Labile dissolved organic matter (DOM) and nitrogen inputs modified greenhouse gas dynamics: A source-to-estuary study of the Yangtze River.

Although rivers are increasingly recognized as essential sources of greenhouse gases (GHG) to the atmosphere, few systematic efforts have been made to reveal the drivers of spatiotemporal variations of dissolved GHG (dGHG) in large rivers under increasing anthropogenic stress and intensified hydrological cycling. Here, through a source-to-estuary survey of the Yangtze River in March (spring) and October (autumn) of 2018, we revealed that labile dissolved organic matter (DOM) and nitrogen inputs remarkably modified the spatiotemporal distribution of dGHG. The average partial pressure of CO2 (pCO2), CH4 and N2O concentrations of all sampling sites in the Yangtze River were 1015 ± 225 µatm, and 87.5± 36.5 nmol L-1, and 20.3 ± 6.6 nmol L-1, respectively, significantly lower than the global average. In terms of longitudinal and seasonal variations, higher GHG concentrations were observed in the middle-lower reach in spring. The dominant drivers of spatiotemporal variations in dGHG were labile, protein-like DOM components and nitrogen level. Compared with the historical data of dGHG from published literature, we found a significant increase in N2O concentrations in the Yangtze River during 2004-2018, and the increasing trend was consistent with the rising riverine nitrogen concentrations. Our study emphasized the critical roles of labile DOM and nitrogen inputs in driving the spatial hotspots, seasonal variations and annual trends of dGHG. These findings can contribute to constraining the global GHG budget estimations and controls of GHG emission in large rivers in response to global change.

Classification and morphological parameters of the coracoid process in Chinese population.

INTRODUCTION: The coracoid process is an important anatomical structure of the scapula, which can be used as a landmark in the diagnosis and treatment of scapula related diseases, such as acromioclavicular joint dislocation, anterior shoulder instability, and coracoid fractures. The aim of this study was to classify the coracoid process according to morphology and to measure the morphological parameters of the coracoid process. MATERIALS AND METHODS: A total of 377 dry and intact scapulae were collected and classified in terms of the connection between the shape of coracoid process and common things in life. The anatomical morphology and the position related to acromion and glenoid socket of the coracoid process were measured in each type by three independent researchers with a digital caliper. The measurements were averaged and recorded. RESULTS: Based on obvious morphological features, five specific types of the coracoid process were described: Type I, Vertical 8-shape; Type II, Long stick shape; Type III, Short stick shape; Type IV, Water drop shape, and Type V, Wedge shape. Type I (30%) and Type III (29%) were more prevalent in China. The tip width of the coracoid process of Type IV was the shortest and significantly different compared to the other types (p <.05), contrary to the longest in Type V. The tip thickness of the coracoid process of Type I was the shortest and significantly different from the other types (p <.05). CONCLUSIONS: The coracoid process was classified into five types based on obvious morphological features. Knowing of morphological classification and anatomical parameters of different types of the coracoid process, to some extent, may be helpful to diagnose and treat the shoulder joint disease, such as acromioclavicular joint dislocation, anterior shoulder instability, and coracoid fractures, and to theoretically reduce postoperative complications.

Plateau river research: spatial-temporal variations of δ18O and δd in the water of the Yarlung Tsangpo River and their controlling factors.

Stable isotope technology has been widely used to trace sources and evolution of water bodies, relationships between different water bodies and pollution sources. Based on δ18O and δD data from the Yarlung Tsangpo River in 2017, this paper analyzes the composition characteristics of δ18O and δD in the river water during the low-flow, high-flow and normal-flow seasons of the entire Yarlung Tsangpo River and further reveals the spatial evolution and influencing factors. The results show that the values of δ18O, δD and d-excess were different in time and space. The δ18O, δD and d-excess values of the Yarlung Tsangpo River in the low-flow season were significantly higher than in the high-flow season. This was mainly due to weak evaporation enrichment and precipitation supply effects on the river water during the wet season. From the perspective of season change, the d-excess in the low-season is significantly higher than in the high-flow season and the normal-flow season; from the perspective of spatial change, the d-excess shows the same spatial variation trend as the δ18O, which first decreases and then increases. Based on the investigation of δ18O and δD in the main and Branch rivers of the Yarlung Tsangpo River Basin, it was found that the upper reaches of the basin were mainly supplied by snowmelt, the lower reaches were mainly supplied by rainfall.

Classification of Hallucal Sesamoid Bone Correlated with Hallux Valgus Severity.

The hallucal sesamoid bones (HSBs), having an important role in reducing load per unit area on the first metatarsal head, can be injured commonly which also affected the first metatarsophalangeal joint and the surrounding structure. Meanwhile, differences among each HSB type may be a major factor affecting the occurrence and development of HV. So far, many researchers had learned that there are three different conditions in hallucal sesamoid bone affecting the choice of clinical surgery corresponding to different solutions in clinic. Thus, it is necessary to study the anatomical morphological characteristics of the HSB which can be helpful in clinical diagnosis and treatment, especially hallux valgus (HV). 150 X-ray and three-dimensional (3D) computed tomographic (CT) images consist of 72 left and 78 right metatarsals were applied in this anatomic study between two variables and showed by a simple scatter plot. The first metatarsophalangeal joint is divided into four different types: type I (no HSB, 1.3%), type II (with one HSB, 0.07%), type IIIa (with two HSBs when THB is bigger, 28%), type IIIb (with two HSBs when FHB is bigger, 65.3%), and type IV (with three HSBs, 4.7%). There was no statistical difference between the left and right sides, except HVA, Meary, and pitch (P < 0.05); all a, b, c, d, and i have statistical difference between male and female (P < 0.05). Meanwhile, HVA and IMA and HVA and type group have a significant correlation. In summary, HVA and IMA and HVA and classification of HSBs have significant correlations. The classification and location of HSBs can be an important basis to choose operation methods and postoperation evaluation.

Water environment in the Tibetan Plateau: heavy metal distribution analysis of surface sediments in the Yarlung Tsangpo River Basin.

To fully understand the environmental quality of sediments in the Yarlung Tsangpo River Basin, surface sediments of the main stream of the Yarlung Tsangpo River and its five major tributaries were studied. In 2016, a total of 201 water samples from the Yarlung Tsangpo River and its tributaries were collected during three water seasons. Fifteen trace elements (including Cd and heavy metals such as Cr, Cu, Pb, and As), which have great environmental effects, were analyzed. The results showed that Ti, Mn, and Cr were the main heavy metals in Yarlung Tsangpo River sediments, accounting for 51%, 10%, and 7% of the total heavy metals, respectively. There were no significant differences among the heavy metal contents in the sediments of Yarlung Tsangpo River among three water seasons, but there were significant spatial variations. During the same period, the concentration of each element in the tributary sediments was generally higher than that in the main stream. According to three different ecological risk assessment models, it is calculated that the heavy metal elements in the surface sediments of the river basin are at low or no pollution risk.

Plateau River research: ecological risk assessment of surface sediments in the Yarlung Tsangpo River.

To fully understand the environmental quality of sediments in the Yarlung Tsangpo River Basin, surface sediments of the mainstream of the Yarlung Tsangpo River and its five major tributaries were studied. In 2017, a total of 201 samples from the Yarlung Tsangpo River and its tributaries were collected during three water seasons. Fifteen trace elements (including Cd and heavy metals such as Cr, Cu, Pb, and As), which have great environmental effects, were analyzed. The results show that titanium, manganese, and chromium are the main heavy metals in the sediments of the Yarlung Zangbo River, accounting for 51%, 10%, and 7% of the total of 15 heavy metal elements measured, respectively. There were no significant differences among the heavy metal contents in the sediments of Yarlung Tsangpo River among three water seasons, but there were significant spatial variations. During the same period, the concentration of each element in the tributary sediments was generally higher than that in the mainstream. According to three different ecological risk assessment models, it is calculated that the heavy metal elements in the surface sediments of the river basin are at low or no pollution risk.

Quantitative source apportionment of water solutes and CO2 consumption of the whole Yarlung Tsangpo River basin in Tibet, China.

The Tibetan Plateau is known as the "Asian water tower," and the Yarlung Tsangpo (YT) River is the largest river that originates in and flows across the southern Tibetan Plateau. Although the solute source of YT River has been extensively and qualitatively analyzed, there is a lack of the quantitative analysis for the whole basin and seasonal variation of hydrochemical characteristics. Here, 212 samples obtained in the mainstream and tributary of YT River in different (wet, normal, and dry) periods were used for the solute apportionment using the mass balance model. The results showed that the solutes in YT River water were mainly derived from the carbonate and silicate rock weathering that accounts 42.2% and 26.9% in the total solute source, respectively, as the complex geological conditions in the basin. A part of the ions (7.5%) was also originated from the atmospheric precipitation as the abundant rainfall in the wet period. Meanwhile, the contribution of solute sources had no significantly seasonal variation in the upstream, whereas it had significantly seasonal variation in the downstream with the tropical climate and heavy rainfall. Importantly, the rock weathering of the basin could consume so much atmospheric CO2 (0.54% of the consumption at global with the only 0.16% of the global surface area) that could mitigate the global warming, which followed an increasing trend from upstream to downstream. The quantitative analysis of the solute source for YT River fills in the gaps in the chemically characteristic cognition of the basin. It is beneficial for the water resource management for the Asian. The proportion of solute sources in the YT River and its tributaries for wet (W), normal (N), and dry (D) periods.

Spatiotemporal variability of heavy metals and identification of potential source tracers in the surface water of the Lhasa River basin.

The Lhasa River basin is the economic and population center of Tibet and has abundant resources. Due to its harsh weather condition, high elevation, and inconvenient accessibility, few studies have focused on heavy metal distributions in this region. In the present study, to investigate the dissolved trace metal pollution and its controlling factors, 57 water samples from the Lhasa River and its tributaries were collected during three water flow regimes in 2016. The data on the dissolved fraction revealed that the Lhasa River basin appeared to have no to low pollution levels. However, the Lhasa River water showed alkaline characteristics which may affect the presence of heavy metal elements in a dissolved fraction. The concentration of heavy metal elements in colloidal or particulate matter therefore needs attention. Multivariate analyses were performed to determine the significant relationship between the data and to identify controlling factors for dissolved heavy metals in the study area. The results suggested that Mn, Cd, Cu, and Zn originated from a natural geological background, whereas Pb originated from mining drainage and As was influenced by geothermal flows. The concentration of dissolved heavy metals in the Meldromarchu tributary was greatly affected by the mining drainage water, while that in the Tölungchu tributary was greatly influenced by the geothermal water sources. This paper provides the first comprehensive analysis of dissolved heavy metal pollution characteristics and the controlling factors of pollution during the three different water flow regimes of the Lhasa River basin.

Multilocular cystic renal cell carcinoma: A case report and review of the literature.

Multilocular cystic renal cell carcinoma (MCRCC), which exhibits low-stage and low-grade characteristics, is a special type of RCC. MCRCC is extremely rare and generally develops at ages >50 years. We herein report a case of MCRCC in a 28-year-old man, which, to the best of our knowledge, is the youngest case reported worldwide to date. The patient presented with irritative bladder symptoms for 1 year. Dynamic enhanced computed tomography (CT) imaging revealed a mass with inhomogeneous enhancement in the left kidney, with a rich blood supply. B-ultrasonography also revealed a renal protruding mass. As the mass was highly suspicious to be a malignant tumor, laparoscopic radical nephrectomy was performed and MCRCC was definitively diagnosed by pathological examination. The patient has been regularly followed up for 6 months, without complications or disease recurrence.

miR-514a-3p functions as a tumor suppressor in renal cell carcinoma.

Renal cell carcinoma (RCC) is the most common type of kidney cancer, and the prognosis of metastatic RCC remains poor with a high rate of recurrence and mortality. A previous study has revealed that microRNA (miRNA), which negatively regulates protein expression, serves a role of oncogene or tumor suppressor. The aim of the present study was to investigate the expression and function of miR-514a-3p in RCC. To detect the expression of miR-514a-3p in 32 paired RCC tissues, quantitative polymerase chain reaction (qPCR) was performed. The function of miR-514a-3p in the proliferation, mobility and apoptosis of RCC cells (786-O and ACHN) was assessed by MTT, CCK-8, cell scratch, Transwell, Hoechst 33342 staining and flow cytometry assay. The results of qPCR revealed that miR-514a-3p was significantly downregulated in RCC tissues compared with adjacent normal tissues. Upregulation of miR-514a-3p by transfection of mimics suppressed RCC cell proliferation, migration and invasion, and induced cell apoptosis. The results revealed that miR-514a-3p was significantly downregulated in RCC and may serve a role as tumor suppressor in RCC. Further studies are required, focusing on the possibility of using miR-514a-3p as a biomarker for RCC as well as the pathway of miR-514a-3p in RCC.

MicroRNA­24­2 is associated with cell proliferation, invasion, migration and apoptosis in renal cell carcinoma.

Micro (mi)RNAs are involved in multiple cellular processes, and alterations in miRNA expression have been demonstrated to lead to tumorigenesis. Previous microarray analysis revealed that miRNA (miR)­24 was downregulated in renal cell carcinoma (RCC). Additionally, miR­24 has been identified as an oncogene and tumor suppressor in various cancers. The present study assessed the expression levels of two stem­loops of miR­24, miR­24­1 and miR­24­2, in RCC tissues and paired healthy tissues by reverse transcription­quantitative polymerase chain reaction. The results revealed that miR­24­2 was upregulated in RCC tissues and ACHN, 786­O and 769P cell lines compared with healthy tissues and HEK­293T cells, respectively, whereas miR­24­1 was almost absent in RCC and healthy kidney tissues. To investigate the role of miR­24­2 in RCC, a synthesized miR­24­2 mimic, negative control (NC), inhibitor or inhibitor NC was transfected into 786­O and ACHN RCC cells, and cell proliferation, mobility and apoptosis assays were performed. The results of the present study revealed that miR­24­2 was associated with cell proliferation, migration, invasion and apoptosis, thus demonstrating that miR­24­2 may serve a role as an oncogene in RCC. Further studies are required to investigate the signaling pathways of miR­24­2, and the potential of miR­24­2 as a therapeutic target or biomarker for the early detection of RCC.

miR-125b is associated with renal cell carcinoma cell migration, invasion and apoptosis.

MicroRNA (miR)-125b has been identified as deregulated in a number of types of cancer. Previous studies have detected the expression of miR-125b in clear cell renal cell carcinoma (ccRCC) tissues by in situ hybridization and revealed that miR-125b was upregulated in ccRCC tissues, and was associated with recurrence and survival of patients with ccRCC. However, the function of miR-125b in RCC remains unclear. Thus, the expression of miR-125b was detected with quantitative polymerase chain reaction (qPCR) in 24 paired RCC and adjacent normal tissues. The result of qPCR showed that miR-125b was upregulated in RCC tissues. Furthermore, the function of miR-125b in RCC (786-O and ACHN) cells was detected by transfecting miR-125 mimic or inhibitor to upregulate or downregulate miR-125b expression. Cell proliferation assays (MTT and Cell Counting Kit-8), cell mobility assays (cell scratch and Transwell assay) and a cell apoptotic assay (flow cytometry assay) were performed to assess the function of miR-125b on RCC cells. Results from the assays demonstrated that overexpression of miR-125b could promote cell migration and invasion, and reduce the cell apoptotic rate. It was also revealed that downregulation of miR-125b could reduce cell migration and invasion, and induce cell apoptosis. However, the results of the cell proliferation assay revealed that miR-125b had no significant effect on cell proliferation. Not only could miR-125b predict recurrence and survival of ccRCC; the present study revealed that miR-125b could regulate RCC cell migration, invasion and apoptosis. Additional studies are required to determine the mechanism of miR-125b in RCC cells and define the target genes of miR-125b in RCC.

Identification of miR­30b as an oncogene in renal cell carcinoma.

microRNAs (miRs) have been investigated as a novel class of regulators of cellular processes, including proliferation, apoptosis and metabolism. In particular, miR­30b has been demonstrated to be deregulated in certain types of cancer, including lung, colorectal and gastric cancer. Previous studies of miR­30b in renal clear cell carcinoma demonstrated that the expression level of miR­30b was associated with distant metastasis. However, the function of miR­30b in renal cell carcinoma (RCC) remained to be elucidated. In the present study, the expression of miR­30b in 31 paired RCC tissues from four cell lines (786­O, 769­P, ACHN and 293T) was detected by reverse transcription­quantitative polymerase chain reaction. In addition, the effect of miR­30b on cell proliferation in RCC cells was also determined using MTT and Cell Counting Kit­8 assay analyses. Furthermore, the function of miR­30b in cell migration and invasion was determined by wound scratch and Transwell assays. Flow cytometry was also performed to quantify the effect of miR­30b on cell apoptosis. The results of the current study indicated that miR­30b was upregulated in RCC tissues from affected cell lines when compared with adjacent normal tissues and a normal kidney cell line, which is different to the downregulation of miR­30b as observed in other types of cancer. miR­30b is associated with RCC cell proliferation, invasion, migration and apoptosis, which indicated that miR­30b acts as an oncogene in RCC. To the best of our knowledge, the present study is the first to demonstrate the upregulation of miR­30b in RCC tissues and describe miR­30b as an oncogene in RCC in the regulation of cell proliferation, migration, invasion and apoptosis. Further studies will define the target gene of miR­30b in RCC and investigate the potential role of miR­30b as a biomarker for RCC.

Identification of miR­195­3p as an oncogene in RCC.

There is increasing evidence that the deregulation of microRNAs (miRNAs; miRs) contributes to tumorigenesis. Previous studies have shown that miR­195 is downregulated in various types of cancer. The present study aimed to investigate the function and expression levels of miR­125b. Results of qPCR revealed that miR­195­3p, the mature sequence of miR­195, was upregulated in renal cell carcinoma (RCC) tissues and cell lines (786­O, 769P and ACHN). This indicated that the function and role of miR­195­3p may differ in different types of tumor. To assess the function of miR­195­3p in RCC cell lines, cell proliferation was examined using MTT and CCK­8 assays, mobility was assessed using a cell scratch assay, Transwell migration assay and invasion assay, and apoptosis was examined using flow cytometry. These assessments were also performed in cells with upregulated or downregulated miR­195­3p via transfection with synthesized miR­195­3p mimic or inhibitor. The results revealed that the overexpression of miR­195­3p promoted 786­O and ACHN RCC cell proliferation, migration and invasion, and inhibited cell apoptosis, whereas the downregulation of miR­195­3p suppressed cell proliferation, migration and invasion, and induced cell apoptosis. These results indicated that miR­195­3p was associated with the tumorigenesis of RCC, with further investigations to focus on the pathway and use of miR­195­3p as a clinical biomarker for RCC.

miR­15a­5p acts as an oncogene in renal cell carcinoma.

miRNAs have been reported to be involved in multiple cellular processes and the tumorigenesis of various cancers. miR­15a­5p (also termed miR­15a) has previously been determined to be upregulated in renal cell carcinoma (RCC) by microarray profile. However, the expression and function of miR­15a­5p in RCC remain to be validated. In the present study, reverse transcription­quantitative polymerase chain reaction (RT­qPCR) was performed to detect the expression levels of miR­15a­5p in RCC tissues and cells. The expression level of miR­15a­5p was upregulated or downregulated by transfecting synthesized miR­15a­5p mimics or inhibitors. The MTT assay, CCK­8 assay, Transwell assay, wound healing assay, Hoechest 33342 staining and flow cytometry were conducted to investigate the role of miR­15a­5p in RCC. The results of the RT­qPCR demonstrated that miR­15a­5p was upregulated in RCC tissues and ACHN, 786­O and 769P RCC cells compared with paired normal tissues and HEK­293T cells. miR­15a­5p was observed to be associated with RCC cell proliferation, migration, invasion and apoptosis. The results demonstrated that miR­15a­5p may be important as a tumor promoter in RCC. To the best of our knowledge, the present study is the first to describe miR­15a­5p as a tumor promoter in RCC. Further research will be performed to investigate the underlying signaling pathway of miR­15a­5p and the potential role of miR­15a­5p as a biomarker for early detection, prognosis prediction and a therapeutic target of RCC.

Glomus tumor of the anterior urethra: A rare case report and review of the literature.

Glomus tumors are rare and benign neoplasms, which normally originate from peripheral soft tissue. To date, reported cases of glomus tumor occurring in genitourinary tract, particularly in the urethra, are exceedingly rare. The present study presented a rare case of glomus tumor of the anterior urethra in a 42 year-old male, his main complaints were a history of anterior urethra pain for 3 years, and a palpable and tender mass in the urethra for 2 weeks. Urethrocystoscopy examination and the resection of the urethral mass were performed. Pathological and immunohistochemical examination revealed that the mass was a benign glomus tumor. The patient remained in good condition by 6 month follow-up, and revealed no problems or recurrence following surgery. This is the first case, to the best of our knowledge, to present a glomus tumor occurring in a male's urethra and the present report provided a supplementary review for the previous cases and the literature.

Bellini's duct carcinoma: A report of two cases and a review of the literature.

Bellini's duct carcinoma (BDC) is a rare and aggressive variant of renal cell carcinoma that possesses an extremely poor prognosis. The greater the grade or stage of disease, the poorer the prognosis tends to be. This study presents two cases of BDC; one case of low grade BDC and one case of high grade BDC in a 47-year-old male and 74-year-old female, respectively. The 47-year-old male patient presented with painless gross hematuria, which had lasted for 3 weeks and subsequently underwent purely laparoscopic nephroureterectomy. After 4-years of follow-up, the patient remained disease-free. By contrast, a right renal tumor was identified in the 74-year-old female patient during a routine examination. Radical right nephrectomy and lymph node dissection were performed, however, 10 months after surgery the patient succumbed due to wide-spread metastasis. The two cases reported in the present study not only represent excellent examples of the disease spectrum, but also act as a reminder of the possibility of detecting BDC in an early stage of disease. Therefore, the epidemiology of BDC has been discussed, and the aggressive growth pattern of BDC has been presented in terms of signs, symptoms and imaging examinations, including ultrasonography, computed tomography (CT), angiography and single photon emission CT, in the early stage of disease.

Tumor suppressive miR-196a is associated with cellular migration, proliferation and apoptosis in renal cell carcinoma.

Certain microRNAs (miRs) are implicated in the genesis and progression of various cancers by regulating multiple cellular processes, including apoptosis, proliferation and migration. The aim of the present study was to explore the functions of miR­196a in renal cell carcinoma (RCC). RCC and paired normal tissues we assessed for miR­196a expression by reverse-transcription quantitative PCR. Furthermore, the effects of miR­196a on renal cell proliferation, apoptosis and migration were determined using an MTT assay, flow cytometry and a scratch wound assay following restoration of miR-196a with synthetic mimics. miR­196a was found to be significantly downregulated in RCC tissues compared with that in normal tissues (P<0.05). In addition, miR­196a suppressed cell proliferation, apoptosis and migration of the 786­O and ACHN RCC cell lines. To the best of our knowledge, the present study was the first to report this tumor suppressor role of miR­196a in RCC. The results indicated that miR­196a may be a potential diagnostic biomarker for RCC and that transfection of miR-196a mimics may represent a novel treatment strategy for RCC.

miR­30a­5p in the tumorigenesis of renal cell carcinoma: A tumor suppressive microRNA.

Renal cell carcinoma (RCC) is the most common type of malignant tumor of the adult kidney and has a poor prognosis. MicroRNAs (miRs) are important in a wide range of biological and pathological processes, including cell differentiation, migration, growth, proliferation, apoptosis and metabolism. The present study aimed to determine the role exerted by miR­30a­5p in the tumorigenesis of RCC. The expression levels of miR­30a­5p in RCC tissues and RCC­derived cells were demonstrated to be significantly downregulated by real­time quantitative polymerase chain reaction (RT­qPCR). Wound scratch assay, cell proliferation assay and flow cytometric analysis revealed that the abilities of migration and proliferation of the RCC­derived cells were suppressed, whereas cell apoptosis was promoted, when miR­30a­5p was overexpressed in these cells. N­acetylgalactosaminyltransferase 7 (GALNT7) was predicted to be one target gene of miR­30a­5p by bioinformatics analysis. Luciferase reporter assay, RT­qPCR and western blotting were performed to confirm that GALNT7 is the direct conserved target of miR­30a­5p. These results suggested that miR­30a­5p has a tumor­suppressive role in the tumorigenesis of RCC.

Left adrenal gland metastasis of breast invasive ductal carcinoma: A case report.

The majority of the metastatic lesions of the adrenal gland normally originate from lung cancer, colon malignant tumor, renal cell carcinoma and melanoma. However, adrenal gland metastasis that metastasize from breast invasive ductal carcinoma are extremely rare. The present study reported a rare case of left adrenal gland metastasis in a 35-year-old female who was diagnosed as breast carcinoma 5 years ago with a mass located on the left adrenal gland, which was detected during a routine examination. The patient was asymptomatic and adrenal gland computed tomography revealed a mass in the left adrenal gland. Definitive preoperative diagnosis failed to be established. Left adrenal gland laparoscopic adrenalectomy was performed and the diagnosis of adrenal gland metastasis of breast invasive ductal carcinoma was confirmed by pathological and immunohistochemical examination. The patient remained in good condition by the time of writing.