Endocrinology and Metabolism

Original Article

Adrenal gland
Clinical Characteristics for 348 Patients with Adrenal Incidentaloma: Jongho Kim, Kwi Hyun Bae, Yeon Kyung Choi, Ji Yun Jeong, Keun Gyu Park, Jung Guk Kim, In Kyu Lee; Endocrinol Metab. 2013;28(1):20-25. Published online March 25, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.1.20

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Background

Adrenal incidentaloma is an adrenal neoplasm frequently encountered in clinical practice for which detection rates have recently increased. We describe here the clinical characteristics of adrenal incidentalomas.

Methods

A retrospective study was performed examining the age, sex, location, size, function, and the histological findings for 348 patients with an adrenal mass discovered incidentally on computed tomography (CT) undertaken for health examination or nonadrenal disease from August 2005 to May 2012.

Results

Patients consisted of 156 males (44.8%) and 192 females (55.2%), aged between 20 and 86. Adrenal masses were most commonly found in patients in their sixth decade (32.5%). Regarding the location of the masses, 62.0% were found in the left adrenal gland, 30.2% were found in the right, and 7.8% were found bilaterally. Of all of the masses analyzed, 87.1% were 1 to 4 cm in size, and an adenoma-like appearance was the most common finding (75.3%) seen on CT scans. Hormonal analysis showed that 82.2% of the masses were nonfunctioning, 6.0% were diagnosed as subclinical Cushing's syndrome, 4.6% were aldosterone-producing adenomas, and 7.2% were pheochromocytomas. Adrenalectomy was performed in a total of 69 patients having adenoma (50.7%), pheochromocytoma (24.6%), and carcinoma (4.3%).

Conclusion

The characteristics of benign, malignant, nonfunctional, and functional adrenal masses that were incidentally found at our hospital were similar to those presented in other studies.

Citations

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Case Reports

A Case of Parathyroid Apoplexy of Primary Hyperparathyroidism Presenting as Auditory Hallucinations Accompanied with Hypocalcemia.: Eon Ju Jeon, Ji Yun Jeong, Jung Guk Kim; Endocrinol Metab. 2012;27(2):163-168. Published online June 20, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.2.163

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Abstract PDF: The natural history of primary hyperparathyroidism, due to parathyroid adenoma, is unknown. Furthermore, spontaneous resolution of parathyroid necrosis or hemorrhage is rare and usually asymptomatic. Here, we report a case of parathyroid apoplexy of primary hyperparathyroidism, presenting as auditory hallucinations, accompanied with hypocalcemia. A 39-year-old man who was incidentally diagnosed with primary hyperparathyroidism, and waiting surgery for parathyroidectomy presented to psychiatric service with auditory hallucinations. He developed tetany, while taking psychiatric drugs. On a follow-up investigation, his serum calcium level fell from 11.8 to 5.8 mg/dL. His intact parathyroid hormone level also decreased from 1,017 pg/mL to 71.1 pg/mL. The parathyroid apoplexy was confirmed after a surgical removal of the infarcted adenoma. The auditory hallucinations disappeared, and serum calcium level was returned to within the normal range.

A Case of Painful Graves' Disease.: Ji Yun Jeong, Tae Yong Kim, Eun Hee Kim, Eui Young Kim, Sang Ah Lee, Ji Hye Yim, Kyung Min Kim, Won Bae Kim, Young Kee Shong; J Korean Endocr Soc. 2008;23(5):337-341. Published online October 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.5.337

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Abstract PDF: Graves' disease rarely presents as pain and tenderness of goiter, with only a few cases reported in the literature. We describe a case of painful Graves' disease presenting as 2 episodes of painful goiter.

A Case of Carcinoma Showing Thymus-Like Differentiation (CASTLE) in the Thyroid.: Eun Hee Kim, Ji Yun Jeong, Eui Young Kim, Sang Ah Lee, Kyung Min Kim, Ji Hye Yim, Won Gu Kim, Tae Yong Kim, Sun A Kim, Gyungyup Gong, Young Kee Shong, Won Bae Kim; J Korean Endocr Soc. 2008;23(4):272-276. Published online August 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.4.272

1,696 View
24 Download
2 Crossref

Abstract PDF

Carcinoma Showing Thymus-Like Differentiation (CASTLE) is a very rare malignant neoplasm of the thyroid, and this resembles lymphoepithelioma or squamous cell carcinoma of the thymus. It originates from ectopic thymic tissue or remnants of the branchial pouches. We recently experienced a case of CASTLE in the thyroid gland of a 61-year-old woman. She presented with an asymptomatic mass in the right thyroid gland and she was diagnosed with 'poorly differentiated carcinoma' of the thyroid by fine needle aspiration cytology (FNAC). Total thyroidectomy was performed for both diagnostic and therapeutic purposes. Histologic examination of the resected tumor showed that the tumor was lobulated with expanding fibrous bands, and it was infiltrated by lymphocytes and plasma cells. The tumor cells had oval, large vesicular nuclei and prominent nucleoli, and the immunohistochemical staining was positive for CD5 and bcl-2, so the patient was diagnosed with thyroid CASTLE. We report here on a case of CASTLE in the thyroid gland treated by surgery and external neck radiation therapy.

Citations

Citations to this article as recorded by

Intrathyroidal thymic carcinoma exhibiting neuroendocrine differentiation: Case report with cytomorphology, immunocytochemistry, and review of the literature focusing on cytology
Wen‐hao Ren, Kun Dong, Xiao‐zheng Huang, Yan‐li Zhu
Diagnostic Cytopathology.2019; 47(11): 1197. CrossRef
Cytologic Findings of Thyroid Carcinoma Showing Thymus-like Differentiation: A Case Report
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Korean Journal of Pathology.2012; 46(3): 302. CrossRef

A Case of Diffuse Hemorrhage into the Thyroid Gland after Fine Needle Aspiration, and This was Treated by Arterial Embolization.: Eui Young Kim, Jung Min Kim, Eun Hee Kim, Ji Yun Jeong, Sang Ah Lee, Ji Young Choi, Ji Hye Yim, Pil Hyung Lee, Tae Yong Kim, Young Kee Shong, Won Bae Kim; J Korean Endocr Soc. 2008;23(3):199-203. Published online June 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.3.199

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Abstract PDF

Although hematoma formation after fine needle aspiration cytology fine needle aspiration cytology (FNAC) is a most common complication and most of these hematomas are self-limiting with minimal pain, a massive intra-thyroidal hemorrhage that produces acute airway obstruction had rarely been reported on.

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