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adrenal incidentalomas

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https://www.readbyqxmd.com/read/29761333/adrenal-incidentalomas-during-diagnostic-work-up-of-colorectal-cancer-patients-what-is-the-risk-of-metastases
#1
Joris van den Broek, Remy Geenen, Luc Heijnen, Carolien Kobus, Hermien Schreurs
BACKGROUND: Adrenal incidentalomas (AIs) are regularly discovered on staging computed tomography (CT) of patients with colorectal cancer (CRC). Although CRC is considered unlikely to metastasize to the adrenal gland, it is not known how often an AI appears to be a CRC metastasis. This causes a diagnostic dilemma for many patients with newly diagnosed CRC. This study aimed primarily to describe the incidence of AIs and adrenal metastases in CRC patients. METHODS: A single-center cohort of 475 consecutive patients with newly diagnosed CRC was defined...
May 14, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29754638/recent-advances-on-subclinical-hypercortisolism
#2
REVIEW
Guido Zavatta, Guido Di Dalmazi
During the last 20 years, a significant body of literature has accumulated regarding subclinical hypercortisolism in patients with adrenal incidentalomas. Retrospective studies have indicated these patients have an increase in cardiovascular events and mortality. Current recommendations for patients with adrenal incidentalomas include an overnight low-dose dexamethasone suppression test and a thorough evaluation of cardiovascular and metabolic risk factors. Further hormonal testing and close monitoring are necessary in patients with incomplete suppression...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29749133/characteristics-of-adrenal-incidentalomas-in-a-large-prospective-computed-tomography-based-multicenter-study-the-coar-study-in-korea
#3
Seong Hee Ahn, Jae Hyeon Kim, Seung Hee Baek, Hyeonmok Kim, Yoon Young Cho, Sunghwan Suh, Beom Jun Kim, Seongbin Hong, Jung Min Koh, Seung Hun Lee, Kee Ho Song
PURPOSE: Previous studies on adrenal incidentalomas (AIs) are limited by their retrospective design, small numbers of patients, Western populations, or use of an outdated imaging technique. We investigated the characteristics of AIs in Korean patients and compared them with those reported in the largest retrospective study in Italy to discover the effects of improved imaging techniques and ethnicity differences. MATERIALS AND METHODS: This was a prospective, multicenter, cross-sectional observational study including 1005 Korean patients...
June 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29748231/management-of-endocrine-disease-differential-diagnosis-investigation-and-therapy-of-bilateral-adrenal-incidentalomas
#4
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/29722113/primary-aldosteronism-in-patients-with-adrenal-incidentaloma-is-screening-appropriate-for-everyone
#5
Konstantinos Stavropoulos, Konstantinos P Imprialos, Niki Katsiki, Konstantinos Petidis, Apostolos Kamparoudis, Panagiotis Petras, Vasiliki Georgopoulou, Stefanos Finitsis, Christodoulos Papadopoulos, Vasilios G Athyros, Michael Doumas, Asterios Karagiannis
Primary aldosteronism (PA) is a common form of secondary hypertension. Several guidelines recommend that patients with adrenal incidentaloma have a high probability of suffering from PA. We conducted a prospective study of 269 consecutive adults with adrenal incidentaloma to investigate the prevalence and clinical characteristics of PA. In total, 9 participants were detected with PA, suggesting a prevalence of 3.35% among the study population. PA participants had a higher blood pressure level by 14/20.8 mm Hg and a lower serum potassium level by 0...
May 2, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29717464/alteration-in-skeletal-muscle-mass-in-women-with-subclinical-hypercortisolism
#6
Jae Hyeon Kim, Mi Kyung Kwak, Seong Hee Ahn, Hyeonmok Kim, Yoon Young Cho, Sunghwan Suh, Beom-Jun Kim, Kee-Ho Song, Seung Hun Lee, Jung-Min Koh
PURPOSE: Despite the well-known deleterious effects of cortisol on skeletal muscle, whether subtle cortisol excess in subclinical hypercortisolism (SH) affects skeletal muscle mass is unknown. Our objective was to understand the effects of the cortisol level on skeletal muscle mass in patients with SH. METHODS: We compared skeletal muscle mass and fat mass (FM) between 21 patients with SH (12 women and 9 men) and 224 controls (67 women and 157 men) with nonfunctioning adrenal incidentaloma (NFAI)...
May 1, 2018: Endocrine
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
#7
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
https://www.readbyqxmd.com/read/29696040/adrenal-ganglioneuroblastoma-in-an-adult-a-rare-case-report
#8
Zahra Heidari, Mahmoud Ali Kaykhaei, Mahdi Jahantigh, Vahid Sheikhi
Ganglioneuroblastoma is a primary malignant tumor of the sympathetic nervous system. It usually occurs in children and is extremely rare in adults. Here, we report a case of an adrenal ganglioneuroblastoma in a 38-year-old man. The adrenal incidentaloma was surgically removed and pathologically diagnosed as a ganglioneuroblastoma. The characteristics were described, because it is an unusual tumor based on the published reports in adults. To the best of our knowledge, fewer than 50 cases of ganglioneuroblastoma and 19 cases of adrenal ganglioneuroblastoma, including this case, are reported in the literature...
January 2018: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29689708/expression-of-adiponectin-and-leptin-receptors-in-adrenal-incidentaloma-patients-with-subclinical-hormone-secretion
#9
Anna Babińska, Rafał Pȩksa, Renata Świa Tkowska-Stodulska, Piotr Wiśniewski, Krzysztof Sworczak
BACKGROUND: The role of adopokines in adrenal tumors' hormonal activity remains unclear. Obesity may induce arterial hypertension, disorders of carbohydrate metabolism, and is a risk factor of cardiovascular disease. In patients with subclinical hormone secretion by the adrenal cortex or medulla the risk of metabolic disease is increased. OBJECTIVE: Authors of this retrospective study selected 78 patients with subclinical hormone secretion out of all adrenal incidentaloma patients hospitalized in the Department of Endocrinology and Internal Medicine between 1995 and 2014...
April 10, 2018: Cancer Biomarkers: Section A of Disease Markers
https://www.readbyqxmd.com/read/29689248/urinary-steroid-profiling-by-gas-chromatography-mass-spectrometry-early-features-of-malignancy-in-patients-with-adrenal-incidentalomas
#10
Z R Shafigullina, L I Velikanova, N V Vorokhobina, S B Shustov, A A Lisitsin, E V Malevanaia, M O Buinova, E A Bessonova, D O Kirsanov
No abstract text is available yet for this article.
April 21, 2018: Steroids
https://www.readbyqxmd.com/read/29643654/role-of-endoscopic-ultrasound-guided-fine-needle-aspiration-in-adrenal-lesions-analysis-of-32-patients
#11
Rakesh K Gupta, Kaushik Majumdar, Ravindra K Saran, Siddharth Srivastava, Puja Sakhuja, Vineeta V Batra
Objective: Endoscopic ultrasound-guided fine-needle aspiration cytology (EUS-FNAC) is a precise and safe technique that provides both radiological and pathological diagnosis with a better diagnostic yield and minimal adverse events. EUS-FNAC led to the remarkable increase in the detection rate of incidentaloma found during radiologic staging or follow-up in various malignancy or unrelated conditions. Aims: We did this preliminary study with an aim to evaluate the role of EUS-FNA in diagnosing and classifying adrenal lesions, clinical impact, and compare the outcome with the previously published literature...
April 2018: Journal of Cytology
https://www.readbyqxmd.com/read/29616752/adrenal-hemorrhage-a-single-center-experience-and-literature-review
#12
Izabela M Karwacka, Łukasz Obołończyk, Krzysztof Sworczak
BACKGROUND: Adrenal hemorrhage (AH) is a rare condition that can lead to acute adrenal insufficiency and may be fatal. The risk factors of AH include focal adrenal lesion, abdominal trauma and anticoagulation therapy. The clinical manifestation of AH varies widely; the symptoms may be related to adrenal insufficiency or may reflect multiple organ failure. However, in many cases, the course of AH is asymptomatic. OBJECTIVES: The study is a retrospective analysis of 23 cases of AH, whose aim is to discuss the etiology and the management of selected patients, as well as a literature review...
March 27, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29608696/serum-cortisol-levels-via-radioimmunoassay-vs-liquid-chromatography-mass-spectrophotometry-in-healthy-control-subjects-and-patients-with-adrenal-incidentalomas
#13
Martha K P Huayllas, Brian C Netzel, Ravinder J Singh, Claudio E Kater
Background: Adrenal incidentalomas (AIs) are present in 4% of adults. As many as 30% may secrete cortisol autonomously in the absence of specific signs of overt hypercortisolism, in a phenomenon called subclinical hypercortisolism (SH). Diagnosis of SH is established by serum cortisol resistance to dexamethasone suppression. Methods: We compared serum cortisol concentrations, as determined by radioimmunoassay (RIA) and liquid chromatography/tandem mass spectronomy (LC/MS-MS), in 73 patients with AI group (52 with unilateral AI) and 34 control subjects in 3 scenarios: basal; after 1-mg dexamethasone suppression; and after 0...
March 28, 2018: Laboratory Medicine
https://www.readbyqxmd.com/read/29606280/cardiovascular-mortality-in-patients-with-subclinical-cushing
#14
Valentina Morelli, Maura Arosio, Iacopo Chiodini
Patients with adrenal incidentaloma (AI) and subclinical hypercortisolism (SH) show a high prevalence of cardiovascular risk factors and an increased prevalence and incidence of cardiovascular events. Furthermore, some recent data suggest that in these patients, the cardiovascular mortality is also increased. Unfortunately, to date, the diagnosis of SH is still a matter of debate, and, therefore, it is still not possible to address the treatment of choice (i.e. surgical or conservative approach) in many AI patients...
March 29, 2018: Annales D'endocrinologie
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/29534610/annals-express-development-of-a-rapid-lc-ms-ms-method-for-the-quantitation-of-serum-dexamethasone-and-its-clinical-verification
#16
James M Hawley, Laura J Owen, Miguel De Bono, John Newell-Price, Brian G Keevil
BACKGROUND: Measurement of serum dexamethasone during the overnight dexamethasone-suppression test (ONDST) has been recommended to reduce false positive results when investigating Cushing's syndrome or increasingly commonly found adrenal incidentalomas. Despite this, there remains a paucity of well-validated dexamethasone methods currently available. Here, we describe the development of a rapid and sensitive LC-MS/MS serum dexamethasone assay and validate its utility in a cohort of postmenopausal females...
January 1, 2018: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/29510982/cardiovascular-features-of-possible-autonomous-cortisol-secretion-in-patients-with-adrenal-incidentalomas
#17
Emilia Sbardella, Marianna Minnetti, Denise D'Aluisio, Laura Rizza, Maria Rosaria Di Giorgio, Fabio Vinci, Riccardo Pofi, Elisa Giannetta, Mary Anna Venneri, Annarita Vestri, Sergio Morelli, Andrea Lenzi, Andrea M Isidori
BACKGROUND: Low-grade incomplete post-dexamethasone cortisol suppression in patients with adrenal incidentalomas - recently defined as possible autonomous cortisol secretion (pACS) - has been associated with increased cardiovascular events and mortality. However, prospective studies documenting cardiac abnormalities in these patients are lacking. SUBJECTS AND METHODS: Between July 2016 and September 2017, 71 consecutive patients with adrenal lesions were prospectively screened for hypercortisolism by dexamethasone suppression test (NCT 02611258)...
May 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29498083/chemical-shift-magnetic-resonance-imaging-could-predict-subclinical-cortisol-production-from-an-incidentally-discovered-adrenal-mass
#18
Serkan Yener, Mustafa Secil, Omer Demir, Basak Ozgen Saydam, Kutsal Yorukoglu
CONTEXT: To investigate whether any association between chemical shift magnetic resonance (MRI) findings, cortisol secretion and pathological findings exists that could predict subclinical hypercortisolism (SCH) in patients with adrenal incidentalomas (AI). DESIGN: Retrospective, cross-sectional study in a tertiary centre. PATIENTS: Sixty-eight subjects with AIs and 13 patients with Cushing's syndrome (CS). Patients with AIs were categorized according to cortisol levels post 1 mg dexamethasone (post-DST)...
March 1, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29495350/the-role-of-insulin-resistance-hyperinsulinism-on-the-rising-trend-of-thyroid-and-adrenal-nodular-disease-in-the-current-environment
#19
REVIEW
Agathocles Tsatsoulis
Thyroid follicular cells, as well as adrenocortical cells, are endowed by an intrinsic heterogeneity regarding their growth potential, in response to various stimuli. This heterogeneity appears to constitute the underlying cause for the focal cell hyperplasia and eventually the formation of thyroid and adrenal nodules, under the influence of growth stimulatory factors. Among the main stimulatory factors are the pituitary tropic hormones, thyroid-stimulating hormone (TSH) or thyrotropin and adrenocorticotropic hormone (ACTH), which regulate the growth and function of their respective target cells, and the insulin/insulin-like growth factor system, that, through its mitogenic effects, can stimulate the proliferation of these cells...
February 26, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29467231/diagnostic-accuracy-of-computed-tomography-to-identify-adenomas-among-adrenal-incidentalomas-in-an-endocrinological-population
#20
M Marty, D Gaye, P Perez, C Auder, M L Nunes, A Ferriere, M Haissaguerre, A Tabarin
CONTEXT: The recent recommendations of the European Endocrine Society states that the performance of computed tomography (CT) to characterize 'true' adrenal incidentalomas (AIs) remains debatable. OBJECTIVE: To determine relevant thresholds for usual CT parameters for the diagnosis of benign tumors using robust reference standard among a large series of 'true' AIs recruited in an endocrinological setting. DESIGN: Retrospective study of 253 AIs in 233 consecutive patients explored in a single university hospital: 183 adenomas, 33 pheochromocytomas, 23 adrenocortical carcinomas, 5 other malignant tumors and 9 other benign tumors...
May 2018: European Journal of Endocrinology
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