[Clear cell carcinoma of the kidney and Conn's syndrome in a patient with arterial hypertension--a case report]. / Rak jasnokomórkowy nerki i zespól Conna u pacjentki z nadcisnieniem tetniczym--opis przypadku.

Recognition of secondary arterial hypertension is one of the main purposes of diagnosis in patients with arterial hypertension. Secondary hyperaldosteronism is one of the most frequent endocrinological causes of arterial hypertension. Because of the increased risk of cardiovascular diseases in these patients, the early diagnosis and proper treatment of primary hyperaldosteronism play a crucial role. The aim of the study was presentation of a patient with secondary arterial hypertension. During the diagnosis of the hypertension cause, a renal tumor was found and then primary hyperaldosteronism due to aldosterone producing adrenal adenoma. The presented case proves the necessity of a thorough diagnosis of etiology of arterial hypertension, as it exists a possibility of coexistence of two independent causes, what can delay the diagnosis and make it more complicated.

Retroperitoneal fibrosis with pancreatic involvement - radiological appearance.

BACKGROUND: Retroperitoneal fibrosis or Ormond's disease is an uncommon process characterized by fibrous tissue proliferation in the retroperitoneum, usually involving the aorta, inferior vena cava and iliac vessels. Obstructive hydronephrosis is often observed due to ureteral entrapment. This report presents a case of the peripancreatic location of the disease. The role of CT and MRI in establishing diagnosis of retroperitoneal fibrosis in an atypical site is discussed. CASE REPORT: A 52-year-old woman with Hashimoto's thyroiditis was admitted to hospital because of pain suggesting renal colic. The patient was subjected to ultrasound, CT, and MRI which did not confirm urolithiasis but revealed pancreatic infiltration. Partial pancreatectomy, left-sided adrenalectomy and splenectomy were performed. Retroperitoneal fibrosis was diagnosed in the histopathological examination. A few weeks after surgery, a complication such as pancreatitis developed. Repeat CT confirmed it and showed right hydronephrosis secondary to ureteral involvement by a mass adjacent to the common iliac artery (defined as a typical manifestation of retroperitoneal fibrosis). Nephrostomy and conservative treatment improved the clinical state of the patient. No progression of the process was observed in the follow-up examinations. CONCLUSIONS: Atypical retroperitoneal fibrosis remains a diagnostic challenge. Imaging techniques CT and MRI are useful tools for evaluating the extent of Ormond's disease. An unusual distribution of the process (e.g. peripancreatic location reported in this study) requires histopathological assessment to establish the final diagnosis.

[Incidentally discovered adrenal masses in the Department of Internal Medicine, Endocrinology and Hemostatic Disorders, Medical University of Gdansk]. / Przypadkowo wykryte guzy nadnerczy w materiale Kliniki Chorób Wewnetrznych, Endokrynologii i Zaburzen Hemostazy Akademii Medycznej w Gdansku.

UNLABELLED: Clinically silent adrenal masses (incidentaloma) are incidentally discovered lesions when noninvasive imaging methods (ultrasonography--USG, computer tomography--CT, magnetic resonance imaging--MRI) are performed for the reason other than known or suspected adrenal disease. Most of studies report the prevalence of adrenal incidentaloma range between 1 and 10% in radiological series. MATERIAL AND METHODS: Between 1993 and 03.2004 we observed 198 patients with incidentalomas of adrenal glands (144 females--72.7% and 54 males--27.3%). RESULTS: After endocrinological evaluation, 164 patients were qualified for surgery. In 119 (72.5%) cases open adrenalectomy was performed, and in 45 (27.5%) laparoscopic adrenalectomy was done. Adrenocortical adenoma was diagnosed in 54.9%, adrenal hyperplasia in 8.5%, adrenal carcinoma in 6.7%, pheochromocytoma in 12.9% (in 3.1% of all cases malignant pheochromocytoma was diagnosed), in 4.9% others malignant tumors (primary or metastatic), in 4.9% adrenal cysts and in 7.1% other rare adrenal pathologies were found. CONCLUSION: All malignancies were found in tumors with the diameter over 3 cm. In tumors with diameter over 6 cm malignant cases were found in 70.8%.