Division of Uro-Oncology, Department of Urology, Hospital de Clínicas de Campinas, State University of Campinas, UNICAMP, Campinas, Brazil.
Published: March 2007
AI Article Synopsis
Article Abstract
Introduction: Adrenal carcinomas are rare and are associated with a very poor prognosis. The incidence is estimated to be 1 in 1.7 million which represents 0.02% of all cancers and 0.2% of all cancer mortality. The 5-year survival rate is 38%. The purpose of this paper is to present a single-institution experience in excising right-sided giant adrenal carcinomas, discussing the difficulties and the usage of special surgical devices to facilitate the procedure.
Patients And Methods: During June 2001 to June 2003, 18 patients with right-sided adrenal tumors were treated at the State University of Campinas Hospital--UNICAMP. 4 out of the 18 patients presented lesions >15 cm, representing the study group. The mean age was 37 (range 26-65) years, 3 patients were younger than 35 years, and 2 patients were men. A right-sided extended subcostal incision was the surgical access in 1 patient (case 1) and a right-sided thoracoabdominal incision in the other 3 patients.
Results: Adrenal cortical carcinoma was the histological diagnosis according to the Weiss criteria; no positive surgical margin was detected, even in those patients with invasion of the hepatic capsule. The median follow-up period was 15 (range 6-30) months.
Conclusions: A subcostal extended incision can accomplish broad exposure, if articulated costal retractors are available (used in liver transplantation), otherwise a thoracoabdominal incision is the best option. The most important feature of surgery is to accomplish an efficient hemostasis of the liver parenchyma. Suture and stitches are not suitable for minor vascular structures, and electrocauterization sometimes promotes hepatic lesions and does not provide bleeding control. Thus, the need for special hemostatic means is real, and they should be available in these situations.
Oncocytic adrenal cortical carcinoma (ACC) is a rare malignant adrenal cortical tumor with limited documented case reports. Herein, a 65-year-old female patient presented with a large, solid adrenal mass. A diagnosis of oncocytic ACC was rendered with the following tumor characteristics: The tumor entirely consists of diffuse sheets of polygonal cells with bizarre nuclear atypia and deeply eosinophilic cytoplasm.
Background: Kinectin 1 () is a membrane protein involved in intracellular organelle motility. However, the role of in human pan-cancer lacks systematic analysis and evaluation. The aim of this study is to evaluate the expression profile and clinical value in human cancers by performing a pan-cancer analysis of .
Adrenocortical carcinomas (ACCs) are rare and aggressive malignancies of adrenal cortex, associated with largely unknown mechanisms of biological development and poor prognosis. Currently, mitotane is the sole approved drug for treating advanced adrenocortical carcinomas (ACCs) and is being utilized more frequently as postoperative adjuvant therapy. Although it is understood that mitotane targets the adrenal cortex and disrupts steroid production, its precise mechanism of action requires further exploration.
Background: Immune checkpoint inhibitors (ICIs) are emerging as important drugs for patients with locally advanced esophageal cancer (EC). Yet, immune-related adverse events (irAEs) may be a major obstacle for these population. Multidisciplinary team (MDT) is an efficient way to deal with such conditions.
