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Mass Spectrometry-Based Adrenal and Peripheral Venous Steroid Profiling for Subtyping Primary Aldosteronism. Differentiating patients with primary aldosteronism caused by aldosterone-producing adenomas (APAs) from those with bilateral adrenal hyperplasia (BAH), which is essential for choice of therapeutic intervention, relies on adrenal venous sampling (AVS)-based measurements of aldosterone and cortisol. We assessed the utility of LC-MS/MS-based steroid profiling to stratify patients (...) with primary aldosteronism.Fifteen adrenal steroids were measured by LC-MS/MS in peripheral and adrenal venous plasma from AVS studies for 216 patients with primary aldosteronism at 3 tertiary referral centers. Ninety patients were diagnosed with BAH and 126 with APAs on the basis of immunoassay-derived adrenal venous aldosterone lateralization ratios.Among 119 patients confirmed to have APAs at follow-up, LC-MS/MS-derived lateralization ratios of aldosterone normalized to cortisol, dehydroepiandrosterone
Adrenalmasses: A urological perspective Adrenalmasses have become increasingly common due to widespread use of sectional imaging. Urologists are commonly faced with management decisions in patients with adrenalmasses. Systemic review of available literature related to surgical adrenal disease was performed to summarise the most pertinent information related to adrenalmasses, diagnostic evaluation and surgical treatment. Detailed hormonal evaluation of adrenal disease was not included, being (...) part of endocrinological rather than urological practice. Adrenalmasses exhibit a wide spectrum of presentation and pathology, and treatment requires different surgical techniques. Full understanding of the pathology and management of such masses should be completely familiar to practicing urologists.
Carotid Intima-Media Thickness as the Cardiometabolic Risk Indicator in Patients with Nonfunctional AdrenalMass and Metabolic Syndrome Screening Our purpose was to show the association of adrenal incidentaloma and metabolic syndrome in consideration of the studies and to detect the increase in the carotid intima-media thickness which is regarded as the precessor of atherosclerosis.Eighty-one patients who were diagnosed with adrenalmass were included in the study. Hormonal evaluation, insulin (...) rezistance measurement with the HOMA-IR and 1-mg DST were performed of all patients. The patients were classified as follows: mass size <3 cm (K1) and mass size of at least 3 cm (K2). Echocardiography and carotid intima-media thickness of the patients were measured using B-mode ultrasound. Thirty-three healthy individuals were enrolled as the control group.Mass size of 64.19% K1, while mass size of the remainder (35.81%) K2 was calculated. Five of the patients with adrenalmass were detected to have
Radiographic Characteristics of AdrenalMasses in Oncologic Patients We aimed to assess the usefulness of pre-contrast Hounsfield unit (HU) and mass size on computed tomography to differentiate adrenalmass found incidentally in oncologic patients.From 2000 to 2012, 131 oncologic patients with adrenal incidentaloma were reviewed retrospectively. Receiver operating characteristic (ROC) curves were applied to determine the optimal cut-off value of the mean HU and size for detecting adrenal (...) metastasis.The median age was 18 years, and 80 patients were male. The initial mass size was 18 mm, and 71 (54.2%) of these were on the left side. A bilateral adrenalmass was found in 11 patients (8.4%). Biochemically functional masses were observed in 9.2% of patients. Thirty-six out of 119 patients with nonfunctional masses underwent adrenalectomy, which revealed metastasis in 13. The primary cancers were lung cancer (n=4), renal cell carcinoma (n=2), lymphoma (n=2), hepatocellular carcinoma (n=2), breast
Bilateral adrenalmasses: a single-centre experience Bilateral adrenalmasses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenalmasses are limited.To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal (...) masses.Retrospective analysis of 70 patients with bilateral adrenalmasses presenting to a single tertiary care endocrine centre from western India (2002-2015).The most common aetiology was pheochromocytoma (40%), followed by tuberculosis (27.1%), primary adrenal lymphoma (PAL) (10%), metastases (5.7%), non-functioning adenomas (4.3%), primary bilateral macronodular adrenal hyperplasia (4.3%), and others (8.6%). Age at presentation was less in patients with pheochromocytoma (33 years) and tuberculosis (41 years
Management of AdrenalMasses An adrenalmass can be either symptomatic or asymptomatic in the form of adrenal incidentalomas (AIs) in up to 8 % in autopsy and 4 % in imaging series. Once a diagnosis of adrenalmass is made, we need to differentiate whether it is functioning or nonfunctioning, benign, or malignant. In this article, we provide a literature review of the diagnostic workup including biochemical evaluation and imaging characteristics of the different pathologies. We also discuss (...) the surgical strategies with laparoscopy as the mainstay with partial adrenalectomy in select cases and adrenalectomy in large masses. Follow-up protocol of AIs and adrenocortical carcinoma is also discussed.
Adrenalmass in a patient with tetralogy of Fallot: beyond expected 28210477 2018 11 13 2008-5117 8 4 2016 Journal of cardiovascular and thoracic research J Cardiovasc Thorac Res Adrenalmass in a patient with tetralogy of Fallot: beyond expected. 190-191 10.15171/jcvtr.2016.38 Martínez-Quintana Efrén E Cardiology Service, Insular-Materno Infantil University Hospital, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. Rodríguez-González Fayna F Dr. Negrín University
Young male with left adrenalmass 27432826 2017 02 17 2018 11 13 1757-790X 2016 2016 Jul 15 BMJ case reports BMJ Case Rep Young male with left adrenalmass. 10.1136/bcr-2016-215669 bcr2016215669 Meshikhes Abdul-Wahed Nasir AW Department of Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia. Abdel Gawad Wael M WM Department of Surgical Oncology, National Cancer Institute, Cairo, Egypt. Al-Saeed Jamal Youssef JY Department of Endocrinology, King Fahad Specialist Hospital, Dammam, Saudi (...) Arabia. eng Case Reports Journal Article 2016 07 15 England BMJ Case Rep 101526291 1757-790X IM Adrenal Gland Neoplasms diagnostic imaging pathology surgery Adrenal Glands diagnostic imaging surgery Adrenocortical Carcinoma diagnostic imaging pathology surgery Adult Fatal Outcome Humans Image-Guided Biopsy Magnetic Resonance Imaging Male Tomography, X-Ray Computed Ultrasonography, Interventional Young Adult 2016 7 20 6 0 2016 7 20 6 0 2017 2 18 6 0 epublish 27432826 bcr-2016-215669 10.1136/bcr-2016
Incidentally Solitary, Synchronous, Metastatic Left AdrenalMass From Colon Cancer The authors report the case of a 63-year-old man who underwent an open adrenalectomy for a synchronous, malignant, metastatic left adrenal tumor and a total colectomy for T3N0M1 (stage 4) primary, malignant colon cancer. Two polypoid lesions, one measuring 40 mm × 30 mm × 30 mm and the other measuring 20 mm × 10 mm × 10 mm, were found in the ascending colon and rectosigmoid (RS) junction, respectively (...) , and a synchronous, malignant, left adrenal gland lesion measuring 70 mm × 50 mm × 30 mm was incidentally found on abdominal computed tomography scan. Histological examination revealed a metastatic, necrotic adenocarcinoma of the left adrenalmass, an adenocarcinoma of the cecal mass, and an adenomatous polyp (tubulovillous type) of the smallest polypoid lesion in RS junction that had invaded deeply into the submucosal layer. The patient recovered uneventfully, and his condition is now stable, with no evidence
Ectopic Thyroid Tissue in the Adrenal Gland Mimicking a Pheochromocytoma Ectopic thyroid tissue in the adrenal gland (ETTAG) usually presents as a well-circumscribed cystic mass on a CT scan. However, the MRI features of ETTAG are incompletely understood. We report a case of ectopic thyroid tissue in the adrenal gland, which demonstrates findings similar to those of a pheochromocytoma on the MRI.
Salivary Cortisol and Cortisone After Low-Dose Corticotropin Stimulation in the Diagnosis of Adrenal Insufficiency Basal and poststimulation salivary cortisol and cortisone levels can be useful in the diagnosis of adrenal insufficiency. However, little is known about the optimal cutoffs and performance characteristics of these tests.To derive the cutoff values and study the performance characteristics of salivary cortisol and salivary cortisone in the diagnosis of adrenal (...) insufficiency.Prospective study in a regional hospital in Hong Kong from January 2014 to September 2015.Fifty-six Chinese healthy volunteers and 171 patients suspected of having adrenal insufficiency.All participants underwent low-dose short Synacthen test (LDSST) with intravenous injection of 1 μg of tetracosactide (Synacthen 1-24). Serum cortisol, salivary cortisol and cortisone levels were measured at baseline and 30 and 60 minutes afterward.Using the reference cutoff (mean - 2 standard deviations of post-LDSST peak
patient presenting a history suggestive of secondary arterial hypertension and typical features of Maffucci syndrome (multiple hemangiomas and enchondromas), which were unrecognized over the previous 3 decades. Given that endocrine diseases are common causes of secondary arterial hypertension and are often associated with Maffucci syndrome, a comprehensive diagnostic workup was performed, revealing the presence of large bilateral adrenalmasses (70 mm right, 35 mm left) and autonomous cortisol (...) endocrine diseases and malignancies. Among them, unilateral cortical adrenalmasses have been previously described, but to our knowledge, this is the first reported case of Maffucci syndrome associated with primary bilateral macronodular adrenal hyperplasia. Additional studies are needed to establish the etiopathological link between these 2 entities and, more in general, between Maffucci syndrome and endocrine diseases, but possible common genetic alterations may be suggested.
findings suggest metastasis or direct invasion of the adrenal gland. ( Clinical Principle ) In patients undergoing surgical excision of a renal mass, a minimally invasive approach should be considered when it would not compromise oncologic, functional and perioperative outcomes. ( Expert Opinion ) Pathologic evaluation of the adjacent renal parenchyma should be performed after PN or RN to assess for possible intrinsic renal disease, particularly for patients with CKD or risk factors for developing CKD (...) Renal mass and localized renal cancer: AUA guideline. Renal mass and localized renal cancer: AUA guideline. | National Guideline Clearinghouse success fail JUN 09 2017 2018 2019 14 Apr 2018 - 12 Jul 2018 COLLECTED BY Organization: Formed in 2009, the Archive Team (not to be confused with the archive.org Archive-It Team) is a rogue archivist collective dedicated to saving copies of rapidly dying or deleted websites for the sake of history and digital heritage. The group is 100% composed
should perform adrenalectomy if imaging and/or intraoperative findings suggest metastasis or direct invasion of the adrenal gland. (Clinical Principle) In patients undergoing surgical excision of a renal mass, a minimally invasive approach should be considered when it would not compromise oncologic, functional and perioperative outcomes. (Expert Opinion) Pathologic evaluation of the adjacent renal parenchyma should be performed after PN or RN to assess for possible intrinsic renal disease (...) and aggressive tumor biology. Contrast-enhanced abdominal imaging (CT or MRI) best characterizes the mass, provides information regarding renal morphology (of the affected and unaffected kidney), assesses extrarenal tumor spread (venous invasion or regional lymphadenopathy) and evaluates the adrenal glands and other abdominal organs for visceral metastases. Patients with CKD and GFR less than 45 ml/min/1.73m 2 should receive contrast with caution as iodinated contrast agents can transiently or permanently
Management of Small Renal Masses Management of Small Renal Masses: American Society of Clinical Oncology Clinical Practice Guideline | Journal of Clinical Oncology Search in: Menu Article Tools ASCO SPECIAL ARTICLE Article Tools OPTIONS & TOOLS COMPANION ARTICLES April, 01 2017 May, 10 2017 ARTICLE CITATION DOI: 10.1200/JCO.2016.69.9645 Journal of Clinical Oncology - published online before print January 17, 2017 PMID: Management of Small Renal Masses: American Society of Clinical Oncology (...) , Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA. A.F. and P.R. were Expert Panel co-chairs. Abstract Section: Purpose To provide recommendations for the management options for patients with small renal masses (SRMs). Methods By using a literature search and prospectively defined study selection, we sought systematic
Castlemanâ€™s disease imitating adrenalmass in the retroperitoneal area Castleman's disease (CD) is a non-clonal lymph node hyperplasia, mostly seen in the mediastinum. It has various clinical and pathological outcomes. There are different treatments because of its rare occurance and heterogenity. We present 2 cases which were referred to our clinic as retroperitoneal mass and diagnosed as CD after surgical resection.
AdrenalMass Causing Secondary Hypertension. Most hypertensive patients have essential (primary) hypertension; only 5% to 10% have a secondary cause. Two clinical characteristics suggestive of secondary hypertension are early onset (< 30 years of age) and severe hypertension (>180/110 mm Hg). When faced with these findings, clinicians should consider a secondary cause of hypertension.A 22-year-old woman being evaluated for asthma exacerbation in the emergency department was noted to have severe (...) persistent hypertension. Additional evaluation revealed severe hypokalemia, metabolic alkalosis, and hypernatremia. The patient was admitted to the hospital for blood pressure management, electrolyte replacement, and further evaluation of presumed hyperaldosteronism. Diagnostic imaging revealed a large adrenalmass. Surgical resection was performed, leading to a diagnosis of hyperaldosteronism caused by adrenal carcinoma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Secondary hypertension is far