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Familial occurrence of congenital bile duct dilatation

World Journal of Gastroenterology 2008年第6期14卷 941-943页

作者： Junji Iwasaki yoshifumi ogura Shunichi Nakagawa Kenji Kato Akinobu Kondo Katsuya Shiraki Department of Surgery Matsusaka City Hospital 1550 Tono-machi Matsusaka Mie 515-8544 Japan First Department of Internal Medicine Mie University School of Medicine 2-174 Edobashi Tsu Mie 514-8507 Japan

Congenital bile duct dilatation (CBD) that developed in a parent and son is presented. Familial occurrence of CBD is rare, with only a few male cases having been reported. Since the initial report of CBD occurring in siblings in 1981, a total of 20 cases (10 pairs) have been published as of 2007. Clinical and genetic features of CBD are discussed.

关键词：家族疾病遗传因素胆汁胆管疾病

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Carcinoembryonic antigen-producing adrenal adenoma resected using combined lateral and anterior transperitoneal laparoscopic surgery

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World Journal of Gastroenterology 2007年第45期13卷 6094-6097页

作者： Tomohide Hori Kentaro Taniguchi Masashi Kurata Kenji Nakamura Kenji Kato yoshifumi ogura Makoto Iwasaki Shinya Okamoto Koichiro Yamakado Shintaro Yagi Taku Iida Takuma Kato Kanako Saito Linan Wang yoshifumi Kawarada Shinji Uemoto Department of Hepatobiliary Pancreatic Surgery Mie University Graduate School of Medicine 2-174 Edobashi Tsu City Mie Prefecture 514-8507 Japan Department of Surgery Matsusaka City Hospital 1550 Tono-machi Matsusaka City Mie Prefecture 515-8544 Japan Department of Anesthesiology Matsusaka City Hospital 1550 Tono-machi Matsusaka City Mie Prefecture 515-8544 Japan Department of Surgery Iwasaki Hospital 333 Isshinden-cho Tsu City Mie Prefecture 514-0114 Japan Department of Cardiology Mie University Graduate School of Medicine 2-174 Edobashi Tsu City Mie Prefecture 514-8507 Japan Department of Radiology Mie University Graduate School of Medicine 2-174 Edobashi Tsu City Mie Prefecture 514-8507 Japan Department of Hepatobiliary Pancreatic and Transplant Surgery Kyoto University Graduate School of Medicine 54 Kawahara-cho Shogoin Sakyo-ku Kyoto 606-8507 Japan Department of Cellular and Molecular Immunology Mie University Graduate School of Medicine 2-174 Edobashi Tsu City Mie Prefecture 514-8507 Japan Department of Medical Oncology and Immunology Mie University Graduate School of Medicine 2-174 Edobashi Tsu City Mie Prefecture 514-8507 Japan

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 × 3.0 cm in diameter. Metaiodobenzylguanidine scintigraphy was negative. Unexpectedly, the serum Serum carcinoembryonic antigen (CEA) level waselevated. 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.

关键词：肾上腺肿瘤腹腔镜临床表现治疗

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