1
|
Lee JH, Choi YD, Cho NH. An Intrarenal Adrenocortical Carcinoma Arising in an Adrenal Rest. J Pathol Transl Med 2018; 52:416-419. [PMID: 30269470 PMCID: PMC6250934 DOI: 10.4132/jptm.2018.07.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 07/20/2018] [Indexed: 11/17/2022] Open
Abstract
We describe a case of a 61-year-old Korean man who was diagnosed with renal cell carcinoma that was discovered on abdominopelvic computed tomography obtained after the patient complained of back pain. A radical nephrectomy was performed, and the surgical specimen showed a relatively well-circumscribed and yellowish lobulated hard mass. Microscopically, the tumor showed sheets and nests of hypercellular pleomorphic cells with thick fibrous septation, frequent mitoses, and areas of adrenal cortical-like tissue. Immunohistochemical staining revealed that the tumor cells were positive for inhibin-α, vimentin, synaptophysin, and melan A. It also revealed that the tumor cells were negative for pan-cytokeratin, epithelial membrane antigen, paired box 8, α-methylacyl-coenzyme A racemase, CD10, cytokeratin 7, carbonic anhydrase 9, c-Kit, renal cell carcinoma, transcription factor E3, human melanoma black 45, desmin, smooth muscle actin, S-100, chromogranin A, CD34, anaplastic lymphoma kinase, and integrase interactor 1. Based on these histopathological and immunohistochemical findings, we diagnosed the tumor as intrarenal adrenocortical carcinoma arising in an adrenal rest. Several cases of intrarenal adrenocortical carcinoma have been reported, although they are very rare. Due to its poor prognosis and common recurrence or metastasis, clinicians and pathologists must be aware of this entity.
Collapse
Affiliation(s)
- Ji Hee Lee
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Deuk Choi
- Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Nam Hoon Cho
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
2
|
Zsippai A, Szabó DR, Tömböl Z, Szabó PM, Éder K, Pállinger É, Gaillard RC, Patócs A, Tóth S, Falus A, Rácz K, Igaz P. Effects of mitotane on gene expression in the adrenocortical cell line NCI-H295R: a microarray study. Pharmacogenomics 2012; 13:1351-61. [DOI: 10.2217/pgs.12.116] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The adrenolytic agent mitotane is widely used in the treatment of adrenocortical cancer; however, its mechanism of action is poorly elucidated. We have studied mitotane-induced mRNA expression changes in the NCI-H295R adrenocortical cancer cell line. Materials & methods: Cell viability and hormone assays were used to select the optimal mitotane concentration effectively inhibiting hormone secretion without affecting cell viability. RNA isolated from cultures treated for 48 and 72 h was subjected to Agilent 4×44K microarray platforms. Microarray results were validated by quantitative reverse-transcription PCR. Results: Altogether, 117 significantly differentially expressed genes were detected at 48 h and 72 h (p < 0.05) in mitotane-treated samples relative to controls. Three significantly underexpressed genes involved in steroid hormone biosynthesis (HSD3B1, HSD3B2 and CYP21A2) and four significantly overexpressed genes (GDF15, ALDH1L2, TRIB3 and SERPINE2) have been validated. Conclusion: Gene-expression changes might be involved in the adrenal action of mitotane and in the inhibition of hormone secretion. Original submitted 20 January 2012; Revision submitted 17 May 2012
Collapse
Affiliation(s)
- Adrienn Zsippai
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Szentkirályi street 46, H-1088 Budapest, Hungary
| | - Diana Rita Szabó
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Szentkirályi street 46, H-1088 Budapest, Hungary
| | - Zsófia Tömböl
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Szentkirályi street 46, H-1088 Budapest, Hungary
| | - Peter M Szabó
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Szentkirályi street 46, H-1088 Budapest, Hungary
| | - Katalin Éder
- Department of Genetics, Cell & Immunobiology, Faculty of Medicine, Semmelweis University, Nagyvárad square 4, H-1089 Budapest, Hungary
| | - Éva Pállinger
- Department of Genetics, Cell & Immunobiology, Faculty of Medicine, Semmelweis University, Nagyvárad square 4, H-1089 Budapest, Hungary
| | - Rolf C Gaillard
- Division of Endocrinology, Diabetology & Metabolism, University Hospital Lausanne, Rue du Bugnon 46., CH-1011 Lausanne, Switzerland
| | - Attila Patócs
- Molecular Medicine Research Group, Hungarian Academy of Sciences & Semmelweis University, Szentkirályi street 46, H-1088 Budapest, Hungary
| | - Sára Tóth
- Department of Genetics, Cell & Immunobiology, Faculty of Medicine, Semmelweis University, Nagyvárad square 4, H-1089 Budapest, Hungary
| | - András Falus
- Department of Genetics, Cell & Immunobiology, Faculty of Medicine, Semmelweis University, Nagyvárad square 4, H-1089 Budapest, Hungary
| | - Károly Rácz
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Szentkirályi street 46, H-1088 Budapest, Hungary
| | - Peter Igaz
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Szentkirályi street 46, H-1088 Budapest, Hungary
| |
Collapse
|
3
|
Normal delivery following resection of an androgen-secreting adrenal carcinoma. Reprod Med Biol 2010; 10:55-58. [PMID: 29699081 DOI: 10.1007/s12522-010-0071-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Accepted: 11/02/2010] [Indexed: 10/18/2022] Open
Abstract
A 31-year-old female presented to a gynecological clinic complaining of amenorrhea and virilism over a 2-month period. Blood tests revealed high serum total testosterone and free testosterone levels. A left adrenal tumor was identified following computed tomography and she was referred to our clinic where a laparoscopic left adrenalectomy was performed. The tumor weighed 98 g and the pathological diagnosis according to Weiss' criteria was adrenocortical carcinoma. The post-operative course was uneventful; her serum free testosterone level normalized and regular menstruation was observed 1 month post-operatively. The patient became pregnant 1 year later, resulting in the normal delivery of a girl.
Collapse
|
7
|
Abstract
Liver metastases from adrenocortical carcinoma are very rare and no clear indications for surgery exist. The aim of the present work was to define surgical indications for these neoplasms. All the patients submitted to hepatic resection for liver metastases from adrenal carcinoma reported in the literature (PubMed source) from 1978 to 2005 were considered for the present study. Forty-eight patients were found in the period of study, but it was only possible to obtain certain data for nine patients (18.7%). The data investigated suggest that metachronous metastases, developed after a minimum of 1 year from the primary tumor, and completely removable, may represent an indication for surgery - although this still needs to be proved.
Collapse
Affiliation(s)
- Isidoro Di Carlo
- Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of CataniaCannizzaro Hospital
| | - Adriana Toro
- Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of CataniaCannizzaro Hospital
| | - Francesca Sparatore
- Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of CataniaCannizzaro Hospital
| | | |
Collapse
|
8
|
Chiche L, Dousset B, Kieffer E, Chapuis Y. Adrenocortical carcinoma extending into the inferior vena cava: Presentation of a 15-patient series and review of the literature. Surgery 2006; 139:15-27. [PMID: 16364713 DOI: 10.1016/j.surg.2005.05.014] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2005] [Revised: 05/15/2005] [Accepted: 05/20/2005] [Indexed: 11/30/2022]
Abstract
BACKGROUND Involvement of the inferior vena cava (IVC) is a controversial risk factor for surgical treatment of adrenocortical carcinoma (ACC). This study aims to assess the outcome of an aggressive surgical policy for ACC extending into the IVC and discuss treatment strategies based on a review of the literature. METHODS Over a 25-year period, 15 patients were treated for ACC extending into the IVC. The upper limit of the extension was the infrahepatic IVC in 2 patients, retrohepatic IVC in 6, and suprahepatic IVC in 7, including 4 with extension into the right atrium. Seven patients presented with concurrent metastases. The operative technique was thrombectomy (n = 13), partial resection with direct closure (n = 1), and total resection with replacement of the IVC (n = 1). Venous control was achieved by caval clamping alone (n = 4), hepatic vascular exclusion (n = 5), and the use of normothermic cardiopulmonary bypass or hypothermic circulatory arrest (n = 6). RESULTS Two patients died postoperatively. Ten patients died of metastatic complications at 4 to 31 months. Median survival time was 8 months. Three patients were still alive after 24, 25, and 45 months of follow-up, one of whom was reoperated at 17 months for a local recurrence. No evidence of recurrent intravenous involvement was found during follow-up in any patient in whom complete resection was achieved. CONCLUSIONS Our findings suggest that surgical treatment can be effective for management of ACC with extension into the IVC. Long-term prognosis is poor owing to delay in diagnosis, frequent associated metastatic disease and lack of effective adjuvant treatment.
Collapse
Affiliation(s)
- Laurent Chiche
- Department of Vascular Surgery, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de l'Hôpital, 75013 Paris, France.
| | | | | | | |
Collapse
|
9
|
Meyer A, Niemann U, Behrend M. Experience with the surgical treatment of adrenal cortical carcinoma. Eur J Surg Oncol 2004; 30:444-9. [PMID: 15063900 DOI: 10.1016/j.ejso.2004.01.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2004] [Indexed: 10/26/2022] Open
Abstract
UNLABELLED We report on a series of 20 consecutive patients (10 males, 10 females) with adrenal cortical carcinoma (ACC) who were treated by surgery between 1987 and 2001. AIM The aim of this study was to evaluate the outcome and the role of surgery in the management of this tumour. RESULT One patient was at stage I, five patients at stage II, five patients at stage III and nine patients at stage IV of disease. Ten patients suffered from a functioning tumour, whilst ten patients revealed non-functioning tumours. In all patients a transabdominal approach was performed for the complete resection of the tumour, adjacent organs or metastases. The medium survival after surgical resection, calculated by the Kaplan-Meier method, was 45 months for the overall group, 65 months for patients at stage I or II, 38 months for patients at stage III and 19 months for patients at stage IV of disease. The 5-year survival rate for all patients was 23%, for patients at stage I or II 33%, for patients at stage III 20%, and for patients at stage IV around zero. CONCLUSION Radical surgery with a complete resection of the tumour, adjacent organs, solitary metastases and loco-regional recurrence wherever possible improves survival, even at advanced stages of disease.
Collapse
Affiliation(s)
- A Meyer
- Abt. Strahlentherapie, Med. Hochschule, Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | | | | |
Collapse
|