Estrogen-secreting adrenocortical carcinoma / 영남의대학술지

Adrenocortical carcinoma is a rare type of endocrine malignancy with an annual incidence of approximately 1–2 cases per million. The majority of these tumors secrete cortisol, and a few secrete aldosterone or androgen. Estrogen-secreting adrenocortical carcinomas are extremely rare, irrespective of the secretion status of other adrenocortical hormones. Here, we report the case of a 53-year-old man with a cortisol and estrogen-secreting adrenocortical carcinoma. The patient presented with gynecomastia and abdominal discomfort. Radiological assessment revealed a tumor measuring 21×15.3×12 cm localized to the retroperitoneum. A hormonal evaluation revealed increased levels of estradiol, dehydroepiandrosterone sulfate, and cortisol. The patient underwent a right adrenalectomy, and the pathological examination revealed an adrenocortical carcinoma with a Weiss' score of 6. After surgery, he was treated with adjuvant radiotherapy. Twenty-one months after treatment, the patient remains alive with no evidence of recurrence.

Estrogen-secreting adrenocortical carcinoma / 영남의대학술지

Adrenocortical carcinoma is a rare type of endocrine malignancy with an annual incidence of approximately 1–2 cases per million. The majority of these tumors secrete cortisol, and a few secrete aldosterone or androgen. Estrogen-secreting adrenocortical carcinomas are extremely rare, irrespective of the secretion status of other adrenocortical hormones. Here, we report the case of a 53-year-old man with a cortisol and estrogen-secreting adrenocortical carcinoma. The patient presented with gynecomastia and abdominal discomfort. Radiological assessment revealed a tumor measuring 21×15.3×12 cm localized to the retroperitoneum. A hormonal evaluation revealed increased levels of estradiol, dehydroepiandrosterone sulfate, and cortisol. The patient underwent a right adrenalectomy, and the pathological examination revealed an adrenocortical carcinoma with a Weiss' score of 6. After surgery, he was treated with adjuvant radiotherapy. Twenty-one months after treatment, the patient remains alive with no evidence of recurrence.

Transscleral Diode Laser Photocoagulation for Retinopathy of Prematurity: Five Years' Experience

PURPOSES: We analysed the five-year outcomes and associated complications of transscleral diode laser photocoagulation (TSDLP), used to treat acute proliferative retinopathy of prematurity (ROP), to evaluate the efficacy and safety of this therapy. METHODS: We performed a retrospective analysis of the records of 163 eyes of 82 infants with acute ROP, who were treated with TSDLP by a single surgeon. Follow-up periods ranged from 15 to 278 weeks. RESULTS: The outcome was favorable in 158 eyes (96.9%) and unfavorable in 5 eyes (3.1%) of the 163 eyes that were treated. Vitreous hemorrhage was found to be an indicator of poor prognosis. Of the complications noted, symblepharon was observed in three eyes, hyphema was observed in four eyes, and a complicated cataract was observed in one eye. CONCLUSIONS: The results suggest that TSDLP is a safe and effective in the treatment of ROP. Vitreous hemorrhage should be regarded as a sign of poor prognosis.

Clinical Results of Combined Surgery: Pars Plana Vitrectomy, Phacoemulsification and Posterior Chamber Intraocular Lens Implantation

PURPOSE: To evaluate the clinical outcomes and complications of combined phacoemulsification and vitrectomy surgery in patients who have vitreoretinal diseases with a concomitant cataract. METHODS: Combined phacoemulsification-vitrectomy surgery was performed in 50 eyes of 45 patients who had various vitreoretinal diseases and a significant cataract that is considered to disturb the postoperative visual rehabilitation or fundus examination. Main outcome measures were visual acuity and intraoperative and postoperative complications. RESULTS: We performed combined surgery consisting of pars plana vitrectomy (PPV), phacoemulsification, and posterior chamber intraocular lens (PC-IOL) implantation. Intraocular lens were inserted in the bag with one case of exception inserted in the ciliary sulcus. Thirty-seven eyes (74%) had improved postoperative visual acuity, in 9 eyes (18%) the acuity was unchanged and 4 eyes (8%) it deteriorated. Intraocular pressure elevation, recurrent vitreous hemorrhage, macular edema, retinal detachment and endophthalmitis were considered to be clinically significant postoperative complications. CONCLUSIONS: The results of this study suggest that combined phacoemulsification-vitrectomy surgery is a viable option in the management of most posterior segment diseases in the presence of cataract.

Transscleral Diode Laser Photocoagulation for Retinopathy of Prematurity: Short-term Structural Outcome

PURPOSE: We observed the short-term outcome and associated complications of transscleral diode laser photocoagulation (TSDL) for acute proliferative retinopathy of prematurity (ROP) to evaluate the efficacy and safety. METHODS: 20 eyes of 10 infants with acute ROP were treated with transscleral diode laser photo-coagulation through conjunctiva by a single surgeon. Anatomical results and postoperative complications were main outcomes. Follow-up ranged from 11 to 40 weeks. RESULTS: In 1 eye (5%), there was a macular temporal dragging. In 19 eyes (95%), regression occurred after a single laser treatment with a flat retina. No significant anterior or posterior segment complications were occurred, even though there was a small amount of preretinal hemorrhage in 1 eye after laser photocoagulation. CONCLUSIONS: The results suggest that transscleral diode laser photocoagulation is a safe and effective alternative to cryotherapy or transpupillary diode laser photocoagulation in the treatment of ROP.