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Tumors of the adrenals

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https://www.readbyqxmd.com/read/29779047/over-diagnosis-of-potential-malignant-behavior-in-men-2a-associated-pheochromocytomas-using-the-pass-and-gapp-algorithms
#1
Adam Stenman, Jan Zedenius, Carl Christofer Juhlin
PURPOSE: Pheochromocytomas (PCCs) exhibit malignant potential, but current histological modalities for the proper detection of aggressive behavior are debated. The two most widespread algorithms are the "Pheochromocytoma of the Adrenal Gland Scaled Score" (PASS) and the "Grading System for Adrenal Pheochromocytoma and Paraganglioma" (GAPP), both which mostly rely on histological parameters to identify PCC patients at risk of disseminated disease. Since the algorithms are derived from studies using predominantly sporadic PCCs, little is known whether the PASS or GAPP scores can predict malignant potential in hereditary cases...
May 19, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29772978/outcomes-of-the-addition-of-pasireotide-to-traditional-adrenal-directed-treatment-for-dogs-with-pituitary-dependent-hyperadrenocorticism-secondary-to-macroadenoma-9-cases-2013-2015
#2
Maya Lottati, David S Bruyette
OBJECTIVE To evaluate clinical signs, endocrine test results, and pituitary tumor size for dogs with medically managed pituitary-dependent hyperadrenocorticism (PDH) and macroadenoma following 6 months of concurrent treatment with pasireotide. DESIGN Prospective case series. ANIMALS 9 client-owned dogs with PDH and macroadenoma in which PDH had been successfully managed with adrenal-directed treatment (trilostane or mitotane). PROCEDURES Dogs were given pasireotide (0.03 mg/kg [0.014 mg/lb], SC, q 12 h) for 6 months, while adrenal-directed treatment was continued...
June 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29772620/-development-of-ectopic-adrenocorticotropic-hormone-syndrome-in-a-patient-with-prostate-cancer-during-combined-androgen-blockade-therapy
#3
Yosuke Sekii, Mitsuhiro Yoshinaga, Masahiro Nakagawa, Hidefumi Kishikawa, Kazumasa Oka, Kenji Nishimura
A 74-year old man presented to us with difficulty urinating. The laboratory examinations revealed an elevated prostate-specific antigen (PSA) level. A prostate biopsy revealed prostate adenocarcinoma. The computed tomography scan showed metastasis to lymph nodes in the pelvic cavity and both adrenal glands. Combined androgen blockade therapy was started, and PSA levels began to decrease gradually. However, 2 months later, he was hospitalized for treatment of cellulitis and was found to have hypertension, hyperglycemia, and hypokalemia...
April 2018: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/29770282/mature-testicular-teratoma-with-a-focus-of-embryonal-carcinoma-a-case-report-and-review-of-literature
#4
Waliul Chowdhury, Muhammad Uzair Lodhi, Intekhab Askari Syed, Umar Rahim, Mustafa Rahim
We present a 37-year-old male patient with a mature teratoma of the right testicle with a focus of embryonal carcinoma. This patient's tumor metastasized radically to the retroperitoneum, right adrenal gland, bilateral lungs, and liver. A metastatic teratoma with embryonal carcinoma in males is a very rare case. We will describe our patient's case, diagnostic workup, and management in detail, in addition to reviewing the related literature.
March 15, 2018: Curēus
https://www.readbyqxmd.com/read/29770148/clinical-characteristics-of-aldosterone-and-cortisol-coproducing-adrenal-adenoma-in-primary-aldosteronism
#5
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/29768344/synchronous-adrenocortical-carcinoma-and-ovarian-malignant-mixed-germ-cell-tumor-a-case-report-and-literature-review
#6
Ying He, Lian Xu, Qingli Li, Min Feng, Wei Wang
RATIONALE: Adrenocortical carcinoma (ACC) is an endocrine malignancy with poor prognosis, which commonly arises in a sporadic manner, but may also become a part of a familial syndrome. ACC rarely arises simultaneously with other malignant tumors. PATIENT CONCERNS: We report a case of a 29-year-old woman with ACC synchronously followed by an ovarian malignant mixed germ cell tumor. We describe the clinical, histopathological, and immunohistochemical findings and review the English literatures...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766416/igg4-associated-adrenalis-a-case-report
#7
Wolfgang Saeger, Bernd Lohe, Christina Luise Engels, Ulrike Werner
A 67-year-old man was adrenalectomized due to a tumor measuring 100 mm. Specimens revealed an inflammation with slight fibrosis and moderate infiltrates of lymphocytes and plasmacytes with immunoreactivity for IgG and IgG4 resulting in the diagnosis of an active IgG4-associated adrenalitis. To our knowledge, this is the first reported active adrenalitis of this type. It should be the precursor lesion of the adrenal calcifying fibrous tumor that was reported once before.
May 15, 2018: Endocrine Pathology
https://www.readbyqxmd.com/read/29760304/metyrapone-responsive-ectopic-acth-secreting-pheochromocytoma-with-a-vicious-cycle-via-a-glucocorticoid-driven-positive-feedback-mechanism
#8
Minako Inoue, Ken Okamura, Chie Kitaoka, Fumio Kinoshita, Ryo Namitome, Udai Nakamura, Masaki Shiota, Kenichi Goto, Toshio Ohtsubo, Kiyoshi Matsumura, Yoshinao Oda, Masatoshi Eto, Takanari Kitazono
In ectopic ACTH-secreting pheochromocytoma, combined ACTH-driven hypercortisolemia and hyper-catecholaminemia are serious conditions, which can be fatal if not diagnosed and managed appropriately, especially when glucocorticoid-driven positive feedback is suggested with a high ACTH/cortisol ratio. A 46-year-old man presented with headache, rapid weight loss, hyperhidrosis, severe hypertension and hyperglycemia without typical Cushingoid appearance. Endocrinological examinations demonstrated elevated plasma and urine catecholamines, serum cortisol and plasma ACTH...
May 15, 2018: Endocrine Journal
https://www.readbyqxmd.com/read/29755915/unusual-long-survival-with-a-giant-invasive-pheochromocytoma-of-an-incompatible-patient
#9
Asli Nar
Pheochromocytomas (PHEOs) are rare neuroendocrine tumors and about 2-13% of PHEOs are malignant. Predicting malignancy in PHEO cases with invasion but without metastasis is still controversial in the literature. This study presents an unusual long survival with a giant invasive PHEO in an incompatible patient and a review of the literature. In 1989, a 23-year-old female patient was operated for a giant adrenal mass with a pathological final diagnosis of PHEO. Information to the patient's family was provided about the short life span of the patient in the postoperative period because the tumor could not be totally resected...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29753511/acute-adrenal-cortex-injury-during-cardiopulmonary-bypass-in-a-canine-model
#10
Bo Mei, Song Yang, Yuan Yue, Jian Hou, Keke Wang, Guangxian Chen, Mengya Liang, Zhongkai Wu
OBJECTIVE: Cardiopulmonary bypass (CPB) might induce systemic inflammatory responses that cause acute injuries to multiple organs. However, no direct evidence exists to determine whether CPB leads to adrenal cortex injury or to describe its underlying mechanism. METHODS: Twelve healthy adult beagles were randomly assigned into control and CPB groups. After cannulation, mild hypothermia CPB was performed in the CPB group but not in the control group. The serum concentrations of various cytokines, cortisol, and aldosterone were assessed...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29752879/an-unusual-circulating-steroid-profile-in-a-virilized-postmenopausal-woman
#11
Patricia Benavent Correro, Marta Sáenz Valls, Ana García Cano, Lucía Jiménez Mendiguchia, Esther Moreno Moreno, Manuel Luque-Ramírez
BACKGROUND: Virilism is a female disorder in which secondary male sexual characteristics develop, caused by an excessive adrenal or ovarian androgen secretion. CASE PRESENTATION: Here, we report an unusual case of an ovarian steroid cell tumor, not otherwise specified (NOS), in a 68-year-old female who presented with androgenic alopecia, clitoromegaly and an increased muscle mass. Laboratory investigations revealed both ovarian and adrenal hyperandrogenism with an elevation of androgen precursors mimicking congenital adrenal hyperplasia...
May 12, 2018: Diagnosis
https://www.readbyqxmd.com/read/29750932/bilateral-posterior-mediastinal-primary-myelolipoma
#12
Ishan Goel, Parul Kaushik, Rama Anand
Myelolipoma(ML) is an uncommon benign mesenchymal tumor consisting of mature adipocytes and hemopoietic elements mostly found in adrenal glands. Bilateral posterior mediastinal primary myelolipoma presents extremely rarely and only 11 such occurrences have been previously described. With no definite symptoms, pathological evaluation is essential for diagnosis. Here the authors present a case of a 63-year old man diagnosed with bilateral posterior mediastinal primary myelolipoma on basis of radiological findings who underwent surgical resection via video-assisted thoracic surgery (VATS)...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29739388/surgical-management-of-large-adrenal-tumors-impact-of-different-laparoscopic-approaches-and-resection-methods-on-perioperative-and-long-term-outcomes
#13
Wei Chen, Yong Liang, Wei Lin, Guang-Qing Fu, Zhi-Wei Ma
BACKGROUND: The indication of retroperitoneal laparoscopic adrenalectomy (RLA) was extended with the retroperitoneal approach and has been wildly accepted and technologically matured. However, the management of large adrenal tumors via this approach still remains controversial. The aim of this study was to perform a comprehensive analysis on the minimally invasive surgical management of larger adrenal tumors. METHODS: A total of 78 patients with large adrenal tumors (> 5 cm) and 97 patients with smaller adrenal tumors (< 5 cm) were enrolled in this study...
May 8, 2018: BMC Urology
https://www.readbyqxmd.com/read/29735160/genomic-insights-into-cushing-syndrome
#14
Guillaume Assié
In the setting of Cushing syndrome, genomic analyses can be performed either in tumors responsible for endogenous Cushing, or in patients exposed to glucocorticoid excess. Genomics of tumors identified several new genes - including ZNRF3 in adrenocortical carcinomas, PRKACA in cortisol-producing adrenal adenomas, ARMC5 in primary macronodular adrenal hyperplasia and USP8 in pituitary corticotroph adenomas. These genes shed new lights on the mechanisms responsible for these tumors. Integrated genomic studies of adrenal carcinomas identified distinct molecular classes, with remarkably different prognostic outcome...
May 4, 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29730647/silencing-of-med27-inhibits-adrenal-cortical-carcinogenesis-by-targeting-the-wnt-%C3%AE-catenin-signaling-pathway-and-the-epithelial-mesenchymal-transition-process
#15
Hongchao He, Jun Dai, Xiaoqun Yang, Xiaojing Wang, Fukang Sun, Yu Zhu
This study aimed to explore the effect of MED27 on the expression of epithelial-mesenchymal transition (EMT)-related proteins and β-catenin in adrenal cortical carcinoma (ACC). The functional mechanism of MED27 on ACC processes was also explored. The expression of MED27 was assessed by quantitative real-time polymerase chain reaction (qRT-PCR). siRNA was utilized to knockdown the expression of MED27. CCK8 assays were performed to evaluate SW-13 cell proliferation. Transwell assays were performed to assess the invasion ability, and wound healing assays were utilized to detect migration...
May 24, 2018: Biological Chemistry
https://www.readbyqxmd.com/read/29729821/a-pediatric-carotid-body-tumor
#16
Anthony R Hogan, Juan E Sola, Sarah C Jernigan, Eric C Peterson, Ramzi T Younis
Carotid body tumors are rare childhood extra-adrenal paragangliomas. We present an 8-year old female with a neck mass mistaken as reactive lymphadenopathy. Computed tomography and magnetic resonance angiography, as well as preoperative embolization and balloon test occlusion, were utilized for planning and management. Surgical excision of the tumor was successful and pathological examination revealed a benign paraganglioma. Surgical treatment is curative for these benign lesions, however rare cases have presented years later with metastatic disease...
April 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29718004/update-on-diagnosis-and-management-of-congenital-adrenal-hyperplasia-due-to-21-hydroxylase-deficiency
#17
Perrin C White
PURPOSE OF REVIEW: Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is a relatively common inherited disorder of cortisol biosynthesis that can be fatal if untreated. RECENT FINDINGS: The basic biochemistry and genetics of CAH have been known for decades but continue to be refined by the discoveries of an alternative 'backdoor' metabolic pathway for adrenal androgen synthesis and the secretion of 11-hydroxy and 11-keto analogs of known androgens, by the elucidation of hundreds of new mutations, and by the application of high-throughput sequencing techniques to noninvasive prenatal diagnosis...
June 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29716804/root-cause-analysis-of-diagnostic-and-surgical-failures-in-the-treatment-of-suspected-cushing-s-disease
#18
Hasan A Zaidi, David L Penn, David J Cote, Edward R Laws
Cushing's disease (CD) is a condition characterized by excess glucocorticoid from an ACTH pituitary adenoma. Identifying surgical candidates represents a major diagnostic challenge. We performed a root cause analysis (RCA) of treatment failures for patients with suspected CD. The present study aims to categorize failures in treatment. Medical records were reviewed from 2008 to 2017 for all patients treated surgically for suspected CD. Demographics, past medical history, endocrine outcomes, imaging findings, laboratory studies and clinical features were collected...
April 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29716734/the-difficulties-of-pseudo-cushing-s-syndrome-or-non-neoplastic-hypercortisolism
#19
Olivier Chabre
Pseudo-Cushing's syndrome covers different pathological conditions responsible for mild-to-moderate ACTH-dependent hypercortisolism, related not to an ACTH-secreting tumor but rather to CRH and/or AVP hypothalamic secretion through activation of various neural pathways, in patients generally displaying excess central adiposity. It is better termed "non-neoplastic hypercortisolism" (NNH). The main conditions implicated in NNH comprise: neuropsychiatric disorder, alcohol abuse, insulin-resistant obesity, polycystic ovary syndrome, and end-stage kidney disease...
April 28, 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29709936/clinical-investigation-of-adrenal-incidentalomas-in-japanese-patients-of-the-fukuoka-region-with-updated-diagnostic-criteria-for-sub-clinical-cushing-s-syndrome
#20
Ichiro Abe, Kaoru Sugimoto, Tetsumasa Miyajima, Tomoko Ide, Midori Minezaki, Kaori Takeshita, Saori Takahara, Midori Nakagawa, Yuki Fujimura, Tadachika Kudo, Shigero Miyajima, Hiroshi Taira, Kenji Ohe, Tatsu Ishii, Toshihiko Yanase, Kunihisa Kobayashi
Objectives We retrospectively investigated the clinical and endocrinological characteristics of adrenal incidentalomas. Methods We studied 61 patients who had been diagnosed with adrenal incidentalomas and had undergone detailed clinical and endocrinological evaluations while hospitalized. We used common criteria to diagnose the functional tumors, but for sub-clinical Cushing's syndrome, we used an updated set of diagnosis criteria: serum cortisol ≥1.8 μg/dL after a positive response to a 1-mg dexamethasone suppression test if the patient has a low morning ACTH level (<10 pg/mL) and a loss of the diurnal serum cortisol rhythm...
April 27, 2018: Internal Medicine
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