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Adrenal surgery

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https://www.readbyqxmd.com/read/29161416/combined-ovarian-and-adrenal-venous-sampling-in-the-localization-of-acth-independent-ectopic-cushing-s-syndrome
#1
Shi Chen, Ran Li, Xiaobo Zhang, Lin Lu, Ji Li, Hui Pan, Huijuan Zhu
Context: Cushing's syndrome is rarely caused by the secretion of cortisol from the ovarian tumors. It is important to determine whether the ovarian tumor is capable of secreting cortisol or not in clinical decision making. Selective ovarian and adrenal venous sampling has not been reported previously in the localization of ACTH-independent ectopic Cushing's syndrome. Case description: Herein, we presented a case of 40-year-old Chinese woman who has been manifested with weight gain, hirsutism, hypertension and menstrual disorder over a period of 6 months...
November 16, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29157938/-vascular-adrenal-cyst-causing-difficult-to-control-high-blood-pressure
#2
D García Escudero, M Torres Roca, M E Hernández Contreras, C Sánchez Rodríguez, J Oñate Celdrán
Hypertension is a prevalent disease in developed countries. Adrenal masses, and especially adrenal cysts, are a rare and usually asymptomatic finding, which can go unnoticed or be detected as incidental findings in imaging tests. These circumstances make the multidisciplinary approach mandatory. The case is presented on a 72 year-old woman with uncontrolled high blood pressure referred to the Urology Department due to the incidental finding of a right retroperitoneal mass. A functional and imaging study was performed, establishing a diagnosis of adrenal cyst causing hypertensive symptoms...
November 17, 2017: Hipertensión y Riesgo Vascular
https://www.readbyqxmd.com/read/29157485/la-chirurgie-d%C3%A2-%C3%A3-pargne-surr%C3%A3-nalienne-du-cortex-%C3%A3-la-m%C3%A3-dulla-cortical-sparing-surgery-from-cortex-to-medulla
#3
A Ferriere, V Kerlan, A Tabarin
The 2017 Endocrine Society annual meeting included several communications and debates on the conservative adrenal surgery in bilateral hereditary pheochromocytomas (BHP), bilateral adrenal macronodular hyperplasia (BAMH) and primary hyperaldosteronism (PHA). The general principle is to preserve a part of the adrenal cortex to prevent the occurrence of a definitive adrenal insufficiency. In BHP, cortical sparing surgery allows more than 50% of patients to maintain normal corticotropic function at 10 years with a low recurrence rate (~ 10%)...
October 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29156014/exhaustive-preoperative-staging-increases-survival-in-resected-adrenal-oligometastatic-non-small-cell-lung-cancer-a-multicentre-study
#4
Julien De Wolf, Jocelyn Bellier, Francoise Lepimpec-Barthes, Francois Tronc, Christophe Peillon, Alain Bernard, Jean-Philippe Le Rochais, Olivier Tiffet, Edouard Sage, Alain Chapelier, Henri Porte
OBJECTIVES: Adrenal oligometastatic non-small-cell lung cancer is rare, and surgical management remains controversial. METHODS: We performed a multicentre, retrospective study from January 2004 to December 2014. The main objective was to evaluate survival in patients who had undergone adrenalectomy after resection of primary lung cancer. Secondary objectives were to determine prognostic, survival and recurrence factors. RESULTS: Fifty-nine patients were included...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29151238/predictability-of-hypoadrenalism-occurrence-and-duration-after-adrenalectomy-for-acth-independent-hypercortisolism
#5
V Morelli, L Minelli, C Eller-Vainicher, S Palmieri, E Cairoli, A Spada, M Arosio, I Chiodini
OBJECTIVE: To evaluate if the parameters of hypothalamic-pituitary-adrenal (HPA) axis activity could predict the occurrence and duration of post-surgical hypocortisolism (PSH) in patients with Cushing's syndrome (CS) and with adrenal incidentaloma (AI). METHODS: We studied 80 patients (54 females, age 53.3 ± 11 years), who underwent adrenalectomy for CS (17 patients) or for AI (53 patients). Before surgery, we measured adrenocorticotroph hormone (ACTH), urinary free cortisol (UFC) and serum cortisol after 1 mg dexamethasone suppression test (1 mg-DST) levels...
November 18, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29141492/a-case-report-of-hyponatremia-after-surgery-for-conn-s-adenoma
#6
Giulia Furlanis, Stella Bernardi, Monica Cavressi, Lorenzo Zandonà, Renzo Carretta, Bruno Fabris, Moreno Bardelli
Primary aldosteronism (PA), also known as Conn's syndrome, is a frequent cause of secondary hypertension. If PA is due to a documented unilateral adrenal adenoma, adrenalectomy is the treatment of choice. Endocrine Society guidelines suggest monitoring potassium after adrenalectomy, while there is no mention of sodium disorders after surgery. Here we report the case of a patient with Conn's syndrome who developed hyponatremia after surgery. This was an unexpected event in the course of the treatment, which sheds light on the fact that low levels of aldosterone strongly influence sodium concentration, and advises clinicians to monitor sodium after adrenalectomy...
October 2017: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/29135139/-laparoscopic-transperitoneal-adrenalectomy
#7
B G Guliev, B K Komyakov, D V Semenov
AIM: To analyze the results of laparoscopic adrenalectomy (LAE) in patients with adrenal gland tumors. MATERIALS AND METHODS: From 2011 to 2016, 24 patients (15 men, 9 women), mean age 49.6 +/- 8.2 years, underwent LAE. The right, left and bilateral LAE was performed in 12, 10 and 2 patients, respectively. Indications for surgery were mainly primary and metastatic adrenal tumors. The operations were performed using a transperitoneal 4-port approach. RESULTS: Twenty six LAE were successfully performed in 24 patients...
October 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/29129366/contralateral-suppression-of-aldosterone-at-adrenal-venous-sampling-predicts-hyperkalemia-following-adrenalectomy-for-primary-aldosteronism
#8
Omair A Shariq, Irina Bancos, Patricia A Cronin, David R Farley, Melanie L Richards, Geoffrey B Thompson, William F Young, Travis J McKenzie
BACKGROUND: We aimed to determine whether a greater degree of contralateral suppression of aldosterone secretion at adrenal venous sampling predicted the development of postoperative hyperkalemia after unilateral adrenalectomy for primary aldosteronism. METHODS: A retrospective analysis of patients undergoing unilateral adrenalectomy for primary aldosteronism between 2004-2015 was performed. Clinical and biochemical parameters of patients who developed hyperkalemia (≥5...
November 9, 2017: Surgery
https://www.readbyqxmd.com/read/29129360/less-is-more-cost-effectiveness-analysis-of-surveillance-strategies-for-small-nonfunctional-radiographically-benign-adrenal-incidentalomas
#9
Kathryn Chomsky-Higgins, Carolyn Seib, Holly Rochefort, Jessica Gosnell, Wen T Shen, Jamess G Kahn, Quan-Yang Duh, Insoo Suh
BACKGROUND: Guidelines for management of small adrenal incidentalomas are mutually inconsistent. No cost-effectiveness analysis has been performed to evaluate rigorously the relative merits of these strategies. METHODS: We constructed a decision-analytic model to evaluate surveillance strategies for <4cm, nonfunctional, benign-appearing adrenal incidentalomas. We evaluated 4 surveillance strategies: none, one-time, annual for 2 years, and annual for 5 years. Threshold and sensitivity analyses assessed robustness of the model...
November 9, 2017: Surgery
https://www.readbyqxmd.com/read/29127554/is-there-any-role-for-minimally-invasive-surgery-in-net
#10
REVIEW
M Thomaschewski, H Neeff, T Keck, H P H Neumann, T Strate, E von Dobschuetz
Neuroendocrine tumors (NET) represent the variability of almost benign lesions either secreting hormones occurring as a single lesion up to malignant lesions with metastatic potential. Treatment of NET is usually performed by surgical resection. Due to the rarity of NET, surgical treatment is mainly based on the experience and recommendations of experts and less on the basis of prospective randomized studies. In addition, the development and establishment of new surgical procedures is made more difficult by their rarity...
November 11, 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/29126554/preoperative-genetic-testing-in-pheochromocytomas-and-paragangliomas-influences-the-surgical-approach-and-the-extent-of-adrenal-surgery
#11
Pavel Nockel, Mustapha El Lakis, Apostolos Gaitanidis, Lily Yang, Roxanne Merkel, Dhaval Patel, Naris Nilubol, Tamara Prodanov, Karel Pacak, Electron Kebebew
BACKGROUND: Our knowledge of the susceptibility genes for pheochromocytomas/paragangliomas has increased; however, data on its impact on surgical decision-making has not been described. The aim of this study was to determine the effect of routine preoperative genetic testing on the operative intervention in patients with pheochromocytomas/paragangliomas. METHODS: One-hundred-eight patients diagnosed with pheochromocytomas/paragangliomas who underwent 118 operations had preoperative genetic testing for 9 known pheochromocytoma/paraganglioma susceptibility genes...
November 7, 2017: Surgery
https://www.readbyqxmd.com/read/29124355/a-multi-institutional-comparison-of-adrenal-venous-sampling-in-patients-with-primary-aldosteronism-caution-advised-if-successful-bilateral-adrenal-vein-sampling-is-not-achieved
#12
Tracy S Wang, Greg Kline, Tina W Yen, Ziyan Yin, Ying Liu, William Rilling, Benny So, James W Findling, Douglas B Evans, Janice L Pasieka
INTRODUCTION: In patients with primary aldosteronism (PA), adrenal venous sampling (AVS) is recommended to differentiate between unilateral (UNI) or bilateral (BIL) adrenal disease. A recent study suggested that lateralization could be predicted, based on the ratio of aldosterone/cortisol levels (A/C) between the left adrenal vein (LAV) and inferior vena cava (IVC), with a 100% positive predictive value (PPV). This study aimed to validate those findings utilizing a larger, multi-institutional cohort...
November 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29122321/each-procedure-matters-threshold-for-surgeon-volume-to-minimize-complications-and-decrease-cost-associated-with-adrenalectomy
#13
Kevin L Anderson, Samantha M Thomas, Mohamed A Adam, Lauren N Pontius, Michael T Stang, Randall P Scheri, Sanziana A Roman, Julie A Sosa
BACKGROUND: An association has been suggested between increasing surgeon volume and improved patient outcomes, but a threshold has not been defined for what constitutes a "high-volume" adrenal surgeon. METHODS: Adult patients who underwent adrenalectomy by an identifiable surgeon between 1998-2009 were selected from the Healthcare Cost and Utilization Project National Inpatient Sample. Logistic regression modeling with restricted cubic splines was utilized to estimate the association between annual surgeon volume and complication rates in order to identify a volume threshold...
November 6, 2017: Surgery
https://www.readbyqxmd.com/read/29118985/acute-development-of-cushing-syndrome-in-an-hiv-infected-child-on-atazanavir-ritonavir-based-antiretroviral-therapy
#14
Gueorgui Dubrocq, Andrea Estrada, Shannon Kelly, Natella Rakhmanina
An 11-year-old male with perinatally acquired human immune deficiency virus (HIV) infection on antiretroviral regimen, which included abacavir plus lamivudine (Epzicom), didanosine, ritonavir and atazanavir presented with bilateral axillary striae, increased appetite, fatigue, facial swelling and acute weight gain. Two months prior to presentation, the patient had received a diagnostic and therapeutic intra-articular triamcinolone injection in the knee for pain relief and subsequently became progressively swollen in the face, developed striae bilaterally at the axillae, experienced increased appetite, fatigue and an 8 pound weight gain...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29117899/volume-outcome-relationship-in-adrenal-surgery
#15
Tracy S Wang, Quan-Yang Duh
No abstract text is available yet for this article.
November 6, 2017: Surgery
https://www.readbyqxmd.com/read/29099418/temozolomide-treatment-of-a-malignant-pheochromocytoma-and-an-unresectable-max-related-paraganglioma
#16
Alfonso M Ferrara, Giuseppe Lombardi, Ardi Pambuku, Domenico Meringolo, Roberta Bertorelle, Margherita Nardin, Francesca Schiavi, Maurizio Iacobone, Giuseppe Opocher, Vittorina Zagonel, Stefania Zovato
Pheochromocytomas (PCCs) and paragangliomas (PGLs) are neuroendocrine tumors with a strong genetic background. The mainstay of treatment for PCC/PGLs is surgery. However, for unresectable lesions, no curative treatment is currently available. Temozolomide (TMZ) has been shown to determine radiological and biochemical response in malignant PCC/PGLs. We report two cases of PCC/PGLs treated with TMZ. Case 1 is a 51-year-old man with local and distant recurrence (liver and bone metastases) of right adrenal PCC...
November 2, 2017: Anti-cancer Drugs
https://www.readbyqxmd.com/read/29098197/simultaneous-bilateral-laparoscopic-adrenalectomy-for-adrenal-metastases-of-renal-cell-carcinoma-a-case-report
#17
Akbar Nouralizadeh, Amir Afyouni, Behnam Shakiba, Fahad Khalid Radhi
The possibility of bilateral adrenal gland metastasis from renal cell carcinoma (RCC) has been extremely rarely reported. Surgery may be the preferred treatment strategy for adrenal metastasis from RCC. In this article, we present a patient with bilateral large adrenal metastases from the left RCC, which was managed with simultaneous bilateral laparoscopic excision. A 64-year-old woman had undergone left adrenal sparing radical nephrectomy for a left RCC 7 years ago. Her abdominal CT scan revealed bilateral large adrenal metastasis...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29095319/malignant-pheochromocytoma-with-multiple-vertebral-metastases-causing-acute-incomplete-paralysis-during-pregnancy-literature-review-with-one-case-report
#18
REVIEW
Shuzhong Liu, An Song, Xi Zhou, Xiangyi Kong, William A Li, Yipeng Wang, Yong Liu
RATIONALE: We present a rare case of malignant pheochromocytoma with thoracic metastases during pregnancy that presented with symptoms of myelopathy and was treated with circumferential decompression, stabilization, and radiation. The management of this unique case is not well documented. The clinical manifestations, imaging results, pathological characteristics, treatment and prognosis of the case were analyzed. PATIENT CONCERNS: A 26-year-old pregnant woman with a history of paroxysmal hypertension during the second trimester presented with lower extremity weakness, numbness, urinary incontinence, and back pain...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29092787/estradiol-metabolites-as-biomarkers-of-endometrial-cancer-prognosis-after-surgery
#19
Yannick Audet-Delage, Jean Grégoire, Patrick Caron, Véronique Turcotte, Marie Plante, Pierre Ayotte, David Simonyan, Lyne Villeneuve, Chantal Guillemette
Endometrial cancer (EC) is the most common gynecologic malignancy prevailing after menopause. Defining steroid profiles may help predict the risk of recurrence after hysterectomy, which remains limited due to the lack of reliable markers. Adrenal precursors, androgens, parent estrogens and catechol estrogen metabolites were measured by mass spectrometry (MS) in preoperative serums and those collected one month after hysterectomy from 246 newly diagnosed postmenopausal EC cases. We also examined the associations between steroid hormones and EC status by including 110 healthy postmenopausal women...
October 29, 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/29082324/left-adrenal-tumor-disappeared-outside-a-field-of-vision-during-laparoscopic-surgery-the-true-identity-was-gastrointestinal-stromal-tumor
#20
Hiroshi Ushida, Hirofumi Goto, Satoshi Ishitoya, Hiroyuki Onishi
Background: We report a case of gastrointestinal stromal tumor (GIST) mimicking a left adrenal tumor. Case Presentation: A 62-year-old female was referred to our hospital for the treatment of left adrenal tumor of 2.8 × 2.3 cm incidentally found during her annual checkup. The preoperative diagnosis based on upper gastroscopy and imaging complete examinations was nonfunctional left adrenal tumor possessing malignant potential. Transperitoneal laparoscopic left adrenalectomy was performed. However, the tumor was not found in the excised adrenal gland that had been completely removed during surgery...
2017: Journal of Endourology Case Reports
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