1
|
Zhang X, Zhang Y, Peng D, Shi X, Zhang Z, Wang J, Zhang X, Leng J, Li W. Adrenal ganglioneuroblastoma with metastasis near the renal hilum in an adult female: A case report and review of the literature. Oncol Lett 2024; 27:187. [PMID: 38486945 PMCID: PMC10938287 DOI: 10.3892/ol.2024.14319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
Ganglioneuroblastoma (GNB), predominantly observed in children, is an uncommon malignant tumor in adults, with established treatment protocols notably lacking. The present study details the case of a 20-year-old woman who presented with a left adrenal gland mass, identified during a physical examination. Additionally, an unidentified mass was noted near the renal hilum in the preoperative evaluation. Following thorough preoperative preparation, both the primary adrenal gland mass and the renal hilar mass were surgically removed. The procedure concluded successfully. Pathological analysis confirmed that the left adrenal mass was a GNB and identified the renal hilar mass as a metastatic extension. Postoperative examination revealed a new formation at the original surgical site, later verified as a postoperative scar. Through the publication of a case report and extensive literature review, the present study aims to enhance our understanding of this condition, providing valuable diagnostic, therapeutic and post-recovery references for this rare adult disease.
Collapse
Affiliation(s)
- Xinzhang Zhang
- Department of Urology, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650100, P.R. China
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Yiwen Zhang
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Dan Peng
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Xin Shi
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Zhuorui Zhang
- Department of Urology, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650100, P.R. China
| | - Junfeng Wang
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Xue Zhang
- Department of Management Science and Information System, Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Jinjun Leng
- Department of Urology, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650100, P.R. China
| | - Wei Li
- Department of Urology, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650100, P.R. China
| |
Collapse
|
2
|
Kumata H, Nishimura R, Nakanishi C, Inoue C, Tezuka Y, Endo H, Miyagi S, Tominaga T, Unno M, Kamei T. Surgical strategy for an adult patient with a catecholamine-producing ganglioneuroblastoma and a cerebral aneurysm: a case report. Surg Case Rep 2018; 4:119. [PMID: 30225726 PMCID: PMC6141414 DOI: 10.1186/s40792-018-0529-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/12/2018] [Indexed: 11/15/2022] Open
Abstract
Background Ganglioneuroblastomas, particularly those that produce catecholamine, are extremely rare in adults. Here, we report an interesting surgical case of an adult patient with a catecholamine-producing ganglioneuroblastomas in her adrenal gland, suspected to be a pheochromocytoma, and with a cerebral aneurysm. Case presentation The patient was a 73-year-old woman under treatment for hypertension. During a health check-up, a cystic retroperitoneal tumor was incidentally found in the superior pole of her right kidney. Her blood adrenaline level was slightly elevated, and her urinary adrenaline, noradrenaline, and dopamine levels were above the upper reference limits. In addition, 24-h urinary excretion of metanephrine, normetanephrine, and vanillylmandelic acid were all increased. 123I-Meta-iodobenzylguanidine scintigraphy showed an abnormal accumulation of the marker in the cyst wall. She was, therefore, diagnosed with a pheochromocytoma and scheduled for tumor resection. However, preoperatively, 8-mm-diameter cerebral aneurysm was incidentally found in her basilar artery. This required careful preoperative discussion. The aneurysm was difficult to approach and treat, and based on its position, shape, and size, the risk of rupture was low. Because hypertension is a major risk factor for aneurysmal rupture, we decided to proceed with the tumor resection. A lumbar catheter was placed to monitor the cerebral aneurysm for intraoperative rupture, and her transcranial motor-evoked potential and somatosensory-evoked potentials were monitored to track her intraoperative neurological function. During surgery, we carefully monitored fluctuations in blood pressure and resected the tumor with minimal mobilization. Postoperatively, head computed tomography confirmed that there was no sign of rupture. Histopathologically, the tumor was diagnosed as a catecholamine-producing ganglioneuroblastoma. The postoperative course was good, and the patient’s blood pressure improved. Conclusions Careful perioperative management is needed for a patient with both a catecholamine-producing tumor and cerebral aneurysm.
Collapse
Affiliation(s)
- Hiroyuki Kumata
- Department of Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan.
| | - Ryuichi Nishimura
- Department of Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan
| | - Chikashi Nakanishi
- Department of Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan
| | - Chihiro Inoue
- Department of Pathology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan
| | - Yuta Tezuka
- Division of Nephrology, Endocrinology and Vascular Medicine Tohoku University Graduate School of Medicine, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan
| | - Hidenori Endo
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan
| | - Shigehito Miyagi
- Department of Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan
| | - Michiaki Unno
- Department of Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan
| | - Takashi Kamei
- Department of Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan
| |
Collapse
|
3
|
Giant, dopamine secreting thoracoabdominal neuroblastoma in a 2-year-old: rapid preoperative blockade with labetalol. J Pediatr Hematol Oncol 2010; 32:163-6. [PMID: 20147848 DOI: 10.1097/mph.0b013e3181cf1175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Neuroblastomas secreting large amounts of catecholamines may require preoperative antihypertensive treatment to avoid intraoperative hypertensive crises as do pheochromocytomas. This is typically achieved with alpha-adrenergic followed if necessary by beta-adrenergic receptor blockade. Because of its predominant beta-blockade, labetalol as a combined alpha-adrenergic and beta-adrenergic receptor antagonist is relatively contraindicated as sole and first agent in pheochromocytomas releasing epinephrine and norepinephrine. We report successful monotherapy with labetalol over 24 hours in a 2-year-old child with a giant thoracoabdominal neuroblastoma and predominant dopamine secretion.
Collapse
|