Laparoscopic excision of a large symptomatic and kidney-displacing adrenal myelolipoma: A case report

Introduction: Adrenal myelolipoma is a rare tumor. Traditionally, open surgical adrenalectomy was the standard treatment for symptomatic myelolipoma. However, laparoscopic excision is a promising alternative approach. Observation: A 38-year-old obese male patient presented with right loin pain of many months duration. Imaging studies revealed a large well-defined high fat content right adrenal mass displacing the right kidney. Adrenal tumor markers were within normal suggesting a non-functioning lesion. In spite of some technical difficulties and adjustments, laparoscopic excision was done, successfully, with uneventful recovery and short convalescence. Histopathological examination described mature adipose tissue with myeloid cells and confirmed the diagnosis of adrenal myelolipoma. Conclusions: Laparoscopic excision of large adrenal myelolipoma may indicate some technical adjustments, but it seems to be a feasible and advantageous approach even in obese patients. Keywords: Laparoscopic adrenalectomy, Myeloid cells, Myelolipom

Transmembrane and Tetratricopeptide Repeat Containing 4 Is a Novel Diagnostic Marker for Prostate Cancer with High Specificity and Sensitivity

The histopathologic diagnosis of prostate cancer (PCa) from biopsies is a current challenge if double or triple staining is needed. Therefore, there is an urgent need for development of a new reliable biomarker to diagnose PCa patients. We aimed to explore and compare the expression of TMTC4 in PCa cells and tissue specimens and evaluate its sensitivity and specificity. The expression of TMTC4 in PCa and normal prostate epithelial cells was determined by real-time PCR and Western blot analyses. Immunohistochemical (IHC) staining of TMTC4 was performed on tissues collected from PCa and benign prostatic hyperplasia (BPH). Our results show a high expression of TMTC4 on mRNA and protein levels in PCa versus BPH1 and normal cells (p < 0.05). IHC results show strong cytoplasmic expressions in PCa cases (p < 0.001) as compared to BPH cases. The overall accuracy as measured by the AUC was 1.0 (p < 0.001). The sensitivity and specificity of the protein were 100% and 96.6%, respectively. Taken together, we report a high TMTC4 expression in PCa cells and tissues and its ability to differentiate between PCa and BPH with high sensitivity and specificity. This finding can be carried over to clinical practice after its confirmation by further studies