Case Report
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2007; 13(45): 6094-6097
Published online Dec 7, 2007. doi: 10.3748/wjg.v13.i45.6094
Carcinoembryonic antigen-producing adrenal adenoma resected using combined lateral and anterior transperitoneal laparoscopic surgery
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
Tomohide Hori, Yoshifumi Kawarada, Department of Hepatobiliary Pancreatic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie Prefecture, 514-8507, Japan
Kentaro Taniguchi, Kenji Nakamura, Kenji Kato, Yoshifumi Ogura, Department of Surgery, Matsusaka City Hospital, 1550 Tono-machi, Matsusaka City, Mie Prefecture, 515-8544, Japan
Masashi Kurata, Department of Anesthesiology, Matsusaka City Hospital, 1550 Tono-machi, Matsusaka City, Mie Prefecture, 515-8544, Japan
Makoto Iwasaki, Department of Surgery, Iwasaki Hospital, 333 Isshinden-cho, Tsu City, Mie Prefecture, 514-0114, Japan
Shinya Okamoto, Department of Cardiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie Prefecture, 514-8507, Japan
Koichiro Yamakado, Department of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie Prefecture, 514-8507, Japan
Shintaro Yagi, Taku Iida, Shinji Uemoto, Department of Hepatobiliary Pancreatic and Transplant Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
Takuma Kato, Linan Wang, Department of Cellular and Molecular Immunology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie Prefecture, 514-8507, Japan
Kanako Saito, Department of Medical Oncology and Immunology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie Prefecture, 514-8507, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Tomohide Hori, 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
Telephone: +81-59-2321111 Fax: +81-59-2328095
Received: July 24, 2007
Revised: August 13, 2007
Accepted: October 8, 2007
Published online: December 7, 2007
Abstract

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 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.

Keywords: Carcinoembryonic antigen, Laparoscopy, Adenoma, Adrenal gland, Cushing syndrome