RESUMO
OBJECTIVE: To describe an additional case of this rare disease entity, with special reference to its diagnosis and treatment, and to briefly review the literature. METHODS: We report on an 82-year-old male with adrenal myelolipoma that had been incidentally discovered during evaluation for another condition. A left adrenalectomy was performed due to the large size of the tumor and in order to determine its benign or malignant nature. RESULTS: The histopathological findings disclosed an andrenal myelolipoma. CONCLUSIONS: Adrenal myelolipoma is an uncommon tumor type. CT is the most effective diagnostic method. Surgery is advocated in symptomatic cases and in asymptomatic cases with a large tumor mass.
Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico , Mielolipoma/induzido quimicamente , Idoso , Idoso de 80 Anos ou mais , Humanos , MasculinoRESUMO
Presentation of 6 cases of pheochromocytoma, diagnosed and treated in our Unit over the last 5 years. Five were adrenal pheochromocytomas and 1 an abdominal paraganglioma in a 42 year-old woman. Distribution by gender was 4 male and 2 female, and mean age at presentation was 45.2 years ranging from 35 to 55 years. Clinically, all patients were hypertensive. Two of the 5 cases with adrenal location presented with catecholaminic crisis with BP > 240/140 mmHg. The paraganglioma was diagnosed while studying a case of sustained HBP in a 42 year-old female referred from another unit. With regard to diagnosis, the sensitivity of urinary tests was 100%, and gammagraphy with meta-iodine-benzyl-guanidine (MIBG) was particularly useful in the extra-adrenal location case. In all our patients, computerized tomography (CT) was the choice procedure to locate the tumour. Treatment was surgical in all cases, access being transperitoneal in 3 cases, thoracoabdominal in 2 and classic lumbotomy in 1. All our patients received prior treatment with alpha-blocking agents, and intraoperative complications were 1 arrythmic crisis, 1 hypotensive picture and 1 hypertensive crisis, all of which resolved successfully. Currently, 5 patients remain disease free. Mild HBP controlled with low dose captopril still persists in one patient.