Endocrinology and Metabolism

Case Reports

Adrenal gland
Incidentally Detected Inoperable Malignant Pheochromocytoma with Hepatic Metastasis Treated by Transcatheter Arterial Chemoembolization: Joong Keun Kim, Bo Hyun Kim, Sung Min Baek, Dong Hun Shin, Won Jin Kim, Yun Kyoung Jeon, Sang Soo Kim, In Joo Kim; Endocrinol Metab. 2014;29(4):584-589. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.584

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Malignant pheochromocytoma (PCC) is a rare condition. Although the liver is the second most frequent site of metastasis in malignant PCC, no definite treatments have been established. Herein, we report a case of liver metastasis of PCC that was successfully treated by transcatheter arterial chemoembolization (TACE). A 69-year-old man was admitted to the Department of Gastroenterology for evaluation of an incidental hepatic mass in August 2013. He had undergone right adrenalectomy in May 2005 and PCC had been confirmed on the basis of histopathological findings. Liver biopsy was performed, and metastatic PCC was diagnosed. The lesion appeared inoperable because of invasion of the portal vein and metastases in the lymph nodes along the hepatoduodenal ligament. Thus, TACE was performed instead. After TACE, symptoms including dizziness and cold sweating improved, and the patient's serum catecholamine levels decreased. On the basis of this case, we believe that TACE may be a useful treatment for liver metastasis in malignant PCC.

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SHUJUN LU, YAJING ZHANG, WENLI YU
Cellulose Chemistry and Technology.2023; 57(9-10): 1001. CrossRef
Progressive metastatic pheochromocytoma induced by multiple endocrine neoplasia type 2A with a lethal outcome
Koshiro Nishimoto, Noriaki Lukas Santo, Masato Yonamine, Kazuhiro Takekoshi, Go Kaneko, Suguru Shirotake, Hisayo Fukushima, Yoshitaka Okada, Masanori Yasuda, Akihiro Sakurai, Masafumi Oyama, Kento Kanao
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Marine Drugs.2015; 13(10): 6064. CrossRef
Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee
Endocrinology and Metabolism.2015; 30(1): 47. CrossRef
Clinical course and prognostic factors in patients with malignant pheochromocytoma and paraganglioma: A single institution experience
Yun Mi Choi, Tae‐Yon Sung, Won Gu Kim, Jong Jin Lee, Jin‐Sook Ryu, Tae Yong Kim, Won Bae Kim, Suck Joon Hong, Dong Eun Song, Young Kee Shong
Journal of Surgical Oncology.2015; 112(8): 815. CrossRef

A Case of Malignant Insulinoma Metastasized to Liver after Partial Pancreatectomy due to Insulinoma 10 Years before.: Yang Il Kang, Byung Hyuk Yang, Suk Chon, Seungjoon Oh, Jeong Taek Woo, Sung Woon Kim, Jin Woo Kim, Young Seol Kim, Ju Hie Lee, Kwanpyo Koh; J Korean Endocr Soc. 2006;21(1):68-73. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.68

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Abstract PDF: Malignant insulinomas are very rare endocrine tumours with a variable clinical course. Here, a case of a malignant insulinoma, resected from the tail of the pancreas 10 years previously, which was found to have hepatic metastasis, is reported. A pancreatic mass, without evidence of metastasis, has been found using an abdominal CT scan and intra-operative ultrasonography 10 years previously. Recently, the patient has suffered from dizziness, sweating and an altered mentality. Hyperinsulinemia was diagnosed from the biochemical laboratory finding. An abdominal CT scan and intra-operative abdominal sonography showed multiple hepatic metastasis, without local recurrence in pancreas. Therefore, a partial hepatic segmentectomy was performed. Immunohistochemical staining of the postoperative specimen was strongly positive for insulin. The postoperative biochemical response was normalized, and the patient experienced no further hypoglycemic symptom.

A Case of Adrenal Cortical Carcinoma with Liver Metastasis.: Hyun Joo Lee, Myung Soo Kim, Hyo Kyoung Park, Dae Jung Kim, Yu Mie Rhee, Chul Woo Ahn, Jae Hyun Nam, Bong Soo Cha, Young Duk Song, Sang Won Han, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2003;18(2):232-238. Published online April 1, 2003

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Abstract PDF: An adrenal cortical carcinoma is a rare malignancy associated with poor prognosis. On diagnosis, most patients present with large tumor masses, which are often detected at an advanced stage. The most effective treatment is a complete resection, which is the only curative treatment for adrenal cortical carcinomas. The most important prognostic factor is a successful resection of the primary tumor, as long as it is low-grade and has not spread to distant sites. However, with advanced adrenal cortical carcinomas, with distant metastasis, there is no strict effective treatment program, and the prognosis is poor. The case of a 50-year-old female patient, presenting with an adrenal cortical carcinoma and Cushing's syndrome, who had a long-term survival of 78 months, is reported. The mass was completely resected on diagnosis, but 16 months later liver metastasis was discovered. She had received chemotherapy, with cisplatin, etoposide and bleomycin, for the liver metastasis for a period of 15 months, but with no response, furthermore, the size had increased after 10 months. Afterward, she received her 10th session of intrahepatic artery cisplatin chemotherapy and her 3rd hepatic artery embolization. Although the patient had a large degree of liver metastasis, this was tolerated. The tumor mass is presently not aggravated, and she still survives after 78 months.

A Case of Somatostatinoma which Manifested as Insulinoma when Metastasized to the Liver.: Joong Yeol Park, Byung Doo Lee, Kyung Soo Ko, Kyung Yub Gong, Ki Soo Kim, Sung Jo Bang, Jae Hwan Lee, Yoon Ey Chung, Sang Wook Kim, Hye Je Cho, Ki Ub Lee; J Korean Endocr Soc. 1998;13(4):670-676. Published online January 1, 2001

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Abstract PDF: We report a case of somatostatinoma, which manifested as insulinoma after liver metastasis. A 74-year-old man suffered from diabetes mellitus and jaundice. The abdominal CT scan of this patient showed a mass in the pancreas head, which obstructed biliary duct. He underwent Whipples procedure. Immunohistochemical staining of postoperative specimen disclosed that this tumor was strongly positive for somatostatin. After 4 months, follow up CT scan showed multiple metastatic lesions in the liver. We performed transarterial chemoinfusion two times, but the response was disappointing. After 2 months, he suffered from altered mentality, which was relieved by intake of sugar. Biochemical laboratory findings and immunohistochemical staining of liver biopsy disclosed that the metastatic lesion in this patient was insulinoma. We performed embolization of hepatic artery with gelform. The biochemical response was dramatic, but he died of septic shock, which was caused by gas forming liver abscess. In summary, we report a case of somatostatinoma which manifested as insulinoma after metastasis to the liver.

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