Unusual presentation of metastatic adenocarcinoma
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BioMed Central
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Unusual presentation of metastatic adenocarcinoma Izhar N Bagwan*1, Gary Cook2, Satvinder Mudan3 and Andrew Wotherspoon1 Address: 1Department of Histopathology, The Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK, 2Department of Nuclear Medicine, The Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK and 3Department of Surgery, The Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK Email: Izhar N Bagwan* - [email protected]; Gary Cook - [email protected]; Satvinder Mudan - [email protected]; Andrew Wotherspoon - [email protected] * Corresponding author
Published: 18 October 2007 World Journal of Surgical Oncology 2007, 5:116
doi:10.1186/1477-7819-5-116
Received: 18 April 2007 Accepted: 18 October 2007
This article is available from: http://www.wjso.com/content/5/1/116 © 2007 Bagwan et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The most common tumours of the adrenal gland are adenoma, pheochromocytoma, adrenocortical carcinoma, and metastases. Although the imaging features of these tumours are established, the imaging characteristics of uncommon adrenal masses are less well known. In patients with extradrenal tumour, incidental discovery of an adrenal mass necessitates excluding the possibility of metastatic malignancy. Case presentation: A 52 year-old female was diagnosed with oesophageal adenocarcinoma and treated with oesophagectomy and adjuvant chemotherapy. Sixteen months later on staging CT scan a 2 × 2 cm adrenal mass was detected, which increased in size over a period of time to 3 × 3 cm in size. Adrenalectomy was performed and histological examination revealed metastatic adenocarcinoma within an adrenal adenoma. Conclusion: The present case highlights the unusual behaviour of an oesophageal adenocarcinoma causing metastasis to an adrenocortical adenoma.
Background Due to improvements in radiological diagnosis capabilities, there has been a recent increase in adrenal tumours that are incidentally discovered in patients who underwent medical examination by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI), i.e. "adrenal incidentalomas" [1]. In patients with extra adrenal tumour, incidental discovery of an adrenal mass necessitates excluding the possibility of metastatic malignancy [2]. Discrimination between benign and malignant adrenal mass lesions is a frequent clinical problem [3]. Important hallmarks used as indications for surgical intervention are the size, growth rate and
the imaging characteristics of the tumour as well as the endocrinological behaviour [1]. Here we present an unusual case of metastatic carcinoma within an adrenal adenoma.
Case presentation A 52-year-old woman presented w
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