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Adrenal Mass

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161. 10 good reasons why adrenal vein sampling is the preferred method for referring primary aldosteronism patients for adrenalectomy. (PubMed)

the age of 35 years have nonfunctioning adrenal tumors, regardless of being hypertensive or not, with a prevalence that raises with aging. Hence, the finding of an adrenal mass at imaging does not reliably detect the culprit of primary aldosteronism. On the other hand, when primary aldosteronism patients are selected for adrenalectomy on the basis of demonstration of lateralized aldosterone excess at adrenal vein sampling (AVS), close to 100% are biochemically cured from the hyperaldosteronism, about (...) 10 good reasons why adrenal vein sampling is the preferred method for referring primary aldosteronism patients for adrenalectomy. : Nowadays most patients diagnosed with surgically curable primary aldosteronism have small or micro aldosterone-producing adenoma or unilateral micronodular hyperplasia, which are undetectable with available imaging technologies. Therefore, a negative imaging test by no means excludes unilateral primary aldosteronism. Moreover, about 10% of the subjects above

2018 Journal of Hypertension

162. Adrenal relapse of primary central nervous system diffuse large B-cell lymphoma: A case report. (PubMed)

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

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2018 Medicine

163. Spontaneous adrenal hematoma in pregnancy: A case report. (PubMed)

scan of the abdomen revealed an 8.1 × 7.7 × 6.8 cm round mass in the left adrenal region, which showed a rim of acute hemorrhage signal. Due to the stable condition of the patient and fetus, she was admitted for observation. Repeat MR scan was performed a month later, and it showed a stable mass with marginal subacute bleeding signal.Laparoscope excision of the hematoma was performed.Simple adrenal hematoma was confirmed by pathological examinations. And the patient was discharged 3 days later (...) Spontaneous adrenal hematoma in pregnancy: A case report. Spontaneous adrenal hematoma in pregnancy is a very rare condition. Herein we present an additional rare case of unilateral spontaneous adrenal hematoma in a pregnant woman, aiming to share this experience and summarize the signal characteristics of simple adrenal hematoma in magnetic resonance imaging (MRI).A 28-year old pregnant woman was referred to our hospital with a vague paroxysmal left-side back pain at 17 weeks of gestation.MR

2018 Medicine

164. Adrenal cavernous hemangioma: a case report. (PubMed)

Adrenal cavernous hemangioma: a case report. Adrenal cavernous hemangiomas are very rare benign tumors that usually present as incidental findings on abdominal imaging. Preoperative differential diagnosis from other benign or malignant adrenal neoplasms may be challenging.A 70-year old man was referred for an 8-cm abdominal mass incidentally discovered on a contrast-enhanced computed tomography (CT) performed to investigate a pulmonary nodule. Biochemical tests ruled out any endocrine (...) dysfunction and iodine 123 metaiodobenzylguanidine whole body scintiscan single-photon emission CT excluded a pheocromocitoma. Findings on magnetic resonance imaging were non-specific and the patient was elected for a left adrenalectomy. Histopathological diagnosis revealed a cavernous hemangioma. A portion of the resected tissue was tested for drug sensitivity to mitotane, doxorubicin, and sunitinib.Adrenal hemangioma is a rare disease but should be included in the differential diagnosis of adrenal

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2018 BMC Surgery

165. High 18F-fluorodeoxyglucose uptake in primary bilateral adrenal diffuse large B-cell lymphomas with nongerminal center B-cell phenotype: A case report. (PubMed)

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

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2018 Medicine

166. ACTH-independent Cushing's syndrome with bilateral cortisol-secreting adrenal adenomas: a case report and review of literatures. (PubMed)

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

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2018 BMC Endocrine Disorders

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

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

168. The Effects of a Korean Ginseng, GINST15, on Hypo-Pituitary-Adrenal and Oxidative Activity Induced by Intense Work Stress. (PubMed)

The Effects of a Korean Ginseng, GINST15, on Hypo-Pituitary-Adrenal and Oxidative Activity Induced by Intense Work Stress. The effect of GINST15, an enzyme fermented ginseng supplement, on hormonal and inflammatory responses to physical stress in humans is unknown. The purpose of this investigation was to examine the constitutive and stress-induced effects of GINST15 supplement on hypo-pituitary-adrenal (HPA) and antioxidant activity in addition to muscle damage. Ten women (age: 38.7 ± 7.8 (...) years; height: 163.81 ± 4.4 cm; body mass 76.0 ± 11.6 kg) and nine men (age: 41.2. ± 9.7 years; height: 177.4 ± 5.3 cm; body mass: 88.5 ± 5.0 kg) participated in a double-blinded, placebo-controlled, counterbalanced within-group study. Participants completed three 14-day treatment cycles with different doses (high: 960 mg; low: 160 mg; placebo: 0 mg) separated by a 1-week washout period. At the end of treatment, physical stress was imposed with intense resistance exercise work stress. Participants

2018 Journal of medicinal food Controlled trial quality: uncertain

169. Gonadotropin-releasing hormone agonist in premenopausal women does not alter hypothalamic-pituitary-adrenal axis response to corticotropin-releasing hormone. (PubMed)

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

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

170. Adrenal activity and metabolic risk during randomized escitalopram or placebo treatment in PCOS (PubMed)

Adrenal activity and metabolic risk during randomized escitalopram or placebo treatment in PCOS Polycystic ovary syndrome (PCOS) is associated with insulin resistance, adrenal hyperactivity and decreased mental health. We aimed to investigate the changes in adrenal activity, metabolic status and mental health in PCOS during treatment with escitalopram or placebo.Forty-two overweight premenopausal women with PCOS and no clinical depression were randomized to 12-week SSRI (20 mg escitalopram/day (...) , n = 21) or placebo (n = 21). Patients underwent clinical examination, fasting blood samples, adrenocorticotroph hormone (ACTH) test, 3-h oral glucose tolerance test (OGTT) and filled in questionnaires regarding mental health and health-related quality of life (HRQoL): WHO Well-Being Index (WHO-5), Major Depression Inventory (MDI), Short Form 36 (SF-36) and PCOS questionnaire.Included women were aged 31 (6) years (mean (s.d.)) and had body mass index (BMI) 35.8 (6.5) kg/m2 and waist 102 (12) cm

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2018 Endocrine connections Controlled trial quality: uncertain

171. Magnetic resonance imaging and spectroscopy evidence of efficacy for adrenal and gonadal hormone replacement therapy in anorexia nervosa. (PubMed)

Magnetic resonance imaging and spectroscopy evidence of efficacy for adrenal and gonadal hormone replacement therapy in anorexia nervosa. Dehydroepiandrosterone (DHEA)+estrogen/progestin therapy for adolescent girls with anorexia nervosa (AN) has the potential to arrest bone loss. The primary aim of this study was to test the effects of DHEA+estrogen/progestin therapy in adolescent girls with AN on bone marrow in the distal femur using magnetic resonance imaging (MRI) and spectroscopy.Seventy (...) of the water resonance dropped significantly less in the active vs. placebo group over 12months at both the medial and lateral distal femur (p=0.02). Body mass index (BMI) was a significant effect modifier for T1 and for T2 of unsaturated (T2unsat) and saturated fat (T2sat) in the lateral distal femur. Positive effects of the treatment of DHEA+estrogen/progestin were seen primarily for girls above a BMI of about 18kg/m2.These findings suggest treatment with oral DHEA+estrogen/progestin arrests the age

2018 Bone Controlled trial quality: predicted high

172. Direct metabolic interrogation of dihydrotestosterone biosynthesis from adrenal precursors in primary prostatectomy tissues. (PubMed)

Direct metabolic interrogation of dihydrotestosterone biosynthesis from adrenal precursors in primary prostatectomy tissues. Purpose: A major mechanism of castration-resistant prostate cancer (CRPC) involves intratumoral biosynthesis of dihydrotestosterone (DHT) from adrenal precursors. We have previously shown that adrenal-derived androstenedione (AD) is the preferred substrate over testosterone (T) for 5α-reductase expressed in metastatic CRPC, bypassing T as an obligate precursor to DHT (...) . However, the metabolic pathway of adrenal-derived DHT biosynthesis has not been rigorously investigated in the setting of primary disease in the prostate.Experimental Design: Seventeen patients with clinically localized prostate cancer were consented for fresh tissues after radical prostatectomy. Prostate tissues were cultured ex vivo in media spiked with an equimolar mixture of AD and T, and stable isotopic tracing was employed to simultaneously follow the enzymatic conversion of both precursor

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2017 Clinical Cancer Research

173. A case report of primary unilateral adrenal NK/T cell lymphoma: good clinical outcome with trimodality treatment. (PubMed)

and was found to have a large mass on the left adrenal and the top of the renal region. The patient underwent surgical resection and the pathology revealed primary adrenal NK/T cell lymphoma. He received adjuvant sandwich therapy encompassing sequential chemotherapy, radiotherapy and chemotherapy. The patient remains clinically and symptomatically disease-free with over two years follow up.Given the rarity of this disease, there is limited experience with regard to its diagnosis and treatment. This case (...) A case report of primary unilateral adrenal NK/T cell lymphoma: good clinical outcome with trimodality treatment. Primary natural killer (NK)/T cell lymphoma of adrenal glands is an extremely rare tumor with aggressive clinical behavior. There have only been a few cases reported worldwide and the highest reported survival was 90 days. We report the first case of primary unilateral adrenal NK/T cell lymphoma in China with good outcome.This is a 28-year-old man who presented with abdominal pain

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2017 BMC Cancer

174. The utility of 18F-FDG PET/CT for the diagnosis of adrenal metastasis in lung cancer: a PRISMA-compliant meta-analysis. (PubMed)

in evaluating adrenal mass in lung cancer patients was performed. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of F-FDG PET/CT on a per lesion-based analysis were calculated. The area under the curve was calculated to measure the accuracy of F-FDG PET/CT.A total of nine studies, involving 707 lung cancer patients with 810 adrenal masses, were included in the present meta-analysis. Of 810 adrenal masses from lung cancer, 411 (50.7%) and 399 (...) excellent performance.F-FDG PET/CT plays a vital role in the differentiation of adrenal metastasis from a benign adrenal mass in lung cancer patients, with excellent diagnostic performance.

2017 Nuclear medicine communications

175. Case report of a bilateral adrenal myelolipoma associated with Cushing disease. (PubMed)

enhanced bilateral adrenal mass, suggesting a myelolipoma.The hormonal evaluation revealed adrenocorticotropic hormone (ACTH) dependent Cushing syndrome.The patient underwent left adrenalectomy, and transsphenoidal resection of a pituitary mass. The final diagnosis was adrenal myelolipoma associated with Cushing disease.Growth of right adrenal myelolipoma was detected during the 7-year follow-up. There were enhancing pituitary lesions in repeat magnetic resonance imaging of the sellar region, which (...) Case report of a bilateral adrenal myelolipoma associated with Cushing disease. Adrenal myelolipomas are rare benign tumors, composed of a variable mixture of mature adipose tissue and hematopoietic tissue. These tumors are frequently detected incidentally and are usually asymptomatic, and hormonally inactive.During a routine health checkup, a 52-year-old man was found to have a tumor on the bilateral adrenal glands. Abdominal computed tomography revealed a well-defined, heterogeneously

2017 Medicine

176. Combined ovarian and adrenal venous sampling in the localization of ACTH-independent ectopic Cushing's syndrome. (PubMed)

had weight gain, hirsutism, hypertension, and menstrual disorder over 6 months. Her physical examination and biochemical assessment revealed adrenocorticotropic hormone-independent Cushing syndrome. Adrenal computed tomography scan indicated no abnormality. A mass of 5.7 cm × 4.2 cm × 3.4 cm was discovered by pelvic ultrasonography. Somatostatin receptor scintigraphy revealed no abnormal radioactivity intake. Combined ovarian and adrenal venous sampling together with a cortisol assay were (...) Combined ovarian and adrenal venous sampling in the localization of ACTH-independent ectopic Cushing's syndrome. Cushing syndrome is rarely caused by the secretion of cortisol from ovarian tumors. In clinical decision-making, it is important to determine whether the ovarian tumor is capable of secreting cortisol. Selective ovarian and adrenal venous sampling is scarcely reported in the localization of ACTH-independent ectopic Cushing syndrome.We present a case of 40-year-old Chinese woman who

2017 Journal of Clinical Endocrinology and Metabolism

177. A case report of primary adrenal angiosarcoma as depicted on magnetic resonance imaging. (PubMed)

-old man was referred to our hospital for 1 year left-flank pain that exacerbated in recent 4 months.A regular mass with clear boundary was revealed on MRI in the region of left adrenal gland. Its signal intensity was inhomogeneous. It mainly showed isointensity with patchy slight hyperintensity on T1-weighted images and marked hyperintensity with patchy hypointensity on T2-weighted images. On contrast-enhanced images, it demonstrated significantly heterogeneous enhancement, and the peripheral (...) solid component showed delayed enhancement. Bulky blood vessels and hemorrhage were identified in the tumor.The mass was surgically excised under a left laparoscopic adrenalectomy.Left adrenal angiosarcoma was confirmed by pathological and immunohistochemical examinations. No evidence of recurrence was found 6 months after operation.In conclusion, primary adrenal angiosarcoma has some MRI features corresponding to its pathological nature. It should be included in the differential diagnosis when

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2017 Medicine

178. Malignant transformation of a mature teratoma of the adrenal gland: A rare case report and literature review. (PubMed)

Malignant transformation of a mature teratoma of the adrenal gland: A rare case report and literature review. Adrenal mature TMT is very rare. So far, only two cases have been reported.We report a rare case of malignant transformation of a mature teratoma in the right adrenal gland of a 36-year-old Chinese female. The patient had been asymptomatic until physical exam identified a palpable mass in the right abdomen. Abdominal non-enhanced computed tomography (CT) scan showed a huge tumor (...) teratoma and our case report is no exception.This article is a case report, no outcomes.Non-enhanced CT findings of a mass with cystic change, fat, calcification and separation are suggestive of a teratoma. If there is significant enhancement of the cyst wall and septations as well as mural nodules in contrast-enhanced CT, then adrenal TMT should be considered. In addition, abnormal levels of hormones including cortisol, ACTH, aldosterone and VMA may also aid in the diagnosis of adrenal TMT.

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2017 Medicine

179. Resetting the Abnormal Circadian Cortisol Rhythm in Adrenal Incidentaloma Patients With Mild Autonomous Cortisol Secretion. (PubMed)

Resetting the Abnormal Circadian Cortisol Rhythm in Adrenal Incidentaloma Patients With Mild Autonomous Cortisol Secretion. Adrenal incidentalomas (AIs) are found commonly on axial imaging. Around 30% exhibit autonomous cortisol secretion (ACS) associated with increased cardiovascular events and death.We hypothesized that AI/ACS patients have an abnormal cortisol rhythm that could be reversed by use of carefully timed short-acting cortisol synthesis blockade, with improvement in cardiovascular (...) disease markers.In a phase 1/2a, prospective study (Eudract no. 2012-002586-35), we recruited six patients with AI/ACS and two control groups of six sex-, age-, and body mass index-matched individuals: (1) patients with AI and no ACS (AI/NoACS) and (2) healthy volunteers with no AI [healthy controls (HC)]. Twenty-four-hour circadian cortisol analysis was performed to determine any differences between groups and timing of intervention for cortisol lowering using the 11β-hydroxylase inhibitor metyrapone

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2017 Journal of Clinical Endocrinology and Metabolism

180. Case report: schwannoma arising from the unilateral adrenal area with bilateral hyperaldosteronism. (PubMed)

Case report: schwannoma arising from the unilateral adrenal area with bilateral hyperaldosteronism. We report a rare case of a juxta-adrenal schwannoma that could not be discriminated from an adrenal tumor before surgical resection and was complicated by bilateral hyperaldosteronism. To the best of our knowledge, this is first case in which both a juxta-adrenal schwannoma and hyperaldosteronism co-existed.A 69-year-old male treated for hypertension was found to have a left supra-renal mass (5.8 (...)  × 5.2 cm) by abdominal computed tomography. His laboratory data showed that his plasma aldosterone concentration (PAC) was within the normal range, but his plasma renin activity (PRA) was reduced, resulting in an increased aldosterone/renin ratio (ARR). Load tests of captopril or furosemide in the standing position demonstrated autonomous aldosterone secretion and renin suppression. Adrenal venous sampling (AVS) with ACTH stimulation indicated bilateral hypersecretion of aldosterone. A left supra

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2017 BMC Endocrine Disorders

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