- Two Cases with Adrenal Myelolipoma Treated by Surgical Resection.
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Jun Lee, Ho Chul Lee, Seung Ha Park, Byung Ik Kim, Seok Won Park, Hwa Young Lee, Yoon Kyong Cho, Yoo Lee Kim, Yong Wook Cho, Sang Jong Lee
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J Korean Endocr Soc. 2002;17(4):617-624. Published online August 1, 2002
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Abstract
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- An increasing number of incidental adrenal masses are found during the evaluation for unrelated problems, which is the result of the development of sensitive noninvasive methods for the imaging of abdominal lesions, such as ultrasonography, computed tomographic scanning, and MRI. When there is no evidence of adrenocortical or medullary dysfunction for such adrenal masses, they are commonly referred to as "incidentalomas". Among these incidentalomas, adrenal myelolipoma is a rare, benign, endocrinologically inactive tumor, the histological structure of which consists of mature adipose tissue cells and normal hemopoietic tissues resembling bone marrow. Even though most eventually prove to be nonhyperfunctioning adrenocortical adenomas, we must not exclude a more serious pathology. Because of the rarity of adrenal myelolipoma, its natural history, proper prognostic considerations and treatment recommendations still need to be investigated. We experienced 46 year-old man with abdominal discomfort, and a 26 year-old man with no specific symptoms, have large incidentalomas (>5 cm) in adrenal sites, detected by abdominal sonography for routine health work-up. The ACTH, cortisol, renin, aldosterenone, metanephrine, VMA and tumor marker levels were normal, which was suggestive of nonfunctional adrenal tumors. Surgical treatments were performed for rule out malignant adrenal tumors due to the tumor size (>5 cm) and hemorrhage within the tumors. The surgical pathology was that of adrenal myelolipomas. An adrenal myelolipoma is a rare, benign, nonfunctional adrenal tumor, but only three cases have been reported in Korea. We report two cases of adrenal myelolipoma found incidentally by surgical treatment for a large tumor size (>5 cm).
- A Case of Malignant Insulinoma Treated with Streptozotocin after Surgery.
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Yun Chang Jun, Byung Hun Lim, Bong Jung Son, Byung Ik Kim, Man Ho Lee, Sang Jong Lee, Won Kil Pae, Myung Suk Kim
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J Korean Endocr Soc. 1994;9(2):150-155. Published online November 6, 2019
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Abstract
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- Insulinoma is clinically characterized by fasting hypoglycemia, various neuropsychiatric symptoms, and these caused by secondary to hypoglycemia.Of patients with insulinoma, 80 percent have single benign tumors, 11 percent have multiple benign tumors, 6 percent have single malignant tumors, and the remainder have multiple malignant tumors or islet hyperplasia according to Service's statement.A 42 year-old male chemical engineer who had insulinoma associated with regional lymph node metastasis has been successfully performed with curative resection and consecutive postoperative therapy with streptozotocin.He entered to this hospital because of frequent occasion of bizarre behavior and language, transient unconsiousness and syncopal episode, and sweating associated with hypoglycemia especially in night four months prior to addmission in November 1992. Those symptoms and hypoglycemia were controlled by intravenous glucose injection and/or oral feeding of glucose riched stuffs.No physical abnormalities were found except neuropsychiatric symptoms. On admission the fasting blood glucose level was 10 mg/dl, plasma immunoreactive plasma insulin level was 125.23 uU/ml, and plasma C-peptide level was 10.24 ng/ml, respectively.Abdominal CT was suggestive of retroperitoneal tumor just behind the pancreas. Selective celiac axis angiography demonstrated hypervascular mass supplied by dorsal pancreatic artery which was compatible with insulinoma. Surgical intervention including distal pancreatectomy, as well as splenectomy and parital omental resection were performed successfully. Consecutive postoperative treatment of streptozotocin was done without any side effects.His condition is very good and enjoyed his life with full activity to date.
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