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Adrenal surgery

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https://www.readbyqxmd.com/read/28640966/linking-the-degree-of-virilization-in-females-with-congenital-adrenal-hyperplasia-to-genotype
#1
Semyon Gurgov, Kerlly J Bernabé, John Stites, Christopher M Cunniff, Karen Lin-Su, Diane Felsen, Maria I New, Dix P Poppas
Mutations of CYP21A2 variably decrease 21-hydroxylase activity and result in a spectrum of disease expressions in patients with congenital adrenal hyperplasia (CAH). We examined the association between CYP21A2 mutations and virilization (Prader score) in females with CAH. The study population included 187 CAH females with fully characterized CYP21A2 mutations. One hundred fifty-eight patients were sorted into groups by expected enzyme activity (percent of normal activity) of the less severely affected allele: (A) null, 0%; (B) I2G, 1%; (C) I172N, 2%; and (D) V281L, >2%...
June 22, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28628416/case-243-extramedullary-hematopoiesis-in-an-adrenal-myelolipoma
#2
James Tanner, Shalini Malhotra, Hesham El-Daly, Edmund M Godfrey
History A 30-year-old man presented to the emergency department with epigastric pain. He was vomiting and in distress, and he had a history of thalassemia. Physical examination findings were unremarkable. Pertinent blood results were a hemoglobin level of 10.5 g/dL (6.52 mmol/L) (normal range, 13.5-18.0 g/dL [8.38-11.17 mmol/L]) and a bilirubin level of 62 µmol/L (normal range, 3-17 µmol/L). The remaining hematologic and biochemical results were normal. Aortic dissection was suspected clinically, so the patient was referred for imaging...
July 2017: Radiology
https://www.readbyqxmd.com/read/28626127/a-case-of-retroperitoneal-paraganglioma
#3
Takao Amaike, Toshihisa Tamura, Atsuhiro Koga, Kazunori Shibao, Aiichiro Higure, Keiji Hirata
We report a surgical case of retroperitoneal paraganglioma. A paraganglioma is a catecholamine-producing tumor originating in the chromaffin cells of the sympathetic ganglion. It is a kind of pheochromocytoma which occurs on the outside of the adrenal gland. The patient was a 72 year old male with a history of hypertension and a pacemaker implantation. A mass in the ventral side of the right iliopsoas muscle was detected during a routine contrasting computed tomography (CT) examination for checking his pacemaker...
2017: Journal of UOEH
https://www.readbyqxmd.com/read/28623178/adrenal-derived-stress-hormones-modulate-ozone-induced-lung-injury-and-inflammation
#4
Andres Henriquez, John House, Desinia B Miller, Samantha J Snow, Anna Fisher, Hongzu Ren, Mette C Schladweiler, Allen D Ledbetter, Fred Wright, Urmila P Kodavanti
Ozone-induced systemic effects are modulated through activation of the neuro-hormonal stress response pathway. Adrenal demedullation (DEMED) or bilateral total adrenalectomy (ADREX) inhibits systemic and pulmonary effects of acute ozone exposure. To understand the influence of adrenal-derived stress hormones in mediating ozone-induced lung injury/inflammation, we assessed global gene expression (mRNA sequencing) and selected proteins in lung tissues from male Wistar-Kyoto rats that underwent DEMED, ADREX, or sham surgery (SHAM) prior to their exposure to air or ozone (1ppm), 4h/day for 1 or 2days...
June 13, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28614036/an-individualized-approach-to-the-evaluation-of-cushing-syndrome
#5
Susmeeta T Sharma
Cushing syndrome (CS) is caused by chronic exposure to excess glucocorticoids. Early recognition and treatment of hypercortisolemia can lead to decreased morbidity and mortality. The diagnosis of CS and thereafter, establishing the cause can often be difficult, especially in patients with mild and cyclic hypercortisolism. Surgical excision of the cause of excess glucocorticoids is the optimal treatment for CS. Medical therapy (steroidogenesis inhibitors, medications that decrease adrenocorticotropic hormone [ACTH] levels or glucocorticoid antagonists) and pituitary radiotherapy may be needed as adjunctive treatment modalities in patients with residual, recurrent or metastatic disease, in preparation for surgery, or when surgery is contraindicated...
June 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28593737/influence-of-opioids-on-immune-function-in-patients-with-cancer-pain-from-bench-to-bedside
#6
REVIEW
Jason W Boland, A Graham Pockley
In patients with cancer, opioids are principally used for the management of acute surgical and chronic cancer-related pain. However, opioids have many non-analgesic effects, including direct and indirect effects on cancer cells and on anti-tumour immunity (natural killer (NK) cells, macrophages and T-cells). Direct effects on immune cells are manifested via opioid and non-opioid Toll-like receptors, whereas indirect effects are manifested via the sympathetic nervous system and hypothalamic-pituitary-adrenal axis...
June 8, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28585682/the-usefulness-of-laparoscopic-adrenalectomy-in-the-treatment-of-adrenal-neoplasms-a-single-centre-experience
#7
Ryszard Pogorzelski, Sadegh Toutounchi, Ewa Krajewska, Patryk Fiszer, Agata Kącka, Mariusz Piotrowski, Małgorzata Szostek, Tomasz Wołoszko, Krzysztof Celejewski, Urszula Ambroziak, Tomasz Bednarczuk, Zbigniew Gałązka
INTRODUCTION: Adrenal neoplasms comprise about 10% of all tumours affecting this organ and constitute a significant, at first diagnostic and subsequently therapeutic, problem, especially since a relatively high proportion of neoplastic lesions are asymptomatic. The number of diagnosed metastases to adrenal glands is increasing. Surgical treatment involves both open surgery as well as laparoscopy. MATERIAL AND METHODS: There were 235 adrenalectomies performed at our centre due to various indications over the past four years...
June 6, 2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28585593/incidentaloma-from-general-practice-to-specific-endocrine-frame
#8
Ancuta Augustina Gheorghisan-Galateanu, Mara Carsote, Ana Valea
Incidentaloma, a modern concept connected to technology progress, represents an accidentally discovered tumour, usually used for hypophysis and adrenals, and rarely for thyroid, parathyroids, and ovaries. This is a narrative review based on PubMed research, between 2012 and 2016 focusing on general and endocrine approach and current controversies. Main dilemma is the terminology itself: randomly imagery finding is enough or non-functioning profile and low-growth rate (not requiring surgery) should be mandatory? The controversies refers to best time framing of re-scanning pituitary and adrenal incidentaloma and setting of clear criteria for subclinical Cushing's syndrome...
June 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28578183/central-precocious-puberty-secondary-to-adrenocortical-adenoma-in-a-female-child-case-report-and-review-of-the-literature
#9
Betül Ersoy, Deniz Kizilay, Hasan Çayirli, Peyker Temiz, Cüneyt Günşar
BACKGROUND: Pediatric adrenocortical tumors are rare but significant causes of virilization and peripheral precocious puberty (PPP). CASE: A 4-year-old girl presented with development of breast, pubic hair, and facial acne. Her bone age was advanced, and gonadotropins did not elevate in gonadotropin-releasing hormone (GnRH) test. High levels of dehydroepiandrosterone-sulfate, estradiol, and testosterone and detection of a tumor in the left adrenal gland of the abdomen by computed tomography led to a diagnosis of PPP due to adrenal tumor...
May 31, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28576687/outcomes-after-adrenalectomy-for-unilateral-primary-aldosteronism-an-international-consensus-on-outcome-measures-and-analysis-of-remission-rates-in-an-international-cohort
#10
Tracy A Williams, Jacques W M Lenders, Paolo Mulatero, Jacopo Burrello, Marietta Rottenkolber, Christian Adolf, Fumitoshi Satoh, Laurence Amar, Marcus Quinkler, Jaap Deinum, Felix Beuschlein, Kanako K Kitamoto, Uyen Pham, Ryo Morimoto, Hironobu Umakoshi, Aleksander Prejbisz, Tomaz Kocjan, Mitsuhide Naruse, Michael Stowasser, Tetsuo Nishikawa, William F Young, Celso E Gomez-Sanchez, John W Funder, Martin Reincke
BACKGROUND: Although unilateral primary aldosteronism is the most common surgically correctable cause of hypertension, no standard criteria exist to classify surgical outcomes. We aimed to create consensus criteria for clinical and biochemical outcomes and follow-up of adrenalectomy for unilateral primary aldosteronism and apply these criteria to an international cohort to analyse the frequency of remission and identify preoperative determinants of successful outcome. METHODS: The Primary Aldosteronism Surgical Outcome (PASO) study was an international project to develop consensus criteria for outcomes and follow-up of adrenalectomy for unilateral primary aldosteronism...
May 30, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28570879/acute-onset-of-paraganglioma-of-filum-terminale-a-case-report-and-surgical-treatment
#11
Domenico Murrone, Bruno Romanelli, Giuseppe Vella, Aldo Ierardi
INTRODUCTION: Paragangliomas of filum terminale are rare benign tumors, arising from the adrenal medulla or extra-adrenal paraganglia. These lesions usually present with chronic back pain and radiculopathy and only two cases of acute neurological deficit have been reported in literature. PRESENTATION OF CASE: A case with an acute paraplegia and cauda equina syndrome due to an hemorrhagic paraganglioma of the filum terminale is described. Magnetic resonance imaging showed an intradural tumor extending from L1 to L2 compressing the cauda equina, with an intralesional and intradural bleed...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28550366/minimally-invasive-resection-of-adrenal-masses-in-infants-and-children-results-of-a-european-multi-center-survey
#12
Francesco Fascetti-Leon, Giovanni Scotton, Luca Pio, Raimundo Beltrà, Paolo Caione, Ciro Esposito, Girolamo Mattioli, Amulya K Saxena, Sabine Sarnaki, Piergiorgio Gamba
BACKGROUND: Minimal access adrenal surgery (MAAS) for adrenal pathologies is the standard for many pediatric surgical centers. However, the literature offers few reports and minimal evidence from small case series. The aim of this study was to evaluate the outcomes of pediatric MAAS through a multi-center data analysis. METHOD: Pediatric patients who underwent MAAS between January 2002 and December 2013 were retrospectively included. Data analysis was conducted using Spss software (Welch's t-test, X-square, Fisher tests, multiple regression model)...
May 26, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28549629/testicular-tumors-of-adrenogenital-syndrome-from-physiopathology-to-therapy
#13
Sahbi Naouar, Salem Braiek, Rafik El Kamel
Testicular tumor of adrenogenital syndrome is a rare and benign anomaly usually presenting as bilateral testicular masses. It is the most important cause of infertility in adult male congenital adrenal hyperplasia. Distinction between testicular tumors of adrenogenital syndrome and Leydig cell tumors can be problematic; it is based on clinical, histopathologic, immunohistochemical and endocrine features. Biopsy is advised in cases of longstanding tumors in infertile patients and when surgery is indicated. Fertility preservation is a key management goal in testicular tumor of adrenogenital syndrome...
May 23, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28540670/open-adrenalectomy-in-the-era-of-laparoscopic-surgery-a-review
#14
REVIEW
Giovanni Taffurelli, Claudio Ricci, Riccardo Casadei, Saverio Selva, Francesco Minni
Open adrenalectomy still plays an important role in adrenal surgery. A review of the current literature has been carried out to discuss the main indication to open adrenalectomy with regards to the main adrenal pathologies. The authors underlined the role of open adrenalectomy on the basis of personal experience and a literature review. Indication to open adrenalectomy for adrenal cysts, myelolipomas, pheochromocytomas, metastases, adrenocortical carcinomas and tumour recurrences were analysed and discussed...
May 24, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28536111/surgery-in-late-melanoma-adrenal-metastasis
#15
Marcello Di Martino, Iñigo García Sanz, Ismael Mora-Guzmán, Ángela de la Hoz Rodríguez
Metastatic melanoma to adrenal gland are very infrequent, being generally associated with additional evidence of systemic disease and, consequently, with short-term survival. However, the prognosis and the therapeutic management vary depending on some important oncological features. Long-term survival rates have been described after complete resection of metastatic disease. Here, we report the case of a woman aged 41 years diagnosed with a cutaneous melanoma on the right side of her paravertebral region, level III of Clark, in 2002, who underwent surgical excision of the tumour with negative margins and a negative sentinel node...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28535944/restoring-normal-anatomy-in-female-patients-with-atypical-genitalia
#16
Laurence S Baskin
Female patients with congenital adrenal hyperplasia (CAH) have varying degrees of atypical genitalia secondary to prenatal and postnatal androgen exposure. Surgical treatment is focused on restoring normal genitalia anatomy by bringing the vagina to the normal position on the perineum, separating the distal vagina from the urethra, forming a normal introitus and preserving sexual function of the clitoris by accepting moderate degrees of hypertrophy as normal and strategically reducing clitoral size only in the most severely virilized patients...
May 20, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28535549/epidural-dexamethasone-influences-postoperative-analgesia-after-major-abdominal-surgery
#17
Jeong-Min Hong, Kyung-Hoon Kim, Hyeon Jeong Lee, Jae-Young Kwon, Hae-Kyu Kim, Hyae-Jin Kim, Ah-Reum Cho, Wang-Seok Do, Hyo Sung Kim
BACKGROUND: Epidurally administered dexamethasone might reduce postoperative pain. However, the effect of epidural administration of dexamethasone on postoperative epidural analgesia in major abdominal surgery has been doubtful. OBJECTIVES: To investigate the effects and optimal dose of epidural dexamethasone on pain after major abdominal surgery. STUDY DESIGN: A prospective randomized, double-blind study. SETTING: University hospital...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28523454/stigma-associated-with-classical-congenital-adrenal-hyperplasia-in-women-s-sexual-lives
#18
Heino F L Meyer-Bahlburg, Jananne Khuri, Jazmin Reyes-Portillo, Anke A Ehrhardt, Maria I New
The risk of intersex-related stigma often serves as social indication for "corrective" genital surgery, but has not been comprehensively documented. In preparation for the development of an intersex-specific stigma assessment tool, this qualitative project aimed to explore stigma in girls and women with classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. As part of a comprehensive follow-up project, 62 adult women with classical CAH (age range 18-51 years) took part in an open-ended retrospective interview focusing on the impact of CAH and its treatment on various aspects of girls' and women's lives...
May 18, 2017: Archives of Sexual Behavior
https://www.readbyqxmd.com/read/28515932/single-stage-laparoscopic-adrenalectomy-for-pheochromocytoma-and-enucleation-of-a-pancreatic-neuroendocrine-tumor-in-von-hippel-lindau-disease-a-case-report
#19
Marco Casaccia, Simona Macina, Rosario Fornaro
Von Hippel-Lindau (VHL) disease is an inherited syndrome with autosomal-dominant transmission, characterized by central nervous system and retinal hemangioblastomas, visceral cysts and tumors. Optimal surgical treatment, including its timing, remains a controversial topic. The present study reports the case of a 67-year-old female patient with adrenal and pancreatic manifestations of VHL. A laparoscopic cortex-sparing left adrenalectomy for a 4-cm pheochromocytoma and pancreatic enucleation for pancreatic polypeptidoma of the pancreas tail were performed during the same operative procedure...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28510798/total-laparoscopic-management-for-stage-iv-colorectal-cancer-requiring-multivisceral-resection
#20
Y Nancy You, Hironori Shiozaki, Jeffrey E Lee, Guillaume Passot, Claire Goumard, Masayuki Okuno, Thomas A Aloia, Cathy Eng, George Chang, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: Surgical resection of all sites of disease, in combination with effective systemic chemotherapy, offers the only potential chance for cure for patients with stage IV colorectal cancer (CRC). Coordinated multistage resection using a minimally invasive approach may provide optimal oncologic outcome while potentially offering the benefit of decreased morbidity. PATIENT: A 66-year-old women presented with transverse colon cancer and synchronous metastasis (CRLM) in segment IV involving the middle hepatic vein and main left portal pedicle, as well as the left adrenal gland...
May 16, 2017: Annals of Surgical Oncology
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