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Unusual presentation of metastatic adenocarcinoma.

Bagwan IN, Cook G, Mudan S, Wotherspoon A - World J Surg Oncol (2007)

Bottom Line: Sixteen months later on staging CT scan a 2 x 2 cm adrenal mass was detected, which increased in size over a period of time to 3 x 3 cm in size.Adrenalectomy was performed and histological examination revealed metastatic adenocarcinoma within an adrenal adenoma.The present case highlights the unusual behaviour of an oesophageal adenocarcinoma causing metastasis to an adrenocortical adenoma.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Histopathology, The Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK. izhar_dr@yahoo.com

ABSTRACT

Background: The most common tumours of the adrenal gland are adenoma, pheochromocytoma, adrenocortical carcinoma, and metastases. Although the imaging features of these tumours are established, the imaging characteristics of uncommon adrenal masses are less well known. In patients with extradrenal tumour, incidental discovery of an adrenal mass necessitates excluding the possibility of metastatic malignancy.

Case presentation: A 52 year-old female was diagnosed with oesophageal adenocarcinoma and treated with oesophagectomy and adjuvant chemotherapy. Sixteen months later on staging CT scan a 2 x 2 cm adrenal mass was detected, which increased in size over a period of time to 3 x 3 cm in size. Adrenalectomy was performed and histological examination revealed metastatic adenocarcinoma within an adrenal adenoma.

Conclusion: The present case highlights the unusual behaviour of an oesophageal adenocarcinoma causing metastasis to an adrenocortical adenoma.

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A). CT scan image and B). 18FDG-PET scan.18FDG-PET scan with CT anatomical image fusion (axial view) shows an intense abnormal FDG uptake within the adrenal gland suggestive of metastasis or possibly a primary tumour.
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Figure 1: A). CT scan image and B). 18FDG-PET scan.18FDG-PET scan with CT anatomical image fusion (axial view) shows an intense abnormal FDG uptake within the adrenal gland suggestive of metastasis or possibly a primary tumour.

Mentions: A 52-year-old woman presented with complaints of dysphagia and hoarseness of voice in December 2003. She was diagnosed to have an advanced moderately differentiated oesophageal adenocarcinoma for which adjuvant chemotherapy was started. In May 2004, she underwent a transcervical oesophagectomy and gastric pull up followed by postoperative chemotherapy. The postoperative interval was uneventful. Staging CT scan performed in April 2005 revealed a 2 × 2 cm left adrenal mass. Half body positron emission tomography (PET) scan with 18F-2-fluoro-D-deoxyglucose (FDG) with CT anatomical image fusion performed in April 2005 and again in February 2006 revealed an increasing left adrenal mass measuring 3 × 3 cm in size. The left adrenal gland showed an intense abnormal FDG uptake (Figure 1). This metabolically active lesion was suggested to represent either a metastasis or possibly a primary adrenal tumour. FDG PET scan showed no other foci of metabolically active disease. The endocrine work-up showed that the adrenal tumour was hormonally non-functioning. Left adrenalectomy was performed and the specimen was sent for histopathological evaluation. Preoperative needle biopsy was not performed.


Unusual presentation of metastatic adenocarcinoma.

Bagwan IN, Cook G, Mudan S, Wotherspoon A - World J Surg Oncol (2007)

A). CT scan image and B). 18FDG-PET scan.18FDG-PET scan with CT anatomical image fusion (axial view) shows an intense abnormal FDG uptake within the adrenal gland suggestive of metastasis or possibly a primary tumour.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2100056&req=5

Figure 1: A). CT scan image and B). 18FDG-PET scan.18FDG-PET scan with CT anatomical image fusion (axial view) shows an intense abnormal FDG uptake within the adrenal gland suggestive of metastasis or possibly a primary tumour.
Mentions: A 52-year-old woman presented with complaints of dysphagia and hoarseness of voice in December 2003. She was diagnosed to have an advanced moderately differentiated oesophageal adenocarcinoma for which adjuvant chemotherapy was started. In May 2004, she underwent a transcervical oesophagectomy and gastric pull up followed by postoperative chemotherapy. The postoperative interval was uneventful. Staging CT scan performed in April 2005 revealed a 2 × 2 cm left adrenal mass. Half body positron emission tomography (PET) scan with 18F-2-fluoro-D-deoxyglucose (FDG) with CT anatomical image fusion performed in April 2005 and again in February 2006 revealed an increasing left adrenal mass measuring 3 × 3 cm in size. The left adrenal gland showed an intense abnormal FDG uptake (Figure 1). This metabolically active lesion was suggested to represent either a metastasis or possibly a primary adrenal tumour. FDG PET scan showed no other foci of metabolically active disease. The endocrine work-up showed that the adrenal tumour was hormonally non-functioning. Left adrenalectomy was performed and the specimen was sent for histopathological evaluation. Preoperative needle biopsy was not performed.

Bottom Line: Sixteen months later on staging CT scan a 2 x 2 cm adrenal mass was detected, which increased in size over a period of time to 3 x 3 cm in size.Adrenalectomy was performed and histological examination revealed metastatic adenocarcinoma within an adrenal adenoma.The present case highlights the unusual behaviour of an oesophageal adenocarcinoma causing metastasis to an adrenocortical adenoma.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Histopathology, The Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK. izhar_dr@yahoo.com

ABSTRACT

Background: The most common tumours of the adrenal gland are adenoma, pheochromocytoma, adrenocortical carcinoma, and metastases. Although the imaging features of these tumours are established, the imaging characteristics of uncommon adrenal masses are less well known. In patients with extradrenal tumour, incidental discovery of an adrenal mass necessitates excluding the possibility of metastatic malignancy.

Case presentation: A 52 year-old female was diagnosed with oesophageal adenocarcinoma and treated with oesophagectomy and adjuvant chemotherapy. Sixteen months later on staging CT scan a 2 x 2 cm adrenal mass was detected, which increased in size over a period of time to 3 x 3 cm in size. Adrenalectomy was performed and histological examination revealed metastatic adenocarcinoma within an adrenal adenoma.

Conclusion: The present case highlights the unusual behaviour of an oesophageal adenocarcinoma causing metastasis to an adrenocortical adenoma.

Show MeSH
Related in: MedlinePlus