A Rare Tumor in the Adrenal Region: Neuron-specific Enolase (NSE)-Producing Leiomyosarcoma in an Elderly Hypertensive Patient

• GOTO Junko

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• OTSUKA Fumio

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• KODERA Ryo

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• MIYOSHI Tomoko

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• KINOMURA Masaru

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• OTANI Hiroyuki

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• MIMURA Yukari

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• OGURA Toshio

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• YANAI Hiroyuki

  Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• NASU Yasutomo

  Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• MAKINO Hirofumi

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

抄録

A 73-year-old Japanese woman was referred for examination of right flank pain and progressive hypertension. Abdominal CT incidentally detected a right adrenal mass 8 cm in size. The tumor exhibited isodensity by CT and contained high-intense lesion by T2-weighted MRI. Scintigraphy with ¹³¹ I-metaiodobenzylguanidine and ¹³¹ I-adosterol showed no abnormal uptake by whole body scan. Positron emission tomography scan with ¹⁸ F-2-fluoro-D-deoxyglucose demonstrated an exclusive uptake in the right adrenal mass. Adrenocortical hormone levels and catecholamine secretion were within normal range; however, the level of serum neuron-specific enolase (NSE) was found to be markedly high. After controlling systemic blood pressure with an α1-blocker, the right adrenal tumor was surgically removed, along with the right kidney and inferior vena cava which adhered to it. The tumor was pathologically proven to be leiomyosarcoma, which was immunohistochemically positive with α-smooth muscle actin and negative with CD57, S-100 and c-kit proteins. Notably, NSE protein was massively expressed in the resected tumor. After surgery blood pressure was controlled with regular medication and serum NSE levels have since normalized. The possibility of leiomyosarcoma should be kept in mind in adrenal incidentalomas with rapid growth and atypical radiological images. Our findings suggest that circulating NSE levels may be clinically useful for early detection of recurrence.<br>

収録刊行物

• Endocrine Journal

  Endocrine Journal 55 (1), 175-181, 2008

  一般社団法人 日本内分泌学会

キーワード

• Adrenal incidentaloma
• Hypertension
• Neuron-specific enolase (NSE)
• Leiomyosarcoma
• FDG-PET

詳細情報

• CRID: 1390282681275706496
• NII論文ID: 10021264950
• NII論文ID: 130004443365
• NII書誌ID: AA10901436
• DOI: 10.1507/endocrj.k07e-020
• ISSN: 13484540
• ISSN: 09188959
• Web Site: http://www.jstage.jst.go.jp/article/endocrj/55/1/55_K07E-020/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2008175212
• 本文言語コード: en
• データソース種別:
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  • Crossref
  • CiNii Articles
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