Oncocitoma quístico papilar de carúncula lagrimal

La carúncula lagrimal forma parte de los anexos oculares y es asiento ocasional de neoplasias, las cuales en su mayoría son benignas. Dentro de estos tumores se encuentran los oncocitomas, los cuales están constituidos por células oncocíticas (oxifílicas) y poseen una baja incidencia con menos del 3 % de los tumores y bajos reportes de casos en la literatura. A pesar de que existen varios estudios en Cuba de tumores de anexos oculares no hay evidencia actualizada de casos con oncocitoma. Por ello se considera necesaria la presentación de este caso. Se trata de paciente blanca, femenina de 83 años de edad con antecedentes de hipertensión arterial, compensada bajo tratamiento y de carcinoma basocelular, operada hace siete años. Acudió por presentar aumento de volumen indoloro en el ángulo interno del ojo izquierdo. Al examen físico oftalmológico se observó lesión de 1 cm, gris-rosácea, bien delimitada. Se procedió a su exéresis con sospecha clínica de carcinoma basocelular y se envió espécimen para estudio anatomopatológico, el cual concluyó como oncocitoma quístico papilar (cistoadenoma papilar eosinofílico) de carúncula.

The lacrimal caruncle is part of the ocular adnexa and is the occasional seat of neoplasms, most of which are benign. Among these tumors are oncocytomas, which are constituted by oncocytic (oxyphilic) cells and have a low incidence with less than 3% of tumors and low case reports in the literature. Although there are several studies in Cuba of ocular adnexal tumors, there is no updated evidence of cases with oncocytoma. Therefore, it is considered necessary to present this case. The patient is a white, 83-year-old female with a history of arterial hypertension, compensated under treatment and basal cell carcinoma, operated seven years ago. She presented with painless enlargement of the inner corner of the left eye. Ophthalmologic physical examination revealed a 1 cm lesion, grayish-pinkish, well demarcated. The lesion was excised with clinical suspicion of basal cell carcinoma and the specimen was sent for anatomopathologic study, which concluded as papillary cystic oncocytoma (eosinophilic papillary cystoadenoma) of the caruncle.

The clinicopathological characteristics and therapeutic analysis of renal oncocytoma / 中华泌尿外科杂志

Objective:To discuss the clinical and pathological features of the patients with renal oncocytoma.Methods:Making a retrospective analysis of the clinical data of 35 patients with renal oncocytoma who were admitted to the department of urology in the First affiliated Hospital of China Medical University from January 2013 to August 2020, discussing their clinical features, pathological characteristics, treatment and prognosis. The age range of the 35 patients was 35-79 years, with an average age of (59.0±11.3) years, there were 15 males and 20 females. The tumors of the 35 patients were unilateral, concluded 22 cases on the left side and 13 cases on the right side.Among the 35 patients, the tumors of 7 cases located in the upper pole, 14 in the middle pole, and 14 in the lower pole. At the time of admission, 5 patients complained with flank pain, 3 patients had gross hematuria, and the other patients were found during physical examination or examination due to other diseases. In the imaging examination, there were 33 cases of ultrasound data, including 18 cases of hypoechoic, 10 cases of hyperechoic, 3 cases of isoechoic and 2 cases of mixed echo. The data of CT were collected in 30 cases. The tumors showed isointense or slightly hypointense on plain scan, after enhancement, it showed low enhancement with clear boundary to the renal parenchyma and 12 patients had typical central stellate scar sign. All patients accepted surgical treatment, including 23 cases of retroperitoneal laparoscopic surgery and 12 cases of open surgery, but only 12 cases had partial nephrectomy.Results:The tumors were incised after the operation, the range of the tumors’diameter was 1.3-14.0 cm, with an average of (4.0±2.3) cm. The color of the cross-section was tawny in 14 cases, mahogany in 19 cases and 2 cases of other colors. The typical features of tumor cell under microscope were arranged in nests, alveolar or tubular shapes, the cells were round or polygonal.The cell size was uniform, the cytoplasm was rich in eosinophilic granules, the nuclei was deeply stained and the nucleoli was small. There are 9 indicators reach to 20 cases in immunohistochemical stain, and the positive rates of each indicator are respectively EMA 100.0%(23/23), E-cadherin 100.0%(20/20), CK 96.2%(25/26), CD117 95.5%(21/22), p504S(AMACR)35.0%(7/20), CD10 33.3%(9/27), CK7 31.0%(9/29), Vimentin 17.2%(5/29), Ki-67(0/28). Thirty-five patients were followed up after surgery, 4 patients were lost to follow-up, and the follow-up time of the other 31 patients ranged from 7 to 90 months, with an average of (46.9±25.0) months. All patients had a good prognosis without recurrence or metastasis. Among them, 3 patients had mild renal insufficiency in a short time after operation, and they have all recovered. Three patients with gross hematuria before the operation disappeared after the operation. In 5 patients with low back pain, only two patients felt significant improvement, and the other three still felt intermittent episodes of dull lumbar pain.Conclusions:Renal oncocytoma is a relatively rare benign tumor of the kidney. Because of the lack of effective diagnostic methods, it is difficult to differentiate from renal malignant tumors preoperatively. Pathological results are the golden standard for the diagnosis and differential diagnosis of renal oncocytoma. The main treatment of renal oncocytoma is surgery, and after surgery, the patient's prognosis is good, but renal oncocytoma has the possibility of recurrence and metastasis, regular follow-up and surveillance are still required.

Oncocitoma suprarrenal / Adrenal oncocytoma

Introducción: El oncocitoma suprarrenal es un tumor infrecuente e incidental y sin manifestaciones clínicas propias. Objetivo: Presentar un caso de oncocitoma suprarrenal y sus particularidades diagnósticas y terapéuticas. Caso clínico: Paciente masculino de 34 años de edad con antecedentes de salud, que se presentó por dolor lumbo-abdominal derecho, sin irradiación ni otros síntomas acompañantes. El examen físico fue normal. El ultrasonido informó un tumor de unos 7 cm de diámetro, localizado hacia el polo superior del riñón derecho. El origen suprarrenal se definió con la tomografía abdominal contrastada. Los valores sanguíneos de hormonas de la corteza suprarrenal fueron normales. Se hizo la exéresis total del tumor, mediante laparotomía convencional. El riñón estaba normal. El examen histopatológico notificó oncocitoma suprarrenal y lo ratificó la inmunohistoquímica. El paciente evolucionó satisfactoriamente. Conclusiones: El oncocitoma suprarrenal es un tumor infrecuente y de hallazgo fortuito. La tomografía abdominal contrastada no tiene alta especificidad para diferenciarlo de otros tumores suprarrenales. El perfil inmunohistoquímico del tumor es concluyente en el diagnóstico definitivo(AU)

Introduction: Adrenal oncocytoma is a rare and incidental tumor without its own clinical manifestations. Objective: To present a case of adrenal oncocytoma and its diagnostic and therapeutic characteristics. Clinical case: 34-year-old male patient with a medical history, who presented with right lumbo-abdominal pain, without radiation or other accompanying symptoms. The physical exam was normal. The ultrasound reported a tumor of about 7 cm in diameter, located towards the upper pole of the right kidney. The adrenal origin was defined with contrast abdominal tomography. The blood levels of hormones of the adrenal cortex were normal. Total excision of the tumor was performed by conventional laparotomy. The kidney was normal. Histopathological examination reported adrenal oncocytoma and immunohistochemistry confirmed it. The patient evolved satisfactorily. Conclusions: Adrenal oncocytoma is a rare and fortuitous tumor. Contrast abdominal tomography does not have high specificity to differentiate it from other adrenal tumors. The immunohistochemical profile of the tumor is conclusive in the definitive diagnosis(AU)

Pediatric Adrenocortical Oncocytoma presenting as Cushing’s Syndrome and Peripheral Precocious Puberty:A case report and review of literature / Journal of the ASEAN Federation of Endocrine Societies

@#Oncocytic adrenocortical tumours (OATs) or oncocytomas are extremely rare and are usually benign and nonfunctional. We report the case of a 4-year-old male with a right-sided, functional oncocytic adrenocortical adenoma, who presented with precocious puberty and Cushing’s syndrome. After work-up, the patient underwent laparoscopic adrenalectomy. The excised adrenal mass weighed 21 g and measured 3.5 cm in maximum dimension. Histological examination demonstrated no features suggestive of aggressive biological behaviour. The patient had no features of recurrent or metastatic disease and had prepubertal testosterone levels with suppressed hypothalamic-pituitary-adrenal axis twelve months after the surgery. A discussion of this case and a review of the literature on functional OATs in the pediatric population are presented.

Oncocitoma em carúncula: relato de caso / Oncocytoma of the caruncle: a case report

RESUMO O oncocitoma é um tipo de neoplasia rara na prática clínica e descrito na literatura, principalmente quando localizado no olho. Quando localizado nos anexos oculares, é mais frequentemente na carúncula. Analisou-se o caso de uma paciente de 74 anos, caucasiana, que relatou desconforto visual no olho esquerdo, e cujo exame físico mostrou lesão tumoral na carúncula esquerda, com volume moderado, presença de neovascularização e secreção excessiva. A excisão cirúrgica da lesão foi realizada sob sedação, e a peça foi enviada para avaliação anatomopatológica. A lesão foi diagnosticada histologicamente como oncocitoma, sem malignidade, e a paciente não apresentou recidiva após o procedimento. Embora raro, esse tumor deve ser reconhecido pelos oftalmologistas, devido ao risco já relatado de desenvolvimento de adenocarcinoma.

ABSTRACT Oncocytoma is a neoplasm rarely observed in clinical practice and reported in the literature, especially when located in the eye. When described in the ocular adnexa, it is most often located in the caruncle. The case of a 74-year-old Caucasian female patient is reported. She complained of visual discomfort in the left eye, and physical examination showed a tumoral lesion in the left caruncle, of moderate volume, presence of neovascularization, and excessive secretion. Surgical excision of the lesion was performed under sedation, and the specimen was sent for pathological examination. The lesion was histologically diagnosed as oncocytoma with no malignancy, and the patient presented no recurrence after the procedure. Although rare, this tumor must be recognized by ophthalmologists due to the risk of developing adenocarcinoma, as already reported.

Large non-functional adrenocortical oncocytoma with uncertain malignant potential: case report and review of literature

Adrenocortical oncocytomas are a very rare group of adrenal tumors. Unless functional, these tumors are incidentally diagnosed for clinical manifestations that are unrelated to the adrenal gland. The majority of these oncocytomas are benign and nonfunctional. Very few cases of uncertain malignant potential are reported. Here we present such a rare case of a 60 years old man presenting with voiding lower urinary tract symptoms but on contrast enhanced computed tomography (CECT) abdomen and pelvis a fairly large well defined heterogeneously enhancing retroperitoneal mass lesion with calcifications in the left anterior pararenal space (measuring 10.8×9.7×9 cm) was detected. On excision a well encapsulated solid mass of size approximately 12×10×9 cm was present in left suprarenal region. Histopathological examination confirmed the diagnosis of adrenocortical oncocytoma with uncertain malignant potential. As the incidence of adrenal oncocytoma is less, the knowledge regarding its clinical pattern, confirmatory imaging or histopathological diagnostic tools and chances of recurrence or turning malignant is limited.

Renal Oncocytoma: Report of Two Cases and Review of the Literature

Introduction:Renal oncocytomas are benign tumours arising from the intercalated cells of the collecting ducts and account for 3% to 7% of primary renal tumours. It was first described by Zippel in 1942. Oncocytomas are mostly asymptomatic and often discovered incidentally. They are often diagnosed postoperatively due to clinical and radiographic challenges in differentiating them from renal cell carcinoma. Presentation of Case:The present study reports two cases of renal oncocytoma in a 61-year-old man who was asymptomatic and a 73-year-old woman who was symptomatic. Relevant clinical and imaging data on the two patients were reviewed. Both patients underwent nephrectomy via flank incisions. Discussion:The typical morphologic features of oncocytoma were observed on histological examination of the excised kidney specimens. The postoperative course of each patient was uneventful and they were discharged 14 and 6-days post-surgery, respectively. In addition, the present study reviews the literature regarding the clinical, radiological and pathological characteristics of renal oncocytoma.Conclusion:Renal oncocytoma though is benign and has an excellent prognosis, the preoperative diagnostic challenges invariable warranted radical nephrectomy.

Neoplasia oncocítica adrenocortical de potencial maligno incierto: reporte de un caso / Adrenocortical oncocytic neoplasm with uncertain malignant potential: a case report

Resumen Objetivo Describir el caso clínico de una paciente con neoplasia oncocitica adrenocortical, tratado quirúrgicamente en una clínica de Lima, Perú. Caso clínico Paciente mujer de 26 años ingresa a emergencia por dolor abdominal inespecífico. Se evidencia tumoración de 15x14x12 cm dependiente de glándula suprarrenal izquierda por lo que se decide tratamiento quirúrgico. Al análisis patológico se evidencia neoplasia oncocítica de potencial maligno incierto. Discusión Las neoplasias oncocíticas adrenocorticales son entidades poco frecuentes, con escasos reportes de casos de esta enfermedad. Para clasificarlas, se usa la escala de Weiss modificada. Obtenemos una neoplasia oncocítica de potencial maligno incierto, cuyo tratamiento incluye la cirugía de resección de tumor y observación. Conclusión Considerar a las neoplasias oncocíticas dentro del diagnóstico diferencial de incidentalomas adrenales.

Objective To describe a case report of a oncocytic adrenocortical neoplasm, treated surgically in a clinic in Lima, Peru. Case report A 26-year-old woman is admitted to the emergency due to nonspecific abdominal pain. A tumor measuring 15x14x12 cm dependent on left adrenal gland is evidenced, so surgical treatment is decided. Pathological analysis evidences oncocytic neoplasia of uncertain malignant potential. Discussion Oncocytic adrenocortical neoplasms are rare entities, with few case reports of this disease. To classify them, the modified Weiss scale is used. We obtain an oncocytic neoplasm of uncertain malignant potential, whose treatment includes surgery for tumor resection and observation. Conclusion Consider oncocytic neoplasms within the differential diagnosis of adrenal incidentalomas.

CT texture analysis for differential diagnosis of renal chromophobe cell carcinoma and renal oncocytoma / 中国医学影像技术

Objective: To investigate the value of texture analysis based on enhanced renal CT for identification of chromophobe cell renal carcinoma (CCRC) and renal oncocytoma (RO). Methods: CT images of 64 patients with CCRC and 31 with RO were retrospectively analyzed. ITK-SNAP version 4.11.0 software was used to delineate the region of interest, and A.K.Version v3.0.0.R software was used to extract texture features. Random forest model was established using texture features included in random forest algorithm. Logistic regression was used to evaluate the discriminative the efficacy of the established models for differential diagnosis of CCRC and RO. Results: The first 20 texture parameters selected with random forest algorithm from corticomedullary phase, nephrographic phase and both of them, with weight values from high to low, were evaluated with Logistic regression, and the AUC values were 0.876, 0.861 and 0.945, respectively. Conclusion: Texture analysis based on enhanced renal CT images has clinical value in differential diagnosis of CCRC and RO.

Oncocitoma suprarrenal / Oncocytic adrenocortical carcinoma

El oncocitoma suprarrenal es un tumor extremadamente infrecuente, con apenas unos 150 casos descriptos. Paciente de sexo masculino, de 48 años, con adrenalectomía derecha por incidentaloma suprarrenal de 7 cm, no funcionante. El oncocitoma suprarrenal no puede distinguirse desde el punto de vista clínico-imagenológico de otros tumores adrenales más frecuentes, por lo que su confirmación es histológica. Rara vez son malignos, y el tratamiento aceptado es la suprarrenalectomía, idealmente por vía laparoscópica. En nuestro caso, la presencia de dos criterios histológicos menores lo clasifican como un tumor con potencial maligno.

Oncocytic adrenocortical carcinoma is an extremely rare tumor, with only 150 cases reported in the literature. A 48-year-old male patient, with right adrenalectomy due to a 7-cm non-functional adrenal incidentaloma. From a clinical imaging point of view, oncocytic adrenocortical carcinoma cannot be distinguished from other more common adrenal tumors; therefore, the diagnostic confirmation is histological. It is rarely malignant, and the accepted treatment is laparoscopic adrenalectomy. In our case, two minor histological criteria classify it as a potentially malignant tumor.

Incidental retroperitoneal oncocytoma (Ectopic oncocytic adrenocortical adenoma): Case report and review of the literature

Ectopic adrenocortical tissue may be present in many anatomical localizations. Hyperplasia, adenoma or carcinoma can occasionally develop from the ectopic adrenal tissue. Therefore, it should be surgically excised when it is detected. Adrenocortical tumors are the most common type of adrenal neoplasms. Ectopic adrenocortical adenomas are rarely seen. A total of 34 cases of ectopic adrenocortical adenoma (14 of which are oncocytomas) have been reported at different localizations in English literature. Most of them are non-functional. Differential diagnosis is required with other benign or malign oncocytic neoplasms. We report a 56-year-old male patient, who presented with a retroperitoneal mass. Our case is the seventh case of ectopic retroperitoneal adrenal adenoma with oncocytic cells.

CT analysis and differentiation of clear cell renal cell carcinoma and renal oncocytoma / 实用放射学杂志

Objective To probe the difference of MSCT features between clear cell renal cell carcinoma (ccRCC)and renal oncocytoma (RO),to improve the diagnostic accuracy.Methods 31 cases of ccRCC and 16 cases of RO which were confirmed by pathology were analyzed retrospectively,and the difference in some CT features including the morphology and CT value of plain scanning and three phases of enhancement scanning were analyzed.Results The diameter of the tumor of the ccRCC group was (5.04 ± 1.9 1 4)cm,meanwhile that of the RO group was (3.5 9±2.1 6)cm,exhibiting statistically significant difference in the diameter which was bigger in ccRCC group than that in RO group (P＝0.023).There were 90.32% (28/31)of cases with cystic necrosis in the ccRCC group and 18.75%(3/16)in the RO group,which was statistically significant that the patients with cystic deterioration in the ccRCC group were more than those in the RO group (P＜0.001).35.48% (11/31)of cases with peritumoral or intratumoral neovascularization in the ccRCC group and no cases in the RO group were found,and there was a statistically significant difference (P＝0.009).The enhancement degree in the ccRCC group was greater than that in the RO group in cortical phase and excretory phase,but lower in parenchy phase.However, there was no significant difference in the enhancement degree and the enhancement index in three phases of enhancement scanning (P＞0.05). Conclusion MSCT can demonstrate the renal tumor with or without cystic necrosis and neovascularization around or inside the tumor,which is helpful to differentiate ccRCC from RO.

A renal oncocytoma in a Maltese dog with renal cysts / 대한수의학회지

A renal oncocytoma was diagnosed in an 8-year-old female Maltese dog with a history of renal cysts. Tumor cells were not detected until six months after observation of renal cysts. Nephrectomy was performed to treat the neoplasia. Tumor-like masses with numerous nodules were observed in the inner surface of cysts present in the caudal part of the left kidney. Histologically, the tumor consisted of cells with abundant eosinophilic cytoplasm. The diagnosis was based on histological features, periodic acid-Schiff reaction, and immunohistochemical cytokeratin staining. Based on a literature review, this is the first canine renal oncocytoma case reported in Korea.

Diagnostic challenge of parotid multifocal adenomatous oncocytic hyperplasia: A case report

@#Parotid glands have diverse histological findings thanks to abundant different types of cells presence in the gland. Our routine fine needle aspiration cytology might be inaccurate and misleading in cases where there are cell changes due to ongoing concurrent infection and chronic sialadenitis, which might have mimicked tumoural changes. We highlighted a rare case of multiple florid benign hyperplasia of oncocytic cells of the parotid gland that manifest as parotid swelling. The characteristic multifocality of the lesion and high rate of recurrences, although not a known malignant entity, resulting in a significant shift in the treatment plan for the patient.

Oncocitoma fusocelular hipofisario / Pituitary spindle cell oncocytoma

El oncocitoma fusocelular es una neoplasia selar primaria no endocrina infrecuente, de curso clínico benigno. Debido a su similitud morfológica con los adenomas hipofisarios, considerar al oncocitoma como diagnóstico diferencial lleva a un abordaje quirúrgico cuidadoso, con el objetivo de evitar el sangrado intraquirúrgico y lograr la resección más completa posible, de la que parecería depender la evolución a largo plazo. Se presenta el caso de un hombre de 60 años que consultó por alteración campimétrica. La evaluación bioquímica evidenció panhipopituitarismo y la resonancia magnética (RM) una lesión selar. Se indicó tratamiento quirúrgico por compromiso visual con diagnóstico presuntivo de macroadenoma hipofisario no funcionante. El diagnóstico anatomopatológico fue compatible con oncocitoma fusocelular. En la RM selar, postquirúrgica (a los 5 meses), se observó remanente tumoral y se decidió realizar radiocirugía, constatándose en las subsiguientes RM disminución tumoral sin evidencia de remanente ni recidiva en 4 años de seguimiento. La comunicación de nuevos casos de esta entidad permitirá aumentar la disponibilidad de evidencia y ayudará a determinar la eficacia de los tratamientos disponibles y el pronóstico.

Spindle cell oncocytoma is an infrequent benign non-endocrine sellar neoplasm. Due to its similar morphology to pituitary adenomas, consideration of this differential diagnosis would conduce to a more careful surgical approach in order to avoid intraoperative bleeding and aiming to a complete resection, on which depends long-term outcomes. We present the case of a 60-year-old male who complained about visual abnormalities, with computerized visual field confirmation. On biochemistry, a panhypopituitarism was detected. The brain magnetic resonance images showed a sellar mass. A non-functioning pituitary macroadenoma was presumptively diagnosed and due to the visual impairment, surgical transesphenoidal treatment was indicated. The histological diagnosis was spindle cell oncocytoma. Five months after surgery, the control image demonstrated a lesion that was considered as remnant tumor, hence radiosurgery was performed. During the follow-up, the tumor reduced its size and four years after initial treatment, the sellar resonance imaging showed disappearance of the residual tumor. Communication of new cases of this rare entity will enlarge the existing evidence and will help to determinate the most effective treatment and prognosis.

The characters of computed tomography and magnetic resonance imaging in adrenal oncoctyoma patients / 中华泌尿外科杂志

Objective To summerize computed tomography (CT) and magnetic resonance imaging (MRI) appearances of the adrenal oncoctyoma(AOC),and to improve the diagnostic accuracy.Methods The 11 cases imaging materials of AOC confirmed by pathology from March 2006 to August 2017 were analyzed retrospectively.There were 3 males and 8 females,aged from 24 to 65 years old(mean 46.8 years).There were 11 cases with CT unenhanced scan in which 9 cases performed enhancing scan,8 cases underwent unenhanced and enhanced MRI scan.Results Of 11 cases (13 lesions),10 cases were singular,1 was unilaterally multiple(3 lesions).5 cases were located in the right side,6 in the left side.10 lesions presented oval,3 were round.The diameters of all lesions ranged from 1.4 to 9.9 cm,with a mean of 3.9 cm.All lesions were shown well-defined soft-tissue density on plain CT scan,69.2％ (9/13) of whom were homogeneous,30.8％ were heterogenous.The CT value ranged from 32.6 to 48.6 HU,with a mean of 37.9 HU.In 9 cases,5 masses were markedly enhanced,2 were slightly enhanced and 2 were moderately enhanced,and all of them depicted prolongedly enhanced on triple-phase scan.The masses of 8 cases appeared isointensity or slightly hypointensity on T1WI,hyperintesity on fat-suppressed T2WI.The signal did not change on opposed-phase imaging.The lesions demonstrated heterogeneously prolonged enhancement to some degree on enhanced TI WI images.There was no peritumoral adjacent invasion,enlarged lymph nodes and metastasis.Conclusions AOC usually presents soft-tissue density on unenhanced CT,no changing on MRI opposed-phase images.The tumors are characterized by markedly heterogeneously prolonged enhanced on enhanced CT and MRI.

MRI features of renal oncocytoma / 中华放射学杂志

Objective To investigate the MRI features of renal oncocytoma(RO). Methods We retrospectively analyzed the data of 26 patients by histologically confirmed with RO in Chinese PLA General Hospital from September 2006 to May 2017 and performed pre-operative MRI and dynamic contrast-enhanced MRI.Lesions were divided into two groups based on the diameter:large group with large than 3 cm(16 cases,16 lesions)and small group with less than 3 cm(10 cases,11 lesions).Features of each lesion were analyzed, including location, pseudocapsules, lipids and other 11 indicators. Tumor imaging features were compared between two groups by univariate and multivariate logistic regression analysis. Results Of 27 RO lesions, 12 were located in the left kidney and 15 in the right kidney. Twenty five lesions appeared exophytic(92.6%,25/27),10 lesions showed exophytic angular interface(37.0%,10/27), 25 lesions showed pseudocapsule(92.6%,25/27),4 lesions appeared lipid(14.8%,4/27),2 lesions showed cystic degeneration or necrosis(7.4%,2/27),1 lesion showed hemorrhage(3.7%,1/27),13 lesions appeared fibrous scar(48.1%,13/27),19 lesions with moderate or intense enhancement in the corticomedullary phase (70.4%, 19/27), 9 lesions with wheel-spoke-like enhancement (33.3%, 9/27), and 2 lesions showed segmental enhancement inversion (7.4%, 2/27). Univariate logistic regression exhibited statistically significant correlation between exophytic angular interface with renal parenchyma,fibrous scar,moderate or intense enhancement in the corticomedullary phase,and wheel-spoke-like enhancement of the tumors both in small and large RO groups with OR value of 0.054, 9.898, 8.400 and 10.000, respectively. In the multivariate logistic regression analysis, exophytic angular interface with renal parenchyma and intense enhancement in the corticomedullary phase were found to be high risk factors with OR value of 0.033 and 15.381,respectively.Conclusions The main manifestation of RO on MRI is that both kidneys can occur, with many exogenesis, pseudocapsules, but less lipids, cystic degeneration, necrosis, hemorrhage and segmental enhanced reversal;smaller lesions(diameter<3 cm)tend to conical interface,while larger lesions (diameter≥3 cm)may have fibrous scars,spoke-shaped enhancement,moderate and significantly enhanced cortical phase characteristics.

Analysis of CT features and misdiagnosis of renal oncocytoma / 实用放射学杂志

Objective To investigate the CT features of renal oncocytoma(RO),and to analyze the causes of misdiagnosis.Methods CT and clinical data of 1 2 patients with RO confirmed by surgery and pathology were analyzed retrospectively,the CT features and the causes of misdiagnosis before operation were analyzed and summarized.Results According to CT features before operation,among the 1 2 cases of RO,9 were misdiagnosed as renal carcinoma,3 were considered as benign occupying lesions.There were 6 cases located in the left kidney and 6 in the right kidney.Seven cases showed round mass and 5 showed irregular mass.Plain CT showed homogeneous masses in 6 cases and heterogeneous masses in 6 cases.Enhanced CT showed masses with homogeneous enhancement in 2 cases and masses with progressive enhancement in 10 cases.The attenuation value of parenchymal enhancement ranged from 41 to 143 HU (mean 90.17 HU).Seven cases had central scar syndrome,of which 1 case had calcification in the scar.One case showed segmental enhancement inversion,8 showed conical interface and 5 had holding ball signs.Conclusion The CT features of RO is central scar syndrome, segmental enhancement inversion,conical interface and holding ball sign,etc,but the definitive diagnosis still rely on pathology.

Hypo-androgen adrenocortical oncocytoma: 1 case report and literature review / 中华泌尿外科杂志

Objective To analysis the clinical features,diagnosis,treatment and prognosis of adrenal eosinophilic tumor with low testosterone levels.Methods The clinical data of a 22 years old male patient with adrenal eosinophilic tumor and low testosterone levels was analyzed.Blood pressure was 151/88 mmHg.The patient got bilateral gynecomastia.His bilateral testicular was soft and became smaller,with short penisr.Endocrine examination results showed:Estradiol 666 pg/ml,Prolactin 19.08 ng/ml,Testosterone 0.18 ng/ml,follicle stimulating hormone ＜ 0.2 U/L.The CT showed the mass density of soft tissue in the left adrenal region with diameter 7 cm,which was inhomogeneous and enhanced.There were many small vessels enhanced in the CT arterial phase,and the blood flow in the tumor was abundant.Clinical diagnosis of left adrenal tumor was pheochromocytoma.The patient underwent laparoscopic left adrenal tumor resection.The left adrenal gland was located in the superior pole of the left kidney,and there was an independent supply of the artery.Results Pathological result showed the tumor weigh was 60 g,7 cm in diameter and brown in section.The tumor cells were arranged in solid nests or acini,with more eosinophilic granules in cytoplasm.The nuclei was round and the nucleoli was located in the center,had clusters of pleomorphic and clustered cells.The tumor was wrapped in a thick fibrous envelope,mainly consisted of eosinophils,granulation tissue.There was no necrosis,mitosis,and vascular invasion.Immunohistochemical staining showed that the expression of CD56 and syn protein was positive.Pathological diagnosis was left adrenal eosinophilic tumor.After 4 months,the blood testosterone levels rose to 3.90 ng/ml,the blood pressure returned to normal (118/75 mmhg).The estradiol (21 pg/ml) was significantly inhibited.The patient began to appear beards and breasts became smaller.There were no signs of clinical or imaging recurrence.After 16 months follow-up,serum testosterone was 4.68 ng/ml and serum estrogen levels dropped to 33 pg/ml.Semen routine showed no sperm.Conclusions The clinical morbidity of functional adrenocortical oncocytoma with low testosterone levels and high estradiol levels is low.The pathological components are mainly eosinophilic granulation tissue.The adrenocortical oncocytoma are rare and preoperative diagnosis is difficult.Clinical manifestation,imaging examination and adrenal biochemistry examination should be considered to determine the localization and qualitative of tumor.Minimally invasive surgery is an effective treatment.The close follow-up after operation is essential.

Oncocitoma: caso clínico / Oncocytoma: a clinical case

El oncocitoma es un tumor benigno que afecta varios órganos como tiroides, paratiroides, riñón y glándulas salivales, que consiste en la proliferación de células oncocíticas producidas por una gran hiperplasia mitocondrial. El oncocitoma representa menos del 1 por ciento de todos lostumores de las gandulas salivales. Cuando en estudios por imágenes de glándula parótida se observen múltiples pequeños nódulos con unamasa sólida o quística, el diagnóstico de oncocitoma debe ser considerado, especialmente en pacientes de sesenta o más años. El objetivo de este artículo es la presentación de un caso de oncocitoma y analizar el estado de arte de los casos reportados en la temática.

The oncocytoma is a benign neoplastic tumor that occurs in several organs, including the thyroid gland, parathyroid gland, kidneys, and salivary glands consisting of a proliferation of oncocytic cells produced by a large mitochondrial hyperplasia. The oncocytoma accounts for less than 1% of the whole salivary gland tumors.When multiple small nodules are found in the parotid gland with a large solid or cystic mass that is evident on imaging, a diagnosis of oncocytoma should be considered, particularly in patients of sixty years of age or older. The objective of this article is the presentation of a case of oncocytoma and the state of art of reported cases in this field.