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Adrenal Mass

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1. Assessment of incidental adrenal mass

Assessment of incidental adrenal mass Assessment of incidental adrenal mass - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of incidental adrenal mass Last reviewed: February 2019 Last updated: June 2018 Summary Incidental adrenal masses are typically found during radiological imaging of kidneys and adrenals. They are classified as hormonally active or non-functioning, and as malignant or benign (...) . Biochemical and imaging evaluations are required to determine this taxonomy. Grumbach MM, Biller BM, Braunstein GD, et al. Management of the clinically inapparent adrenal mass ("incidentaloma"). Ann Intern Med. 2003;138:424-429. http://www.annals.org/cgi/content/full/138/5/424 http://www.ncbi.nlm.nih.gov/pubmed/12614096?tool=bestpractice.com Adrenal masses are among the most common tumours in humans. The prevalence of clinically inapparent adrenal masses increases with age, being <1% for patients younger

2018 BMJ Best Practice

2. Congenital Adrenal Hyperplasia Presenting as an Adrenal Mass With Increased 18F-FDG Positron Emission Tomography Uptake (PubMed)

Congenital Adrenal Hyperplasia Presenting as an Adrenal Mass With Increased 18F-FDG Positron Emission Tomography Uptake This article describes congenital adrenal hyperplasia presenting as an adrenal mass with increased 18F-FDG positron emission tomography uptake.

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2017 Journal of the Endocrine Society

3. Predictive factors for adrenal metastasis in extra-adrenal malignancy patients with solitary adrenal mass. (PubMed)

Predictive factors for adrenal metastasis in extra-adrenal malignancy patients with solitary adrenal mass. The adrenal gland is a frequent site for metastasis, and a solitary adrenal mass is often observed during staging workup or imaging follow-up in patients with extra-adrenal malignancy. To create an appropriate management plan, it is essential to distinguish between benign adrenal lesions and metastasis in patients with extra-adrenal cancer having solitary adrenal masses. Therefore, here we (...) evaluated the predictive factors for adrenal metastasis in patients with extra-adrenal malignancy having solitary adrenal mass.From September 2003 to June 2016, we retrospectively reviewed patients with extra-adrenal malignancy having solitary adrenal mass on a cancer staging workup or follow-up study who subsequently underwent adrenalectomy at our institution. All patients underwent preoperative functional studies; those with positive results were excluded from this study. Characteristics of oncology

2018 Journal of Surgical Oncology

4. An unusual cause of adrenal insufficiency and bilateral adrenal masses (PubMed)

An unusual cause of adrenal insufficiency and bilateral adrenal masses Primary adrenal insufficiency secondary to syphilis is extremely rare, with only five cases being reported in the literature. We report a case of adrenal insufficiency as a manifestation of Treponema pallidum infection (tertiary syphilis). A 69-year-old, previously fit and well Caucasian male was found to have adrenal insufficiency after being admitted with weight loss, anorexia and postural dizziness resulting in a fall (...) . Following a course of penicillin, repeat imaging 5 months later showed resolution of the abnormal radiological appearances. However, adrenal function has not recovered and 3 years following initial presentation, the patient remains on both glucocorticoid and mineralocorticoid replacement. In conclusion, this case highlights the importance of considering syphilis as a potential differential diagnosis in patients presenting with adrenal insufficiency and bilateral adrenal masses, given the recent re

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2018 Endocrinology, diabetes & metabolism case reports

5. Outcomes of Adrenal Venous Sampling in Patients with Bilateral Adrenal Masses and ACTH-Independent Cushing's Syndrome. (PubMed)

Outcomes of Adrenal Venous Sampling in Patients with Bilateral Adrenal Masses and ACTH-Independent Cushing's Syndrome. Management of patients with bilateral adrenal masses and ACTH-independent Cushing's syndrome (AICS) is challenging, as bilateral adrenalectomy can lead to steroid dependence and lifelong risk of adrenal crisis. Adrenal venous sampling (AVS) has been previously reported to facilitate lateralization for guiding adrenalectomy. The aim of the current study was to investigate (...) the utility of AVS using protocol from study by Young et al. in the management of patients with bilateral adrenal masses and AICS.A retrospective review of all patients with bilateral adrenal masses and AICS who underwent AVS from 2008 to 2016 was performed. AVS for cortisol and epinephrine was performed with dexamethasone suppression. The adrenal vein to peripheral vein cortisol ratios and side-to-side cortisol lateralization ratios were calculated.AVS was successful in 8 of 9 patients. All 8 patients

2018 World Journal of Surgery

6. A Liquid Chromatography/Tandem Mass Spectometry Profile of 16 Serum Steroids, Including 21-Deoxycortisol and 21-Deoxycorticosterone, for Management of Congenital Adrenal Hyperplasia (PubMed)

A Liquid Chromatography/Tandem Mass Spectometry Profile of 16 Serum Steroids, Including 21-Deoxycortisol and 21-Deoxycorticosterone, for Management of Congenital Adrenal Hyperplasia Congenital adrenal hyperplasia (CAH) due to steroid 21-hydroxylase deficiency (CAH21) is most often diagnosed by newborn screening. The classic parameter studied is 17-hydroxy-progesterone, but the positive predictive value for the diagnosis of CAH is low in full-term newborns and even lower in preterm newborns.To (...) evaluate the diagnostic utility of simultaneously quantifying a large number of steroids by using liquid chromatography/tandem mass spectrometry (LC-MS/MS) from a small serum volume in patients with CAH, particularly during the neonatal period.LC-MS/MS was applied to sera from patients with CAH who had a classic form (n = 48) and rare forms (n = 2) of 21-hydroxylase deficiency, normal preterm (n = 10) and normal full-term (n = 20) neonates, and young patients without CAH (non-CAH; n = 149

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2017 Journal of the Endocrine Society

7. The effects of cortisol and adrenal androgen on bone mass in Asians with and without subclinical hypercortisolism. (PubMed)

The effects of cortisol and adrenal androgen on bone mass in Asians with and without subclinical hypercortisolism. Analyses using the largest Korean cohort of adrenal incidentaloma (AI) revealed that subtle cortisol excess in premenopausal women and reduced dehydroepiandrosterone-sulfate (DHEA-S) in postmenopausal women and men are associated with bone mineral density (BMD) reduction in Asian patients with subclinical hypercortisolism (SH).Few studies evaluated bone metabolism in Asians with SH (...) . We investigated associations of cortisol and DHEA-S, an adrenal androgen, with BMD in Asians with AI, with or without SH.We used cross-sectional data of a prospective multicenter study from Korea. We measured BMD, bone turnover markers, cortisol levels after 1-mg dexamethasone suppression test (1-mg DST), DHEA-S, and baseline cortisol to DHEA-S ratio (cort/DHEA-S) in 109 AI patients with SH (18 premenopausal, 38 postmenopausal women, and 53 men) and 686 with non-functional AI (NFAI; 59

2019 Osteoporosis International

8. Robotic enucleation of adrenal masses: technique and outcomes. (PubMed)

Robotic enucleation of adrenal masses: technique and outcomes. To evaluate the feasibility and safety of the application of robotic enucleation of adrenal masses (REAM).Thirteen patients at Shanghai Changhai Hospital who underwent robotic enucleation of adrenal mass from February 2017 to March 2018 were reviewed. After mobilizing the adrenal gland and clamping the feeding blood vessels, the tumor was enucleated and reconstruction was performed. Relevant clinical data were recorded including (...) . After a median follow-up period of 12 months (range 9-15), no evidence of disease recurrence was detected.Robotic enucleation of adrenal masses is a safe and feasible procedure with excellent short-term functional and oncologic outcomes. Steroid supplementation is not necessary and recurrence is not usual with limited follow-up. Long-term follow-up and larger studies should be conducted to further evaluate outcomes of this robotic adrenal-sparing approach.

2019 World journal of urology

9. High-Resolution, Accurate-Mass (HRAM) Mass Spectrometry Urine Steroid Profiling in the Diagnosis of Adrenal Disorders. (PubMed)

High-Resolution, Accurate-Mass (HRAM) Mass Spectrometry Urine Steroid Profiling in the Diagnosis of Adrenal Disorders. Steroid profiling is a promising diagnostic tool with adrenal tumors, Cushing syndrome (CS), and disorders of steroidogenesis. Our objective was to develop a multiple-steroid assay using liquid-chromatography, high-resolution, accurate-mass mass spectrometry (HRAM LC-MS) and to validate the assay in patients with various adrenal disorders.We collected 24-h urine samples from (...) 114 controls and 71 patients with adrenal diseases. An HRAM LC-MS method was validated for quantitative analysis of 26 steroid metabolites in hydrolyzed urine samples. Differences in steroid excretion between patients were analyzed based on Z-score deviation from control reference intervals.Limits of quantification were 20 ng/mL. Dilution linearity ranged from 80% to 120% with means of 93% to 110% for all but 2 analytes. Intraassay and interassay imprecision ranged from 3% to 18% for all but 1

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2017 Clinical Chemistry

10. High resolution tissue mass spectrometry imaging reveals a refined functional anatomy of the human adult adrenal gland. (PubMed)

High resolution tissue mass spectrometry imaging reveals a refined functional anatomy of the human adult adrenal gland. In the adrenal gland, neuroendocrine cells that synthesize catecholamines and epithelial cells that produce steroid hormones are united beneath a common organ capsule to function as a single stress-responsive organ. The functional anatomy of the steroid hormone-producing adrenal cortex and the catecholamine-producing medulla is ill defined at the level of small molecules. Here (...) , we report a comprehensive high-resolution mass spectrometry imaging (MSI) map of the normal human adrenal gland. A large variety of biomolecules was accessible by matrix-assisted laser desorption/ionization-Fourier transform-ion cyclotron resonance MSI, including nucleoside phosphates indicative of oxidative phosphorylation, sterol and steroid metabolites, intermediates of glycolysis and the tricarboxylic acid cycle, lipids, and fatty acids. Statistical clustering analyses yielded a molecularly

2018 Endocrinology

11. Characteristics of Adrenal Masses in Familial Adenomatous Polyposis. (PubMed)

Characteristics of Adrenal Masses in Familial Adenomatous Polyposis. Adrenal masses are a known extraintestinal manifestation of familial adenomatous polyposis. However, the literature on this association is largely confined to case reports.This study aimed to determine the characteristics of adrenal masses in familial adenomatous polyposis and their clinical significance, as well as to estimate their prevalence. Mutational analysis was conducted to determine if any potential genotype-phenotype (...) correlations exist.This is a retrospective cohort study.Analysis included all patients meeting the criteria of classic familial adenomatous polyposis who were registered with the Familial Gastrointestinal Cancer Registry, a national Canadian database.Appropriate imaging or autopsy reports were available in 311 registry patients. Patients with adrenal metastases were excluded.Data collection included demographic data, mutation genotype, adrenal mass characteristics, surgical interventions and mortality.The

2018 Diseases of the Colon & Rectum

12. MKSAP: 62-year-old woman with a left adrenal mass

MKSAP: 62-year-old woman with a left adrenal mass Biochemical testing is needed to identify functional incidentalomas MKSAP: 62-year-old woman with a left adrenal mass | | March 24, 2018 1 Shares Test your medicine knowledge with the , in partnership with the . A 62-year-old woman is evaluated for an incidentally discovered left adrenal mass. Two weeks ago, the patient was evaluated in the emergency department for diffuse abdominal pain and vomiting. A CT scan was obtained that was normal (...) except for the adrenal mass. Three hours after presentation to the emergency department, the pain resolved spontaneously. Her medical history is significant for diet-controlled type 2 diabetes mellitus diagnosed 1 year ago and osteoporosis diagnosed 4 years ago. Her only medication is alendronate. On physical examination, temperature is 37.0 °C (98.6 °F), blood pressure is 120/80 mm Hg, and pulse rate is 70/min. BMI is 26. The remainder of the physical examination is normal. Laboratory evaluation

2018 KevinMD blog

13. Simultaneous peritoneal and retroperitoneal splenosis mimics metastatic right adrenal mass (PubMed)

Simultaneous peritoneal and retroperitoneal splenosis mimics metastatic right adrenal mass Right retroperitoneal splenosis is rare with few reported cases. We report, here, the case of simultaneous peritoneal and retroperitoneal splenosis mimics metastatic right adrenal mass.A 28-year-old man who had previously undergone post traumatic splenectomy at childhood and subsequently presented with an large incidental non-functioning right adrenal mass with presence of extra-hepatic peritoneal focal (...) . Traditional imaging techniques cannot differentiate splenosis from malignancy.Large right adrenal incidentalomas present with other abdominal, peritoneal masses could be splenosis in patient following post-traumatic splenectomy.Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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2018 International journal of surgery case reports

14. Detection of a unicentric type of Castleman-like mass at the site of adrenal grand: A case report and review of literature (PubMed)

Detection of a unicentric type of Castleman-like mass at the site of adrenal grand: A case report and review of literature We present a case of adrenal CD in a 26-year-old female. The patient was referred to our hospital because of left flank pain for 1 wk. A computed tomography scan revealed a 4 cm × 3 cm well-defined mass, considered as a paraganglioma. A preoperative diagnosis of left adrenal neoplasm and urinary tract infection was made. The patient underwent anti-inflammatory therapy (...) followed by an open operation to remove the mass in the left adrenal. Through analysis of the morphological pattern and immunohistochemical markers, a diagnosis of CD was made. During the 12-mo follow-up, there was no evidence of metastasis or recurrence. This case reminds clinicians that CD should be considered in the evaluation of an adrenal mass. Surgery is suggested for its therapeutic management.

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2018 World journal of clinical cases

15. A case of adrenal Cushing’s syndrome with bilateral adrenal masses (PubMed)

A case of adrenal Cushing’s syndrome with bilateral adrenal masses A functional lesion in corticotrophin (ACTH)-independent Cushing's syndrome is difficult to distinguish from lesions of bilateral adrenal masses. Methods for distinguishing these lesions include adrenal venous sampling and (131)I-6β-iodomethyl-19-norcholesterol ((131)I-NP-59) scintigraphy. We present a case of a 29-year-old Han Chinese female patient with a history of hypercholesterolaemia and polycystic ovary syndrome. She (...) presented with a 6month history of an 8kg body weight gain and gradual rounding of the face. Serial examinations revealed loss of circadian rhythm of cortisol, elevated urinary free-cortisol level and undetectable ACTH level (<5pg/mL). No suppression was observed in both the low- and high-dose dexamethasone suppression tests. Adrenal computed tomography revealed bilateral adrenal masses. Adrenal venous sampling was performed, and the right-to-left lateralisation ratio was 14.29. The finding from adrenal

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2016 Endocrinology, diabetes & metabolism case reports

16. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumours

: Research Article Online Publication Date: 01 Aug 2016 Copyright: © 2016 European Society of Endocrinology 2016 Free access By definition, an adrenal incidentaloma is an asymptomatic adrenal mass detected on imaging not performed for suspected adrenal disease. In most cases, adrenal incidentalomas are nonfunctioning adrenocortical adenomas, but may also represent conditions requiring therapeutic intervention (e.g. adrenocortical carcinoma, pheochromocytoma, hormone-producing adenoma or metastasis (...) autonomous cortisol secretion, formerly called ‘subclinical’ Cushing’s syndrome?; (C) Who should have surgical treatment and how should it be performed?; (D) What follow-up is indicated if the adrenal incidentaloma is not surgically removed? Selected recommendations: (i) At the time of initial detection of an adrenal mass establishing whether the mass is benign or malignant is an important aim to avoid cumbersome and expensive follow-up imaging in those with benign disease. (ii) To exclude cortisol

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2016 European Society of Endocrinology

17. Characterization of adrenal masses by using FDG PET: a systematic review and meta-analysis of diagnostic test performance

Characterization of adrenal masses by using FDG PET: a systematic review and meta-analysis of diagnostic test performance Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2011 DARE.

18. Evidenced-based care of pregnant women with symptomatic adrenal masses - accepting imperfect data. (PubMed)

Evidenced-based care of pregnant women with symptomatic adrenal masses - accepting imperfect data. 29090509 2019 02 15 2019 02 15 1471-0528 125 6 2018 05 BJOG : an international journal of obstetrics and gynaecology BJOG Evidenced-based care of pregnant women with symptomatic adrenal masses - accepting imperfect data. 728 10.1111/1471-0528.15005 Blumenfeld Y J YJ Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA. eng Journal Article Comment 2017 12 06 England (...) BJOG 100935741 1470-0328 AIM IM BJOG. 2018 May;125(6):719-727 28872770 Adrenal Gland Neoplasms Case-Control Studies Female Humans Hypertension Pregnancy Pregnancy Outcome Pregnant Women 2017 11 2 6 0 2019 2 16 6 0 2017 11 2 6 0 ppublish 29090509 10.1111/1471-0528.15005

2017 BJOG

19. Minimally invasive resection of adrenal masses in infants and children: results of a European multi-center survey. (PubMed)

Minimally invasive resection of adrenal masses in infants and children: results of a European multi-center survey. Minimal access adrenal surgery (MAAS) for adrenal pathologies is the standard for many pediatric surgical centers. However, the literature offers few reports and minimal evidence from small case series. The aim of this study was to evaluate the outcomes of pediatric MAAS through a multi-center data analysis.Pediatric patients who underwent MAAS between January 2002 and December (...) 2013 were retrospectively included. Data analysis was conducted using Spss software (Welch's t-test, X-square, Fisher tests, multiple regression model).Six European centers participated, 68 patients were included with mean age of 5.2 years (2 months-16 years). Lesion volume was of 18.1 cc (0.78-145.6), with a mean diameter of 2.8 cm (1.1-6.5). Localization was 50% left-sided masses, 45.6% right-side masses, and 4.4% bilateral. Histological examination revealed 36 neuroblastomas, 15 adenomas, nine

2017 Surgical endoscopy

20. Performance of 18F-FDG PET/CT in the characterization of adrenal masses in non-cancer patients: A prospective study. (PubMed)

Performance of 18F-FDG PET/CT in the characterization of adrenal masses in non-cancer patients: A prospective study. Few prospective studies have evaluated the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the characterization of adrenal masses.To assess the performance of 18F-FDG PET/CT in the malignancy diagnosis of adrenal masses in noncancer patients.Prospective multicenter study.The study population consisted of 87 patients (87 adrenal (...) masses) referred to endocrine surgeons: 56 with mass diameter ≥40 mm and 31 with a diameter <40 mm and of indeterminate nature based on unenhanced and washout CT attenuation densities. Fourteen patients had hypercortisolism. Adrenal masses were characterized by 18F-FDG PET/CT. Histology was the gold standard for the diagnosis of malignancy. In the absence of pathological proof (n = 23), the nature of the lesion was based on the 12-month imaging follow-up.Fifteen adrenal masses were classified

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2017 Journal of Clinical Endocrinology and Metabolism

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