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MRI of the upper abdomen showing one parasitic lesion in liver segment 7 with infiltrative growth into the right adrenal gland. a T2 sequence. b T1 sequence.
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Ten years after his last treatment for diffuse large B-cell lymphoma, a seemingly healthy, 64-year-old man presented for his lymphoma-related follow-up. Ultrasound revealed an impressive tumor in the right adrenal gland. Due to recurrent cancer therapies in the past, this seemed highly suspicious of a second malignancy, such as primary adrenal carc...
Context in source publication
Context 1
... of the upper abdomen detected 3 hepatic lesions, 1 small lesion in segment 7 with infiltrative growth into the right adrenal gland (Fig. 2), and 2 further satellite lesions in seg- ments 6 and 8. Treatment with albendazole (2 × 400 mg/day) was administered. In a 2-step procedure, the parasitic lesions were surgically resected, necessitating en bloc adrenalectomy, hemi- hepatectomy, and resection of the middle lobe of the lung (Fig. 3). Parasite-free resection margins (R0 ...
Citations
... The limit of our report is that we do not have the de nitive diagnosis of this adrenal mass. Adrenal pseudotumors described in the literature were secondary to infection such as tuberculosis [3,4], aleveolar echinococcosis [5] or CMV [6]. None of these infectious agents were found in our patient. ...
Purpose. European Society of Endocrinology recommend surgical approach for suspicious adrenal mass with a limited role for adrenal biopsy. We report here a case of a patient with a 70 mm adrenal mass in whom adrenal biopsy avoided unnecessary adrenalectomy.
Case report. A 80-year-old man was explored for a 67x41 mm suspect left adrenal tumor. Hormonal explorations were normal. ¹⁸F-FDG-PET/CT showed an increase of uptake of the adrenal mass (SUVmax: 44.6). As the diagnostic was uncertain, biopsy was performed. Pathology found T lymphocytic inflammatory infiltrate with CD4 phenotype without malignancy criteria. Simple close monitoring was decided in multidisciplinary meeting and with the patient’s consent. At one and three month, CT and ¹⁸F-FDG-PET/CT showed a significant decrease of size and uptake of adrenal mass (40x20 mm and 19x10 mm and SUVmax 5.9 and 0.0).
Conclusion. This report shows the interest of adrenal biopsy for well-selected cases to avoid unnecessary adrenal surgery.
... Extrahepatic lesions are usually located in the lung and brain (Tappe et al., 2008). Adrenal AE, however, is rare, with only 9 cases reported in the literature so far (Huang and Zheng, 2013;Spahn et al., 2016;Seidel et al., 2017). Our case suggests that AE may involve all parts of the body. ...
Introduction: Alveolar echinococcosis (AE) is a rare parasitic disease caused by the infection of Echinococcus multilocularis. AE may mimic malignancy both in clinical presentation and radiological imaging, which is often misdiagnosed as metastatic tumor. Recently, next-generation sequencing (NGS) technologies are increasingly being used to address a diverse range of biological questions. Here, we describe a rare case of alveolar echinococcosis diagnosed by pan-pathogen screening, using next-generation sequencing. To the best of our knowledge, this is the first reported case of AE which was definitely diagnosed relying NGS of cerebrospinal fluid (CSF).
Case Presentation: A 33-year-old man presented with repeat seizure and progressive headache for six months. Head magnetic resonance imaging (MRI) showed multiple masses with edema. Lung and abdominal computer tomography (CT) revealed multiple masses in bilateral lung, liver and the right adrenal gland. Bacterial, tuberculosis and fungal infection were excluded by CSF examination. Repeated target biopsy on the masses in the lung and liver showed as fibrous connective tissue without positive findings. NGS of CSF was performed and detected nucleic acid sequences of E. multilocularis. Consequently, the patient has accepted 1-year albendazole therapy. His case was followed up through imaging procedures.
Conclusion: The next-generation sequencing of CSF is a reliable and sensitive diagnostic method for the detection of pathogenic microorganisms, and may allow the accurate diagnosis of alveolar echinococcosis. In view of this case, we recommend NGS as a potential tool for diagnosis of cerebral AE, especially if repeated biopsies are negative.
... The study by Akbulut and colleague [4] reported a patient who was 16 years old but was stated as 64 years old in the Table-1. On the contrary, the study by Seidel and colleagues [5] states that the patient was 64 years old but was reported as 16 years old in Table-1. The gender of the patient reported in the study by Fitzgerald and colleague [6] states that the patient was female but it was reported as male in the Table-1. ...
