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Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis.
[adrenal incidentaloma]
An
adrenal
"
incidentaloma
"
is
defined
as
an
unexpected
finding
on
radiological
imaging
performed
for
unrelated
indications
.
Improvements
in
radiological
technology
have
seen
a
dramatic
increase
in
this
phenomenon
.
We
report
the
unique
case
of
a
60
-
year
-old
female
presenting
with
a
6
-
month
history
of
abdominal
pain
,
altered
bowel
habit
,
and
rectal
bleeding
.
Her
past
medical
history
included
situs
inversus
totalis
and
a
patent
ductus
arteriosus
.
Colonoscopy
revealed
an
ulcerated
tumour
in
her
sigmoid
colon
.
Staging
PET-
CT
confirmed
a
sigmoid
tumour
and
also
identified
a
large
heterogenous
enhancing
FDG-avid
right
adrenal
mass
.
Biochemical
testing
/
MIBG
imaging
confirmed
a
right
adrenal
phaeochromocytoma
.
Hypertension
was
controlled
and
excision
was
performed
via
a
transperitoneal
laparoscopic
adrenalectomy
,
in
the
left
lateral
decubitus
position
.
Uniquely
,
liver
retraction
was
not
required
due
to
its
position
in
the
left
hypochondrium
.
Histology
confirmed
a
benign
46
 
mm
phaeochromocytoma
.
Subsequent
uncomplicated
sigmoid
colectomy
/
right
salpingo-oophorectomy
for
a
locally
advanced
colonic
tumour
was
performed
with
adjuvant
chemotherapy
.
This
case
highlights
the
importance
of
accurately
identifying
functioning
adrenal
tumours
before
elective
surgery
as
undiagnosed
phaeochromocytomas
carry
significant
intraoperative
morbidity
/
mortality
.
Right
adrenalectomy
was
made
easier
in
this
patient
by
the
liver
's
unique
position
.
Uncomplicated
colorectal
resection
was
made
possible
by
combined
preoperative
functional
/
anatomical
imaging
.
Diseases
Validation
Diseases presenting
"hypertension"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
aniridia
aromatase deficiency
cadasil
child syndrome
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cushing syndrome
cystinuria
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
fabry disease
familial hypocalciuric hypercalcemia
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
holt-oram syndrome
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
kallmann syndrome
kindler syndrome
lamellar ichthyosis
lymphangioleiomyomatosis
pendred syndrome
primary effusion lymphoma
scrub typhus
severe combined immunodeficiency
sneddon syndrome
typhoid
von hippel-lindau disease
well-differentiated liposarcoma
werner syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
This symptom has already been validated