title: [Misdiagnosis of corticomedullary mixed pathological changes in adrenals: report of 4 cases].
abstract: Pathological changes usually occur independently in the adrenal cortex and medulla because of their distinct embryonic origins, and changes involving both the cortex and medulla are rare. We report 4 cases of corticomedullary mixed pathological changes adrenal glands. CT scanning of the adrenal glands showed unilateral abnormalities in all the 4 cases, 3 of which were diagnosed as aldosteronism and the other pheochromocytoma before surgery. Unilateral adrenalectomy was performed in the 4 patients 3 being cured and discharged. The other 1 had recurrence 18 months postoperatively with suspected pathological changes on the other side. Subsequent pathological examination confirmed the suspicion in both the cortex and medulla of the other adrenal gland. In cases with clinical presentations as simultaneous onset of aldosteronism and catecholamine responses, pathological changes in both the cortex and medulla of the adrenal glands should be considered. Perioperative management of such cases should be the same as that in cases of catecholamine responses, and the diagnosis relies on histopathological examination.
authors.affiliation: Department of Urology, Guangzhou General Hospital of Guangzhou Command, Urological Center of Guangzhou Command, Guangzhou 510010, China.
authors.forename: Wei-Lie
authors.initials: WL
authors.lastname: Hu
authors.forename: Qi-You
authors.initials: QY
authors.lastname: Cao
authors.forename: Hui-Xu
authors.initials: HX
authors.lastname: He
authors.forename: Jun
authors.initials: J
authors.lastname: L
authors.forename: Qing-Rong
authors.initials: QR
authors.lastname: Li
authors.forename: Yuan-Li
authors.initials: YL
authors.lastname: Wang
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Nie
authors.forename: Huai
authors.initials: H
authors.lastname: Yang
authors.forename: Xiao-Ting
authors.initials: XT
authors.lastname: Huang
authors.forename: Yun-Song
authors.initials: YS
authors.lastname: Zhu
authors.forename: Zhi-Xiong
authors.initials: ZX
authors.lastname: Deng
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
mesh_terms: D000302:Adrenal Cortex / Q000473:pathology*; D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000473:pathology; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000473:pathology; D000313:Adrenal Medulla / Q000473:pathology*; D000328:Adult; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000473:pathology