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Adrenal Mass

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121. 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

122. 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

123. 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

124. Adrenal angiosarcoma Full Text available with Trip Pro

right adrenal mass, 14 cm in size, was recognized. A right subcostal incision was made, and adrenalectomy was performed successfully with tumor-free surgical margins. Two months after the operation, a positron emission tomography-computed tomography scan was ordered for follow-up. No tumor tissue or any other metastatic foci remained. The patient had been referred to our medical oncology department and underwent retroperitoneal radiotherapy. However, unfortunately, the patient died due to cardiac (...) Adrenal angiosarcoma Adrenal angiosarcoma is an uncommon neoplasm that derives from the vascular endothelium; due to its biological behavior, it should be distinguished from other adrenal tumors. We herein report a case of a 57-year-old woman with diagnosis of an adrenal tumor that was suspected to be malignant. The specimen was histopathologically proved to be an angiosarcoma. The patient was suffering from right upper quadrant pain; after laboratory and radiological workup, a non-functioning

2018 Turkish Journal of Surgery

125. Giant bilateral adrenal myelolipoma:Case presentation and a brief literature review Full Text available with Trip Pro

Giant bilateral adrenal myelolipoma:Case presentation and a brief literature review 29785374 2019 02 26 2214-4420 18 2018 May Urology case reports Urol Case Rep Giant bilateral adrenal myelolipoma:Case presentation and a brief literature review. 67-69 10.1016/j.eucr.2018.03.008 Posses S P SP Department of Urology, Federal University of Espírito Santo, Vitória, ES, Brazil. Prado B C BC Department of Urology, Federal University of Espírito Santo, Vitória, ES, Brazil. Bechara G R GR Department (...) of Urology, Federal University of Espírito Santo, Vitória, ES, Brazil. Puppim A R AR Department of Medical Clinic, Federal University of Espírito Santo, Vitória, ES, Brazil. Carli C R S CRS Department of Pathology, Federal University of Espírito Santo, Vitória, ES, Brazil. Miranda M M L MML Department of Urology, Federal University of Espírito Santo, Vitória, ES, Brazil. eng Case Reports 2018 03 15 United States Urol Case Rep 101626357 2214-4420 Adrenal myelolipoma Bilateral myelolipoma Giant adrenal

2018 Urology case reports

126. Bone Health in Adrenal Disorders Full Text available with Trip Pro

Bone Health in Adrenal Disorders Secondary osteoporosis resulting from specific clinical disorders may be potentially reversible, and thus continuous efforts to find and adequately treat the secondary causes of skeletal fragility are critical to ameliorate fracture risk and to avoid unnecessary treatment with anti-osteoporotic drugs. Among the hyperfunctional adrenal masses, Cushing's syndrome, pheochromocytoma, and primary aldosteronism are receiving particularly great attention due (...) to their high morbidity and mortality mainly by increasing cardiovascular risk. Interestingly, there is accumulating experimental and clinical evidence that adrenal hormones may have direct detrimental effects on bone metabolism as well. Thus, the present review discusses the possibility of adrenal disorders, especially focusing on pheochromocytoma and primary aldosteronism, as secondary causes of osteoporosis.Copyright © 2018 Korean Endocrine Society.

2018 Endocrinology and Metabolism

127. Ewing sarcoma of the adrenal gland: a case report and review of the literature Full Text available with Trip Pro

the importance of adjuvant treatment, and the efficacy of neoadjuvant chemotherapy.We report the case of a 23-year-old Moroccan woman presenting with flank pain. An abdominal computed tomography scan showed a large and enhancing left suprarenal mass. After radical nephrectomy, histologic examination revealed a small round cell proliferation. The diagnosis of Ewing sarcoma was confirmed by molecular analysis; time to final diagnosis was 5 months due to financial and coordination issues. Computed tomography (...) Ewing sarcoma of the adrenal gland: a case report and review of the literature Ewing sarcoma/primitive neuroectodermal tumor is a family of highly malignant proliferation of neuroectodermal origin, most often skeletal, adrenal localization is extremely rare. Only few cases have been reported in the literature. Classical management includes radical surgery with adjuvant chemotherapy or radiotherapy or both. This case report is the only one where recurrence was surgically removed, and it confirms

2018 Journal of medical case reports

128. A Rare Adrenal Incidentaloma That Mimics Adrenocortical Carcinoma Full Text available with Trip Pro

A Rare Adrenal Incidentaloma That Mimics Adrenocortical Carcinoma We present a case of an adrenal hemangioma, an uncommon cause of an adrenal mass, and review the clinical presentation, work-up, and management of adrenal incidentalomas.A 64-year-old male was found to have a right adrenal incidentaloma during work-up for elevated liver transaminase levels, later found to be from hepatitis C. The mass was suspicious for adrenocortical carcinoma on CT imaging. Biochemical evaluation revealed (...) no evidence of function. He underwent an open right adrenalectomy. The mass was found to be an adrenal hemangioma on histopathologic analysis.This is a case report with pertinent review of the diagnosis and management of adrenal incidentalomas.Adrenal hemangiomas are rare, benign, nonfunctional tumors typically found during imaging for other reasons. As illustrated by this case, they appear similar to adrenocortical carcinoma on CT imaging. The diagnosis is usually not made prior to surgical

2018 Case reports in surgery

129. EGFR T790M-Positive Lung Adenocarcinoma Metastases to the Pituitary Gland Causing Adrenal Insufficiency: A Case Report Full Text available with Trip Pro

pituitary mass. Initial evaluation revealed low morning cortisol, and the patient was diagnosed with adrenal insufficiency. His symptoms rapidly improved with maintenance glucocorticoids. Soon thereafter, the patient developed an acute visual deficit secondary to enlargement of the pituitary mass, and biopsy revealed EGFR T790M positive metastatic lung adenocarcinoma. Hence, we present a rare case of metastatic lung adenocarcinoma to the pituitary causing secondary adrenal insufficiency. (...) EGFR T790M-Positive Lung Adenocarcinoma Metastases to the Pituitary Gland Causing Adrenal Insufficiency: A Case Report A 64-year-old man, with history of micropapillary thyroid cancer and epidermal growth factor receptor-positive lung adenocarcinoma with no evidence of active disease for 3 years after chemotherapy and radiation on erlotinib, presented with fatigue, nausea, lack of appetite, and xeroderma. A screening magnetic resonance image of the patient's head demonstrated a new bilateral

2018 Case reports in oncological medicine

130. Diagnosis of lung adenocarcinoma with left adrenal metastasis via transesophageal endoscopic ultrasound-guided fine-needle aspiration biopsy: A case report Full Text available with Trip Pro

cough and was found to have a pulmonary mass in the upper lobe of the right lung. The results of positron emission tomography revealed an elevated level of 18F-fluorodeoxyglucose accumulation (maximum standardized uptake value of 13.6) in the left adrenal gland. Thus, EUS-FNA was performed to identify the suspected metastasis to the left adrenal gland, and the histopathological examination of the bioptic specimen demonstrated an adenocarcinoma, confirming the value of EUS-FNA as a first-line (...) Diagnosis of lung adenocarcinoma with left adrenal metastasis via transesophageal endoscopic ultrasound-guided fine-needle aspiration biopsy: A case report Lung cancer is generally diagnosed through traditional bronchoscopy by pulmonologists, whereas data on the application of transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for lung cancer diagnosis in China are very rarely reported. We herein describe a case of a 62-year-old woman who presented with non-productive

2018 Molecular and clinical oncology

131. Neonatal neuroblastoma 4s with diffuse liver metastases (Pepper syndrome) without an adrenal/extraadrenal primary identified on imaging Full Text available with Trip Pro

Neonatal neuroblastoma 4s with diffuse liver metastases (Pepper syndrome) without an adrenal/extraadrenal primary identified on imaging We report the imaging appearances of a case of pathologically proven, neonatal neuroblastoma 4S with diffuse hepatic metastatic involvement at presentation. Patient had an abnormal appearing liver both by ultrasound and MR. There was no evidence for associated adrenal tumor by imaging. Lack of an associated adrenal mass led to initial misinterpretation (...) of diffuse hepatic accumulation of MIBG seen with radionuclide scintigraphy. To the best our knowledge, this is the first report of metastatic neonatal 4S neuroblastoma without an adrenal (or extra-adrenal) primary identified either on pre- or post-natal imaging.

2018 Journal of Radiology Case Reports

132. First Case of Bacteremia Due to Kytococcus schroeteri in a Child with Congenital Adrenal Hyperplasia. (Abstract)

First Case of Bacteremia Due to Kytococcus schroeteri in a Child with Congenital Adrenal Hyperplasia. Kytococcus schroeteri is a commensal organism of the human skin, which may cause serious infections in immunocompromised patients. We report the first case of K. schroeteri bacteremia in a child with congenital adrenal hyperplasia, identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (Bruker Daltonics, Germany). İdentification was confirmed by 16S rRNA gene

2018 Pediatric Infectious Dsease Journal

133. MR-guided Gated Stereotactic Radiation Therapy Delivery for Lung, Adrenal, and Pancreatic Tumors: A Geometric Analysis. (Abstract)

, relative to PTV-center of mass (COM), were, respectively, -3.3 mm to 2.8 mm, -2.5 mm to 3.7 mm, and -4.4 mm to 2.9 mm. Corresponding distributions in the craniocaudal direction were -2.6 mm to 4.6 mm, -4.1 mm to 4.4 mm, and -4.4 mm to 4.5 mm, respectively. Mean GTV areas encompassed during beam-on for all fractions were 94.6%, 94.3%, and 95.3% for lung, adrenal, and pancreas tumors, respectively. Mean treatment duty cycle efficiency ranged from 67% to 87% for these tumors. Use of higher threshold-ROI (...) MR-guided Gated Stereotactic Radiation Therapy Delivery for Lung, Adrenal, and Pancreatic Tumors: A Geometric Analysis. We implemented magnetic resonance-guided breath-hold stereotactic body radiation therapy in combination with visual feedback using the MRIdian system. Both accuracy of gated delivery and reproducibility of tumor positions were studied.Tumor tracking is realized through repeated magnetic resonance imaging in a single sagittal plane at 4 frames per second with deformable image

2018 Biology and Physics

134. Transesophageal approach to lung, adrenal biopsy and fiducial placement using endoscopic ultrasonography (EUS): An interventional pulmonology experience. Initial experience of the UCSF-FRETOC (fresno tracheobronchial & oesophageal center) study group. (Abstract)

Transesophageal approach to lung, adrenal biopsy and fiducial placement using endoscopic ultrasonography (EUS): An interventional pulmonology experience. Initial experience of the UCSF-FRETOC (fresno tracheobronchial & oesophageal center) study group. Routine lung cancer surveillance has resulted in early detection of pulmonary nodules and masses. Combined endobronchial ultrasound (EBUS) and trans-esophageal endoscopic ultrasound (EUS) are approved methods for sampling lymph nodes or masses (...) . All patients underwent a post-procedure chest radiograph and were followed outpatient.20 of 39 patients underwent sampling of a suspicious lung mass. An adequate sample was obtained in 19 of 20 patients. In all 19 patients a definitive diagnosis was achieved (95%). In all 13 patients who underwent adrenal sampling, presence or absence of metastasis was conclusively established. 6 patients successfully underwent fiducial placement. In all 39 patients, no major procedure related complications were

2018 Respiratory medicine

135. Feminizing adrenocortical carcinoma - the source of estrogens production and the role of adrenal-gonadal de-differentiation. Full Text available with Trip Pro

manifestations, high levels of estradiol that were normalized after surgery, and histological Weiss score. Gonadal steroidogenic biomarkers including CYP19A1, HSD17B3, and LHCGR were markedly elevated in the feminizing ACC tissues. Adrenal vein sampling and liquid chromatography-tandem mass spectrometry suggested high CYP19A1 activity in the adrenal mass. β-catenin expression was also elevated. When treated with niclosamide and PNU-74654, the H295R cell line showed a decrease in β-catenin expression, cell (...) Feminizing adrenocortical carcinoma - the source of estrogens production and the role of adrenal-gonadal de-differentiation. Feminizing adrenocortical carcinoma (ACC) is rare. The source of estrogen production and the underlying mechanism remain unclear.In the current study, we investigated the source and the molecular mechanism of estrogen production in feminizing ACC.A total of 46 consecutive patients with a diagnosis of ACC were recruited in our center. We described the clinical

2018 Journal of Clinical Endocrinology and Metabolism

136. Elevated heat shock proteins in bipolar disorder patients with hypothalamic pituitary adrenal axis dysfunction. Full Text available with Trip Pro

. The study also included 94 healthy controls. Among the BD patients, 33 had abnormal hypothalamic-pituitary-adrenal (HPA) axis activity. Blood samples were obtained from the patients and controls. The chemiluminescence method, mass spectrometry, and flow cytometry were used for analysis.The BD patients compared with the controls had a significantly lower level of CPN10 and significantly higher levels of CPN60 and CPN70. The BD patients with abnormal HPA axis activity had a significantly lower level (...) Elevated heat shock proteins in bipolar disorder patients with hypothalamic pituitary adrenal axis dysfunction. Heat shock proteins (HSP) might be useful as biomarkers for bipolar disorder (BD) which would be clinically valuable since no reliable biomarker for BD has so far been identified. The purpose of this study was to assess the heat shock proteins CPN10, CPN60, and CPN70 as potential biomarkers of BD.The study included 100 BD patients recruited from a hospital during 2012 and 2013

2018 Medicine

137. High 18F-fluorodeoxyglucose uptake in primary bilateral adrenal diffuse large B-cell lymphomas with nongerminal center B-cell phenotype: A case report. Full Text available with Trip Pro

of non-GCB DLBCL showing significantly high uptake of 18F-FDG on PET/CT examination.Histopathological and immunohistochemical examination further confirmed that the bilateral adrenal masses were non-GCB DLBCL.The maximal standardized uptake value (SUVmax) of the adrenal lesion was 17.2. Abnormal 18F-FDG uptake was observed in a retroperitoneal lymph node, the SUVmax of which was 14.2.He was administered CHOP chemotherapy without rituximab due to high costs.His therapeutic effect and survival time (...) High 18F-fluorodeoxyglucose uptake in primary bilateral adrenal diffuse large B-cell lymphomas with nongerminal center B-cell phenotype: A case report. Bilateral adrenal diffuse large B-cell lymphoma, nongerminal center B-cell phenotype (non-GCB DLBCL), is an uncommon malignancy that exhibits rapid development. Fluorine-18-fluorodeoxyglucose position emission tomography/computed tomography (CT) is extremely sensitive in distinguishing highly malignant tumors from benign tumors.We report a case

2018 Medicine

138. ACTH-independent Cushing's syndrome with bilateral cortisol-secreting adrenal adenomas: a case report and review of literatures. Full Text available with Trip Pro

with a complaint of exertional dyspnea for over 10 years. ACTH-independent CS was diagnosed based on undetectable ACTH and unsuppressed cortisol levels by dexamethasone. Computed tomography (CT) scan indicated bilateral adrenal masses, and adrenal venous sampling (AVS) adjusted by plasma aldosterone revealed hypersecretion of cortisol from both adrenal glands. Bilateral cortisol-secreting adrenal adenomas were suspected and confirmed by the postoperative pathology in subsequent two-step bilateral laparoscopic (...) ACTH-independent Cushing's syndrome with bilateral cortisol-secreting adrenal adenomas: a case report and review of literatures. Adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome (CS) with bilateral cortisol-secreting adenomas has been rarely reported in the literatures. Precise recognition and management of this disorder constitute a challenge to clinicians due to the difficulty of exact location of the functional lesions.We herein report a new case of a Chinese female patient

2018 BMC Endocrine Disorders

139. The human fetal adrenal produces cortisol but no detectable aldosterone throughout the second trimester. Full Text available with Trip Pro

analysis of adrenal steroid levels and steroidogenic enzyme expression in normal second trimester human fetuses.This was an observational study of steroids, messenger RNA transcripts and proteins in adrenals from up to 109 second trimester fetuses (11 weeks to 21 weeks) at the Universities of Aberdeen and Glasgow. The study design was balanced to show effects of maternal smoking.Concentrations of 19 intra-adrenal steroids were quantified using liquid chromatography and mass spectrometry. Pregnenolone (...) The human fetal adrenal produces cortisol but no detectable aldosterone throughout the second trimester. Human fetal adrenal glands are highly active and, with the placenta, regulate circulating progesterone, estrogen and corticosteroids in the fetus. At birth the adrenals are essential for neonate salt retention through secretion of aldosterone, while adequate glucocorticoids are required to prevent adrenal insufficiency. The objective of this study was to carry out the first comprehensive

2018 BMC Medicine

140. Mice overexpressing chromogranin A display hypergranulogenic adrenal glands with attenuated ATP levels contributing to the hypertensive phenotype. Full Text available with Trip Pro

Mice overexpressing chromogranin A display hypergranulogenic adrenal glands with attenuated ATP levels contributing to the hypertensive phenotype. Elevated circulating chromogranin A (CHGA) is observed in human hypertension. CHGA is critical for granulogenesis and exocytosis of catecholamine stores from secretory large dense core vesicles (LDCV). This study aims to understand the morphological, molecular and phenotypic changes because of excess CHGA and the mechanistic link eventuating in hyper (...) -adrenergic hypertension.Blood pressure and heart rate was monitored in mouse models expressing normal and elevated level of CHGA by telemetry. Catecholamine and oxidative stress radicals were measured. Adrenal ultrastructure, LDCV content and mitochondrial abundance were compared and respiration analyzed by Seahorse assay. Effect of CHGA dosage on adrenal ATP content, electron transport chain components and uncoupling protein 2 (UCP-2) were compared in vivo and in vitro.Mice with excess-CHGA displayed

2018 Journal of Hypertension

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