. Cross Sectional Imaging of Solitary Lesions of the Neurocranium.

    Science.gov (United States)

    Schäfer, Max-Ludwig; Koch, Arend; Streitparth, Florian; Wiener, Edzard

    2017-12-01

    Background  Although a wide range of processes along the neurocranium are of a benign nature, there are often difficulties in the differential diagnosis. Method  In the review CT/MRI scans of the head were evaluated retrospectively regarding solitary lesions along the neurocranium. The majority of the lesions were histologically proven. Results  The purpose of the review is to present typical pathologies of the neurocranium and provide a systematic overview based on 12 entities, their locations, prevalence and radiological characteristics. Conclusion  Processes, which primarily originate from the neurocranium have to be differentiated from secondary processes infiltrating the neurocranium. For this important diagnostic feature, MRI is typically essential, while the definitive diagnosis is often made on the basis of the medical history and the typical appearance on computer tomography. Key Points   · There are often difficulties in the precise differential diagnosis of solitary lesions along the neurocranium. Typical solitary pathologies of the neurocranium based on 12 entities were presented. Both magnetic resonance imaging and computed tomography are often essential for an exact differential diagnosis.. Citation Format · Schäfer M, Koch A, Streitparth F et al. Cross Sectional Diagnosis of Solitary Lesions of the Neurocranium. Fortschr Röntgenstr 2017; 189: 1135 - 1144. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Giant solitary fibrous tumor of the lung: A case report

    OpenAIRE

    Xiao, Ping; Sun, Linlin; Zhong, Diansheng; Lian, Linjuan; Xu, Dongbo

    2014-01-01

    A solitary fibrous tumor arising from the lung parenchyma is rarely described. Here, we present the clinical, imaging, and histological features of a case of a 54-year-old woman with an incidental lung mass of the right lower lobe on a chest radiograph.

  8. Quantum ion-acoustic solitary waves in weak relativistic plasma

    Indian Academy of Sciences (India)

    Abstract. Small amplitude quantum ion-acoustic solitary waves are studied in an unmagnetized two- species relativistic quantum plasma system, comprised of electrons and ions. The one-dimensional quantum hydrodynamic model (QHD) is used to obtain a deformed Korteweg–de Vries (dKdV) equation by reductive ...

  9. Phase-Space Models of Solitary Electron Hoies

    DEFF Research Database (Denmark)

    Lynov, Jens-Peter; Michelsen, Poul; Pécseli, Hans

    1985-01-01

    Two different phase-space models of solitary electron holes are investigated and compared with results from computer simulations of an actual laboratory experiment, carried out in a strongly magnetized, cylindrical plasma column. In the two models, the velocity distribution of the electrons...

  10. Sonographic Appearance of a Solitary Intramuscular Cysticercosis: A Case Report

    International Nuclear Information System (INIS)

    Moon, Ju Hee; Joo, Seung Ho; Shim, Joo Eun; Kim, Yee Jeong; Oh, Hyun Cheol; Kim, Tae Hwan

    2009-01-01

    The development of antiparasitic drugs and public health strategies has reduced the prevalence of cysticercosis in South Korea. In contrast, the disease is still endemic in Southeast Asia. The influx of immigrants from endemic areas has been on the increase. We report the sonographic and pathological findings of cysticercosis that presented as an intramuscular solitary mass in a 27-year-old Philippine woman

  11. Sonographic Appearance of a Solitary Intramuscular Cysticercosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Ju Hee; Joo, Seung Ho; Shim, Joo Eun; Kim, Yee Jeong; Oh, Hyun Cheol; Kim, Tae Hwan [NHIC Ilsan Hospital, Ilsan (Korea, Republic of)

    2009-03-15

    The development of antiparasitic drugs and public health strategies has reduced the prevalence of cysticercosis in South Korea. In contrast, the disease is still endemic in Southeast Asia. The influx of immigrants from endemic areas has been on the increase. We report the sonographic and pathological findings of cysticercosis that presented as an intramuscular solitary mass in a 27-year-old Philippine woman

  12. Exact solitary ion acoustic waves in a magnetoplasma

    International Nuclear Information System (INIS)

    Ray, D.

    1979-01-01

    Solitary ion acoustic waves in a magnetoplasma have been studied by Shukla and Yu [J. Math. Phys. 19, 2506 (1978)]. A more rigorous study confirms the conditions that Shukla and Yu said would be necessary for humps. However, it is shown that a density cavity is also possible in the limiting case

  13. Solitary wave solution to a singularly perturbed generalized Gardner ...

    Indian Academy of Sciences (India)

    2017-03-24

    Mar 24, 2017 ... Abstract. This paper is concerned with the existence of travelling wave solutions to a singularly perturbed gen- eralized Gardner equation with nonlinear terms of any order. By using geometric singular perturbation theory and based on the relation between solitary wave solution and homoclinic orbits of the ...

  14. Interaction of solitary pulses in single mode optical fibres | Usman ...

    African Journals Online (AJOL)

    Two solitary waves launched, by way of incidence, into an optical fibre from a single pulse if the pulses are in-phase as understood from results of inverse scattering transform method applied to the cubic nonlinear Schrödinger equations, (CNLSE\\'s). The single CNLSE is then understood to describe evolution of coupled ...

  15. Solitary pulmonary nodule: radiologic features and diagnostic approach

    International Nuclear Information System (INIS)

    Rodriguez Cambronero, Luis Enrique

    2012-01-01

    A literature review is conducted on the solitary pulmonary nodule, to determine the diagnostic methods and specific characteristics. The diagnostic methods used have been: chest radiography, computed tomography, positron emission tomography and magnetic resonance imaging. The radiological features are defined: location, size, definition of contours or edges (margins), densitometric and attenuation characteristics, cavitation, air bronchogram, growth, doubling time, satellite nodules, nutrient vessels [es

  16. Exact solitary waves of the Korteveg - de Vries - Burgers equation

    OpenAIRE

    Kudryashov, N. A.

    2004-01-01

    New approach is presented to search exact solutions of nonlinear differential equations. This method is used to look for exact solutions of the Korteveg -- de Vries -- Burgers equation. New exact solitary waves of the Korteveg -- de Vries -- Burgers equation are found.

  17. Dust acoustic solitary and shock waves in strongly coupled dusty ...

    Indian Academy of Sciences (India)

    between nonlinear and dispersion effects can result in the formation of symmetrical solitary waves. Also shock ... et al have studied the effect of nonadiabatic dust charge variation on the nonlinear dust acoustic wave with ..... Figure 5 presents the border between oscillatory- and monotonic-type shock waves as functions of ...

  18. Flow and sediment transport induced by a plunging solitary wave

    DEFF Research Database (Denmark)

    Sumer, B. Mutlu; Sen, M.Berke; Karagali, Ioanna

    2011-01-01

    Two parallel experiments involving the evolution and runup of plunging solitary waves on a sloping bed were conducted: (1) a rigid-bed experiment, allowing direct (hot film) measurements of bed shear stresses, and (2) a sediment-bed experiment, allowing for the measurement of pore-water pressures...

  19. A relativistic solitary wave in electron positron plasma

    International Nuclear Information System (INIS)

    Berezhiani, V.I.; Skarka, V.; Mahajan, S.

    1993-09-01

    The relativistic solitary wave propagation is studied in cold electron-positron plasma embedded in an external arbitrary strong magnetic field. The exact, analytical soliton-like solution corresponding to a localized, purely electromagnetic pulse with arbitrary big amplitude is found. (author). 7 refs, 1 fig

  20. The frequency of carcinoma in solitary thyroid nodules and in ...

    African Journals Online (AJOL)

    Muhimbili Medical Centre, Dar es Salaam was made to determine the frequency of malignancy in patients with solitary non-toxic thyroid nodule (STN) and in those with multinodular goitre (MNG). There were 60 cases of STN and. 178 with MNG. Nodular goitre was found to be predominantly a disease of females with sex.

  1. Solitary wave exchange potential and nucleon-nucleon interaction

    International Nuclear Information System (INIS)

    Prema, K.; Raghavan, S.S.; Sekhar Raghavan

    1986-11-01

    Nucleon-nucleon interaction is studied using a phenomenological potential model called solitary wave exchange potential model. It is shown that this simple model reproduces the singlet and triplet scattering data and the deuteron parameters reasonably well. (author). 6 refs, 2 figs, 1 tab

  2. Novel antimicrobial peptides from the venom of solitary bees

    Czech Academy of Sciences Publication Activity Database

    Čeřovský, Václav; Cvačka, Josef; Voburka, Zdeněk; Hovorka, Oldřich; Slaninová, Jiřina; Fučík, Vladimír; Bednárová, Lucie

    2008-01-01

    Roč. 14, č. 8 (2008), s. 92-92 ISSN 1075-2617. [European Peptide Symposium /30./. 31.08.2008-05.09.2008, Helsinki] Institutional research plan: CEZ:AV0Z40550506 Keywords : antimicrobial peptides * solitary bees * melectin * isolation and characterization Subject RIV: CC - Organic Chemistry

  3. Ultrasonographic Localization of Solitary Fibrous Tumor of Pleura: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyoung Tae; Jeon, Yong Sun; Cho, Soon Gu; Kim, Kwang Ho; Lee, Kyung Hee [Inha University School of Medicine, Incheon (Korea, Republic of)

    2010-03-15

    Plain radiography and computed tomography are widely used in the field of chest disease. Yet ultrasonography has a limitation as a diagnostic tool, except in the case of pleural effusion and chest wall lesion. We experienced a case of solitary fibrous tumor of the diaphragmatic pleura, and the origin of this tumor could be exactly localized by ultrasonography, but not by other imaging modalities

  4. Ultrasonographic Localization of Solitary Fibrous Tumor of Pleura: Case Report

    International Nuclear Information System (INIS)

    Kim, Kyoung Tae; Jeon, Yong Sun; Cho, Soon Gu; Kim, Kwang Ho; Lee, Kyung Hee

    2010-01-01

    Plain radiography and computed tomography are widely used in the field of chest disease. Yet ultrasonography has a limitation as a diagnostic tool, except in the case of pleural effusion and chest wall lesion. We experienced a case of solitary fibrous tumor of the diaphragmatic pleura, and the origin of this tumor could be exactly localized by ultrasonography, but not by other imaging modalities

  5. Solitary wave and periodic wave solutions for Burgers, Fisher ...

    Indian Academy of Sciences (India)

    Home; Journals; Pramana – Journal of Physics; Volume 85; Issue 1. Solitary wave and periodic wave solutions for Burgers, Fisher, Huxley and combined forms of these equations by the (′/)-expansion method. Jalil Manafian Mehrdad Lakestani. Volume 85 Issue 1 July 2015 pp 31-52 ...

  6. Percutaneous nephrolithotomy in patients with a solitary kidney

    Directory of Open Access Journals (Sweden)

    Tufan Süelözgen

    2014-12-01

    Full Text Available Material and method: The results of percutaneous nephrolithotomy applied to 716 patients in our clinic between January 2008 and January 2014 were retrospectively evaluated. Age, gender, urinary calculi size (mm2, urinary calculi localization, ESWL history, operation duration (min, fluoroscopy duration (sec, access type, reason of solitary kidney, hemoglobin drawdown (g/dl and operation success of the patients with a solitary kidney were recorded. The patients having no preoperative and postoperative non contrast abdominal tomography were excluded from the study. Results: Fifteen of nineteen patients (79% were men and 4 of them (21% were women. The average age of the patients was 42.52 ± 16.72 (14-72. Ten patients had anatomical solitary kidney and nine patients had physiological solitary kidney. In fact counter kidney was non functional in 9 patients (47% whereas there was agenesis in 2 (11% and outcome of nephrectomy in 8 (42% patients. In our study, presence of residual stone less than 4 mm at 1st month postoperative non contrast abdominal tomography was accepted as a successful result and accordingly our success rate was detected as 84%. Mean urinary calculi size was 405 ± 252.9 mm2; urinary calculi localization was pelvic, lower pole, upper-middle pole, middle-lower pole and staghorn in 11 (58%, 4 (21%, 1 (5%, 1 (5% and 1 (5% patients, respectively; previous ESWL history was 16%; operation duration was 55.47-± 28.1 min and fluoroscopy duration 131.10 ± 87.6 sec; access type was subcostal in 79%, supracostal in 10.5% and multiple in 10.5%; hemoglobin drawdown was 1.75 ± 0.97 mg/dl. Conclusions: PNL can be effectively and safely administered for the treatment of solitary kidney. In the treatment of large urinary calculi in patients with a solitary kidney, PNL has some advantages such as short surgery duration, less complication, acceptable hemoglobin drawdown and high success rates. According to our study, PNL operation in patients with a

  7. Robotic adrenalectomy for sigmoid colon cancer oligometastasis.

    Science.gov (United States)

    Pai, Vishwas D; Bhandare, Manish; Deodhar, Kedar; Yuvaraja, Thyavihally Boregowda; Saklani, Avanish P

    2015-12-01

    Solitary adrenal metastasis from colorectal cancer is rare with reported incidence from 3.1% to 14.4% in the literature. Conventionally, adrenal metastasis is considered as indicative of widespread systemic disease and hence treated with palliative intent. Surgical resection remains controversial although a median survival of 32 months was found in the largest reported case series. It has been postulated that surgical resection should be offered when the adrenal metastasis develops more than 6 months after the treatment of the primary tumor. For the metastatic lesions and potentially malignant lesions, role of minimally invasive surgery is still considered controversial. We are presenting a case of metachronous, solitary adrenal metastasis from sigmoid colon carcinoma treated surgically with curative intent.

  8. MDCT Findings of Traumatic Adrenal Injury in Children

    International Nuclear Information System (INIS)

    Choi, Seung Joon; Kim, Jee Eun; Ryu, Il; Kim, Jin Joo; Choi, Hye Young

    2011-01-01

    We wanted to evaluate the MDCT findings and concomitant injuries of traumatic adrenal injury in children. Among 375 children who had undergone a MDCT scan for abdominal trauma during the recent five years at our institution, 27 children who had revealed adrenal injury on their CT scan were included in the study. We retrospectively evaluated the causes of the trauma, the patterns of adrenal injury, the associated CT findings and the concomitant injuries of the other organs in the abdomen. We identified 27 children (7.5%) (17 boys and 10 girls, mean age: 9.9 years, range: 2-18 years) with adrenal injury. The causes of adrenal injury were a traffic accident for 20 patients (74%), falls for four patients (15%) and blunt trauma for three patients (11%). The right adrenal gland was injured in 20 patients (74%), while the left adrenal gland was injured in three patients and bilateral involvement was noted in four patients. The patterns of adrenal injury were round or oval shaped hematoma in 23 lesions (74%), irregular hemorrhage with obliterating the gland in six lesions (19%) and active extravasation of contrast material from the adrenal region in two lesions (7%). Concomitant injuries were noted in 22 patients (81%), including 15 patients with liver laceration (56%), 11 patients with lung contusion (41%) and nine patients with renal injury (33%). The frequency of adrenal injury was 7.5%. The right adrenal gland was more frequently involved. Concomitant organ injury was noted 81% of the patients and the most frequently involved organ was the liver (56%)

  9. Adrenal clocks and the role of adrenal hormones in the regulation of circadian physiology.

    Science.gov (United States)

    Leliavski, Alexei; Dumbell, Rebecca; Ott, Volker; Oster, Henrik

    2015-02-01

    The mammalian circadian timing system consists of a master pacemaker in the suprachiasmatic nucleus (SCN) and subordinate clocks that disseminate time information to various central and peripheral tissues. While the function of the SCN in circadian rhythm regulation has been extensively studied, we still have limited understanding of how peripheral tissue clock function contributes to the regulation of physiological processes. The adrenal gland plays a special role in this context as adrenal hormones show strong circadian secretion rhythms affecting downstream physiological processes. At the same time, they have been shown to affect clock gene expression in various other tissues, thus mediating systemic entrainment to external zeitgebers and promoting internal circadian alignment. In this review, we discuss the function of circadian clocks in the adrenal gland, how they are reset by the SCN and may further relay time-of-day information to other tissues. Focusing on glucocorticoids, we conclude by outlining the impact of adrenal rhythm disruption on neuropsychiatric, metabolic, immune, and malignant disorders. © 2014 The Author(s).

  10. Parental management of adrenal crisis in children with congenital adrenal hyperplasia.

    Science.gov (United States)

    Fleming, Louise; Knafl, Kathleen; Knafl, George; Van Riper, Marcia

    2017-10-01

    Congenital adrenal hyperplasia (CAH) requires parents to inject their child with hydrocortisone intramuscularly during times of illness and adrenal crisis. The purpose of this study was to describe circumstances surrounding adrenal crisis events in children with CAH; to explore parents' perceptions of the consequences of having a child with a life-threatening condition; and to examine a relationship between parents' perceived management ability and the impact CAH has on the family. In Phase 1 of this mixed-methods, cross-sectional study, 77 parents were asked to complete questionnaires comprising measures of family life in the context of childhood illness. Descriptive statistics were computed with four separate analyses using linear mixed models allowing for correlation between responses from parents of the same family and for the variance to be different for fathers and mothers. The following relationships were examined: (1) parental management ability and type of provider instruction on how to manage adrenal crises; (2) parental management ability and child age; (3) the perceived impact of the condition on the family and management ability; and (4) the age of the child and number of adrenal crisis events. In Phase 2, 16 semi-structured interviews were conducted to elicit detailed descriptions of parents' experiences in managing crises. There was a significant, positive relationship between detailed provider instruction to parents on adrenal crisis management and perceived management ability (p = .02), additionally the stronger the perceived management ability, the less impact CAH had on the family (p crisis events and less perceived ability to manage the condition when compared with parents of older children (p = .009). The threat of an adrenal crisis event is a pervasive concern for parents, especially when they are not being properly prepared by providers. Provider support is needed for these parents throughout childhood, but especially in the first 5 years of

  11. Extra-adrenal Pheochromocytoma in an Adolescent

    Directory of Open Access Journals (Sweden)

    Abdullah, Ibrahim

    2011-05-01

    Full Text Available A 17-year-old male with symptoms of headache and diaphoresis presented to the emergency department. He had eight months of noted hypertension attributed to medications. On arrival his blood pressure was 229/117mmHg, and he was ill-appearing. His blood pressure was managed aggressively, and he was diagnosed with extra-adrenal pheochromocytoma by computed tomography. He eventually underwent resection of the mass. Children with severe, symptomatic hypertension should be evaluated for pheochromocytoma. Although rare, it is curable. Failure to diagnose carries a high risk of morbidity and mortality. [West J Emerg Med. 2011;12(2:258-261.

  12. Adrenal insufficiency in critically ill septic patients at Dr George ...

    African Journals Online (AJOL)

    Adele

    eosinophillia and hypoglycemia. Hyponatremia and hyperkalemia are uncommon. There has been much controversy regarding the criteria for the diagnosis of adrenal insufficiency.10,11,12 The diagnosis would be best made using an end-organ marker of adrenal steroid action. No such marker is available at present. Free.

  13. Incidence and Cause of Hypertension During Adrenal Radiofrequency Ablation

    International Nuclear Information System (INIS)

    Yamakado, Koichiro; Takaki, Haruyuki; Yamada, Tomomi; Yamanaka, Takashi; Uraki, Junji; Kashima, Masataka; Nakatsuka, Atsuhiro; Takeda, Kan

    2012-01-01

    Purpose: To evaluate the incidence and cause of hypertension prospectively during adrenal radiofrequency ablation (RFA). Methods: For this study, approved by our institutional review board, written informed consent was obtained from all patients. Patients who received RFA for adrenal tumors (adrenal ablation) and other abdominal tumors (nonadrenal ablation) were included in this prospective study. Blood pressure was monitored during RFA. Serum adrenal hormone levels including epinephrine, norepinephrine, dopamine, and cortisol levels were measured before and during RFA. The respective incidences of procedural hypertension (systolic blood pressure >200 mmHg) of the two patient groups were compared. Factors correlating with procedural systolic blood pressure were evaluated by regression analysis.ResultsNine patients underwent adrenal RFA and another 9 patients liver (n = 5) and renal (n = 4) RFA. Asymptomatic procedural hypertension that returned to the baseline by injecting calcium blocker was found in 7 (38.9%) of 18 patients. The incidence of procedural hypertension was significantly higher in the adrenal ablation group (66.7%, 6/9) than in the nonadrenal ablation group (11.1%, 1/9, P 2 = 0.68, P 2 = 0.72, P < 0.0001) levels during RFA. The other adrenal hormones did not show correlation with procedural systolic blood pressure. Conclusion: Hypertension occurs frequently during adrenal RFA because of the release of catecholamine.

  14. The Influence of Adrenal Secretons on Leucocyte Distribution and ...

    African Journals Online (AJOL)

    Many apparently, health Africans present with leuko-neutropenia. The origin of the so-called benign ethnic leuko-neutropenia remains uncertain. Africans are also, known to have small adrenal cortices. Cortisol is the major secretion of the adrenal cortex, which profoundly influences leukocyte profile. We investigated the ...

  15. Volume of the adrenal and pituitary glands in depression

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Willer, Inge Stoel; Knorr, Ulla

    2011-01-01

    Numerous studies have shown that the hypothalamic-pituitary-adrenal (HPA) axis is hyperactive in some depressed patients. It is unclear whether such hyperactivity results in changed volumes of the adrenal glands, pituitary gland and hypothalamus. We systematically reviewed all controlled studies ...

  16. Laparoscopic Adrenalectomy is Feasible for Large Adrenal Masses > 6cm

    Directory of Open Access Journals (Sweden)

    H. Sanjay Bhat

    2007-01-01

    Conclusion: LA is the procedure of choice for small adrenal masses but is also feasible for large functioning and nonfunctioning adrenal masses with equally good results. Even bilateral large functioning tumours can be treated safely by LA in a single stage when sufficient experience with the procedure is attained.

  17. Clinical experience with 75Se selenomethylcholesterol adrenal imaging

    International Nuclear Information System (INIS)

    Shapiro, B.; Britton, K.E.; Hawkins, L.A.; Edwards, C.R.W.

    1981-01-01

    The results of quantitative adrenal imaging using 75 Se selenomethylcholesterol in sixty-two subjects are analysed. The adrenal area was localized by a renal scan, lateral views of which enabled adrenal depth to be estimated. The first nineteen cases were scanned with a rectilinear scanner and the remaining forty-three cases imaged with a gamma camera. Quantitation of adrenal uptake was performed on computer-stored static images obtained 7 and 14 days post-injection of 75 Se selenomethylcholesterol (3 and 6 days in the first ten cases studied). Normal uptake was found to be 0.07-0.30% of the administered dose. Overall predictive accuracy of the type of adrenal disorder of thirty-two patients with Cushing's syndrome was 90.6%. Overall predictive accuracy of the cause of Conn's syndrome in twenty-two cases was 86.4%. The mean uptake in the normal adrenal in cases of unilateral adenoma was 0.19% (range 0.07-0.30%). Causes of unsatisfactory adrenal imaging are examined. The procedure is recommended as the localizing and lateralizing technique of choice in Cushing's syndrome except where due to adrenal carcinoma, and as an important non-invasive technique in Conn's syndrome for the lateralization of adenoma. (author)

  18. Giant adrenal cyst - a case report and classification

    International Nuclear Information System (INIS)

    Pitaki, Sergio Augusto Munhoz; Louveira, Maria Helena

    1999-01-01

    Cystic lesions of the adrenal gland are relatively rare, but they must be considering in the differential diagnosis of abdominal masses. The authors report a case of a giant adrenal cyst assessed by ultrasonography, computed tomography and magnetic resonance imaging, and outline their features and classification. (author)

  19. Adrenal disorders: Is there Any role for vitamin D?

    Science.gov (United States)

    Tirabassi, Giacomo; Salvio, Gianmaria; Altieri, Barbara; Ronchi, Cristina L; Della Casa, Silvia; Pontecorvi, Alfredo; Balercia, Giancarlo

    2017-09-01

    An emerging branch of research is examining the linkage between Vitamin D and nonskeletal disorders, including endocrine diseases. In this regard, a still little studied aspect concerns the involvement of vitamin D in adrenal gland disorders. Adrenal gland disorders, which might be theoretically affected by vitamin D unbalance, include adrenal insufficiency, Cushing's syndrome, adrenocortical tumors and hyperaldosteronism. In this review, we provide an updated document, which tries to collect and discuss the limited evidence to be found in the literature about the relationship between vitamin D and adrenal disorders. We conclude that there is insufficient evidence proving a causal relationship between vitamin D levels and adrenal disorders. Evidence coming from cross-sectional clinical studies can hardly clarify what comes first between vitamin D unbalance and adrenal disease. On the other hand, longitudinal studies monitoring the levels of vitamin D in patients with adrenal disorders or, conversely, the possible development of adrenal pathologies in subjects affected by impaired vitamin D levels would be able to elucidate this still unclear issue.

  20. Is There Such a Thing as Adrenal Fatigue?

    Science.gov (United States)

    ... it? Is there such a thing as adrenal fatigue? Answers from Todd B. Nippoldt, M.D. Adrenal fatigue is a term applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems. The term ...

  1. Incidence and Cause of Hypertension During Adrenal Radiofrequency Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Yamakado, Koichiro, E-mail: yama@clin.medic.mie-u.ac.jp; Takaki, Haruyuki [Mie University School of Medicine, Department of Interventional Radiology (Japan); Yamada, Tomomi [Mie University School of Medicine, Department of Translational Medicine (Japan); Yamanaka, Takashi; Uraki, Junji; Kashima, Masataka; Nakatsuka, Atsuhiro; Takeda, Kan [Mie University School of Medicine, Department of Interventional Radiology (Japan)

    2012-12-15

    Purpose: To evaluate the incidence and cause of hypertension prospectively during adrenal radiofrequency ablation (RFA). Methods: For this study, approved by our institutional review board, written informed consent was obtained from all patients. Patients who received RFA for adrenal tumors (adrenal ablation) and other abdominal tumors (nonadrenal ablation) were included in this prospective study. Blood pressure was monitored during RFA. Serum adrenal hormone levels including epinephrine, norepinephrine, dopamine, and cortisol levels were measured before and during RFA. The respective incidences of procedural hypertension (systolic blood pressure >200 mmHg) of the two patient groups were compared. Factors correlating with procedural systolic blood pressure were evaluated by regression analysis.ResultsNine patients underwent adrenal RFA and another 9 patients liver (n = 5) and renal (n = 4) RFA. Asymptomatic procedural hypertension that returned to the baseline by injecting calcium blocker was found in 7 (38.9%) of 18 patients. The incidence of procedural hypertension was significantly higher in the adrenal ablation group (66.7%, 6/9) than in the nonadrenal ablation group (11.1%, 1/9, P < 0.0498). Procedural systolic blood pressure was significantly correlated with serum epinephrine (R{sup 2} = 0.68, P < 0.0001) and norepinephrine (R{sup 2} = 0.72, P < 0.0001) levels during RFA. The other adrenal hormones did not show correlation with procedural systolic blood pressure. Conclusion: Hypertension occurs frequently during adrenal RFA because of the release of catecholamine.

  2. CT diagnosis of peritoneal metastasis tumor

    International Nuclear Information System (INIS)

    Deng Xueying; Chen Xiaoqi; Qi Le; Huang Feng

    2005-01-01

    Objective: To study the CT findings and diagnosis of peritoneal metastasis. Methods: The CT findings of 17 cases with surgical- pathologically proved peritoneal metastasis were analyzed retrospectively. Results The CT findings of peritoneal metastasis included: (1)ascites (12 cases ); (2)the aternation of parietal peritoneum including broad band thickening (7 cases), nodular sign (2 cases), and massive thickening (1 cases); (3) the involved omentum and mesenterium: 'smut' appearances (7 cases), nodular sign (2 cases), 'omental cake' (5 cases); (4) the invlovement of mesenteric vessels; (5) single-or multi-cystic lesions within peritoneum (1 case) . Conclusion: CT scan is the first choice for metastasis of peritoneum. (authors)

  3. Breast metastasis and lung large-cell neuroendocrine carcinoma: first clinical observation.

    Science.gov (United States)

    Papa, Anselmo; Rossi, Luigi; Verrico, Monica; Di Cristofano, Claudio; Moretti, Valentina; Strudel, Martina; Zoratto, Federica; Minozzi, Marina; Tomao, Silverio

    2017-09-01

    The lung large-cell neuroendocrine carcinoma (LCNEC) is a very rare aggressive neuroendocrine tumor with a high propensity to metastasize and very poor prognosis. We report an atypical presentation of lung LCNEC was diagnosed from a metastatic nodule on the breast. Our patient is a 59-years-old woman that presented in March 2014 nonproductive cough. A CT scan showed multiple brain, lung, adrenal gland and liver secondary lesions; moreover, it revealed a breast right nodule near the chest measuring 1.8 cm. The breast nodule and lung lesions were biopsied and their histology and molecular diagnosis were LCNEC of the lung. To our knowledge, this is the first documented case of breast metastasis from LCNEC of the lung. Furthermore, breast metastasis from extramammary malignancy is uncommon and its diagnosis is difficult but important for proper management and prediction of prognosis. Therefore, a careful clinical history with a thorough clinical examination is needed to make the correct diagnosis. Moreover, metastasis to the breast should be considered in any patient with a known primary malignant tumor history who presents with a breast lump. Anyhow, pathological examination should be performed to differentiate the primary breast cancer from metastatic tumor. Therefore, an accurate diagnosis of breast metastases may not only avoid unnecessary breast resection, more importantly it is crucial to determine an appropriate and systemic treatment. © 2015 John Wiley & Sons Ltd.

  4. Anomalous adrenal vein anatomy complicating the evaluation of primary hyperaldosteronism

    Directory of Open Access Journals (Sweden)

    Kaitlin M. Ford, BS

    2018-02-01

    Full Text Available Adrenal vein development in utero occurs concurrently with the development of the inferior vena cava, the renal veins, and the gonadal veins. The embryologic formation of these veins involves communication of various venous systems. Although the left adrenal-renal vein complex is most commonly described as a shared emptying of the left adrenal vein and the left inferior phrenic vein into the left renal vein, there have been reports of numerous anatomic variations of this complex. In this report, we present a case of a rare variant of the left adrenal vein, in which the left adrenal vein empties into the left gonadal vein, which takes an atypical course superolateral to the left kidney.

  5. Volume of the adrenal and pituitary glands in depression

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Willer, Inge Stoel; Knorr, Ulla

    2011-01-01

    Numerous studies have shown that the hypothalamic-pituitary-adrenal (HPA) axis is hyperactive in some depressed patients. It is unclear whether such hyperactivity results in changed volumes of the adrenal glands, pituitary gland and hypothalamus. We systematically reviewed all controlled studies...... on the adrenal or pituitary glands or hypothalamus volume in unipolar depressive disorder published in PubMed 1966 to December 2009. We identified three studies that investigated the volume of the adrenal glands and eight studies that examined the volume of the pituitary gland, but no studies on hypothalamus...... were found. Two out of three studies found a statistically significant increase in adrenal volume in patients compared to controls. Four out of eight studies found a statistically significant increase in pituitary volume in patients compared to controls. Different methodological problems were...

  6. Giant adrenal myelolipoma: Incidentaloma with a rare incidental association

    Directory of Open Access Journals (Sweden)

    Wani Nisar

    2010-01-01

    Full Text Available Adrenal myelolipoma is an unusual, benign and biochemically inactive tumor that is composed of mature adipose and hematopoietic tissue. It is usually diagnosed accidentally and nowadays much more frequently because of widespread use of ultrasonography, computed tomography (CT and magnetic resonance imaging. Adrenal myelolipoma is usually unilateral and asymptomatic, though known to be associated with obesity, hypertension, endocrinological disorders and some malignancies. We report herein two cases of right-sided giant adrenal myelolipoma diagnosed by multidetector-row CT. One patient was symptomatic because of a large mass in the right upper abdomen, which on imaging with CT was seen to be right adrenal myelolipoma. Another patient had a large left side Bochdalek hernia and right adrenal myelolipoma was incidentally discovered on CT.

  7. Uncommon adrenal masses: CT and MRI features with histopathologic correlation

    International Nuclear Information System (INIS)

    Guo Yingkun; Yang Zhigang; Li Yuan; Deng Yuping; Ma Ensen; Min Pengqiu; Zhang Xiaochun

    2007-01-01

    Adrenal glands are common sites of diseases. With dramatically increased use of computed tomography (CT) and magnetic resonance (MR) imaging, more and more uncommon adrenal masses have been detected incidentally at abdominal examinations performed for other purposes. In this article, uncommon adrenal masses are classified as cystic masses (endothelial cysts, epithelial cysts, parasitic cysts, and pseudocysts), solid masses (ganglioneuroma, ganglioneuroblastoma, extramedullary plasmacytoma (EMP), neurilemmoma, and lymphoma), fat-containing masses (myelolipoma, teratoma), and infectious masses (tuberculoma), and the imaging features of these uncommon masses are demonstrated. Although most of these lesions do not have specific imaging features, some fat-containing masses and cystic lesions present with characteristic appearances, such as myelolipoma, teratoma, and hydatid. Combination with histopathologic characteristic of these uncommon masses of adrenal gland, radiological features of these lesions on CT and MR imaging can be accurately understood with more confidences. Moreover, CT and MRI are highly accurate in localization of uncommon adrenal masses, and useful to guide surgical treatments

  8. Adrenal vein sampling in the diagnosis of aldosteronism

    Directory of Open Access Journals (Sweden)

    Deipolyi AR

    2015-06-01

    Full Text Available Amy R Deipolyi,1 Rahmi Oklu2 1Vascular and Interventional Radiology, NYU Langone Medical Center, New York, NY, USA; 2Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Abstract: Primary aldosteronism causes 15%–25% of cases of drug-resistant hypertension. Adrenal vein sampling (AVS is a procedure entailing the measurement of aldosterone from both adrenal veins, to diagnose an adrenal source of excess aldosterone secretion. Because unilateral adrenal etiologies of primary aldosteronism may be surgically resected, identifying these sources by venous sampling is critical. Technical aspects of the procedure are reviewed, with emphasis on strategies to avoid common difficulties during AVS. Keywords: primary aldosteronism, hypertension, venous sampling, adrenal adenoma

  9. Mandibular metastasis presenting as the initial maifestation of malignant pheochromocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Yanagi, Yoshinobu; Asaumi, Jun-ichi E-mail: asaumi@md.okayama-u.ac.jp; Hisatomi, Miki; Konouchi, Hironobu; Wakasa, Toru; Kishi, Kanji

    2002-10-01

    A case of 59-year-old male patient presenting with metastasis to the mandible from malignant pheochromocytoma is described. The conventional radiographs and CT images suggested that the lesion was malignant osteogenic tumors or metastatic tumors due to the existence of calcification and widesoread periosteal sunburst spiculation. On MRI, an expansive mass was clearly depicted and the signal intensities of the lesion were low to intermediate on T1 weighted image with intermediate to high signal intensity on T2 weighted image. A strong enhancement of the lesion was also observed on contrast enhanced T1 weighted image. On maximum intensity projection image in the arterial phase, the mass showed exceedingly early enhancement and excessively dislocated adjacent vessels. The diagnosis of a pheochromcytoma was difficult on the basis of these imagings. The final diagnosis was based on a biopsy of the mandible and I-131 Meta-iodobenzylguanidine scintigraphy (MIBG) scintigraphy. A primary lesion of the right adrenal showed low uptake due to wide centric necrosis and metastatic lesions of liver, lumber vertebrae, ribs and sacroiliac joint showed high uptake on the I-131 MIBG scintigraphy. The final diagnosis was nonfunctioning malignant pheochromocytoma due to the absence of elevation of catecholamine or its metabolite.

  10. Brain Metastasis as Initial Manifestation of Melanoma (A Case Report

    Directory of Open Access Journals (Sweden)

    Vitorino Modesto Santos

    2016-06-01

    Full Text Available Background: Melanoma is a malignancy derived from the neural crest, constituted of melanocytes found in the basal layer of epidermis, with the main function of melanin production. Case: A 64-year-old woman was admitted with headache and dyslalia and reported some episodes of vertigo and falls in the last six months. A superficial red and dark skin discoloration in the scalp and a node in the right parotid gland were observed. Computed tomography of the brain showed nodular lesions in the left parietal and right temporal and occipital lobes with hemorrhagic features, in addition to mass effect. Furthermore, PET-CT images were suggestive of brain, lung, and adrenal metastasis. The patient evolved with intracranial hypertension and a neurosurgery was performed. Histopathological and immunohistochemistry studies revealed metastatic melanoma. Conclusions: She underwent schedules of radiation therapy and chemotherapy, but developed uncontrolled sepsis and died in spite of clinical management and intensive care support. Cutaneous primary site of this malignancy in the scalp was previously neglected; therefore, neurological disturbances were the initial manifestations of melanoma. Immunohistochemistry findings allowed ruling out the main differential hypotheses.

  11. Adrenal hormones in human follicular fluid.

    Science.gov (United States)

    Jimena, P; Castilla, J A; Peran, F; Ramirez, J P; Vergara, F; Molina, R; Vergara, F; Herruzo, A

    1992-11-01

    Considerable evidence indicates that adrenal hormones may affect gonadal function. To assess the role of some adrenal hormones in human follicular fluid and their relationship with the ability of the oocyte to be fertilized and then to cleave in vitro, cortisol and dehydroepiandrosterone sulfate were measured in follicular fluid obtained at the time of oocyte recovery for in vitro fertilization from cycles stimulated by clomiphene citrate, human menopausal gonadotropin and human chorionic gonadotropin. Thirty-six follicular fluid containing mature oocyte-corona-cumulus complexes and free of visible blood contamination were included in this study. There was no significant difference in follicular fluid dehydroepiandrosterone sulfate concentration between follicles with oocytes which did or did not fertilize (5.1 +/- 1.1 vs 5.8 +/- 2.0 mumol/l). However, follicular fluid from follicles whose oocytes were not fertilized had levels of cortisol significantly higher than those in follicular fluid from follicles containing successfully fertilized oocytes (406.0 +/- 75.9 vs 339.2 +/- 37.0 nmol/l; p < 0.005). No significant correlations were found between rates of embryo cleavage and cortisol and dehydroepiandrosterone levels in follicular fluid. We conclude that cortisol levels in follicular fluid may provide an index of fertilization outcome, at least in stimulated cycles by clomiphene citrate, human menopausal gonadotropin and human chorionic gonadotropin.

  12. Laparoscopic and robotic adrenal surgery: transperitoneal approach.

    Science.gov (United States)

    Okoh, Alexis K; Berber, Eren

    2015-10-01

    Recent advances in technology and the need to decrease surgical morbidity have led a rapid progress in laparoscopic adrenalectomy (LA) over the past decade. Robotics is attractive to the surgeon owing to the 3-dimensional image quality, articulating instruments, and stable surgical platform. The safety and efficacy of robotic adrenalectomy (RA) have been demonstrated by several reports. In addition, RA has been shown to provide similar outcomes compared to LA. Development of adrenal surgery has involved the description of several surgical approaches including the anterior transperitoneal, lateral transperitoneal (LT) and posterior retroperitoneal (PR). Among these, the most frequently preferred technique is LT adrenalectomy, primarily due to the surgeon's familiarity of the operative field, wider working space and visibility. The LT technique is suitable for the resection of larger, unilateral tumors and in scenarios where conversion to an open transperitoneal approach is warranted, it offers a lesser burden. Also, the larger view of the entire abdominal cavity and excellent exposure of both adrenal glands and surrounding structures provided by the LT technique render it safe and feasible in pediatric and pregnant individuals.

  13. Enterobius vermicularis infection of the liver in a patient with colorectal carcinoma with suspected liver metastasis

    Science.gov (United States)

    Furnée, Edgar J B; Spoto, Clothaire; de Graaf, Melanie J; Smakman, Niels

    2015-01-01

    A 68-year-old man diagnosed with cT3N2 adenocarcinoma of the rectum presented with a synchronous solitary liver metastasis on CT scan. Neoadjuvant chemoradiotherapy was started to downstage the primary tumour. Resection of the rectal tumour followed 3 months after the last radiotherapy session and primary resection of the isolated liver lesion was performed in the intervening period. Histopathological assessment of the liver lesion, however, showed no malignancy, but did reveal a necrotic infection due to Enterobius vermicularis. This parasite is frequently found in the intestines, but only rarely infects the liver. The patient was subsequently treated with the anthelmintic drug mebendazole 100 mg once a week for 2 weeks. Histopathological assessment of the rectal specimen showed complete regression after neoadjuvant chemoradiotherapy without evidence of remaining E. vermicularis, suggesting pinworm eradication. The patient recovered promptly after both surgical procedures. PMID:26546623

  14. Neural control of adrenal medullary and cortical blood flow during hemorrhage

    International Nuclear Information System (INIS)

    Breslow, M.J.; Jordan, D.A.; Thellman, S.T.; Traystman, R.J.

    1987-01-01

    Hemorrhagic hypotension produces an increase in adrenal medullary blood flow and a decrease in adrenal cortical blood flow. To determine whether changes in adrenal blood flow during hemorrhage are neurally mediated, the authors compared blood flow responses following adrenal denervation (splanchnic nerve section) with changes in the contralateral, neurally intact adrenal. Carbonized microspheres labeled with 153 Gd, 114 In, 113 Sn, 103 Ru, 95 Nb or 46 Se were used. Blood pressure was reduced and maintained at 60 mmHg for 25 min by hemorrhage into a pressurized bottle system. Adrenal cortical blood flow decreased to 50% of control with hemorrhage in both the intact and denervated adrenal. Adrenal medullary blood flow increased to four times control levels at 15 and 25 min posthemorrhage in the intact adrenal, but was reduced to 50% of control at 3, 5, and 10 min posthemorrhage in the denervated adrenal. In a separate group of dogs, the greater splanchnic nerve on one side was electrically stimulated at 2, 5, or 15 Hz for 40 min. Adrenal medullary blood flow increased 5- to 10-fold in the stimulated adrenal but was unchanged in the contralateral, nonstimulated adrenal. Adrenal cortical blood flow was not affected by nerve stimulation. They conclude that activity of the splanchnic nerve profoundly affects adrenal medullary vessels but not adrenal cortical vessels and mediates the observed increase in adrenal medullary blood flow during hemorrhagic hypotension

  15. Pulmonary metastasis in thyroid cancer

    International Nuclear Information System (INIS)

    Samuel, A.M.; Rajashekharrao, B.; Shah, D.H.

    1999-01-01

    Although thyroid cancer (TC) in its differentiated form is generally associated with a good prognosis and a near normal life expectancy, a subset of patients especially with distant metastatic disease may run an aggressive course leading to poor survival and early death. The clinical presentation and the manner in which the disease progresses differs with the site and type of the metastatic disease. The behaviour and course of skeletal metastasis has been described elsewhere. The biological behaviour and treatment of pulmonary metastatic disease is focussed on

  16. Pancreatic Metastasis from Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Julian Jacob

    2010-01-01

    Full Text Available The pancreas is an unusual location for metastases from other primary cancers. Rarely, pancreatic metastases from kidney or colorectal cancers have been reported. However, a variety of other cancers may also spread to the pancreas. We report an exceptional case of pancreatic metastasis from prostate cancer. Differences in management between primary and secondary pancreatic tumors make recognition of metastases to the pancreas an objective of first importance. Knowledge of unusual locations for metastatic spread will reduce diagnostic delay and lead to a timely delivery of an appropriate treatment.

  17. Dissecting and Targeting Latent Metastasis

    Science.gov (United States)

    2014-09-01

    Option in Brain Metastasis Manuel Valiente,1 Anna C. Obenauf,1 Xin Jin,1 Qing Chen,1 Xiang H.-F. Zhang,1,8 Derek J. Lee,1 Jamie E. Chaft,2 Mark G. Kris,2...of poor response to tamoxifen therapy in recurrent breast cancer. J. Natl. Cancer Inst. 87, 751–756. Francia, G., Cruz -Munoz, W., Man, S., Xu, P... Manuel Valiente1, Xin Jin1†, Ekrem Emrah Er1, Ruzeen Patwa1, Ke Xu3 and Joan Massagué1 1 Cancer Biology and Genetics Program, 2 Department of

  18. Endocannabinoids as Guardians of Metastasis

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    Irmgard Tegeder

    2016-02-01

    Full Text Available Endocannabinoids including anandamide and 2-arachidonoylglycerol are involved in cancer pathophysiology in several ways, including tumor growth and progression, peritumoral inflammation, nausea and cancer pain. Recently we showed that the endocannabinoid profiles are deranged during cancer to an extent that this manifests in alterations of plasma endocannabinoids in cancer patients, which was mimicked by similar changes in rodent models of local and metastatic cancer. The present topical review summarizes the complexity of endocannabinoid signaling in the context of tumor growth and metastasis.

  19. Metastasis

    Science.gov (United States)

    ... and Care Surgical Treatment Laparoscopic Surgery Vaccine Radiation Therapy Chemotherapy Clinical Trials Pain Management Nutrition and Exercise Holistic Care Pathology Intraductal Papillary Mucinous Neoplasms Islet Cell ...

  20. Solitary myofibroma of the lumbar vertebra: adult case

    International Nuclear Information System (INIS)

    Konishi, E.; Yanagisawa, A.; Mazaki, T.; Urata, Y.; Tanaka, K.; Kanoe, H.; Ikenaga, M.; Hayakawa, K.

    2007-01-01

    We present the first known adult case of solitary myofibroma of bone, which affected a lumbar vertebra in a 33-year-old male. Radiography identified a purely lytic lesion with a sclerotic rim in the right pedicle of L1. CT showed an expansile lytic lesion with a sclerotic rim. MRI of the lesion revealed an isointense signal on T1-weighted images, an inhomogeneously hyperintense signal on T2-weighted images, and marked enhancement with gadolinium. Pathological study showed a mixed picture of nodular proliferation of spindle-shaped myoid cells and hemangiopericytomatous proliferation of short spindle/small round cells. The tumor cells were immunoreactive for smooth muscle actin and immunonegative for desmin. This case of solitary myofibroma of bone is exceptionally rare because of its occurrence in an adult older than 20 years of age and its location at an extra-craniofacial site. (orig.)