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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. Chemical shift imaging for evaluation of adrenal masses: a systematic review and meta-analysis

Chemical shift imaging for evaluation of adrenal masses: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address

2018 PROSPERO

10. 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

11. 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.

12. 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

13. 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

14. 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

15. 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

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2018 Endocrinology

16. Transperitoneal versus retroperitoneal laparoscopic adrenalectomy for adrenal tumours in adults. (PubMed)

tumours or masses of the adrenal gland, which were assessed by both laboratory and imaging studies.Two review authors independently extracted data, assessed trials for risk of bias, and evaluated overall study quality using GRADE criteria. We calculated the risk ratio (RR) for dichotomous outcomes, or the mean difference (MD) for continuous variables, and corresponding 95% confidence interval (CI). We primarily used a random-effects model for pooling data.We examined 1069 publications, scrutinized 42 (...) Transperitoneal versus retroperitoneal laparoscopic adrenalectomy for adrenal tumours in adults. Laparoscopic adrenalectomy is an accepted treatment worldwide for adrenal gland disease in adults. The transperitoneal approach is more common. The retroperitoneal approach may be preferred, to avoid entering the peritoneum, but no clear advantage has been demonstrated so far.To assess the effects of laparoscopic transperitoneal adrenalectomy (LTPA) versus laparoscopic retroperitoneal adrenalectomy

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2018 Cochrane

17. Hydrocortisone (Alkindi) - Adrenal Insufficiency

Hydrocortisone (Alkindi) - Adrenal Insufficiency 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2018. Reproduction is authorised provided the source is acknowledged. 14 December 2017 EMA/4145/2018 Committee for Medicinal Products for Human Use (CHMP) Assessment report Alkindi International non (...) . Conclusions on clinical safety 49 2.5. Risk Management Plan 49 2.6. Pharmacovigilance 50 2.7. Product information 50 2.7.1. User consultation 50 Assessment report EMA/4145/2018 Page 3/59 3. Benefit-risk balance 51 4. Recommendation 58 5. Appendix Error! Bookmark not defined. Assessment report EMA/4145/2018 Page 4/59 List of abbreviations ACTH Adrenocorticotropin ADME Absorption, distribution, metabolism and excretion AhR Aryl hydrocarbon receptor AI Adrenal insufficiency ARNT AhR Nuclear Translocator AUC

2018 European Medicines Agency - EPARs

18. Incidentally Discovered Adrenal Mass

Incidentally Discovered Adrenal Mass Date of origin: 1996 Last review date: 2012 ACR Appropriateness Criteria ® 1 Incidentally Discovered Adrenal Mass American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Incidentally Discovered Adrenal Mass Variant 1: No history of malignancy; mass 1-4 cm in diameter. Initial evaluation. Radiologic Procedure Rating Comments RRL* CT abdomen without IV contrast 8 Presumes that a noncontrast CT has not already been performed (...) Only for suspicion of pheochromocytoma. ??? MRI abdomen without and with IV contrast 2 O US adrenal gland 1 O Biopsy adrenal gland 1 Varies CT abdomen with IV contrast 1 ??? X-ray abdomen 1 ?? Iodocholesterol scan 1 This agent may be used to detect functionally active adenomas. ???? FDG-PET/CT skull base to mid-thigh 1 ???? Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level Variant 2: No history of malignancy; mass 1–4 cm

2012 American College of Radiology

19. Management of Adrenal Masses in Patients with Beckwith-Wiedemann Syndrome (PubMed)

Management of Adrenal Masses in Patients with Beckwith-Wiedemann Syndrome Beckwith-Wiedemann syndrome (BWS) is a genetic overgrowth and cancer predisposition syndrome, associated with both benign and malignant adrenal findings. Literature review and an institutional case series elucidate the wide spectrum of adrenal findings in BWS patients. The altered expression of the 11p15 region is likely related to adrenal gland hyperplasia and growth dysregulation. Given the absence of guidelines (...) for managing adrenal findings in BWS, we propose a systematic approach to adrenal findings in BWS patients, to allow for maximum detection of potentially malignant pathology without posing additional risk to patients.© 2017 Wiley Periodicals, Inc.

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2017 Pediatric blood & cancer

20. A Rare Adrenal Mass in a 3-Month-Old: A Case Report and Literature Review (PubMed)

A Rare Adrenal Mass in a 3-Month-Old: A Case Report and Literature Review A three-month-old female infant presented with abdominal distention for 2 months. A large palpable mass in right upper quadrant was noted on physical exam. Abdominal ultrasound revealed a large heterogeneous mass with multiple cystic components. Mass was surgically excised and pathology was consistent with mature adrenal teratoma. Teratoma is a germ cell tumor mainly found in gonadal tissues. Occurrence of adrenal gland (...) teratoma in children is very rare with less than 10 pediatric case reports in English literature. We present a rare case of primary adrenal tumor in an infant and a review of the literature.

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2017 Case reports in pediatrics

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