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Adrenal Mass

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101. A rare case of pure testosterone-secreting adrenal adenoma in a postmenopausal elderly woman. Full Text available with Trip Pro

elevated serum testosterone level (714.8 ng/ml), whereas DHEAS, androstenedione, 17-hydroxyprogesterone, and cortisol were within the normal range. Imaging examination showed a mass of 1.5 cm in diameter in the left adrenal gland and normal appearance of both ovaries. PET-CT indicated that it was a case of benign adrenal adenoma and excluded ovarian abnormalities and other ectopic tumors. Thus, a pure testosterone-secreting adrenal tumor was suspected and then adrenalectomy was performed. Histology (...) A rare case of pure testosterone-secreting adrenal adenoma in a postmenopausal elderly woman. Hyperandrogenemia is more common in puberty and reproductive age, but relatively rare in postmenopausal women. Postmenopausal virilization may result from androgen-producing tumors. Androgen-secreting adrenal tumors are rare in clinical practice and are diagnosed as adrenocortical carcinoma, most of which can co-secrete androgen and cortisol. Highly elevated serum testosterone level with normal adrenal

2019 BMC Endocrine Disorders

102. Gonadotropin-releasing hormone agonist in premenopausal women does not alter hypothalamic-pituitary-adrenal axis response to corticotropin-releasing hormone. Full Text available with Trip Pro

Gonadotropin-releasing hormone agonist in premenopausal women does not alter hypothalamic-pituitary-adrenal axis response to corticotropin-releasing hormone. Sex hormones appear to play a role in the regulation of hypothalamic-pituitary-adrenal (HPA) axis activity. The objective was to isolate the effects of estradiol (E2) on central activation of the HPA axis. We hypothesized that the HPA axis response to corticotropin-releasing hormone (CRH) under dexamethasone (Dex) suppression would (...) be exaggerated in response to chronic ovarian hormone suppression and that physiologic E2 add-back would mitigate this response. Thirty premenopausal women underwent 20 wk of gonadotropin-releasing hormone agonist therapy (GnRHAG) and transdermal E2 (0.075 mg per day, GnRHAG + E2, n = 15) or placebo (PL) patch (GnRHAG + PL, n = 15). Women in the GnRHAG + PL and GnRHAG + E2 groups were of similar age (38 (SD 5) yr vs. 36 (SD 7) yr) and body mass index (27 (SD 6) kg/m2 vs. 27 (SD 6) kg/m2). Serum E2 changed

2018 American journal of physiology. Endocrinology and metabolism Controlled trial quality: uncertain

103. A challenging case of pyrexia of unknown origin: adrenal histoplasmosis mimicking tuberculosis in a patient with chronic hepatitis C. (Abstract)

A challenging case of pyrexia of unknown origin: adrenal histoplasmosis mimicking tuberculosis in a patient with chronic hepatitis C. We present an unusual case of fever of unknown origin with bilateral adrenal masses in a patient with compensated chronic liver disease (compensated) due to hepatitis C who had been treated elsewhere with four months of anti-tuberculous therapy for suspected disseminated tuberculosis (TB). At our institution, he underwent a CT-guided biopsy of the adrenal lesion

2018 Tropical Doctor

104. 18FDG PET Textural Indices in Adrenal Lesion

Summary: Tumors are characterized by a great heterogeneity. Characterizing this intra-tumor heterogeneity is a major challenge in oncology to improve the therapeutic management and move towards personalized medicine adapted to each patient. However, intra-tumor heterogeneity remains rarely used for diagnostic purposes The discovery of an adrenal mass can occur in different circumstances. Detection of an adrenal mass can be done in a context of secreting syndrome, in the assessment of an extra-adrenal (...) neoplasia or fortuitously when performing an imaging for another reason. The etiologies are numerous (cortical tumors, medullary tumors, metastatic lesion of a extra-adrenal neoplasia, others). The adrenal masses can be divided into two categories, depending on whether they are hyperfunctional or not. In patients without an oncological history, an adrenal mass discovered is most often a benign adenoma, but requires an endocrine assessment. In patients with known primary cancer, approximately 30

2018 Clinical Trials

105. Non-α-fetoprotein-producing adrenal hepatoid adenocarcinoma: A case report and literature review. Full Text available with Trip Pro

Non-α-fetoprotein-producing adrenal hepatoid adenocarcinoma: A case report and literature review. Adrenal hepatoid adenocarcinoma typically secretes alpha-fetoprotein (AFP). Here, we report a case of non-AFP-producing adrenal hepatoid adenocarcinoma. Next-generation sequencing (NGS) was conducted to identify gene mutations.A 64-year-old man presented with mild back pain and unexplained weight loss for 3 months.Contrast-enhanced magnetic resonance imaging (MRI) showed a mass (9.9 × 9.7 × 9.1 mm (...) ) above the upper pole of the left kidney. The left renal artery and vein were compressed. The tumor was positive for CK8/18, CK19, CK7, hepatocyte marker (Hepatocyte), and Hep Par 1, but negative for AFP. Plasma AFP was 2.75 ng/mL (normal range: 0-7 ng/mL). NGS revealed mutations of the following genes: ATM, CDKN2A, EGFR, STK11, TP53, BIM, and MLH1. A diagnosis of adrenal hepatoid adenocarcinoma was established.The treatment included 4 cycles of the mFOLFOX6 regimen (oxaliplatin, leucovorin

2018 Medicine

106. Adrenal relapse of primary central nervous system diffuse large B-cell lymphoma: A case report. Full Text available with Trip Pro

was diagnosed with endometrial cancer. Interestingly, a radiological study following the treatment of endometrial cancer demonstrated a right adrenal mass, which was suspicious for malignancy. Morphologic examination and immunohistochemistry studies confirmed the diagnosis of diffuse large B-cell lymphoma. A fluorescent in situ hybridization panel for lymphoma showed rearrangement of Immunoglobulin heavy chain (IGH) and B-cell lymphoma 6 (BCL6), respectively, suggesting fusion of BCL6/IGH. Immunoglobulin (...) Adrenal relapse of primary central nervous system diffuse large B-cell lymphoma: A case report. Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma with a dismal outcome. Most patients relapse in intracranial sites and <5% of patients relapse in extracranial sites. Here, we present the first case of PCNSL with an adrenal relapse.A 72-year-old woman, first presented 7 years ago with complaints of headache and dizziness.Enhanced magnetic resonance imaging

2018 Medicine

107. Growth characteristics in children with congenital adrenal hyperplasia Full Text available with Trip Pro

who suffered from short stature is 159.8 cm.This study showed a significant effect of congenital adrenal hyperplasia on both height, weight, and body mass index. Risk factors includes glucocorticoids dosage, compliance to treatment, and regular follow up. Personalized treatment approach should be followed with all patients diagnosed with congenital adrenal hyperplasia as well as close monitoring and targeted therapy. (...) Growth characteristics in children with congenital adrenal hyperplasia To evaluate the growth parameters in congenital adrenal hyperplasia patients in Jeddah, Saudi Arabia.  Methods: This is a descriptive retrospective study over the period of 5 years. Data analysis was using Statistical Package for Social Science. The study included 90 participants in which 61 were girls and 29 were boys aged 0 to 18 years . They were evaluated in Pediatric Endocrinology Clinic at King Abdulaziz University

2018 Saudi medical journal

108. Adrenal collision tumor (parachordoma and ganglioneuroma): A case report Full Text available with Trip Pro

Adrenal collision tumor (parachordoma and ganglioneuroma): A case report Adrenal collision tumors (ACTs) are distinct tumors that occur simultaneously in the same adrenal gland and are very rare. We herein report the case of a 56-year-old woman who was admitted to the hospital for medical imaging. The findings of the physical and laboratory examinations, including endocrine function, were unremarkable. Contrast-enhanced computed tomography of the abdomen revealed a 28×20×33-mm mass in the left (...) adrenal medial limb, for which a laparoscopic surgery was performed. Postoperative pathological examination revealed two distinct tumors, namely a parachordoma and a ganglioneuroma. To the best of our knowledge, and following a thorough literature search, this is the first report of coexisting parachordoma and ganglioneuroma in the same adrenal gland.

2018 Molecular and clinical oncology

109. Laparoscopic Trans-Abdominal Right Adrenalectomy for a Large Primitive Adrenal Oncocytic Carcinoma: A Case Report and Review of Literature Full Text available with Trip Pro

. CASE REPORT We report the case of a 48-year-old man with a primitive 12-cm mass affecting the right adrenal gland, detected by ultrasonography during follow-up for alcoholic liver cirrhosis. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a mass of the right adrenal gland compressing the inferior vena cava (IVC) and dislocating the right lobe of the liver, with no invasion of kidney, liver, or IVC. Preoperative blood tests showed mild transaminase increase. Laparoscopic (...) right adrenalectomy with lateral transperitoneal approach was performed. The postoperative course was uneventful. The lesion was diagnosed as a primitive adrenal oncocytic carcinoma (AOC). No recurrence was evidenced during 24-month follow-up. CONCLUSIONS Although AONs are very rare, they must be considered in the differential diagnosis of adrenal masses due to their prognostic difference compared to non-oncocytic tumors. AOCs are a rare presentation of AONs. Only 30 cases are described

2018 The American journal of case reports

110. A Rare Case Report of Extra-adrenal Pheochromocytoma with Normal Blood Pressure: Is that Possible? Full Text available with Trip Pro

A Rare Case Report of Extra-adrenal Pheochromocytoma with Normal Blood Pressure: Is that Possible? Extra-adrenal pheochromocytoma is uncommon and usually secreting nor-epinephrine. We are presenting a possible case of extra-adrenal pheochromocytoma in a 68-year-old male who was admitted to Queens Hospital Center complaining of shortness of breath for two days. Physical examination was unremarkable except tachycardia. Ventilation/perfusion (V/Q) scan showed the intermediate probability (...) for pulmonary thromboembolism. Computed tomography (CT) chest confirmed the presence of old embolism and showed the 1.1 cm nodule in the left upper lobe. He suddenly collapsed and went into cardio-respiratory failure and attempts to resuscitate were futile. Results for pheochromocytoma workup received after the patient has passed away and it showed elevated levels of 24-hour urine metanephrine, normetanephrine, and Vanillylmandelic acid (VMA). In our patient, CT abdomen did not identify any mass

2018 Cureus

111. Lymph node imaging of pediatric renal and suprarenal malignancies Full Text available with Trip Pro

Lymph node imaging of pediatric renal and suprarenal malignancies Pediatric renal and suprarenal cancers are relatively rare malignancies, but are not without significant consequence to both the patient and caretakers. These tumors are often found incidentally and present as large abdominal masses. Standard of care management involves surgical excision of the mass, but contemporary treatment guidelines advocate for use of neoadjuvant or adjuvant chemotherapy for advanced stage disease (...) for studies published on imaging-based detection of LNI in pediatric renal and suprarenal cancers. Further review focused on surgical and medical management of those cases with suspected LNI. Current imaging protocols assisting in diagnosis and staging of pediatric renal and suprarenal cancers are generally limited to abdominal ultrasound and cross-sectional imaging, mainly computed tomography (CT). Recent research has investigated the role of more advance modalities, such as magnetic resonance imaging

2018 Translational andrology and urology

112. First Reported Case of Endoscopic Ultrasound-Guided Core Biopsy Yielding Diagnosis of Primary Adrenal Leiomyosarcoma Full Text available with Trip Pro

glands. We describe the case of a 50-year-old male presenting with abdominal pain and unintentional weight loss over the course of one year. CT imaging revealed an 8.1 cm heterogeneous left adrenal mass with PET-confirmed metastases to the liver and lung. Pheochromocytoma was ruled out. Adrenal cortical carcinoma was the other critical differential diagnosis. As the patient was not a candidate for surgery, an EUS-FNA and CB were performed on this left adrenal mass revealing a spindle cell neoplasm (...) First Reported Case of Endoscopic Ultrasound-Guided Core Biopsy Yielding Diagnosis of Primary Adrenal Leiomyosarcoma Primary adrenal leiomyosarcoma (PAL) is an extremely rare mesenchymal tumor with only a few isolated case reports in the medical literature. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or endoscopic ultrasound-guided core biopsy (EUS-CB) is a safe, effective modality for sampling lesions in the gastrointestinal tract and adjacent organs, including the adrenal

2018 Case reports in gastrointestinal medicine

113. New insights into morphological, stereological and functional studies of the adrenal gland under exposure to the potent goitrogen thiourea Full Text available with Trip Pro

to that of the control. Increased lipid peroxidation (p=0.0054) and up-regulated corticosterone release (p=0.0064) through adrenocortical stress signalling pathway were also noted. Stereological analysis of the left adrenal gland showed significant increase in volume (p=0.0025) and mass of cells (p=0.0031) in adrenocortical region in comparison to that of control animals. This study concludes that thiourea, in addition to its antithyroidal activity, develops stress in the adrenal as evident by enhanced lipid (...) New insights into morphological, stereological and functional studies of the adrenal gland under exposure to the potent goitrogen thiourea Thiourea (thiophen-3-yl-acetic acid) is a well established antithyroid drug used for treating hyperactivity of the thyroid gland as it blocks the conversion of thyroxine (T4) to triiodothyronine (T3) in peripheral tissues. Human exposures to thiourea include contaminated drinking water and vegetables for its extensive use in fertilizers. Chronic thiourea

2018 Interdisciplinary toxicology

114. Glycometabolic Alterations in Secondary Adrenal Insufficiency: Does Replacement Therapy Play a Role? Full Text available with Trip Pro

described in both primary and secondary adrenal insufficiency. However, few studies have provided compelling evidences on the underlying mechanism in SAI, because of the heterogeneity of the condition. Recently, some studies suggested that inappropriate glucocorticoid (GCs) replacement therapy, as for dose and/or timing of administration, may play a role. Hypertension, insulin resistance, weight gain, visceral obesity, increased body mass index, metabolic syndrome, impaired glucose tolerance, diabetes (...) Glycometabolic Alterations in Secondary Adrenal Insufficiency: Does Replacement Therapy Play a Role? Secondary adrenal insufficiency (SAI) is a potentially life-threatening endocrine disorder due to an impairment of corticotropin (ACTH) secretion from any process affecting the hypothalamus or pituitary gland. ACTH deficit can be isolated or associated with other pituitary failures (hypopituitarism). An increased mortality due to cardiovascular, metabolic, and infectious diseases has been

2018 Frontiers in endocrinology

115. A rare case of co-existing adrenal and pelvic myelolipomas Full Text available with Trip Pro

, and attenuation characteristics of the pelvic mass, retroperitoneal liposarcoma was thought to be a differential diagnosis, prompting the decision for an elective CT-guided biopsy. Both masses were targeted successfully using core biopsy needles. Subsequently, histopathology results for both the right adrenal and the left pelvic masses showed features compatible with myelolipomas. The right retroperitoneal mass was compatible with an adrenal myelolipoma and left pelvic mass was deemed as an extra-adrenal (...) A rare case of co-existing adrenal and pelvic myelolipomas We are reporting a case of co-existing left sided pelvic and right sided adrenal myelolipomas in a 68-year-old male patient. Both lesions were incidentally discovered on CT whilst undergoing a staging scan for suspected urinary bladder cancer. The patient had a background of hypertension and type 2 diabetes. Contrast enhanced CT scan showed both lesions to be of mixed fat and soft tissue density. Given the size, location

2018 Radiology Case Reports

116. Extra-adrenal paraganglioma masquerading as severe preeclampsia Full Text available with Trip Pro

Extra-adrenal paraganglioma masquerading as severe preeclampsia Paraganglioma in pregnancy is an extremely rare condition and its diagnosis is often delayed because the clinical symptoms can mimic those of preeclampsia or gestational hypertension. Here, we report the case of a 32-year-old, gravida 2, para 1 woman who presented with severe headache, palpitation, and sweating at 37 weeks' gestation. Although emergent cesarean section was performed on the assumption of severe preeclampsia, blood (...) pressure fluctuated and heart rate remained tachycardiac. We suspected that she might have thromboembolic lesion in the chest or pheochromocytoma. Chest and abdominal computed tomography revealed a 4 cm mass in the left para-aortic space. Serum and urinary catecholamine levels were found to be significantly increased. She underwent laparoscopic mass removal and the pathology confirmed paraganglioma. When typical paroxysmal hypertension is accompanied by headache, palpitation, and sweating during

2018 Obstetrics & gynecology science

117. Clinical Investigation of Adrenal Incidentalomas in Japanese Patients of the Fukuoka Region with Updated Diagnostic Criteria for Sub-clinical Cushing's Syndrome Full Text available with Trip Pro

Clinical Investigation of Adrenal Incidentalomas in Japanese Patients of the Fukuoka Region with Updated Diagnostic Criteria for Sub-clinical Cushing's Syndrome Objectives We retrospectively investigated the clinical and endocrinological characteristics of adrenal incidentalomas. Methods We studied 61 patients who had been diagnosed with adrenal incidentalomas and had undergone detailed clinical and endocrinological evaluations while hospitalized. We used common criteria to diagnose (...) , 13 (21.3%) had cortisol-secreting adenomas (Cushing's syndrome and sub-clinical Cushing's syndrome), and 25 (41.0%) had non-functional tumors. Compared with the non-functional tumor group, the primary aldosteronism group and the cortisol-secreting adenoma group were significantly younger and had significantly higher rates of hypokalemia, whereas the pheochromocytoma group had significantly larger tumors and a significantly lower body mass index. Conclusion Our study found a larger percentage

2018 Internal Medicine

118. Single-plane retroperitoneoscopic adrenalectomy: a new operative procedure for benign adrenal disease Full Text available with Trip Pro

Single-plane retroperitoneoscopic adrenalectomy: a new operative procedure for benign adrenal disease To evaluate the therapeutic effect of single-plane retroperitoneoscopic adrenalectomy. From February 2014 to March 2017, 251 patients underwent single-plane retroperitoneoscopic adrenalectomy, and their operative outcomes were compared with those of 98 patients who underwent anatomical three-plane retroperitoneoscopic adrenalectomy. Among 35 patients with a body mass index (BMI) of ≥30 kg/m2 (...) requirement (56/251 vs 33/98, p = 0.03). For obese patients with a BMI of ≥30 kg/m2, single-plane adrenalectomy was also associated with a significantly shorter operation time(48.1 ± 6.2 vs 64.1 ± 5.1 mins, p < 0.0001). Single-plane retroperitoneoscopic adrenalectomy is feasible, safe, and effective in the treatment of adrenal masses <5 cm in size and provides a shorter operation time and better pain control than anatomical retroperitoneal adrenalectomy, especially in obese patients.

2018 Scientific reports

119. Adrenal Hemangioma: A Case of Retroperitoneal Tumor Full Text available with Trip Pro

Adrenal Hemangioma: A Case of Retroperitoneal Tumor Adrenal hemangioma is a rare disease, with only some 60 cases reported previously. Due to the difficulty of the preoperative diagnosis of adrenal hemangioma, almost all of the cases were diagnosed by a histopathological analysis of surgical specimens.A 52-year-old man was referred to our department for further examination of his left retroperitoneal tumor. He had received hemodialysis due to chronic renal failure resulting from membranous (...) nephropathy. Computed tomography revealed a mass around his left hilum. Magnetic resonance imaging (MRI) and positron-emission tomography (PET)-CT were unable to confirm or deny malignancy, and tumor markers, including CEA and CA19-9, showed slight elevation. His tumor grew from 38 mm to 54 mm in diameter in 7 months of follow-up. We therefore planned retroperitoneal tumor resection with left nephrectomy. Histopathologically, hyperplastic small vessels with hemorrhaging and denaturation were seen

2018 Case reports in medicine

120. Obstructive Sleep Apnea in Gestational Diabetes: A Pilot Study of the Role of the Hypothalamic-Pituitary-Adrenal Axis Full Text available with Trip Pro

Obstructive Sleep Apnea in Gestational Diabetes: A Pilot Study of the Role of the Hypothalamic-Pituitary-Adrenal Axis Obstructive sleep apnea (OSA) in pregnancy is associated with gestational diabetes mellitus (GDM). This propensity toward heightened insulin resistance in OSA patients has not been well characterized and may be related to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. The aim of this study was to (1) assess the prevalence of OSA in pregnant women with GDM, (2 (...) -hypopnea index ≥ 5 events/h. Homeostasis Model Assessment of insulin resistance was derived from measurements of fasting glucose and C-peptide levels. Three salivary cortisol levels were obtained across 1 day to assess circadian variation. Multivariable linear regression analyses were used to assess associations between variables.The sample consisted of 54% Caucasian pregnant women with a median body mass index of 36.1 and interquartile ratio of 10.6 kg/m2. OSA was diagnosed in 17% of participants

2018 Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

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