Carcinoembryonic antigen-producing adrenal adenoma resected using combined lateral and anterior transperitoneal laparoscopic surgery.
A 74-year-old woman presented with symptoms consistent with hyperadrenocorticism and hyperca-techolaminism. She had a cushingoid appearance and her cortisol level was elevated. Her serum dopamine and noradrenalin levels were also elevated. Computed tomography detected a left adrenal mass measuring 3.5 cm multiply 3.0 cm in diameter. Metaiodobenzylguanidine scintigraphy was negative. Unexpectedly, the serum Serum carcinoembryonic antigen (CEA) level was elevated. Fluorodeoxyglucose positron emission tomography showed increased uptake in the adrenal tumor only, with a maximum standardized uptake value of 2.8. Selective venography and blood sampling revealed that the concentrations of cortisol, catecholamines and CEA were significantly elevated in the vein draining the tumor. A diagnosis of CEA-producing benign adenoma was made. After preoperative management, we performed a combined lateral and anterior transperitoneal laparoscopic adrenectomy. Her vital signs remained stable during surgery. Histopathological examination revealed a benign adenoma. Her cortisol, catecholamine and CEA levels normalized immediately after surgery. We present, to the best of our knowledge, the first case of CEA-producing adrenal adenoma, along with a review of the relevant literature, and discuss our laparoscopic surgery techniques.
Hori
Tomohide
T
Department of Hepatobiliary Pancreatic Surgery and Breast Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie Prefecture, 514-8507, Japan. tomohide@clin.medic.mie-u.ac.jp
Taniguchi
Kentaro
K
Kurata
Masashi
M
Nakamura
Kenji
K
Kato
Kenji
K
Ogura
Yoshifumi
Y
Iwasaki
Makoto
M
Okamoto
Shinya
S
Yamakado
Koichiro
K
Yagi
Shintaro
S
Iida
Taku
T
Kato
Takuma
T
Saito
Kanako
K
Wang
Linan
L
Kawarada
Yoshifumi
Y
Uemoto
Shinji
S
D000236:Adenoma / Q000097:blood* / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000097:blood* / Q000601:surgery; D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010537:Peritoneum / Q000601:surgery
D002272:Carcinoembryonic Antigen