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Adrenal Mass

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3661. Bilateral testicular adrenal rests after bilateral adrenalectomies in a cushingoid patient with von Hippel-Lindau disease. (PubMed)

Bilateral testicular adrenal rests after bilateral adrenalectomies in a cushingoid patient with von Hippel-Lindau disease. We report a case of bilateral testicular masses in a 25-year-old man with von Hippel-Lindau disease presenting with cushingoid symptoms. His medical history was significant for bilateral adrenalectomies secondary to pheochromocytomas, and he began steroid therapy at that time. After exhaustive endocrinologic, radiographic, and physical examinations, the testicular masses (...) were postulated to be active adrenal rest tissue. Bilateral testicular venous sampling found elevated glucocorticoids that were responsive to dexamethasone suppression, which confirmed the testicular masses as testicular adrenal rests without the need for surgical intervention. Successful conservative management consisted of appropriate steroid manipulation and radiographic evaluation and resulted in the resolution of presenting symptoms, a decrease in size of the bilateral testicular masses

2004 Urology

3662. Pleomorphic leiomyosarcoma of the adrenal gland: case report and review of the literature. (PubMed)

mass abutting the renal vessels. The adrenal mass was resected and histopathologic examination revealed a highly pleomorphic malignant spindle cell neoplasm diffusely infiltrating the adrenal parenchyma with an immunoprofile consistent with that of a leiomyosarcoma. Clinical management and subsequent follow-up of this patient is presented. (...) Pleomorphic leiomyosarcoma of the adrenal gland: case report and review of the literature. Primary adrenal leiomyosarcomas (LMS) are extremely rare mesenchymal tumors. To the best of our knowledge only 12 cases (9 cases of conventional and 2 cases of pleomorphic LMS) have been reported in the literature until the present date. Herein we report a case of pleomorphic LMS in a 47-year-old woman who presented with severe abdominal pain. Computed tomography showed a large heterogeneous left adrenal

2007 Urology

3663. Retroperitoneoscopic adrenalectomy without previous control of adrenal vein is feasible and safe for pheochromocytoma. (PubMed)

Retroperitoneoscopic adrenalectomy without previous control of adrenal vein is feasible and safe for pheochromocytoma. To evaluate the effectiveness and safety of retroperitoneal laparoscopic adrenalectomy for pheochromocytoma and report our experience in adrenalectomy without previous control of the adrenal vein.From January 2000 to December 2005, 56 patients underwent 58 retroperitoneal laparoscopic adrenalectomy procedures for the treatment of pheochromocytoma. Adequate preoperative (...) antihypertensive preparation was performed. Intraoperative hemodynamic changes were documented in detail. During surgery, the adrenal vein was identified and ligated after dissection and mobilization of the adrenal gland.One patient required conversion to open surgery. The mean operative time and estimated blood loss was 50.4 +/- 19.8 minutes (range 25 to 150) and 76.4 +/- 23.5 mL (range 20 to 300), respectively. A systolic blood pressure greater than 200 mm Hg or less than 80 mm Hg was observed in 6 and 3

2007 Urology

3664. Giant nonfunctioning carcinoma of the adrenal cortex mimicking renal cell carcinoma: a diagnostic dilemma. (PubMed)

Giant nonfunctioning carcinoma of the adrenal cortex mimicking renal cell carcinoma: a diagnostic dilemma. Adrenocortical carcinoma is a rare, highly malignant neoplasm that originates in the adrenal cortex and is difficult to differentiate from renal cell carcinoma, especially if it is gigantic and nonfunctional. We report the case of a 40-year-old man with an incidental mass in the right upper abdomen. Magnetic resonance imaging revealed that the mass originated from the right kidney (...) and was highly suggestive of renal cell carcinoma. However, histologic examination after radical nephrectomy confirmed the mass to be an adrenocortical carcinoma compressing the kidney. We discuss the obscurity and implications of such a diagnosis.

2007 Urology

3665. Handling and pathology reporting of adrenal gland specimens. (PubMed)

Handling and pathology reporting of adrenal gland specimens. Proper treatment of resection specimens by the urologist and pathologist is critical in accurately reporting tumors and tumor-like nodules of the adrenal gland. Clinically inapparent adrenal masses are discovered, with increasing frequency, in the course of diagnostic testing or treatment for conditions that are not related to adrenal diseases. As a consequence an increasing number of relatively small tumors lacking the characteristic (...) gross features of malignancy is detected. There is a need for identification of pathological findings that can improve the diagnostic accuracy and predict patient outcome. The aim of this paper is to review the handling and pathology reporting of adrenal gland specimens in the light of recent advances in this field of pathology.

2004 European Urology

3666. Laparoscopic adrenalectomy for suspected metastasis of adrenal glands: our experience. (PubMed)

Laparoscopic adrenalectomy for suspected metastasis of adrenal glands: our experience. To present our experience in laparoscopic adrenalectomy for isolated adrenal metastasis.A total of 34 adrenalectomies were performed in 32 patients for incidental adrenal masses discovered at primary tumor diagnosis or during follow-up. The primary tumors diagnosed were 13 cases of lung carcinoma, 9 of renal cell carcinoma, 2 of colorectal carcinoma, 2 of bladder carcinoma, and 1 each of ovarian carcinoma (...) by expert laparoscopists. We did not find a correlation between mass size and malignancy. Nevertheless, we believe that longer follow-up is mandatory before definitive conclusions can be drawn.

2007 Urology

3667. Adenomatoid of the adrenal gland. (PubMed)

Adenomatoid of the adrenal gland. Adenomatoid tumors are common in the genital tract but rare in the adrenal gland. These tumors can be difficult to diagnose when present in extragenital sites. This type of adrenal tumor lacks specific radiographic features and can be confused preoperatively with more common adrenal gland tumors. We present the case of a 54-year-old man with an incidental right adrenal mass with calcified components and elevated urinary levels of homovanillic acid (...) that was found to be an adenomatoid tumor of the adrenal gland.

2005 Urology

3668. Beyond adrenal and ovarian androgen generation: Increased peripheral 5 alpha-reductase activity in women with polycystic ovary syndrome. (PubMed)

Beyond adrenal and ovarian androgen generation: Increased peripheral 5 alpha-reductase activity in women with polycystic ovary syndrome. Hyperandrogenism, a main clinical feature of polycystic ovary syndrome (PCOS), is thought to result from enhanced ovarian and adrenal androgen generation. To investigate the contribution of peripheral steroidogenesis, we used an oral challenge with dehydroepiandrosterone (DHEA) and analyzed its downstream conversion toward androgens in eight women with PCOS (...) (age, 20-32 yr; body mass index, 20-41 kg/m(2)) and eight healthy women matched for age and body mass index. They underwent frequent serum sampling and urine collection for 8 h on three occasions: at baseline, and after 4 d of dexamethasone (Dex; 4 x 0.5 mg/d), followed by ingestion of 100 mg DHEA or placebo. Dex induced similar significant suppression of circulating steroids in both groups. The oral DHEA challenge led to similar significant increases in the area under the concentration-time curve

2003 The Journal of clinical endocrinology and metabolism Controlled trial quality: uncertain

3669. Effect of intranasal fluticasone propionate and triamcinolone acetonide on basal and dynamic measures of hypothalamic-pituitary-adrenal-axis activity in healthy volunteers. (PubMed)

Effect of intranasal fluticasone propionate and triamcinolone acetonide on basal and dynamic measures of hypothalamic-pituitary-adrenal-axis activity in healthy volunteers. Most published studies show that intranasal corticosteroids have no effect on the hypothalamic-pituitary-adrenal (HPA) axis, but there have been isolated reports to the contrary, contradicting accumulated knowledge on pharmacokinetics.To re-evaluate the effect of fluticasone propionate aqueous nasal spray (FPANS (...) was collected to assess cortisol excretion and cortisol creatinine ratio. Approximately 26 h after the last administration of study medication, volunteers underwent stimulation with 0.5 microg adrenocorticotropic hormone (ACTH). Serum cortisol concentrations were measured before and 20 and 30 min after injection. Blood and urine samples were analysed for cortisol by liquid chromatography tandem mass spectrometry.Compared with placebo, EP or TAA had no significant effect on mean overnight (12 h) urinary

2004 Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology Controlled trial quality: uncertain

3670. Troglitazone decreases adrenal androgen levels in women with polycystic ovary syndrome. (PubMed)

Troglitazone decreases adrenal androgen levels in women with polycystic ovary syndrome. To determine whether amelioration of insulin resistance in polycystic ovary syndrome (PCOS) with the insulin sensitizer troglitazone (TGZ) decreases circulating adrenal androgens (AAs), as reflected by DHEAS levels.Prospective, randomized, double-blind clinical trial.Multicenter study.Three-hundred five women with PCOS.Subjects were randomly assigned to receive either placebo (PBO; n = 73) or TGZ in doses (...) of 150 mg/day (TGZ-150; n = 78), 300 mg/day (TGZ-300; n = 77), or 600 mg/day (TGZ-600; n = 77) for 20 weeks. Blood was sampled before (week 0) and at week 20 of treatment.DHEAS, insulin, and glucose levels were determined in the blood samples.There were no differences in age, body mass, or racial composition among the groups. Our results indicate that basal insulin declined in a dose-related fashion. Likewise, TGZ administration caused a dose-related decrease in DHEAS levels. To detect extreme

2003 Fertility and sterility Controlled trial quality: uncertain

3671. Response of the hypothalamic-pituitary-adrenal axis to small dose arginine-vasopressin and daily urinary free cortisol before and after alprazolam pre-treatment differs in obesity. (PubMed)

Response of the hypothalamic-pituitary-adrenal axis to small dose arginine-vasopressin and daily urinary free cortisol before and after alprazolam pre-treatment differs in obesity. Arginine vasopressin (AVP) has a central role in the response of the hypothalamic-pituitary-adrenal (HPA) axis to stress conditions. A low dose of AVP has been shown to have a modest, but significant effect on ACTH response in normal weight subjects. The aim of this study was to test the response of the HPA axis (...) and by approximately 50% in the overweight/obese subjects. These changes were unrelated to the cortisol response to the AVP test before and after APZ pretreatment. On the other hand, percent changes of 24h-UFC/creatinine after APZ were negatively related to the body mass index (BMI) but positively with waist circumference values, which indicates that the abdominal obesity phenotype may counteract the 24 h-UFC/creatinine that would be expected on the basis of BMI values.Our data further support the concept

2004 Journal of endocrinological investigation Controlled trial quality: uncertain

3672. Increased adrenal androgen secretion with inhibition of 11beta-hydroxylase in HIV-infected women. (PubMed)

Increased adrenal androgen secretion with inhibition of 11beta-hydroxylase in HIV-infected women. Adrenal androgen production is reduced in association with disease severity in HIV-infected women. This response may be maladaptive in terms of maintenance of lean body mass, functional status, and immune function. The aim of this study was to assess whether the use of an adrenal enzyme inhibitor of 11beta-hydroxylase might increase androgen production in this population. We conducted a randomized (...) did not change, and signs of adrenal insufficiency were not apparent. These data demonstrate that inhibition of 11beta-hydroxylase with metyrapone increases adrenal androgen secretion in HIV-infected women. Further studies are needed to assess the physiological effects of this strategy to increase anabolic hormone levels in severe stress, including detailed testing to rule out the potential risk of concomitant adrenal insufficiency.

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2006 American journal of physiology. Endocrinology and metabolism Controlled trial quality: predicted high

3673. Differentiation of Adrenal Adenoma and Nonadenoma in Unenhanced CT: New Optimal Threshold Value and the Usefulness of Size Criteria for Differentiation (PubMed)

Differentiation of Adrenal Adenoma and Nonadenoma in Unenhanced CT: New Optimal Threshold Value and the Usefulness of Size Criteria for Differentiation To determine the optimal threshold for the attenuation values in unenhanced computed tomography (CT) and assess the value of the size criteria for differentiating between an adrenal adenoma and a nonadenoma.The unenhanced CT images of 45 patients at our institution, who underwent a surgical resection of an adrenal masses between January 2001 (...) and July 2005, were retrospectively reviewed. Forty-five adrenal masses included 25 cortical adenomas, 12 pheochromocytomas, three lymphomas, and five metastases confirmed by pathology were examined. The CT images were obtained at a slice thickness of 2 mm to 3 mm. The mAs were varied from 100 to 160 and 200 to 280, while the 120 KVp was maintained in all cases. The mean attenuation values of an adrenal adenoma and nonadenoma were compared using an unpaired t test. The sensitivity, specificity

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2007 Korean Journal of Radiology

3674. Effects on Hemostasis, Lipids, Carbohydrate Metabolism, Adrenal & Thyroid Function of the Combined Oral Contraceptive NOMAC-E2 Compared to a COC Containing LNG-EE (292004)(COMPLETED)(P05764)

Effects on Hemostasis, Lipids, Carbohydrate Metabolism, Adrenal & Thyroid Function of the Combined Oral Contraceptive NOMAC-E2 Compared to a COC Containing LNG-EE (292004)(COMPLETED)(P05764) Effects on Hemostasis, Lipids, Carbohydrate Metabolism, Adrenal & Thyroid Function of the Combined Oral Contraceptive NOMAC-E2 Compared to a COC Containing LNG-EE (292004)(COMPLETED)(P05764) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting (...) registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Effects on Hemostasis, Lipids, Carbohydrate Metabolism, Adrenal & Thyroid Function of the Combined Oral Contraceptive NOMAC-E2 Compared to a COC Containing LNG-EE (292004)(COMPLETED)(P05764) The safety and scientific validity of this study is the responsibility of the study

2007 Clinical Trials

3675. Study of UK Adults With Congenital Adrenal Hyperplasia.

adrenal androgen production. Patients suffer from problems with growth and development and as adults patients may have problems with fertility, virilisation in women, testicular masses in men and both men and women have an impaired quality of life. Patients have to take life-long therapy. Despite its frequency knowledge surrounding the management of adults with CAH remains fairly limited. There has been a lot of work describing the management of children with CAH but to date there is no consensus (...) Study of UK Adults With Congenital Adrenal Hyperplasia. Study of UK Adults With Congenital Adrenal Hyperplasia. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Study of UK Adults With Congenital Adrenal

2008 Clinical Trials

3676. Malignant adrenal neuroblastoma in a young dog (PubMed)

Malignant adrenal neuroblastoma in a young dog A 1.5-year-old dog was evaluated for abnormal mentation, collapse, and weight loss. Radiographs and ultrasonographs revealed soft tissue masses in the mid abdomen. Ultrasound-guided fine-needle aspirates provided a diagnosis of malignant epithelial or round cell neoplasia. Histopathologic and immunohistochemical findings on the tumors were consistent with a primitive neuroblastoma.

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2004 The Canadian Veterinary Journal

3677. Laparoscopic Adrenalectomy for Isolated Adrenal Metastasis (PubMed)

Laparoscopic Adrenalectomy for Isolated Adrenal Metastasis Laparoscopic adrenalectomy is accepted by many as the standard of care for the majority of adrenal masses less than 8 cm. The question exists whether laparoscopic removal of metastatic lesions to the adrenal is more difficult than laparoscopic removal of primary adrenal lesions.We performed a retrospective analysis of all laparoscopic adrenalectomies performed at a single institution from 1998 to 2001, comparing laparoscopic (...) =332 minutes, average tumor size=7.3 cm, median hospital stay=2 days). No major complications occurred in either group.We feel laparoscopic adrenalectomy is the preferred approach for primary adrenal masses less than 8 cm. Based on our experience and a review of the literature, isolated metastatic lesions to the adrenal gland appear less amenable to laparoscopic removal than do primary lesions of the same size.

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2004 JSLS : Journal of the Society of Laparoendoscopic Surgeons

3678. Adrenal Adenoma Presenting with Ventricular Fibrillation (PubMed)

level. Computed tomography then revealed a right adrenal mass. The patient was treated with surgical resection of the adenoma. This case emphasizes the importance of meticulous search for secondary causes of hypertension, before the occurrence of serious complications. (...) Adrenal Adenoma Presenting with Ventricular Fibrillation We report the case of a 58-year-old man who presented with ventricular fibrillation. The serum potassium level was 1.8 mEq/L after successful cardioversion. Coronary angiography showed a normal heart with no structural defects, but 12-lead electrocardiography showed indications of left ventricular hypertrophy, which was confirmed by echocardiography. Laboratory examinations showed a suppressed renin level and an elevated serum aldosterone

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2005 Texas Heart Institute Journal

3679. Laparoscopic Management of an Adrenal Leiomyoma in an AIDS Patient. A Case Report and Review of the Literature (PubMed)

Laparoscopic Management of an Adrenal Leiomyoma in an AIDS Patient. A Case Report and Review of the Literature Laparoscopic management of adrenal masses has been well described. Immunologically compromised patients can obtain significant benefit from these minimally invasive procedures. We describe a case of an enlarging smooth muscle tumor of the adrenal gland in an acquired immunodeficiency syndrome (AIDS) patient and review the sparse literature available on this subject.A 49-year-old female (...) with AIDS complaining of vague abdominal discomfort was found to have a left adrenal mass. Significant enlargement of the mass was noted during routine follow-up. The patient underwent an elective laparoscopic left adrenalectomy without complications. Pathological review found the mass to be a rare adrenal leiomyoma.Benign, smooth muscle tumors arising from the adrenal glands are rare. A review of the literature does reveal a propensity for these tumors to occur in the immunocompromised population.The

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2005 JSLS : Journal of the Society of Laparoendoscopic Surgeons

3680. Incidentally Discovered Adrenal Schwannoma (PubMed)

Incidentally Discovered Adrenal Schwannoma Schwannoma is a rare tumor of neural crest cell origin that is rarely seen arising from the adrenal gland. We report a case of an adrenal mass discovered incidentally in a 70-year-old man as part of a hematuria workup. Metabolic evaluation was unremarkable, and imaging studies did not meet strict imaging criteria for a typical adenoma. Following surgical excision and pathologic evaluation with confirmatory immunohistochemical staining, the mass

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2007 JSLS : Journal of the Society of Laparoendoscopic Surgeons

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