Introduction: Large adrenal adenomas are clinically rare. We report a case of a large adrenal adenoma with a renal arteriovenous malformation, mimicking a malignant adrenal tumor in preoperative imaging.
Case Presentation: A 66-year-old woman presented to a local hospital with abdominal pain. A right adrenal tumor was detected, 66 mm in diameter and surrounded by thick and tortuous vessels. Based on the imaging findings, pheochromocytoma was suspected. However, clinical symptoms and endocrine abnormalities were absent, and radionuclide accumulation in scintigraphy was negative. Laparoscopic right adrenalectomy was performed. Intraoperatively, a notable growth of vessels forming a nidus surrounding the tumor was observed. Pathologically, this was diagnosed as an adrenocortical adenoma in conjunction with a renal arteriovenous malformation.
Conclusion: We report a case of a large adrenal tumor surrounded with an arteriovenous malformation. To the best of our knowledge, this is the first reported case of this combination.
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http://dx.doi.org/10.1002/iju5.12293 | DOI Listing |
J Mark Access Health Policy
March 2025
BHF Cardiovascular Research Centre, University of Glasgow, Glasgow G12 8TA, UK;
This study illustrates the utility of a mixed-methods approach in assessing the value of an example novel technology-biosensor-integrated self-reporting arteriovenous grafts (smart AVGs). Currently in preclinical development, the device will detect arteriovenous graft stenosis (surveillance-only use case) and treat stenosis (interventional use case). The approach to value assessment adopted in this study was multifaceted, with one stage informing the next and comprised a stakeholder engagement with clinical experts to explore the device's clinical value, a cost-utility analysis (CUA) from a US Medicare perspective to estimate pricing headroom, and an investment model estimating risk-adjusted net present value analysis (rNPVs) to determine commercial viability.
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
January 2025
Department of Cardiothoracic and Vascular Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Introduction: Arteriovenous (AV) fistula creation is the most common surgical procedure for providing vascular access for haemodialysis in patients with chronic kidney disease (CKD). The functioning of fistula dictates the quality of dialysis and the longevity of patients. The most common circumstances that require surgical takedown of AV fistula are thrombosis and rupture.
View Article and Find Full Text PDFEur J Vasc Endovasc Surg
January 2025
Department of Surgery, Division of Vascular and Endovascular Surgery, University of California, San Francisco, CA, USA.
Objective: This retrospective, single centre, comparative effectiveness study aimed to compare the long term outcomes of percutaneous arteriovenous fistulae (pAVF) and surgically created arteriovenous fistulae (sAVF) created in the proximal forearm for haemodialysis access.
Methods: Data were reviewed from a prospectively maintained database on patients who underwent pAVF or sAVF creation from September 2017 to September 2023. A total of 217 pAVFs (61 WavelinQ and 156 Ellipsys) and 158 sAVFs were analysed.
Med Sci Monit
January 2025
Department of Nephrology, Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing, China.
BACKGROUND For patients with end-stage renal disease, arteriovenous fistulas (AVFs) are often used for hemodialysis, but stenosis can impair their function. Traditional inpatient procedures to address AVF stenosis are effective but resource-intensive, prompting the need for alternative approaches like day surgery to optimize care and reduce costs. This study evaluated the feasibility of a day surgery model for AVF stenosis treatment in maintenance hemodialysis (MHD) patients, aiming to develop a cost-effective and high-quality care model.
View Article and Find Full Text PDFAm J Kidney Dis
January 2025
Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA; Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA. Electronic address:
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