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Adrenal adenomas

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https://www.readbyqxmd.com/read/29674485/management-of-endocrine-disease-diagnosis-and-management-of-primary-aldosteronism-the-endocrine-society-guideline-2016-revisited
#1
Tracy Ann Williams, Martin Reincke
The syndrome of primary aldosteronism (PA) is characterized by hypertension with excessive, autonomous aldosterone production and is usually caused by either a unilateral aldosterone-producing adenoma (APA) or bilateral adrenal hyperplasia (BAH). The diagnostic workup of PA is a sequence of three phases comprising screening tests, confirmatory tests and the differentiation of unilateral from bilateral forms. The latter step is necessary to determine the optimal treatment approach of unilateral laparoscopic adrenalectomy (for patients with unilateral PA) or medical treatment with a mineralocorticoid receptor antagonist (for patients with bilateral PA)...
April 19, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29671009/interobserver-agreement-in-distinguishing-large-adrenal-adenomas-and-adrenocortical-carcinomas-on-computed-tomography
#2
Aaron J Thomas, Mouhammed A Habra, Priya R Bhosale, Aliya A Qayyum, Kareem Ahmed, Rafael Vicens, Khaled M Elsayes
PURPOSE: Large adrenal masses pose a diagnostic dilemma. The purpose of this study was twofold: first, to assess the degree of interobserver agreement in evaluating the morphology of pathologically proven adrenal adenomas and adrenocortical carcinomas larger than 4 cm in diameter; and second, to identify morphologic characteristics that correlated with the pathologic diagnosis. MATERIALS AND METHODS: For this blinded, retrospective study, we collected cases of 25 adrenal adenomas and 33 adrenocortical carcinomas measuring larger than 4 cm...
April 19, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29669941/activating-prkacb-somatic-mutation-in-cortisol-producing-adenomas
#3
Stéphanie Espiard, Matthias J Knape, Kerstin Bathon, Guillaume Assié, Marthe Rizk-Rabin, Simon Faillot, Windy Luscap-Rondof, Daniel Abid, Laurence Guignat, Davide Calebiro, Friedrich W Herberg, Constantine A Stratakis, Jérôme Bertherat
Mutations in the gene encoding the protein kinase A (PKA) catalytic subunit α have been found to be responsible for cortisol-producing adenomas (CPAs). In this study, we identified by whole-exome sequencing the somatic mutation p.S54L in the PRKACB gene, encoding the catalytic subunit β (Cβ) of PKA, in a CPA from a patient with severe Cushing syndrome. Bioluminescence resonance energy transfer and surface plasmon resonance assays revealed that the mutation hampers formation of type I holoenzymes and that these holoenzymes were highly sensitive to cAMP...
April 19, 2018: JCI Insight
https://www.readbyqxmd.com/read/29665181/mir-193a-3p-functions-as-a-tumour-suppressor-in-human-aldosterone-producing-adrenocortical-adenoma-by-down-regulating-cyp11b2
#4
Guoxi Zhang, Xiaofeng Zou, Quanliang Liu, Tianpeng Xie, Ruohui Huang, Huan Kang, Changfu Lai, Jiaxing Zhu
The mechanism of aldosterone-producing adrenocortical adenoma (APA) pathogenesis and the role of microRNAs (miRNAs) in APA pathogenesis have not been completely clarified. We examined the expression and function of miR-140-3p, miR-193a-3p and miR-22-3p, which have binding sites in CYP11B2. Expression of miRNAs and CYP11B2 mRNA was measured by quantitative reverse transcription PCR (qRT-PCR). Cell proliferation was monitored by colorimetric analysis, and cell apoptosis and cell cycle progression were analysed by flow cytometry...
April 17, 2018: International Journal of Experimental Pathology
https://www.readbyqxmd.com/read/29650226/are-cushing-s-disease-patients-curable
#5
Xavier Bertagna
Treatment of Cushing's disease remains a challenge. Whereas pituitary surgery can "cure" the patient and restore a completely normal pituitary adrenal axis, there are immediate failures and late recurrences which ultimately require alternate therapeutic approaches. These are numerous, but so are their drawbacks, and all appear to be "default options". For the future, pituitary adenoma has to remain the "reasonable obsession" of efficient and optimistic therapists….
April 9, 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29644340/the-lateralizing-asymmetry-of-adrenal-adenomas
#6
Meng Hao, Diana Lopez, Miguel Angel Luque-Fernandez, Kathryn Cote, Jessica Newfield, Molly Connors, Anand Vaidya
Context: It is presumed that the incidence of adrenal adenomas is symmetric between the left and right adrenal gland; however, anecdotal observations suggest a potential lateralizing asymmetry. Objective: To investigate the symmetry in detection of adrenal adenomas and relevance to patient care. Design: Cross-sectional and longitudinal studies. Population and Setting: One thousand three hundred seventy-six patients with abdominal computed tomography or magnetic resonance imaging demonstrating benign-appearing adrenal adenomas...
April 1, 2018: Journal of the Endocrine Society
https://www.readbyqxmd.com/read/29642543/comparative-genomics-and-transcriptome-profiling-in-primary-aldosteronism
#7
REVIEW
Elke Tatjana Aristizabal Prada, Isabella Castellano, Eva Sušnik, Yuhong Yang, Lucie S Meyer, Martina Tetti, Felix Beuschlein, Martin Reincke, Tracy A Williams
Primary aldosteronism is the most common form of endocrine hypertension with a prevalence of 6% in the general population with hypertension. The genetic basis of the four familial forms of primary aldosteronism (familial hyperaldosteronism FH types I-IV) and the majority of sporadic unilateral aldosterone-producing adenomas has now been resolved. Familial forms of hyperaldosteronism are, however, rare. The sporadic forms of the disease prevail and these are usually caused by either a unilateral aldosterone-producing adenoma or bilateral adrenal hyperplasia...
April 9, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29611662/adrenal-gland-tumors-in-dairy-cattle-from-northern-italy-morphological-and-phenotypical-characterization-in-comparison-with-human-pathology
#8
E Biasibetti, J Giorcelli, F Deideri, P Bianco, M T Capucchio, M Volante
Bovine adrenal gland tumours are considered relatively common, although scarce data are available about their real incidence, pathological characterization, classification criteria and immunohistochemical profile. This study describes the morphological and immunophenotypical characteristics of 35 dairy cattle adrenal gland tumors from Northern Italy and compare them with human pathology. Macroscopical, histological, histochemical and immunohistochemical investigations were performed. Microscopically proliferative lesions were classified as focal hyperplasia (8/35), primary cortical tumors (15/35) , primary medullary tumors (12/35)...
December 2017: Polish Journal of Veterinary Sciences
https://www.readbyqxmd.com/read/29594118/the-many-faces-of-primary-aldosteronism-and-cushing-syndrome-a-reflection-of-adrenocortical-tumor-heterogeneity
#9
REVIEW
Ozgur Mete, Kai Duan
Adrenal cortical tumors constitute a heterogeneous group of neoplasms with distinct clinical, morphological, and molecular features. Recent discoveries of specific genotype-phenotype correlations in adrenal cortical adenomas have transformed our understanding of their respective endocrine syndromes. Indeed, a proportion of patients with primary aldosteronism are now known to harbor adrenal cortical adenomas with heterogeneous molecular alterations ( KCNJ5, ATP1A1, ATP2B3 , and CACNA1D ) involving the calcium/calmodulin kinase signaling pathway...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29578356/an-unusual-case-of-hematemesis-and-epistaxis-caused-by-a-pheochromocytoma
#10
Kader Ugur, Mustafa Girgin, İbrahim Halil Bahcecioglu, Hakan Artas, Fikri Selcuk Simsek, Suleyman Aydin
Pheochromocytoma is a rare catecholamine-secreting neoplasm that is the cause of hypertension in <0.2% of patients with hypertension. We encountered an unusual case of pheochromocytoma involving hematemesis and epistaxis episodes with accompanying hypertensive attacks. Venous ectasia was detected in the esophagus. Abdominal magnetic resonance imaging revealed an adenoma in the left adrenal region. The present case illustrates that pheochromocytoma can mimic different clinical conditions.
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29577261/clock-genes-alterations-and-endocrine-disorders
#11
REVIEW
Anna Angelousi, Eva Kassi, Narjes Nasiri-Ansari, Martin O Weickert, Harpal Randeva, Gregory Kaltsas
BACKGROUND: Various endocrine signals oscillate over the 24-hour period and so does the responsiveness of target tissues. These daily oscillations do not occur solely in response to external stimuli but are also under the control of an intrinsic circadian clock. DESIGN: We searched the PubMed database to identify studies describing the associations of clock genes with endocrine diseases. RESULTS: Various human single nucleotide polymorphisms of BMAL1 and CLOCK genes exhibited significant associations with type 2 diabetes mellitus...
March 25, 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29574994/worse-health-related-quality-of-life-at-long-term-follow-up-in-patients-with-cushing-s-disease-than-patients-with-cortisol-producing-adenoma-data-from-the-ercusyn
#12
Elena Valassi, Richard Feelders, Dominique Maiter, Philippe Chanson, Maria Yaneva, Martin Reincke, Michal Krsek, Miklós Tóth, Susan M Webb, Alicia Santos, Isabel Paiva, Irina Komerdus, Michael Droste, Antoine Tabarin, Christian J Strasburger, Holger Franz, Peter J Trainer, John Newell-Price, John A H Wass, Eleni Papakokkinou, Oskar Ragnarsson
OBJECTIVE: Hypercortisolism in Cushing's syndrome (CS) is associated with impaired Health-Related Quality of Life (HRQoL), which may persist despite remission. We used the data entered into the European Registry on Cushing's syndrome (ERCUSYN) to evaluate if patients with CS of pituitary origin (PIT-CS) have worse HRQoL, both before and after treatment, than patients with adrenal causes (ADR-CS). METHODS: Data from 595 patients (492 women; 83%) who completed the CushingQoL and/or EQ-5D questionnaires at baseline and/or following treatment were analyzed...
March 24, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29570377/pheochromocytomas-versus-adenoma-role-of-venous-phase-ct-enhancement
#13
Mohammed F Mohammed, Khaled Y ElBanna, David Ferguson, Alison Harris, Faisal Khosa
OBJECTIVE: Our objective was to investigate whether the quantitative measurement of venous phase enhancement on CT can distinguish a pheochromocytoma from an adrenal adenoma. MATERIALS AND METHODS: A pathology database was retrospectively appraised over a period of 7 years and revealed 43 histopathologically proven adrenal adenomas and 34 pheochromocytomas. The lesion densities were measured on the 60-second venous phase CT on all adrenal lesions to assess venous phase enhancement values...
March 23, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29570013/value-of-pituitary-gland-mri-at-7-t-in-cushing-s-disease-and-relationship-to-inferior-petrosal-sinus-sampling-case-report
#14
Meng Law, Regina Wang, Chia-Shang J Liu, Mark S Shiroishi, John D Carmichael, William J Mack, Martin Weiss, Danny J J Wang, Arthur W Toga, Gabriel Zada
Cushing's disease is caused by adrenocorticotrophic hormone (ACTH)-secreting pituitary adenomas, which are often difficult to identify on standard 1.5-T or 3-T MRI, including dynamic contrast imaging. Inferior petrosal and cavernous sinus sampling remains the gold standard for MRI-negative Cushing's disease. The authors report on a 27-year-old woman with Cushing's disease in whom the results of standard 1.5-T and 3-T MRI, including 1.5-T dynamic contrast imaging, were negative. Inferior petrosal sinus sampling showed a high central-to-peripheral ACTH ratio (148:1) as well as a right-to-left ACTH gradient (19:1), suggesting a right-sided pituitary microadenoma...
March 23, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29561525/adrenal-hemangioma-definite-diagnosis-on-ct-mri-and-fdg-pet-in-a-patient-with-primary-lung-cancer
#15
Benjamin Wilson, Allison Becker, Thomas Estes, Jayanth Keshavamurthy, Darko Pucar
Distinguishing adrenal incidentalomas (5% of all abdominal CT scans) from metastasis is a frequent diagnostic challenge in primary malignancies with a propensity for adrenal spread, such as lung cancer. Adrenal myelolipoma and adenoma can be definitively characterized as benign by demonstrating gross and microscopic fat, respectively, on CT and MRI and an absence of abnormal uptake on PET. Unfortunately, adrenal sampling is frequently necessary in indeterminate cases for adequate staging of extra-adrenal primary malignancy...
March 20, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29555192/arterial-stiffness-evaluated-by-pulse-wave-velocity-is-not-predictive-of-the-improvement-in-hypertension-after-adrenal-surgery-for-primary-aldosteronism-a-multicentre-study-from-the-french-european-society-of-hypertension-excellence-centres
#16
Béatrice Bouhanick, Jacques Amar, Laurence Amar, Philippe Gosse, Xavier Girerd, Yves Reznik, Claire Mounier-Vehier, Jean Philippe Baguet, Pierre Boutouyrie, Benoit Lepage, Pierre Lantelme, Bernard Chamontin
BACKGROUND: Predictive factors associated with normal blood pressure (BP) after unilateral adrenalectomy for primary aldosteronism (PA) are not clearly identified. AIMS: To evaluate the predictive value of arterial stiffness before surgery on BP after surgery. METHODS: During 2009-2013, 96 patients with PA due to unilateral adrenal adenoma who underwent surgery were enrolled in a multicentre open-label, prospective study. Aortic pulse wave velocity (PWV) was assessed before surgery...
March 16, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29551244/surgical-outcomes-of-patients-with-beckwith-wiedemann-syndrome
#17
Candace C Style, Stephanie M Cruz, Patricio E Lau, Timothy C Lee, David E Wesson, Oluyinka O Olutoye
PURPOSE: The purpose of this study was to evaluate treatment and surgical outcomes of patients of Beckwith-Wiedemann Syndrome (BWS) treated at a tertiary children's hospital. METHODS: A retrospective review of infants evaluated at Texas Children's Hospital for BWS from August 2000 to December 2016 was performed. Data collected included demographic information, clinical presentation, genetic evaluation, fetal imaging, operative treatment, and outcomes. RESULTS: Forty-seven children with a diagnosis of BWS were identified...
February 12, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29542030/does-igf-1-play-a-role-in-the-etiopathogenesis-of-non-functioning-adrenocortical-adenoma
#18
C T Bahadir, G C Ecemis, H Atmaca
PURPOSE: The aim of this study was to investigate the possible association of insulin-like growth factor-1 (IGF-1) with the pathogenesis of non-functioning adrenocortical adenomas (NFAs). METHODS: This study included 50 female patients (mean age 54 years) with NFAs, 55 patients (mean age 48 years; 20 male, 35 female) with acromegaly and 38 female control subjects (mean age 58 years). Body mass index (BMI) and waist circumference (WC) of the subjects were recorded and blood samples for IGF-1 were taken...
March 14, 2018: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29525561/secreting-ectopic-adrenal-adenoma-a-rare-condition-to-be-aware-of
#19
Yang Zhao, Hui Guo, Ying Zhao, Bingyin Shi
Ectopic adrenal adenoma causing chronic Cushing's syndrome (CS) is a rare phenomenon. Diagnosis is usually made years after disease onset because of the insidious nature of the ectopic adrenal gland and because it overlaps with common symptoms, such as overweight and hypertension, in the general population (Kreitschmann-Andermahr et al., 2015). Here, we report the case of a 46-year-old male with a 15-year history of severe hypertension, facial plethora, and centripetal obesity. During treatment for herpes zoster, the patient presented with severe hypokalemia and flaccid paralysis, characteristic changes associated with CS...
March 7, 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29523633/management-of-endocrine-disease-management-of-cushing-s-syndrome-during-pregnancy-solved-and-unsolved-questions
#20
Thierry Brue, Vincent Amodru, Frédéric Castinetti
With fewer than 200 reported cases, Cushing's syndrome (CS) in pregnancy remains a diagnostic and therapeutic challenge. In normal pregnancies, misleading signs may be observed such as striae or hypokalemia, while plasma cortisol and urinary free cortisol may rise up to 2-3-fold. While the dexamethasone suppression test is difficult to use, reference values for salivary cortisol appear valid. The predominant cause is adrenal adenoma (sometimes without decreased ACTH), rather than Cushing's disease. There are considerable imaging pitfalls in Cushing's disease...
March 9, 2018: European Journal of Endocrinology
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