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adrenal incidentaloma

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https://www.readbyqxmd.com/read/29223281/human-studies-on-hypothalamo-pituitary-adrenal-hpa-axis
#1
REVIEW
Kamani Liyanarachchi, Richard Ross, Miguel Debono
The daily rhythm of the hypothalamo-pituitary-adrenal (HPA) axis is regulated by the central clock in the suprachiasmatic nucleus. Cortisol, a glucocorticoid, acts as a secondary messenger between the central clock and the peripheral tissues. Changes in clock time, as seen in shift workers, alters the HPA axis and results in metabolic disturbances associated with ill health. Depression, anorexia nervosa and obstructive sleep apnoea, are associated with cortisol rhythm phase shifts and increased cortisol exposure...
October 2017: Best Practice & Research. Clinical Endocrinology & Metabolism
https://www.readbyqxmd.com/read/29217652/initial-clinical-presentation-and-spectrum-of-pheochromocytoma-a-study-of-94-cases-from-a-single-center
#2
Henrik Falhammar, Magnus Kjellman, Jan Calissendorff
BACKGROUND: With the increasing access to imaging more pheochromocytomas are diagnosed in the workup of adrenal incidentalomas. This may have changed the occurrence of the classic presentation with hypertension and the classic triad (headaches, sweating and palpitation). METHODS: We reviewed 94 consecutive cases of pheochromocytomas. Two cases of ectopic ACTH-syndrome were subsequently excluded. RESULTS: Of the 92 cases included 64% had presented as an incidentaloma, 32% as a suspected pheochromocytoma and 4% had been screened because of previously diagnosed MEN2A...
December 7, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/29212491/case-report-schwannoma-arising-from-the-unilateral-adrenal-area-with-bilateral-hyperaldosteronism
#3
Naru Babaya, Yukako Makutani, Shinsuke Noso, Yoshihisa Hiromine, Hiroyuki Ito, Yasunori Taketomo, Kazuki Ueda, Hokuto Ushijima, Yoshifumi Komoike, Yuto Yamazaki, Hironobu Sasano, Yumiko Kawabata, Hiroshi Ikegami
BACKGROUND: We report a rare case of a juxta-adrenal schwannoma that could not be discriminated from an adrenal tumor before surgical resection and was complicated by bilateral hyperaldosteronism. To the best of our knowledge, this is first case in which both a juxta-adrenal schwannoma and hyperaldosteronism co-existed. CASE PRESENTATION: A 69-year-old male treated for hypertension was found to have a left supra-renal mass (5.8 × 5.2 cm) by abdominal computed tomography...
December 6, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29176595/the-presence-of-nonfunctioning-adrenal-incidentalomas-increases-arterial-hypertension-frequency-and-severity-and-is-associated-with-cortisol-levels-after-dexamethasone-suppression-test
#4
Mariana Arruda, Emanuela Mello Ribeiro Cavalari, Marcela Pessoa de Paula, Felipe Fernandes Cordeiro de Morais, Guilherme Furtado Bilro, Maria Caroline Alves Coelho, Nathalie Anne de Oliveira E Silva de Morais, Diana Choeri, Aline Moraes, Leonardo Vieira Neto
There are limited data regarding the frequency of hypertension in nonfunctioning adrenal incidentaloma (NFAI). Our objectives were to investigate rates of hypertension and resistant hypertension in NFAI patients, and compare them to a control group without adrenal adenoma. We also aimed to evaluate the relationship between cortisol levels after 1 mg-dexamethasone suppression test (DST) and hypertension in NFAI patients. We selected 40 patients with NFAI and 40 control patients over the age of 18 without adrenal lesions on abdominal imaging...
November 24, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29164520/adrenal-myelolipoma-a-comprehensive-review
#5
REVIEW
Ábel Decmann, Pál Perge, Miklós Tóth, Peter Igaz
INTRODUCTION: Adrenal myelolipoma is an invariably benign neoplasm of the adrenal gland that is the second most common primary adrenal incidentaloma following adrenocortical adenomas. It is composed of elements of adipose tissue and extramedullary hematopoiesis. Hypotheses on stem cells and hormonal factors have been formulated regarding its pathogenesis that is still obscure. Despite its benign behavior, adrenal myelolipoma is clinically relevant as it might cause significant difficulties in the differential diagnosis of adrenal tumors...
November 21, 2017: Endocrine
https://www.readbyqxmd.com/read/29151238/predictability-of-hypoadrenalism-occurrence-and-duration-after-adrenalectomy-for-acth-independent-hypercortisolism
#6
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/29144180/intraoperative-hemodynamic-instability-and-diagnosis-of-pheochromocytoma-during-excision-of-adrenal-incidentaloma-with-incomplete-workup-a-case-report
#7
Anthony Chang, George Silvay, Andrew Goldberg
Preoperative evaluation of incidentalomas for pheochromocytoma is imperative. This case report describes a scheduled adrenalectomy in an asymptomatic patient with what was eventually determined to be an incomplete biochemical workup. The intraoperative course was complicated by labile and rapid increases in blood pressure and heart rate, suggesting the missed diagnosis of pheochromocytoma. It is important for anesthesiologists to ensure adequate preoperative biochemical workup before excluding the possibility of coexisting pheochromocytoma...
November 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29141379/-clinical-value-of-tumor-size-in-the-evaluation-of-adrenal-incidentalomas
#8
L L Li, L Zhao, J T Dou, G Q Yang, W J Gu, Z H Lü, J M Ba, Y M Mu, J M Lu, C Y Pan
Objective: To investigate the clinical value of tumor size in the evaluation of endocrinological and histological natures regarding adrenal incidentaloma (AI) patients. Methods: A total of 1 941 AI patients who were hospitalized in Department of Endocrinology, Chinese PLA General Hospital between January 1997 and December 2016 were retrospectively reviewed. The demographics of patients, imaging features, functional status and histological results were analyzed. Results: Of 1 941 patients, 984 (50.70%) were males, and 957 (49...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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/29126119/lower-trabecular-bone-score-in-patients-with-primary-aldosteronism-human-skeletal-deterioration-by-aldosterone-excess
#10
Beom-Jun Kim, Mi Kyung Kwak, Seong Hee Ahn, Hyeonmok Kim, Seung Hun Lee, Jung-Min Koh
Context: Despite the potential detrimental effects of aldosterone excess on bone metabolism, there are discrepancies between fracture risk and bone mass in patients with and without primary aldosteronism (PA). Objective: To clarify the possibility that aldosterone excess may mainly affect bone properties which are not explained by bone mineral density (BMD). Design, Setting, and Patients: Among 625 consecutive patients with newly diagnosed adrenal incidentaloma, 72 patients with biochemically confirmed PA and 335 patients with nonfunctional adrenal incidentaloma were defined as cases and controls, respectively...
November 6, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29125476/adrenalectomy-was-recommended-for-patients-with-subclinical-cushing-s-syndrome-due-to-adrenal-incidentaloma
#11
Dong Wang, Zhi-Gang Ji, Han-Zhong Li, Yu-Shi Zhang
OBJECTIVE: To assess whether adrenalectomy may improve biochemical and metabolic impairment for patients with subclinical Cushing syndrome (SCS) due to adrenal incidentaloma (AI) compared with conservative management. METHODS: A total of 87 patients with SCS due to AI in Peking Union Medical College Hospital between September 2011 and January 2016 have been treated. Forty-eight patients underwent laparoscopic adrenalectomy (operative group), whereas 39 were managed conservatively (control group)...
October 31, 2017: Cancer Biomarkers: Section A of Disease Markers
https://www.readbyqxmd.com/read/29118987/massive-adrenal-incidentalomas-and-late-diagnosis-of-congenital-adrenal-hyperplasia-in-prostate-cancer
#12
Xin Feng, Gregory Kline
In a 61-year-old Caucasian male with prostate cancer, leuprolide and bicalutamide failed to suppress the androgens. He presented to endocrinology with persistently normal testosterone and incidental massive (up to 18 cm) bilateral adrenal myelolipomas on CT scan. Blood test did not reveal metanephrine excess. The patient was noted to have short stature (151 cm) and primary infertility. Elementary school photographs demonstrated precocious puberty. Physical examination revealed palpable abdominal (adrenal) masses...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29081161/-surgery-versus-conservative-management-for-subclinical-cushing-s-syndrome-in-adrenal-incidentalomas
#13
L L Li, L Zhao, J T Dou, G Q Yang, W J Gu, Z H Lü, J M Ba, Y M Mu, J M Lu, C Y Pan
Objective: To determine the effect of the surgical and conservative approaches on the metabolic profiles in patients with subclinical Cushing's syndrome (SCS) in adrenal incidentalomas (AI). Methods: A hundred and thirty AI patients with SCS in Department of Endocrinology, PLA General Hospital between January 2008 and December 2016 were studied, surgery was performed in 88 patients (surgical group), and the rest received conservative approach (conservative group). The improvement/worsening of blood pressure, blood glucose, lipid profiles and body weight after a duration of >18 months follow-up were analyzed, respectively...
October 31, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29068510/characteristics-of-adrenal-incidentalomas-in-a-new-zealand-centre
#14
Z Goh, I Phillips, P J Hunt, S Soule, T J Cawood
BACKGROUND: Management of adrenal incidentalomas (AI) is becoming more conservative, based on international data showing a low incidence of functional or malignant lesions. The clinical characteristics of AI in New Zealand are unknown. Therefore, whether the AI guidelines apply to the New Zealand population is also unknown. AIMS: To investigate the clinical characteristics of patients with AI presenting to a tertiary-care centre in New Zealand. METHOD: This study prospectively evaluated consecutive patients aged 18 or older with AI, 1 cm or larger, diagnosed in Canterbury, New Zealand...
October 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29043559/nonfunctioning-adrenal-incidentaloma-affecting-central-blood-pressure-and-arterial-stiffness-parameters
#15
Tolga Akkan, Mustafa Altay, Yasemin Ünsal, Murat Dağdeviren, Esin Beyan
PURPOSE: Recently, cardiovascular risk is thought to be increased in patients with nonfunctioning adrenal incidentaloma (NFAI). There are no sufficient studies in the literature to evaluate this situation in NFAI patients without cardiovascular risk. The objective of this study is to compare peripheral and central blood pressure and arterial stiffness between patients with NFAI and healthy volunteers (of a similar age, gender and body mass index as the NFAI group) who have no traditional cardiovascular risk factors and autonomous cortisol secretion, with pulse wave analysis (PWA)...
December 2017: Endocrine
https://www.readbyqxmd.com/read/28981236/-adrenal-disease-diagnosis-management-of-adrenal-incidentaloma
#16
A S Azzi, N Driessens
Adrenal glands are specialized in biosynthesis of several hormones correlated to different clinical phenotypes in case of excess or lack of production. In addition to secretion disorders, tumors, secreting or not, can take place in adrenal glands. Incidentalomas are the most common adrenal diseases in clinical practice. The challenge of the management is to determine whether the lesion is benign or malignant and secreting or not in order to direct therapeutic management towards surgical option, pharmacotherapy or clinical follow-up...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28972640/nationellt-v%C3%A3-rdprogram-f%C3%A3-r-adrenala-incidentalom-programmet-har-harmoniserats-med-europeiska-riktlinjer-%C3%A2-ger-f%C3%A3-renklad-handl%C3%A3-ggning-av-patienter
#17
Andreas Muth, Lilian Hammarstedt, Mikael Hellström, Ulf Nyman, Anders Sundin, Hans Wahrenberg, Bo Wängberg
Swedish guidelines for the management of adrenal incidentalomas  Adrenal incidentalomas are seen in about five percent of abdominal CT examinations, and in most cases represent non-hormone-producing adrenocortical adenomas, but hormone-producing or malignant lesions occur. Revised Swedish guidelines for the evaluation and management of adrenal incidentalomas based on recently published European guidelines are presented. The importance of a thorough radiological, clinical and biochemical initial evaluation is emphasized...
September 29, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28956783/congenital-adrenal-hyperplasia-as-a-cause-of-adrenal-incidentaloma
#18
E Buitenwerf, T P Links, I P Kema, M L Haadsma, M N Kerstens
Congenital adrenal hyperplasia (CAH) can present as a benign adrenal tumour, which should be treated medically. The diagnosis of CAH must be considered in a patient presenting with adrenal incidentaloma in order to avoid unnecessary adrenalectomy. Urinary steroid profiling is a useful diagnostic tool to identify the presence of CAH.
September 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28956262/daily-salivary-cortisol-and-cortisone-rhythm-in-patients-with-adrenal-incidentaloma
#19
Filippo Ceccato, Mattia Barbot, Nora Albiger, Giorgia Antonelli, Marialuisa Zilio, Marco Todeschini, Daniela Regazzo, Mario Plebani, Carmelo Lacognata, Maurizio Iacobone, Franco Mantero, Marco Boscaro, Carla Scaroni
BACKGROUND AND AIM: Impaired cortisol rhythm is a characteristic feature of Cushing's Syndrome, nevertheless late night salivary cortisol (LNSC) is not suitable to detect subclinical hypercortisolism in patients with adrenal incidentaloma (AI). We studied daily salivary cortisol (F) and cortisone (E) rhythm in patients with AI. MATERIALS AND METHODS: Six saliva samples were collected from awakening to night in 106 patients with AI and 40 controls. F and E were measured with LC-MS/MS and daily F exposure was calculated with the area under the curve (AUC)...
September 27, 2017: Endocrine
https://www.readbyqxmd.com/read/28932767/patient-specific-workup-of-adrenal-incidentalomas
#20
REVIEW
Romy R de Haan, Johannes B R Visser, Ewoud Pons, Richard A Feelders, Uzay Kaymak, M G Myriam Hunink, Jacob J Visser
PURPOSE: : To develop a clinical prediction model to predict a clinically relevant adrenal disorder for patients with adrenal incidentaloma. MATERIALS AND METHODS: : This retrospective study is approved by the institutional review board, with waiver of informed consent. Natural language processing is used for filtering of adrenal incidentaloma cases in all thoracic and abdominal CT reports from 2010 till 2012. A total of 635 patients are identified. Stepwise logistic regression is used to construct the prediction model...
2017: European Journal of Radiology Open
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