A case of robot‐assisted adrenalectomy performed for an adrenal tumor (anastomosing hemangioma) exceeding 7 cm

Nishikimi, Toshinori; Mizuno, Hideki; Kashima, Ayano; Morikami, Hiroko; Ishiguro, Shigeki; Ohashi, Tomoyoshi; Yamada, Hiroshi

doi:10.1002/iju5.12517

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…Interestingly, none of the patients have presented with a haemorrhagic incident. The largest lesion reported so far was 7.2×6.4×5.6 cm in size by Nishikimi et al and the patient underwent robot-assisted left adrenalectomy 11. All diagnoses were confirmed at adrenalectomy except one where CT-guided biopsy was performed 22…”

Section: Discussionmentioning

confidence: 92%

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Anastomosing haemangioma of adrenal gland: an unusual vascular tumour

Rewari,

Wadhwa,

Talwar

et al. 2024

BMJ Case Rep

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With only 15 reported cases, anastomosing haemangioma of adrenal is a rare entity and usually presents as adrenal incidentaloma. A hypertensive, diabetic, non-smoker man in his late 60s presented with irritative voiding symptoms. On evaluation, he was found to have a urinary bladder mass and left adrenal incidentaloma measuring 8 cm. Metabolic evaluation confirmed it to be non-functional.The patient underwent transurethral resection of bladder tumour with left laparoscopic adrenalectomy. Intraoperatively, the adrenal tumour was highly vascular with multiple feeder vessels. Grossly it was soft, encapsulated with focal grey-brown areas. Microscopically, most of adrenal gland was replaced by anastomosing proliferating capillary vessels within framework of non-endothelial supporting cells reminiscent of splenic sinusoids. The tumour was positive for CD-31, CD-34, Glut-1 and SMA.Anastomosing haemangioma is a benign entity but it must be differentiated from angiosarcoma. Characteristic imaging features are not yet defined and is, therefore, difficult to diagnose preoperatively.

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Section: Discussionmentioning

confidence: 92%

“…Since then, around 64 cases of AH have been reported, adrenal as a site for AH was first described by Ross et al 10. Since then, only 15 cases have been reported; the largest being a case series of 7 cases in a retrospective 25-year analysis of adrenal pathologies at the Cleveland Clinic 11–17…”

Section: Discussionmentioning

confidence: 99%

Anastomosing haemangioma of adrenal gland: an unusual vascular tumour

Rewari,

Wadhwa,

Talwar

et al. 2024

BMJ Case Rep

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“…7 To date, 10 anastomosing haemangiomas of the adrenal gland have been reported, 5,7-12 but two were actually periadrenal soft tissue in location. 13,14 In Table 2, we present clinicopathological and radiological findings from six of the eight reported cases of adrenal anastomosing haemangioma for which the data were available. The mean age of patients in our study (61 years, range = 37-75) was higher than that reported in the literature (49 years, range = 32-68), while the gender distribution was similar.…”

Section: Discussionmentioning

confidence: 99%

“…The true incidence of anastomosing haemangioma in the adrenal gland is not known, due to its rarity, but estimates suggest that 3–4% of all anastomosing haemangiomas arise in the adrenal gland 7 . To date, 10 anastomosing haemangiomas of the adrenal gland have been reported, 5,7–12 but two were actually peri‐adrenal soft tissue in location 13,14 . In Table 2, we present clinicopathological and radiological findings from six of the eight reported cases of adrenal anastomosing haemangioma for which the data were available.…”

Section: Discussionmentioning

confidence: 99%

Anastomosing haemangioma of the adrenal gland: A clinicopathological series of seven cases

et al. 2023

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AimsAnastomosing haemangioma is a rare benign vascular neoplasm that may histologically mimic angiosarcoma. We report the largest single institution series of anastomosing haemangioma in the adrenal gland with emphasis on clinical and radiological features.Methods and resultsOur laboratory information system was searched for a 25‐year period (1999–2023), yielding seven cases confirmed as anastomosing haemangioma of the adrenal gland after pathological re‐review. Clinical, radiological and pathological information was obtained from medical charts and submitting pathologists. Of a total of seven patients, four (57.1%) were men and three women, ranging in age from 37 to 75 years (mean = 61). Six of seven patients underwent adrenalectomies and one had radical nephrectomy. Tumours ranged from 0.7 to 6.4 cm (mean = 2.1 cm) and five of seven (71%) were grossly well‐circumscribed. Five of seven lesions were found incidentally at imaging for other indications. All tumours were unifocal except one, which presented with multifocal disease with a concurrent adjacent retroperitoneal anastomosing haemangioma. Three of five tumours imaged with contrast enhancement were almost completely hyperenhancing with a small central non‐enhancing portion, features overlapping with pheochromocytoma. One of seven tumours involved the peri‐adrenal adipose tissue with a focally infiltrative pattern. There were no recurrences or metastases in six patients with available follow‐up data (median = 95 months).ConclusionsBenign anastomosing haemangiomas of the adrenal gland tend to occur in older patients, may mimic pheochromocytoma on imaging and must be distinguished from angiosarcoma pathologically. Better awareness of this entity by pathologists, radiologists and surgeons is crucial to appropriate work‐up, diagnosis and management.

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Robot-Assisted Surgery and Multigene Panel Testing for Pheochromocytoma and Paraganglioma Syndrome

Takagi,

Hashimoto,

Muramatsu-Maekawa

et al. 2024

Cureus

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Pheochromocytoma and paraganglioma are often associated with hereditary syndromes, particularly those involving genes such as RET, which is linked to multiple endocrine neoplasia type 2A. Genetic testing plays a crucial role in diagnosing these conditions, guiding treatment strategies, and providing early intervention options for the affected families. A 57-year-old man presenting with back pain was found to have a left adrenal tumor and a retroperitoneal tumor near the left renal hilum. Hormonal studies and imaging confirmed the diagnosis of pheochromocytoma and paraganglioma. The patient underwent robot-assisted laparoscopic surgery to remove the tumors. Postoperative multigene panel testing identified a mutation in RET c.1901G > T (p.Cys634Phe) leading to the diagnosis of multiple endocrine neoplasia type 2A. Despite this genetic finding, no other endocrine tumors, such as medullary thyroid cancer or hyperparathyroidism, were detected at the time of diagnosis. The patient remains under close surveillance for the potential development of associated conditions. This case highlights the importance of comprehensive genetic testing in patients with pheochromocytoma and paraganglioma, particularly when hereditary syndromes are suspected. Genetic insights ensure precise management, allowing for tailored treatment and improved outcomes in patients with hereditary pheochromocytoma and paraganglioma.

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A case of robot‐assisted adrenalectomy performed for an adrenal tumor (anastomosing hemangioma) exceeding 7 cm

Cited by 3 publications

References 17 publications

Anastomosing haemangioma of adrenal gland: an unusual vascular tumour

Anastomosing haemangioma of adrenal gland: an unusual vascular tumour

Anastomosing haemangioma of the adrenal gland: A clinicopathological series of seven cases

Robot-Assisted Surgery and Multigene Panel Testing for Pheochromocytoma and Paraganglioma Syndrome

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