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A rare coexistence of non-functional adrenocortical carcinoma and multicentric papillary thyroid microcarcinoma: a case report.

Karakose M, Hasdemir O, Cakal E, Delibasi T - J Med Case Rep (2013)

Bottom Line: The patient did not have specific signs and symptoms of hormone excess.The patient was also found to have a multicentric papillary thyroid microcarcinoma.When an endocrine tumor is diagnosed, endocrinologists must be consider the possibility of the existence of another endocrine tumor.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Altindag, Ankara, Turkey. meliakarakose@yahoo.com.

ABSTRACT

Introduction: In this report, we describe a rare case of papillary thyroid carcinoma with adrenocortical carcinoma without excess hormone production.

Case presentation: A 40-year-old Turkish man was admitted to our institution with a large left adrenal mass that was identified during the work-up for shortness of breath. The patient did not have specific signs and symptoms of hormone excess. The mass was removed surgically. The pathological findings were consistent with adrenocortical carcinoma. The patient was also found to have a multicentric papillary thyroid microcarcinoma.

Conclusion: Most adrenocortical carcinomas and papillary thyroid carcinomas are sporadic; however, the occurrence of two different endocrine neoplasms during the same period of time is a rare situation, but it is possible, as in our patient. When an endocrine tumor is diagnosed, endocrinologists must be consider the possibility of the existence of another endocrine tumor.

No MeSH data available.


Related in: MedlinePlus

Dynamic magnetic resonance imaging scans (left adrenal mass).
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Figure 1: Dynamic magnetic resonance imaging scans (left adrenal mass).

Mentions: A 40-year-old Turkish man who presented to our institution with shortness of breath was evaluated by computed tomography. A mass in his left adrenal gland was diagnosed incidentally. A magnetic resonance imaging (MRI) scan showed a large mass measuring 8×9.5×10.4cm in diameter in the left adrenal gland area (Figure 1). His serum cortisol, adrenocorticotropic hormone, dehydroepiandrosterone sulfate, total testosterone, urinary metanephrine, serum electrolytes (Na+, K+,Cl–), fasting blood glucose, and fasting insulin levels were normal. Plasma cortisol was suppressed after administration of 1mg dexamethasone. The patient was diagnosed with a non-functional adrenal mass, and a left adrenalectomy was performed. The resected tumor was 11×9×6cm in size and weighed 339g. The tumor was of high nuclear grade and had diffuse architecture, focal necrotic areas, more than 5 mitoses per 50 high-power fields, and an infiltrated capsule. Sinusoidal vascular infiltration was observed, but clear cells were less than 25%. Immunohistochemical studies showed that melan-A and inhibin were positive, and thyroid transcription factor-1 (TTF-1) and thyroglobulin were negative. The pathological findings were consistent with ACC. Treatment with adjuvant radiotherapy with concurrent mitotane was planned for the patient.


A rare coexistence of non-functional adrenocortical carcinoma and multicentric papillary thyroid microcarcinoma: a case report.

Karakose M, Hasdemir O, Cakal E, Delibasi T - J Med Case Rep (2013)

Dynamic magnetic resonance imaging scans (left adrenal mass).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750629&req=5

Figure 1: Dynamic magnetic resonance imaging scans (left adrenal mass).
Mentions: A 40-year-old Turkish man who presented to our institution with shortness of breath was evaluated by computed tomography. A mass in his left adrenal gland was diagnosed incidentally. A magnetic resonance imaging (MRI) scan showed a large mass measuring 8×9.5×10.4cm in diameter in the left adrenal gland area (Figure 1). His serum cortisol, adrenocorticotropic hormone, dehydroepiandrosterone sulfate, total testosterone, urinary metanephrine, serum electrolytes (Na+, K+,Cl–), fasting blood glucose, and fasting insulin levels were normal. Plasma cortisol was suppressed after administration of 1mg dexamethasone. The patient was diagnosed with a non-functional adrenal mass, and a left adrenalectomy was performed. The resected tumor was 11×9×6cm in size and weighed 339g. The tumor was of high nuclear grade and had diffuse architecture, focal necrotic areas, more than 5 mitoses per 50 high-power fields, and an infiltrated capsule. Sinusoidal vascular infiltration was observed, but clear cells were less than 25%. Immunohistochemical studies showed that melan-A and inhibin were positive, and thyroid transcription factor-1 (TTF-1) and thyroglobulin were negative. The pathological findings were consistent with ACC. Treatment with adjuvant radiotherapy with concurrent mitotane was planned for the patient.

Bottom Line: The patient did not have specific signs and symptoms of hormone excess.The patient was also found to have a multicentric papillary thyroid microcarcinoma.When an endocrine tumor is diagnosed, endocrinologists must be consider the possibility of the existence of another endocrine tumor.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Altindag, Ankara, Turkey. meliakarakose@yahoo.com.

ABSTRACT

Introduction: In this report, we describe a rare case of papillary thyroid carcinoma with adrenocortical carcinoma without excess hormone production.

Case presentation: A 40-year-old Turkish man was admitted to our institution with a large left adrenal mass that was identified during the work-up for shortness of breath. The patient did not have specific signs and symptoms of hormone excess. The mass was removed surgically. The pathological findings were consistent with adrenocortical carcinoma. The patient was also found to have a multicentric papillary thyroid microcarcinoma.

Conclusion: Most adrenocortical carcinomas and papillary thyroid carcinomas are sporadic; however, the occurrence of two different endocrine neoplasms during the same period of time is a rare situation, but it is possible, as in our patient. When an endocrine tumor is diagnosed, endocrinologists must be consider the possibility of the existence of another endocrine tumor.

No MeSH data available.


Related in: MedlinePlus