{Reference Type}: Case Reports
{Title}: Corticomedullary mixed tumour resembling a small adrenal gland-involvement of cancer stem cells: case report.
{Author}: Duan L;Fang F;Fu W;Fang Z;Wang H;Yu S;Tang Z;Liu Z;Zheng H;
{Journal}: BMC Endocr Disord
{Volume}: 17
{Issue}: 1
{Year}: Feb 2017 13
{Factor}: 3.263
{DOI}: 10.1186/s12902-017-0157-7
{Abstract}: <B>BACKGROUND: </B>Adrenal corticomedullary mixed tumours are very rare. Its mechanism is rarely reported. Here we report the first case of a corticomedullary mixed tumour resembling a "small adrenal gland" with distinct arrangement of the cortical and medullary layers. We further hypothesize regarding the tumorigenic mechanism of this tumour.<BR><B>METHODS: </B>A 58-year man had been diagnosed with diabetes and hypertension for 3 years. His 24-h urine vanillylmandelic acid (VMA) levels were slightly elevated. An abnormal circadian cortisol rhythm was noted, and his cortisol levels were not suppressed by dexamethasone. Abdominal computed tomography (CT) revealed a right adrenal gland lesion (diameter, 30 × 38 mm), while an enhanced CT showed enhancement and hypervascularization. The tumour was positive for adrenocorticotropic hormone, chromogranin A (CGA), and steroidogenic factor-1 (SF-1) on the tumour surface. Acetaldehyde dehydrogenase 1(ALDH1), CD44, CD133, Nestin, Nerve growth factor receptor (NGFR), and Sex determining region y-box 9(SOX9) staining were positive. Although administration of medications for diabetes and hypertension was stopped until surgery was performed, the blood sugar level and blood pressure were maintained after surgery.<BR><B>CONCLUSIONS: </B>This is the first report about a possible mechanism by which cancer stem cells induce adrenal corticomedullary tumours.