An ectopic adreocortical adenoma of the renal sinus: a case report and literature review

Zhang, Jiexiu; Liu, Bianjiang; Song, Na; Lv, Qiang; Wang, Zenjun; Gu, Min

doi:10.1186/s12894-016-0123-0

Cited by 17 publications

(12 citation statements)

References 8 publications

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“…Sixty-five had all the inclusion criteria, and 29 were included in this systematic review. Among these, 22 were single case reports (6, 8, 9, 13-31), 2 articles reported more than one case (11,32), 4 were literature reviews with case report (10,(33)(34)(35), and 1 article was a letter to the publisher including a case reports (5). We therefore compared the cases present in the literature with one that happened in our center in January 2018 (Box 1), evaluating the main characteristics.…”

Section: Resultsmentioning

confidence: 99%

“…Most ectopic adrenal tissue is located along the migration path of the urogenital system but it could be present also at the level of celiac axis, broad ligament, spinal cord and other retroperitoneal parenchymatous organs (9). Ectopic adrenal tissue can be present in 50% of newborns, usually regressing and persisting in only 1% of the adult population (10). It is not a rare condition and can manifest clinically as endocrine abnormalities due to secretory activity, mass effect or neoplastic transformations.…”

Section: Introductionmentioning

confidence: 99%

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Ectopic adrenal tissue in the kidney: A systematic review

Marchi

Tafuri

Mantica

et al. 2021

Arch Ital Urol Androl

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Introduction: Ectopic adrenal tissue in the kidney, including “Ectopic adrenal tissue” and “Adrenal-renal fusion”, is a rare event with a specific behavior which may be difficult to distinguish clinically from renal neoplasms. We performed a systematic review on ectopic adrenal tissue variants reported in the literature underlining its clinical aspects. Methods: Manuscripts which presented a case report or case series of ectopic adrenal tissue in the kidney were included even if published in original articles, reviews, or letters to the editor. A specific search on SCOPUS®, PubMed®, and Web of Science® database was performed. Only English language papers published in a period ranging between August 1991 and April 2020 were considered. Additionally, a case we had at our institution is described, and its characteristics are included. Data on clinical presentation, type of adrenal anomaly, location, anatomopathological and immune-histotype characteristics were collected. Results: We identified 888 manuscripts. Among these 29 were included in this systematic review. Overall, 39 patients with renal adrenal fusion or adrenal ectopia were considered. In most cases, the diagnosis was made incidentally, or following investigation for flank pain, abdominal pain, or endocrinological disorders. CT scan frequently identified a solid vascularized lesion that was difficult to distinguish from renal neoplasm. Adrenal fusion was mostly located at the level of the upper pole. Adrenal rest was found in the renal parenchyma, renal hilum, or retroperitoneum in close proximity to the renal peduncle. Often these ectopic adrenal tissue lesions follow a benign behavior and can be classified as functioning or non-functioning adenomas. Rarely, they may experience neoplastic degeneration. The most frequently positive markers were inhibin, vimentin, melan-A, synaptophysin and anti-p450 scc. Conclusions: Ectopic adrenal tissue in the kidney is a rare event with specific clinical characteristics that need to be identified in order to arrive at a correct diagnosis and carry out appropriate treatment management.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ectopic adrenal tissue in the kidney: A systematic review

Marchi

Tafuri

Mantica

et al. 2021

Arch Ital Urol Androl

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“…We identified five related articles and considered them (Table ). Among the reported cases of ectopic adrenal tissue in the renal sinus, a 27‐year‐old woman presented amenorrhea with borderline elevation of testosterone, a 37‐year‐old woman with possible primary aldosteronism, a 38‐year‐old man with Cushing's syndrome, and a 63‐year‐old woman with Cushing's syndrome . Only one report, a 53‐year‐old woman with Cushing's syndrome, the mRNA levels of 3βHSD, CYP17, CYP11B2, and CYP11B1 were analyzed by quantitative reverse transcription polymerase chain reaction and were suggestive of cortisol excess .…”

Section: Discussionmentioning

confidence: 99%

Ectopic adrenal adenoma causing gross hematuria: Steroidogenic enzyme profiling and literature review

et al. 2019

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Abbreviations & Acronyms 3bHSD = 3b-hydroxysteroid dehydrogenase CA19-9 = carbohydrate antigen 19-9 CEA = carcinoembryonic antigen CT = computed tomography IgG4 = immunoglobulin G4 NSE = neuron-specific enolase PCA = positive cell area SCC = squamous cell carcinoma antigen sIL-2R = soluble interleukin-2 receptor TA = total area Introduction: Aberrant cortical adrenal tissues are not generally identified in adults. Herein, we present a very rare case of an ectopic adrenal tumor located in the renal hilum that caused gross hematuria. Case presentation: A 33-year-old man suddenly presented with asymptomatic gross hematuria. Abdominal computed tomography revealed a 35-mm mass in the left renal hilum encroaching the renal vein. Following the surgical removal with frozen section of the mass, his gross hematuria immediately improved. Pathological analysis of the specimen revealed the features adrenal adenoma. Immunohistochemical staining for key steroidogenic enzymes confirmed the adrenocortical origin without excessive hormone production. Conclusion: This is the first case of an ectopic adrenocortical adenoma in the renal hilum that caused gross hematuria without hormonal symptoms. This is the first case of an ectopic adrenocortical adenoma in the renal hilum that caused gross hematuria without excessive hormone production. To further investigate the etiology and hormonal function of the mass, we performed immunohistochemical analysis of key steroidogenic enzymes with literature review.

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“…The immunohistochemistry stain of the tumor (inhibitin +, Melan-A +, synaptophysin +, vimentin + and AE1/AE3+) supported an adrenocortical origin rather than a renal or mesenchymal origin, which was in accordance with preview reports. [13,14] Therefore, a pre-operative biopsy of the tumor, if possible, should be performed to confirm the diagnosis of ectopic adrenocortical adenoma and provide evidence for clinical treatment.…”

Section: Discussionmentioning

confidence: 99%

An ectopic adrenocortical adenoma in renal hilum presenting with Cushing's syndrome

et al. 2018

Medicine

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Rationale:Ectopic adrenal tissue is the adrenal rests along the path from gonads to adrenal glands during embryogenesis. Ectopic adrenocortical adenoma is a rare disease represented with over-production of cortisol by the ectopic adrenocortical tissue.Patient concerns:An 18-year-old Chinese female patient was presented with weight-gain for 6 months. She had elevated plasma cortisol and a solitary mass was revealed using computed tomography scan in the left renal hilum.Diagnosis:The tumor was removed and the immunohistochemical profile indicated an ectopic adrenocortical adenoma.Interventions:After the tumor was removed, the patient was under glucocorticoid replacement therapy in 6-month.Outcomes:During 6-month of follow-up, the patient showed no signs of tumor recurrence.Lessons:Ectopic adrenocortical adenoma is difficult to diagnose due to its low incidence, and the ectopic rests in renal hilum could be misdiagnosed as renal cell carcinoma. This case reminds clinicians to be aware of ectopic site in the diagnosis of adrenocorticotropic hormone (ACTH) independent Cushing's syndrome. Immunohistochemical stain may assist in evaluating the origin of the ectopic rests. A certain rate of local recurrence indicated the need of long-term follow-up.

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An ectopic adreocortical adenoma of the renal sinus: a case report and literature review

Cited by 17 publications

References 8 publications

Ectopic adrenal tissue in the kidney: A systematic review

Ectopic adrenal tissue in the kidney: A systematic review

Ectopic adrenal adenoma causing gross hematuria: Steroidogenic enzyme profiling and literature review

An ectopic adrenocortical adenoma in renal hilum presenting with Cushing's syndrome

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