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Adrenal surgery

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https://www.readbyqxmd.com/read/28107213/computed-tomography-in-the-management-of-adrenal-tumors-does-size-still-matter
#1
Saïd C Azoury, Neeraja Nagarajan, Allen Young, Aarti Mathur, Jason D Prescott, Elliot K Fishman, Martha A Zeiger
OBJECTIVE: We sought to evaluate computed tomography (CT) imaging as a predictor of adrenal tumor pathology. METHODS: A retrospective review was conducted of patients who underwent unilateral adrenalectomy for an adrenal mass between January 2005 and July 2015. Tumors were classified as benign, indeterminate, or malignant based on preoperative CT findings. RESULTS: Of 697 patients who underwent unilateral adrenalectomy, 216 met the inclusion criteria...
January 20, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28104753/the-effect-of-adrenal-medullectomy-on-metabolic-responses-to-chronic-intermittent-hypoxia-in-the-frequently-sampled-intravenous-glucose-tolerance-test
#2
Mi-Kyung Shin, Woobum Han, Hoon Joo, Shannon Bevans-Fonti, Masakazu Shiota, Darko Stefanovski, Vsevolod Y Polotsky
Obstructive sleep apnea is associated with type 2 diabetes. We have previously developed a mouse model of intermittent hypoxia (IH) mimicking oxyhemoglobin desaturations in patients with sleep apnea and have shown that IH increases fasting glucose, hepatic glucose output, and plasma catecholamines. We hypothesize that adrenal medulla modulates glucose responses to IH, and that such responses can be prevented by adrenal medullectomy. We performed adrenal medullectomy or sham surgery in lean C57BL/6J mice, which were exposed to IH or intermittent air (control) for 4 weeks followed by the frequently sampled intravenous glucose tolerance test (FSIVGTT) in unanesthetized unrestrained animals...
January 19, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28099341/laparoscopic-distal-splenoadrenal-shunt-for-the-treatment-of-portal-hypertension-in-children-with-congenital-hepatic-fibrosis-a-case-report
#3
Jin-Shan Zhang, Wei Cheng, Long Li
BACKGROUND: The distal splenorenal shunt is an effective procedure for the treatment of portal hypertension in children. However, there has been no report about laparoscopic distal splenorenal shunt in the treatment of portal hypertension in children. METHODS: From December 2015 to August 2016, 4 children with upper gastrointestinal bleeding underwent laparoscopic distal splenoadrenal shunt. Portal hypertension and splenomegaly were demonstrated on the preoperative computed tomography (CT) and sonography...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28081522/adrenal-giant-cystic-pheochromocytoma-treated-by-posterior-retroperitoneoscopic-adrenalectomy
#4
Carlos E Costa Almeida, Marta Silva, Luis Carvalho, Carlos Manuel Costa Almeida
INTRODUCTION: Giant cystic pheochromocytoma (>10cm) is rare with only a few cases described in the literature. Preoperative diagnosis is very difficult because clinical, biochemical and radiologic finds are usually not consistent with a pheochromocytoma. Open surgery is traditionally the gold standard. CASE PRESENTATION: A 51 year-old male patient resorted to surgery department with an adrenal cystic incidentaloma. He was asymptomatic, mild hypertension easily controlled, with increased plasma fractionated metanephrines...
December 27, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28079049/lateralization-index-but-not-contralateral-suppression-at-adrenal-vein-sampling-predicts-improvement-in-blood-pressure-after-adrenalectomy-for-primary-aldosteronism
#5
M Tagawa, M Ghosn, H Wachtel, D Fraker, R R Townsend, S Trerotola, D L Cohen
Adrenal vein sampling (AVS) is essential in differentiating unilateral from bilateral sources of aldosterone excess in primary aldosteronism (PA). However, its ability to predict blood pressure (BP) improvement after adrenalectomy has not been well studied. This is a retrospective observational study of 119 patients who underwent AVS by sequential technique followed by adrenalectomy for PA at the Hospital of the University of Pennsylvania from 1997 to 2015. Median age was 52 years (interquartile range 44-59), 67% were male and median duration of hypertension was 10 (interquartile range 6-20) years...
January 12, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28050427/cystic-pheochromocytoma-presenting-as-adrenal-cyst
#6
Mohammed Shafi Abdulsalam, Vijaya Ganapathy, Priyanka Satish, Raghunath Keddy Janakiraman, Shivshankar Singh
Pheochromocytomas are usually solid tumours. But it can present as cystic lesions in the adrenal gland. Cystic lesions in adrenal gland with hypertension needs attention to rule out pheochromocytoma. If ignored, it may lead to hypertensive emergency, multisystem crisis and death. Early diagnosis with biochemistry, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) of abdomen, proper functional imaging like Meta Iodo Benzyl Guanidine (MIBG) scan is essential. Proper preoperative preparation is important to prevent hypertensive crisis during and after surgery...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043926/laparoscopic-versus-robotic-adrenalectomy-a-comprehensive-meta-analysis
#7
REVIEW
Konstantinos P Economopoulos, Konstantinos S Mylonas, Aliki A Stamou, Vasileios Theocharidis, Theodoros N Sergentanis, Theodora Psaltopoulou, Melanie L Richards
BACKGROUND: The benefit of robotic adrenalectomy (RA) compared to laparoscopic adrenalectomy (LA) is still debatable. The purpose of this paper was to systematically review and synthesize all available evidence comparing RA to LA so as to evaluate which procedure provides superior clinical outcomes. METHODS: A systematic literature search of PubMed and Scopus databases was performed with respect to the PRISMA statement (end-of-search date: January 31, 2016). Data on perioperative variables were extracted by three independent reviewers...
December 30, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/28032206/ovarian-adrenal-rest-tumors-undetected-by-imaging-studies-and-identified-at-surgery-in-three-females-with-congenital-adrenal-hyperplasia-unresponsive-to-increased-hormone-therapy-dosage
#8
Hua-Dong Chen, Li-E Huang, Zhi-Hai Zhong, Zhe Su, Hong Jiang, Jing Zeng, Jun-Cheng Liu
Patients with congenital adrenal hyperplasia have a predisposition for developing adrenal rest tumors. In contrast to testicular adrenal rest tumors, ovarian adrenal rest tumors are less common, and only a few cases have been reported in the literature. This report presents three Chinese female congenital adrenal hyperplasia patients (9 to 15 years of age) with small ectopic adrenal cortical nodules that were not detected by imaging but were diagnosed at surgery. All three patients developed virilization with elevation of 17- hydroxyprogesterone, androstenedione, and androgen levels despite receiving maximum adrenal hormone replacement therapy...
December 28, 2016: Endocrine Pathology
https://www.readbyqxmd.com/read/28031665/splenorenal-arterial-bypass-description-of-technique-and-case-example-in-an-instance-of-renal-revascularization-during-adrenalectomy-for-adrenocortical-carcinoma
#9
J Yozawitz, M Kissin, M Szuchmacher, J Sullivan, J Nicastro, G Coppa, E Molmenti
We present a patient with a 16 cm adrenocortical carcinoma that underwent a left adrenalectomy en bloc with resection of the involved segment of the left renal artery. A splenectomy and splenorenal bypass was performed to revascularize the left kidney. To our knowledge, this is the first instance in the literature of a splenorenal arterial bypass being reported for renal revascularization during an extirpative oncologic procedure. A 64-year-old male patient, with history significant for adrenocortical carcinoma, status post prior right adrenalectomy with partial right nephrectomy, presented for an elective left adrenalectomy...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28024808/total-and-free-cortisol-responses-and-their-relation-to-outcomes-after-cardiopulmonary-bypass-in-infants
#10
Eric L Wald, Carl L Backer, Joseph A Dearani, Zhuo Li, William C Oliver, Sheri S Crow
BACKGROUND: Hypothalamic-pituitary-adrenal (HPA) axis dysfunction may be partially responsible for the hemodynamic instability experienced by infants after cardiopulmonary bypass (CPB). We report the full spectrum of the HPA response surrounding CPB for infant congenital cardiac surgery. METHODS: We enrolled 84 infants who received 1 mg/kg of dexamethasone before initiation of CPB. Total cortisol (TC), free cortisol (FC), adrenocorticotropic hormone (ACTH), and corticosteroid-binding globulin (CBG) were measured at 3 time points: immediately before CPB (TP1), on intensive care unit arrival (TP2), and at 24 hours after surgery (TP3)...
November 21, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28018684/a-large-isolated-hydatid-cyst-of-the-adrenal-gland-a-case-report-and-review-of-the-literature
#11
Fatehi Elnour Elzein, Abdullah Aljaberi, Abdullah AlFiaar, Abdullah Alghamdi
A 44-year-old patient presented with two-year history of (R) lumbar pain. There was a strong history of childhood animals' contact, including dogs. A brother had multiple hydatid cysts requiring surgery. Initial ultrasound showed a large (R) adrenal mass measuring 10 × 9 × 8 cm. Subsequent CT scan confirmed a heavily calcified cyst in the (R) adrenal gland. Hormonal studies were normal. He had an uneventful course following a total adrenalectomy. Isolated adrenal hydatid is extremely rare with an incidence of less than 0...
2016: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28018063/endoprosthetic-reconstruction-for-metastatic-phaeochromocytoma-in-the-distal-femur-a-case-report
#12
Kanchana Pala Srikanth, Chirukuri Srinivas, Lakshmipura Gangadharaiah Gowrishankarswamy, Chikkamuniyappa Chandrasekar
Metastatic spread of malignant phaeochromocytoma is known to involve multiple organs including the axial skeleton. Its presentation as a solitary lesion in the long bones of the extremities is extremely rare. We report a unique case of solitary metastatic phaeochromocytoma presenting in the distal femur, 16 years after excision of primary abdominal tumor. A 60 year old female, operated for adrenal phaeochromocytoma 16 years back was detected to have a bone tumor in her left distal femur. Chest and abdominal CT evaluation including bone scintigraphy confirmed the lesion to be solitary...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28011503/surgical-resection-of-giant-pheochromocytomas-arising-behind-the-retrohepatic-inferior-vena-cava
#13
Yuji Soejima, Tomoharu Yoshizumi, Toru Ikegami, Norifumi Harimoto, Shinji Ito, Noboru Harada, Takashi Motomura, Akihisa Nagatsu, Tetsuo Ikeda, Yoshihiko Maehara
BACKGROUND: Surgical resection of retrocaval giant pheochromocytomas (PCs) and of extra-adrenal paragangliomas (EAPs) is a technically challenging procedure but data on these procedures are scarce. The purpose of this study was to present and evaluate our surgical results for such tumors. PATIENTS AND METHODS: We retrospectively analyzed four consecutive patients who had surgery for giant retro-caval PCs and EAPs in terms of surgical technique, resectability of the tumor, requirement for bypass, and postoperative complications...
January 2017: Anticancer Research
https://www.readbyqxmd.com/read/27998513/sexual-orientation-and-medical-history-among-iranian-people-with-complete-androgen-insensitivity-syndrome-and-congenital-adrenal-hyperplasia
#14
Behzad S Khorashad, Ghasem M Roshan, Alistair G Reid, Zahra Aghili, Mehran Hiradfar, Mozhgan Afkhamizadeh, Ali Talaei, Azadeh Aarabi, Nosrat Ghaemi, Negin Taghehchian, Hedieh Saberi, Nazanin Farahi, Mohammad Reza Abbaszadegan
OBJECTIVE: To report sexual orientation, relationship status and medical history of Iranian people with Differences of Sex Development (DSD) who were raised female. METHODS: Our participants consisted of nineteen 46,XY individuals with Complete Androgen Insensitivity Syndrome (CAIS) and eighteen 46,XX individuals with Congenital Adrenal Hyperplasia (CAH) who were raised as females and older than 13years. As well as their relationship status and detailed medical history, an expert psychiatrist assessed their sexual orientation by a semi-structured psychiatric interview with them and, where applicable, their parents...
January 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27995217/robotic-assisted-adrenalectomy-is-it-ready-for-prime-time
#15
REVIEW
Xin Ling Teo, Sey Kiat Lim
Adrenal surgery is undergoing continuous evolution and minimally invasive surgery is increasingly being used for the surgical management of adrenal masses. With robotic-assisted surgery being a widely accepted surgical treatment for many urological conditions such as prostate carcinoma and renal cell carcinoma, the use of the robot has been expanded to include robotic-assisted adrenalectomy, offering an alternative minimally invasive platform for adrenal surgery. We performed a literature review on robotic-assisted adrenalectomy, reviewing the current surgical techniques and perioperative outcomes...
December 2016: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/27994341/anesthetic-management-of-clinically-silent-familial-pheochromocytoma-with-men-2a-a-report-of-four-cases
#16
Shipra Aggarwal, Vandana Talwar, Pooja Virmani, Suniti Kale
Familial pheochromocytomas are commonly associated with multiple endocrine neoplasia type 2 (MEN 2) syndrome. Majority of the patients present with normal clinical and biochemical parameters in the preoperative period, the incidence of hypertension being only 50 %. Even though patients may be clinically asymptomatic, surveillance and proper preoperative evaluation is important, as surgery for associated tumors may precipitate a hypertensive crisis and result in severe complications. A family of 19 members, of which 12 were positive for MEN 2A syndrome, presented to our hospital...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27979469/review-of-primary-extra-adrenal-myelolipoma-of-the-thorax
#17
REVIEW
Cheng Shen, Kun Zhou, Yutian Lai, Jun Fan, Lunxu Liu, Guowei Che
Extra-adrenal myelolipoma happens in adrenal glands, and the thoracic location is extremely unusual. This is the first study involving 36 of patients with thoracic myelolipoma of English literature by investigating the clinical data, pathologic findings, radiological manifestation, and treatment strategy of all patients. Imageologic diagnosis including computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography scans is useful to identify the feature of extra-adrenal myelolipoma...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27975081/laparoscopic-treatment-of-adrenal-tumors-a-single-center-experience-with-58-patients
#18
Aziz Ari, Kenan Buyukasik, Cihad Tatar, Ozgur Segmen, Feyzullah Ersoz, Soykan Arikan, Feray Gunver, Serkan Sari
Background. The aim of this study is to discuss the laparoscopic approach and assess the immunohistochemical expression profiles of synaptophysin, Ki-67, and inhibin and patient outcomes in adrenal masses through a series of cases treated at our institution. Method. The study was conducted on 58 patients who were diagnosed with adrenal masses. All cases were operated on laparoscopically for adrenal masses. Results. Both inhibin and synaptophysin were found positive in 45 patients (77,6%). Ki-67 was negative in 11 patients, whereas it was found positive in 42 with a rate of 1%...
2016: Surgery Research and Practice
https://www.readbyqxmd.com/read/27965907/a-rare-tumor-in-the-cervical-sympathetic-trunk-ganglioneuroblastoma
#19
Ozan Erol, Alper Koycu, Erdinc Aydin
Ganglioneuroblastoma is a rare tumor with moderate malignancy, which is composed of mature ganglion cells and seen in sympathetic ganglia and adrenal medulla. The diagnosis is possible after cytological and immunohistochemical studies following a needle biopsy or surgical excision. There is no consensus regarding the need for chemo- or radiotherapy after surgery. In this case report, clinical behavior and diagnosis and treatment of the rare tumor cervical ganglioneuroblastoma were discussed.
2016: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/27965122/assembling-a-functional-clitoris-and-vulva-from-a-pseudo-penis-a-surgical-technique-for-an-adult-woman-with-congenital-adrenal-hyperplasia
#20
Wiebren A A Tjalma
BACKGROUND: Congenital adrenal hyperplasia (CAH) is associated with a genital deformation that may cause a negative body image. The genital ambiguity is generally "corrected" surgically during early infancy. The advantage is a psychological benefit. The disadvantages are multiple surgical procedures and the loss of orgasm. CASE: A 22-year-old woman with CAH consulted for genital reconstructive surgery. She had a pseudo-penis of 4 cm and could achieve an orgasm by masturbating...
December 10, 2016: Journal of Pediatric and Adolescent Gynecology
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