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Adrenal Mass

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81. Adrenal Mass Causing Secondary Hypertension. (Abstract)

Adrenal Mass 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 adrenal mass. 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

2015 Journal of Emergency Medicine

82. Large retroperitoneal mass diagnosed as adrenal chronoc expanding hematoma. Full Text available with Trip Pro

Large retroperitoneal mass diagnosed as adrenal chronoc expanding hematoma. Chronic expanding hematoma is defined as a structure with central mass of blood and granulation tissue encapsulated with dense fibrous membrane that slowly grows over a month. We report a case of a 67-year-old man with left adrenal chronic expanding hematoma who underwent surgical resection after 7-year surveillance, presenting natural history of an adrenal chronic expanding hematoma.Copyright © 2015 Elsevier Inc. All

2015 Urology

83. Incidental Adrenal Nodules and Masses: The Imaging Approach Full Text available with Trip Pro

Incidental Adrenal Nodules and Masses: The Imaging Approach Adrenal nodules are detected with increasing frequency. The National Institute of Health (NIH), American College of Radiology (ACR), and the American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons (AACE/AAES) have produced guidelines for the management of incidental adrenal nodules. This review provides a summary of the consensus radiologic approach to these nodules.

2015 International journal of endocrinology

84. Adrenal Mass in Patients who Underwent Abdominal Computed Tomography Examination Full Text available with Trip Pro

Adrenal Mass in Patients who Underwent Abdominal Computed Tomography Examination Adrenal masses are usually discovered incidentally (IAM) during abdominal computed tomography (CT).We aimed to describe the prevalence, management, and outcome of incidentally discovered adrenal mass on radiological investigation.A retrospective analysis was conducted to look for IAM identified by abdominal CT performed for other reasons between 2004 and 2008 and were followed for 4 years. IAM patients with known (...) malignancy or clinically evident adrenal disease or overt disease originally missed due to insufficient clinical examination were excluded.A total of 13,115 patients underwent abdominal CT, of which 136 were identified with adrenal mass (69 males and 67 females). Overall, 84 patients had benign IAM and six had primary adrenal carcinoma (all had tumor size ≥4 cm and five were males). Hormonal evaluation was performed in 80 cases, which revealed hypersecretion in 10 cases (six had Conn's syndrome and four

2015 North American journal of medical sciences

85. All Those Liver Masses are not Necessarily from the Liver: A Case of a Giant Adrenal Pseudocyst Mimicking a Hepatic Cyst Full Text available with Trip Pro

All Those Liver Masses are not Necessarily from the Liver: A Case of a Giant Adrenal Pseudocyst Mimicking a Hepatic Cyst Most abdominal cysts, including adrenal pseudocysts, are benign and asymptomatic. Rapid enlargement, hemorrhage, infection, rupture with leakage of cyst contents, or pressure on adjacent organs can cause symptoms. Although usually diagnosed incidentally on imaging, determining the origin of a cyst can sometimes be challenging. In these situations, surgical excision (...) laparotomy was performed, and the origin was determined intraoperatively to be right adrenal, which was later confirmed by pathology.Contrast-enhanced CT scan is the criterion standard for evaluation for abdominal cystic masses. Precise diagnosis of a giant abdominal cyst can be challenging. Surgery is both diagnostic and curative in such situations. We also discuss the specific situations in which surgery should be considered in cases of adrenal cystic masses.

2015 The American journal of case reports

86. Solitary adrenal metastasis from advanced gastric cancer invading duodenal bulb with situs inversus totalis: A case report. Full Text available with Trip Pro

, especially with intraoperative radiotherapy (IORT).A 61-year-old SIT man found a mass on the right clavicle and the biopsy revealed a metastatic cancer. Around 14 years ago, he had a rectal cancer resection surgery and no sign of occurrence. Five months later, the patient had a pain in his right low abdomen and abdominal CT found a right adrenal mass.Gastroscopy and the pathology revealed the gastric antrum cancer invading the duodenal bulb. Abdominal enhanced CT suspected the adrenal mass as a hematoma (...) Solitary adrenal metastasis from advanced gastric cancer invading duodenal bulb with situs inversus totalis: A case report. Situs invsersus totalis (SIT) is a rare anomaly featured by complete inversion of abdominal and thoracic organs. Adrenal metastasis is often encountered as part of advanced systemic dissemination, which is usually unresectable. Few published cases reported the adrenal metastasis from gastric cancer with SIT and the treatment of gastrectomy combined with adrenalectomy

2019 Medicine

87. A successful pregnancy in a patient with secondary hypertension caused by adrenal adenoma: a case report. Full Text available with Trip Pro

by 30 mg nifedipine twice a day. Examination in our department revealed her 24 h urinary free cortisol (24 h UFC) level was 1684.3 μg/24 h (normal range: 20.26-127.55 μg/24 h) and plasma adrenocorticotropic hormone was < 1.00 ng/L in three independent measurements (normal range: 5-78 ng/L). Ultrasonography demonstrated a mass (2.9 cm × 2.8 cm) in the right side of the adrenal gland. Magnetic resonance imaging without contrast showed a 3.2 cm diameter mass in the right-side of the adrenal gland (...) A successful pregnancy in a patient with secondary hypertension caused by adrenal adenoma: a case report. Secondary hypertension is a rare complication in pregnancy that causes poor outcomes, such as preeclampsia, premature delivery, intrauterine growth retardation, stillbirths, spontaneous abortion or intrauterine death. Cushing's disease caused by an adrenal adenoma is rare during pregnancy and may be overlooked by obstetricians and physicians, but can lead to hypertension, diabetes mellitus

2019 BMC Pregnancy and Childbirth

88. Systemic and prophylactic intrathecal chemotherapy for primary adrenal lymphoma: A retrospective study of 20 case reports. Full Text available with Trip Pro

. The estimated 5-year overall survival (OS) and progression-free survival (PFS) were 52.5% [95% confidence interval (95% CI: 28.2-72.0)] and 53.2% (95% CI: 29.0-72.5), respectively.These findings suggest that PAL should always be considered in differential diagnosis of adrenal mass with AI. Despite the contrasting previous reports, long-term prognosis of PAL is not necessarily inferior to that of non-Hodgkin lymphoma in general. (...) Systemic and prophylactic intrathecal chemotherapy for primary adrenal lymphoma: A retrospective study of 20 case reports. Primary adrenal lymphoma (PAL) is a rare entity of lymphoma with dismal prognosis using systemic chemotherapy. More clinical reports are needed to guide the treatment for PAL.We performed a retrospective analysis of 20 patients diagnosed with PAL who presented to our center between January 2005 and January 2014.Median age at presentation was 48 years (range: 27-73

2019 Medicine

89. Primary hepatic gastrointestinal stromal tumor with right adrenal gland invasion: A case report and systematic literature review. Full Text available with Trip Pro

with right upper abdominal pain and thirsty for more than 20 days.A diagnosis of a 15 × 14 × 7 cm liver mass located in the posterior right lobe of liver and spread to the right adrenal gland was confirmed. Pathological results showed that the tumor was mainly composed of epithelial cells and tested positive for CD117 and SDHB (succinate dehydrogenase complex iron sulfur subunit B). The gene mutational analyses for c-Kit and platelet-derived growth factor receptor alpha exons revealed negative results (...) Primary hepatic gastrointestinal stromal tumor with right adrenal gland invasion: A case report and systematic literature review. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors that mainly occur in the gastrointestinal tract. The GISTs that are sporadically reported in extra-gastrointestinal regions are named as extra-gastrointestinal stromal tumors (EGISTs). However, the primary EGISTs that originate from the liver are rare.A 64-year-old female presenting

2019 Medicine

90. Identifying a disease-specific renin-angiotensin-aldosterone system fingerprint in patients with primary adrenal insufficiency. (Abstract)

Identifying a disease-specific renin-angiotensin-aldosterone system fingerprint in patients with primary adrenal insufficiency. In patients suffering from primary adrenal insufficiency (AI) mortality is increased despite adequate glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy, mainly due to an increased cardiovascular risk. Since activation of the renin-angiotensin-aldosterone system (RAAS) plays an important role in the modulation of cardiovascular risk factors, we (...) by liquid chromatography mass spectrometry.In patients suffering from primary AI, RAAS activity was highly increased with elevated concentrations of renin concentration (P = 0.027), angiotensin (Ang) I (P = 0.022), Ang II (P = 0.032), Ang 1-7 and Ang 1-5. As expected, aldosterone was not detectable in the majority of AI patients, resulting in a profoundly suppressed aldosterone-to-AngII ratio (AA2 ratio, P = 0.003) compared to controls. PRA-S, the angiotensin-based marker for plasma renin activity

2019 European Journal of Endocrinology

91. Comparative assessment of hypothalamic-pituitary-adrenal axis suppression secondary to intrabursal injection of different glucocorticoids: a pilot study. (Abstract)

Comparative assessment of hypothalamic-pituitary-adrenal axis suppression secondary to intrabursal injection of different glucocorticoids: a pilot study. Hypothalamic-pituitary-adrenal axis (HPAA) suppression is the most common and dangerous, although often unrecognized and untreated, side effect of glucocorticoid administration. The risk and duration depend both on patient and treatment characteristics. High-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) currently

2019 Journal of endocrinological investigation Controlled trial quality: uncertain

92. Measurement of salivary adrenal-specific androgens as biomarkers of therapy control in 21-hydroxylase deficiency. (Abstract)

between plasma and salivary adrenal-specific androgens in CAH as a novel non-invasive monitoring strategy.This prospective cross-sectional study recruited patients between 2015-2018.Multi-center study including 13 tertiary centers in the UK.Seventy-eight children with CAH and sixty-two matched healthy controls.Using liquid-chromatography tandem mass spectrometry, plasma and salivary concentrations of five steroids were measured: 17-hydroxyprogesterone, androstenedione, testosterone, 11 (...) Measurement of salivary adrenal-specific androgens as biomarkers of therapy control in 21-hydroxylase deficiency. Monitoring of hormonal control represents a key part of the management in congenital adrenal hyperplasia (CAH). Monitoring strategies remain suboptimal as they rely on frequent blood tests and are not specific for adrenal-derived hormones. Recent evidence suggests a crucial role of adrenal-specific 11-oxygenated-C19 androgens in the pathogenesis of CAH.To establish the correlation

2019 Journal of Clinical Endocrinology and Metabolism

93. Steroid metabolome analysis in disorders of adrenal steroid biosynthesis and metabolism. Full Text available with Trip Pro

Steroid metabolome analysis in disorders of adrenal steroid biosynthesis and metabolism. Steroid biosynthesis and metabolism is reflected by the serum steroid metabolome and, in even more detail, by the 24-hour urine steroid metabolome, which can provide unique insights into alterations of steroid flow and output indicative of underlying conditions. Mass spectrometry-based steroid metabolome profiling has allowed for the identification of unique multi-steroid signatures associated (...) with disorders of steroid biosynthesis and metabolism that can be used for personalized approaches to diagnosis, differential diagnosis and prognostic prediction. In addition, steroid metabolome analysis has been used successfully as a discovery tool, for the identification of novel steroidogenic disorders and pathways as well as revealing insights into the pathophysiology of adrenal disease. Increased availability and technological advances in mass spectrometry-based methodologies have refocused attention

2019 Endocrine Reviews

94. Central Precocious Puberty as Presenting Sign of Non-Classical Congenital Adrenal Hyperplasia - Clinical Characteristics. (Abstract)

Central Precocious Puberty as Presenting Sign of Non-Classical Congenital Adrenal Hyperplasia - Clinical Characteristics. Central precocious puberty (CPP) may be the first presentation of non-classical congenital adrenal hyperplasia (NCCAH) in girls. Data on the prevalence and the clinical phenotype of CPP associated with NCCAH are sparse.To study the clinical and laboratory characteristics that could differentiate idiopathic CPP from CPP associated with NCCAH and to determine the prevalence (...) the NCCAH group and the 140 girls with idiopathic CPP (ICPP group).No between-group differences were found in height, weight, body mass index, bone age, and Tanner stage. Mean basal levels of androstenedione, DHEAS, and 17-OHP were significantly higher in the NCCAH group, although ranges overlapped between the groups, and stimulated cortisol level was higher in the ICPP group.NCCAH was found in 4.8% of girls presenting with true CPP over a 10-year period, and no one parameter could differentiate between

2019 Journal of Clinical Endocrinology and Metabolism

95. Primary adrenal extranasal NK/T cell lymphoma with subcutaneous involvement demonstrated on FDG PET/CT: A clinical case report. Full Text available with Trip Pro

which showed huge bilateral well-defined adrenal masses with heterogeneous enhancement, she was tentatively diagnosed as having primary adrenal malignancy. Postoperative pathology revealed the diagnosis of primary adrenal Epstein-Barr virus-associated nasal type extranodal NK/T-cell lymphoma.Then, she underwent F-fluoro-2-deoxy-D-glucose (F-FDG) positron emission tomography (PET)/CT examination for staging, which showed homogeneously increased FDG uptake in the right adrenal gland and left thigh (...) chemotherapy and autologous stem cell transplantation.The enhanced CT and FDG PET/CT features of primary adrenal extranasal NK/T cell lymphoma are huge bilateral well-defined adrenal masses with heterogeneous enhancement, high FDG uptake, especially with subcutaneous involvement. And the awareness of this entity may help clinicians to differentiate it from other primary adrenal tumors and make reasonable therapeutic strategies. Besides, FDG PET/CT scan is very useful for the treatment follow-up

2019 Medicine

96. Novel GC-MS/MS technique reveals a complex steroid fingerprint of subclinical hypercortisolism in adrenal incidentalomas. (Abstract)

and bilateral adrenal incidentalomas to uncover full steroid profile changes in patients with subclinical hypercortisolism (SH).Cross-sectional study.The study was conducted at a tertiary inpatient clinic.Fifty-two patients with adrenal incidentalomas (unilateral, n = 29; bilateral, n = 23), including nonfunctioning (n = 11) vs SH (n = 41), and 26 age- and sex-matched controls from the general population were included.Eighty-three serum steroids were measured by gas chromatography-tandem mass spectrometry (...) Novel GC-MS/MS technique reveals a complex steroid fingerprint of subclinical hypercortisolism in adrenal incidentalomas. Improvement of imaging methods has led to more incidental adrenal tumor findings, especially adenomas. Routine hormonal evaluation uses only a few steroids to evaluate possible hormonal hypersecretion of these adenomas, but a wide spectrum of serum steroid hormone changes has not been published.To measure the serum levels of 83 steroids from patients with unilateral

2019 Journal of Clinical Endocrinology and Metabolism

97. Insulin resistance and adrenal incidentalomas: A bidirectional relationship. (Abstract)

Insulin resistance and adrenal incidentalomas: A bidirectional relationship. An adrenal incidentaloma (AI) is an adrenal mass incidentally found via a radiological modality, independent of an endocrinological investigation. In this review, we aimed to investigate the possible reasons behind the increased frequency in AI detection, especially in ageing populations. The pathophysiological effects of insulin resistance (IR), hyperinsulinemia and various anabolic pathways are analyzed. In addition (...) , we review data from studies indicating an increased incidence of adrenal adenomas and carcinomas in patients with type 2 diabetes mellitus (T2DM). The establishment of obesity as a global epidemic, with a higher prevalence in the female than in the male population, coincide with data regarding AIs and the conditions may share a pathophysiological basis. Furthermore, we discuss the bidirectional association of AIs with obesity, insulin resistance and T2DM, especially in patients with autonomous

2019 Maturitas

98. Influence of antihypertensive drugs in the subtype diagnosis of primary aldosteronism by adrenal venous sampling. (Abstract)

with successful ACTH-AVS.Patients who received any DAPD (n = 209) showed higher prevalence of comorbidity burdens and took more antihypertensive drugs compared with patients without DAPD. In patients taking DAPD, those with laterality index more than 4 had a higher prevalence of hypokalemia, a higher aldosterone-to-renin ratio and a higher prevalence of adrenal mass than those with laterality index of 4 or less. Adrenalectomy was performed in 76% patients with laterality index more than 4 and 20 (...) Influence of antihypertensive drugs in the subtype diagnosis of primary aldosteronism by adrenal venous sampling. Because of the influence on the renin-angiotensin-aldosterone system, it is recommended to avoid, if possible, the use of angiotensin-converting-enzyme inhibitors, angiotensin II type 1 receptor blockers, diuretics, β-blockers, and mineralocorticoid receptor antagonists during the diagnostic period of primary aldosteronism. A laterality index more than 4 in adrenocorticotropic

2019 Journal of Hypertension

99. Plasma steroid profiles in subclinical compared to overt adrenal Cushing's syndrome. Full Text available with Trip Pro

patients were tested for hypercortisolism among whom disease was excluded in 152 and confirmed in 21 with overt clinical Cushing's syndrome due to adrenal tumors (AC) compared to 35 with SC. Another 277 age- and gender-matched hypertensive and normotensive volunteers were included for reference.Panel of 15 plasma steroids measured by mass spectrometry with classification by discriminant analysis.Patients with SC showed lower (P<0.05) plasma concentrations of dehydroepiandrosterone (...) Plasma steroid profiles in subclinical compared to overt adrenal Cushing's syndrome. Diagnosis of subclinical adrenal hypercortisolism is based on several tests of the hypothalamic-pituitary-adrenal axis to establish mild alterations of cortisol secretion and dysregulated cortisol physiology.This study assessed whether plasma steroid profiles might assist diagnosis of subclinical Cushing's syndrome (SC).Retrospective cross-sectional study.Two tertiary medical centers.Two hundred and eight

2019 Journal of Clinical Endocrinology and Metabolism

100. A case report on 111In chloride bone marrow scintigraphy in management of adrenal myelolipoma. Full Text available with Trip Pro

peritoneal mass detected on a medical checkup. Abdominal CT revealed a mass measuring 14.3 cm in diameter located between the left kidney and the left adrenal gland, which showed coexistence of fat and soft tissue densities.A bone marrow scan is a nuclear medicine examination to assess hematopoietic activity. To avoid excessive resection of the tumor, we thought that a bone marrow scan could be applied for differentiation between myelolipoma and retroperitoneal liposarcoma by evaluating the hematopoietic (...) A case report on 111In chloride bone marrow scintigraphy in management of adrenal myelolipoma. Adrenal myelolipoma is a benign hormone-inactive tumor composed of hematopoietic tissue and mature adipose tissue. Because this tumor tends to be rich in fat, in many cases it can be diagnosed based on computed tomography (CT) or magnetic resonance imaging (MRI) findings alone. However, in the presence of much necrosis, calcification and hematopoietic tissue and/or the absence of much fat

2019 Medicine

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