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Adrenal adenomas

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https://www.readbyqxmd.com/read/29923085/characterization-of-adrenal-lesions-using-mdct-wash-out-parameters-diagnostic-accuracy-of-several-combinations-of-intermediate-and-delayed-phases
#1
Giovanni Foti, Giuseppe Malleo, Niccolò Faccioli, Andrea Guerriero, Lino Furlani, Giovanni Carbognin
PURPOSE: To evaluate the diagnostic accuracy of wash-out parameters calculated using multiple intermediate and delayed phases. MATERIALS AND METHODS: This prospective study had institutional review board approval and informed consent was obtained from all patients. Between January 2012 and October 2016, 108 consecutive oncologic patients (59 males, 49 females, mean age 52.6 years; 129 diagnosed lesions) underwent multiphasic CT protocol including unenhanced (UE), arterial (AE), portal (PE), 5-min (DE-5) and the 15-min (DE-15) delayed phases of adrenal glands...
June 19, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29921267/an-unusual-case-of-ectopic-corticotrophin-releasing-hormone-syndrome-caused-by-an-adrenal-noncatecholamine-secreting-pheochromocytoma-a-case-report
#2
Bao-Ping Wang, Lei-Lei Yang, Hao Wang, Qing He, Zhong-Shu Ma, Yi Lin, Chang-Xin Jiang, Hao-Ran Sun, Ming Liu
BACKGROUND: Pheochromocytoma, especially for noncatecholamine-secreting pheochromocytoma, is an extremely rare cause of ectopic corticotrophin-releasing hormone (CRH) syndrome. CASE PRESENTATION: A 27-year-old Chinese woman was administered dexamethasone for a skin allergy, but her general condition rapidly deteriorated over a month. She was subsequently hospitalized for typical clinical features of Cushing's syndrome. Endocrinological investigation confirmed severe hypercortisolism along with elevated plasma adrenocorticotropin hormone (ACTH)...
June 19, 2018: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29914251/visfatin-levels-in-hormonally-inactive-adrenal-adenoma-and-their-association-with-metabolic-parameters
#3
Alp Atasoy, Evrim Çakır, Süleyman Ahbab, Yasemin Erdoğan Döventaş, Macit Koldaş, Esra Ataoğlu, Mustafa Yenigün
Background/aim: In parallel with increased frequency and higher quality of imaging techniques, the prevalence of adrenal adenoma has gradually increased. However, despite the growing incidence, the metabolic and tumorigenesis processes involved in its etiology are still unclear. Although visfatin has been reported to be associated with inflammation and tumorigenesis, its role in adrenal adenoma has not yet been investigated. Therefore, the present study was performed with an aim to evaluate visfatin levels and cardiometabolic risk factors in patients with adrenal adenoma...
June 14, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29905434/the-role-of-steroid-metabolome-analysis-for-the-diagnosis-and-follow-up-of-adrenocortical-tumours
#4
Vasileios Chortis
The diagnostic work up of adrenal tumours, often incidentally discovered, has emerged as an ever-increasing diagnostic problem for clinical endocrinologists. No imaging modality has sufficiently high sensitivity and specificity at differentiating benign from malignant adrenal lesions. It has long been observed that adrenocortical carcinomas (ACCs) present an immature pattern of steroidogenesis, dominated by steroid hormone precursors. Modern mass spectrometry-based assays can generate multi-steroid metabolite profiles in urine collections, which can detect differences between ACCs and benign adrenocortical adenomas (ACAs)...
June 14, 2018: Minerva Endocrinologica
https://www.readbyqxmd.com/read/29903850/long-term-survival-in-recurrent-adrenocortical-cancer
#5
Md Shuayb, Arunangshu Das, Mirza Nazim Uddin
Adrenocortical carcinoma (ACC) comprises approximately 0.02% of all malignant tumours, which are a very small fraction of a group of cancers that affect in 0.7 to 2 in 1 000 000 people per year. Recurrence is very common even after complete resection and prognosis is poor. We report a case of a sporadic form of ACC found in a 41-year-old Asian Bangladeshi man. His tumour was surgically excised completely with negative margins and he did not receive any adjuvant therapy. Four years later, adrenal adenoma was developed at his opposite side which was also excised...
June 13, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29899838/impact-of-aldosterone-producing-cell-clusters-on-diagnostic-discrepancies-in-primary-aldosteronism
#6
Mitsuhiro Kometani, Takashi Yoneda, Daisuke Aono, Shigehiro Karashima, Masashi Demura, Koshiro Nishimoto, Masakazu Yamagishi, Yoshiyu Takeda
Adrenocorticotropic hormone (ACTH) stimulation is recommended in adrenal vein sampling (AVS) for primary aldosteronism (PA) to improve the AVS success rate. However, this method can confound the subtype diagnosis. Gene mutations or pathological characteristics may be related to lateralization by AVS. This study aimed to compare the rate of diagnostic discrepancy by AVS pre- versus post-ACTH stimulation and to investigate the relationship between this discrepancy and findings from immunohistochemical and genetic analyses of PA...
May 25, 2018: Oncotarget
https://www.readbyqxmd.com/read/29895075/psychological-symptoms-and-well-being-after-treatment-for-primary-aldosteronism
#7
Marieke S Velema, Jannie M Terlouw, Aline H de Nooijer, Marjan D Nijkamp, Nele Jacobs, Jaap Deinum
Primary aldosteronism (PA) is an increasingly identified cause of secondary hypertension. PA can be caused by an aldosterone-producing adenoma or by bilateral adrenal hyperplasia, generally treated by adrenalectomy or mineralocorticoid receptor antagonists, respectively. Recent studies suggest that PA is associated with more psychological symptoms and lower levels of well-being. The purpose of this study was to investigate the associations between subtype of PA and psychological symptoms and well-being after specific treatment...
June 12, 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29886288/a-method-for-determination-of-aldosterone-in-adrenal-tributary-venous-serum-by-derivatization-using-girard-p-reagent-isotopologues-followed-by-lc-esi-ms-ms
#8
Tatsuya Higashi, Miho Akaishi, Mai Yokota, Tatsunori Suzuki, Shoujiro Ogawa, Yuki Sugiura, Tetsuo Nishikawa, Koshiro Nishimoto, Makoto Suematsu
The quantification of aldosterone (ALD) in adrenal tributary venous blood serum/plasma combined with the super-selective adrenal venous sampling (ssAVS) technique is recognized as a definitive procedure for differentiation of the forms of primary aldosteronism (PA), identification of the affected segment(s) and operating decision-making. In this study, an enhanced throughput and sensitive method was developed and validated for the quantification of ALD in ssAVS serum samples by liquid chromatography/electrospray ionization-tandem mass spectrometry (LC/ESI-MS/MS) combined with derivatization using the Girard P reagent (GP) isotopologues (2 H0 - and 2 H5 -GP)...
June 2, 2018: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/29884668/systolic-heart-failure-in-a-patient-with-primary-aldosteronism
#9
Chikezie Alvarez, Vinuta Mohan
A 53-year-old African man with a 25-year history of uncontrolled hypertension and systolic heart failure presented with an acute congestive heart failure exacerbation. He was found to have severe hypokalaemia, so additional testing was performed, and primary aldosteronism was confirmed. CT scan showed a 1.2×2.4 cm well-defined, homogeneous adenoma of the left adrenal gland. Adrenal vein sampling confirmed unilateral primary aldosteronism with lateralisation to the left adrenal gland. The patient was started on spironolactone and was referred to surgery for laparoscopic left adrenalectomy...
June 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29874863/role-of-cryptochrome-1-and-cryptochrome-2-in-aldosterone-producing-adenomas-and-adrenocortical-cells
#10
Martina Tetti, Isabella Castellano, Francesca Venziano, Corrado Magnino, Franco Veglio, Paolo Mulatero, Silvia Monticone
Mice lacking the core-clock components, cryptochrome-1 (CRY1) and cryptochrome-2 (CRY2) display a phenotype of hyperaldosteronism, due to the upregulation of type VI 3β-hydroxyl-steroid dehydrogenase ( Hsd3b6 ), the murine counterpart to the human type I 3β-hydroxyl-steroid dehydrogenase ( HSD3B1 ) gene. In the present study, we evaluated the role of CRY1 and CRY2 genes, and their potential interplay with HSD3B isoforms in adrenal pathophysiology in man. Forty-six sporadic aldosterone-producing adenomas (APAs) and 20 paired adrenal samples were included, with the human adrenocortical cells HAC15 used as the in vitro model...
June 5, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29861570/autosomal-dominant-polycystic-kidney-disease-and-hypertension-masquerading-primary-aldosteronism
#11
P D Mital, K Abhijit, G Shishir
Hypertension is a frequent early manifestation of autosomal dominant polycystic kidney disease (ADPKD). Many mechanisms cause hypertension in ADPKD; however, primary aldosteronism (PA) as a possible manifestation of hypertension in ADPKD is extremely rare. The diagnosis of PA in ADPKD is extremely challenging because multiple renal cysts can mask the identification of adrenal adenomas, and ADPKD is associated with hypertension in majority of cases. Here, we report a unique case of a young lady with ADPKD with hypertension masquerading PA...
March 2018: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29813041/-adrenal-gangliuoneuroma-features-of-10-cases-in-own-material
#12
Radosław Samsel, Andrzej Cichocki, Lucyna Papierska, Karolina Nowak, Katarzyna Roszkowska-Purska
Adrenal ganglioneuroma is a rare benign neuroblastic tumor. Most of adrenal ganglioneuromas are asymptomatic and discovered incidentally during imaging examinations performed for many different indications. Proper preoperative diagnosis is challenging and most of this masses are described as being poor lipid adenomas or pheochromocytomas. AIM: The aim of the study was to present experience of referral center with this rare adrenal pathologies. MATERIALS AND METHODS: Analysis of our data - 374 adrenalectomies performed over last 13 years (2004-2016) in patients referred to our department from different endocrinological centers...
May 25, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29779837/-hypertension-associated-with-paraparesis-of-the-lower-limbs-revealing-an-adrenal-adenoma
#13
E Tabti, A Benmekki, M H Bestaoui, M Messad, M A Ghembaza, A Lounici
Cushing's syndrome is a rare cause of high blood pressure. The originally adrenal cause is found in 15% of cases. We describe the case of a patient with hypertension associated with paraparesis of the lower limbs revealing a Cushing syndrome due to a left adrenal adenoma. A 23-year-old man consults for a paraparesis of the lower limbs. The highlighting of an arterial high blood pressure led to the realization of complementary examinations. Computed tomography of the abdomen shows a left adrenal mass. Chirurgical excision of the mass was performed and histological examination concluded with adrenal adenoma...
May 17, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29770148/clinical-characteristics-of-aldosterone-and-cortisol-coproducing-adrenal-adenoma-in-primary-aldosteronism
#14
Lu Tang, Xintao Li, Baojun Wang, Xin Ma, Hongzhao Li, Yu Gao, Liangyou Gu, Wenyuan Nie, Xu Zhang
Aldosterone- and cortisol-coproducing adrenal adenoma (A/CPA) cases have been observed in patients with primary aldosteronism (PA). This study investigated the incidence, clinical characteristics, and molecular biological features of patients with A/CPAs. We retrospectively identified 22 A/CPA patients from 555 PA patients who visited the Chinese People's Liberation Army General Hospital between 2004 and 2015. Analysis of clinical parameters revealed that patients with A/CPAs had larger tumors than those with pure APAs ( P < 0...
2018: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29754639/adrenal-surgery-for-cushing-s-syndrome-an-update
#15
REVIEW
Guido Di Dalmazi, Martin Reincke
Recent advances in the molecular pathogenesis and the natural history of Cushing's syndrome have improved the understanding of the management of this disease. The long-term efficacy of several cortisol-lowering medical treatments is currently under evaluation. However, adrenalectomy is a safe option for the treatment of patients affected by Cushing's syndrome. Unilateral adrenalectomy is the gold standard for treatment of adrenocortical adenomas associated with hypercortisolism. Bilateral adrenalectomy has been widely used in the past as definitive treatment of bilateral macronodular hyperplasia and persistent or recurrent Cushing's disease...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754634/mortality-in-patients-with-endogenous-cushing-s-syndrome
#16
REVIEW
Pedram Javanmard, Daisy Duan, Eliza B Geer
Cushing's syndrome is associated with increased morbidity and mortality. Cardiovascular events, sepsis, and thromboembolism are the leading causes of mortality. Patient's with Cushing's due to a pituitary adenoma and those with Cushing's due to benign adrenal adenoma have relatively good survival outcomes often mirroring that of the general population. Persistent or recurrent disease is associated with high mortality risk. Ectopic Cushing's syndrome and Cushing's due to adrenocortical carcinoma confer the highest mortality risk among Cushing's etiologies...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29748231/management-of-endocrine-disease-differential-diagnosis-investigation-and-therapy-of-bilateral-adrenal-incidentalomas
#17
Isabelle Bourdeau, Nada El Ghorayeb, Nadia Gagnon, Andre Lacroix
The investigation and management of unilateral adrenal incidentalomas have been extensively considered in the last decades. While bilateral adrenal incidentalomas represent about 15 percent of adrenal incidentalomas, they have been less frequently discussed. The differential diagnosis of bilateral incidentalomas includes metastasis, primary bilateral macronodular adrenal hyperplasia (BMAH) and bilateral cortical adenomas. Les frequent etiologies are bilateral pheochromocytomas, congenital adrenal hyperplasia, Cushing's disease or ectopic ACTH secretion with secondary bilateral adrenal hyperplasia, primary malignancies, myelolipomas, infections or hemorrhage...
May 10, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29742971/insufficiency-of-the-zona-glomerulosa-of-the-adrenal-cortex-and-progressive-kidney-insufficiency-following-unilateral-adrenalectomy-case-report-and-discussion
#18
Joanna Kanarek-Kucner, Adrian Stefański, Rufus Barraclough, Tomasz Gorycki, Jacek Wolf, Krzysztof Narkiewicz, Michał Hoffmann
BACKGROUND: Primary aldosteronism (PA) is the most common cause of secondary hypertension and bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenoma (APA) seem to be the most common causes of PA. Unilateral adrenalectomy (UA) is the preferred treatment for APA, although the benefits are still difficult to assess. CASE REPORT: We present a case report of a 69-year old man with a 30 year history of hypertension and probably long-standing PA due to APA, with typical organ complications...
May 9, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29741297/a-pedunculated-aldosterone-producing-adenoma-drained-by-an-extra-vein-causing-puzzling-results-of-adrenal-vein-sampling
#19
Marieke S Velema, Tanja Dekkers, Ad R M M Hermus, Henri J L M Timmers, Johan Langenhuijsen, Mark Arntz, Benno Kusters, Graeme Eisenhofer, Jacques W M Lenders, Jaap Deinum
Primary aldosteronism (PA) is a common cause of endocrine hypertension in which two main subtypes are distinguished: bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenomas (APA).1 Computed tomography (CT) and adrenal vein sampling (AVS) are used to differentiate between these subtypes. There are two basic conditions for AVS. First, aldosterone concentrations should be corrected for peripheral blood admixture by normalizing for cortisol concentration. Second, it is assumed that either adrenal is drained by one vein...
May 9, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29741215/role-of-dotatate-pet-ct-in-preoperative-assessment-of-phaeochromocytoma-and-paragangliomas
#20
Matti L Gild, Nikita Naik, Jeremy Hoang, Edward Hsiao, Rachel T McGrath, Mark Sywak, Stan Sidhu, Leigh Walter Delbridge, Bruce Gregory Robinson, Geoff Schembri, Roderick John Clifton-Bligh
CONTEXT: Diagnosis of paragangliomas (PGL) and phaeochromocytomas (PC) can be challenging particularly if the tumour is small. Detection of metastatic disease is important for comprehensive management of malignant PC/PGL. Somatostatin receptor imaging (SRI) agents have high sensitivity for these tumours, particularly the DOTA family of radiopharmaceuticals labelled with 68 Gallium. OBJECTIVE: To describe the utility of SRI in primary assessment (ie before surgery) for PC/PGL and whether measures of maximum standardized uptake (SUVmax) could be used to distinguish between adrenal adenomas and PCs...
May 9, 2018: Clinical Endocrinology
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