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adrenal incidentalomas

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https://www.readbyqxmd.com/read/27869719/targeted-molecular-imaging-in-adrenal-disease-an-emerging-role-for-metomidate-pet-ct
#1
REVIEW
Iosif A Mendichovszky, Andrew S Powlson, Roido Manavaki, Franklin I Aigbirhio, Heok Cheow, John R Buscombe, Mark Gurnell, Fiona J Gilbert
Adrenal lesions present a significant diagnostic burden for both radiologists and endocrinologists, especially with the increasing number of adrenal 'incidentalomas' detected on modern computed tomography (CT) or magnetic resonance imaging (MRI). A key objective is the reliable distinction of benign disease from either primary adrenal malignancy (e.g., adrenocortical carcinoma or malignant forms of pheochromocytoma/paraganglioma (PPGL)) or metastases (e.g., bronchial, renal). Benign lesions may still be associated with adverse sequelae through autonomous hormone hypersecretion (e...
November 18, 2016: Diagnostics
https://www.readbyqxmd.com/read/27846915/alveolar-echinococcosis-of-the-right-adrenal-gland-a-case-report-and-review-of-the-literature
#2
Silke Spahn, Birgit Helmchen, Urs Zingg
BACKGROUND: Extrahepatic manifestations of Echinococcus multilocularis are very rare, especially in the adrenal glands. To the best of our knowledge, only seven cases of adrenal alveolar echinococcosis have been reported, all from the Far East. All of these occurred exclusively in the right adrenal gland. CASE PRESENTATION: We report a rare case of an extrahepatic alveolar echinococcosis in an asymptomatic 78-year-old white man with an incidentaloma of his right adrenal gland...
November 15, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27802863/adrenal-incidentalomas-are-they-being-worked-up-appropriately
#3
Pooja Sahni, Apoorva Trivedi, Abdulkadir Omer, Nitin Trivedi
INTRODUCTION: Adrenal incidentalomas are defined as masses picked up on imaging studies that were done for apparently different reasons. With frequent use of imaging modalities, incidental adrenal masses are commonly encountered in clinical practice. Guidelines are currently available for the diagnosis and management of adrenal incidentalomas, but the appropriateness of initial work-up and subsequent follow-up of incidental adrenal masses in the community hospital setting is unknown. OBJECTIVE: We studied the appropriateness of initial work-up and follow-up of incidental adrenal masses discovered on abdominal computerized tomography (CT)...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27797672/low-dheas-a-sensitive-and-specific-test-for-detection-of-subclinical-hypercortisolism-in-adrenal-incidentalomas
#4
Michael Conall Dennedy, Anand K Annamalai, Olivia Prankerd Smith, Natalie Freeman, Kuhan Vengopal, Johann Graggaber, Olympia Koulouri, Andrew S Powlson, Ashley Shaw, David J Halsall, Mark Gurnell
CONTEXT: Subclinical hypercortisolism (SH) occurs in 5-30% of adrenal incidentalomas (AIs). Common screening tests for adrenocorticotropin (ACTH)-independent hypercortisolism have significant false positive rates, mandating further time and resource intensive investigations. OBJECTIVE: To determine whether low basal dehydroepiandrosterone sulphate (DHEAS) is a sensitive and specific screening test for SH in AI. SETTING AND PATIENTS: 185 patients with AI were screened for adrenal medullary (plasma metanephrines) and cortical [1 mg overnight dexamethasone suppression test (ONDST), 24h urinary free cortisol (UFC), serum DHEAS, plasma renin and aldosterone] hyperfunction...
October 31, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27790975/unusual-case-of-pheochromocytoma-presenting-with-diabetic-ketoacidosis
#5
Yub Raj Sedhai, Kruthika Reddy, Dhruvan Patel, James A Lozada
Pheochromocytoma is a rare catecholamine-secreting tumour that arises from chromaffin cells in the adrenal medulla or extra-adrenal sympathetic ganglia. It classically presents with paroxysmal headaches, hypertension, palpitations and sweating related to catecholamine excess. Diabetes is reported to be present in approximately one-third of patients with pheochromocytoma; however, diabetic ketoacidosis is an extremely rare complication. We present a case of an African-American male aged 30 years who initially presented with diabetic ketoacidosis and hypertensive urgency whose blood pressure and glycaemic control improved remarkably following tumour excision...
October 19, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27787920/phaeochromocytomas-are-diagnosed-incidentally-and-at-older-age-in-neurofibromatosis-type-1
#6
Jessica Moramarco, Nada El Ghorayeb, Nadine Dumas, Serge Nolet, Luce Boulanger, Nelly Burnichon, André Lacroix, Zaki Elhaffaf, Anne-Paule Gimenez Roqueplo, Pavel Hamet, Isabelle Bourdeau
INTRODUCTION: Guidelines do not currently recommend routine systematic hormonal screening for phaeochromocytoma (PHEO) in all/normotensive patients with Neurofibromatosis type 1 (NF1), in contrast to other PHEO predisposing genetic syndromes such as Von Hippel Lindau syndrome and Multiple endocrine neoplasia type 2. OBJECTIVES: To characterise and compare parameters of PHEO in NF1 patients to patients with or without other germline mutations. METHODS: Retrospective chart review of patients with histologically proven PHEO at the Centre Hospitalier de l'Université de Montréal from 2000 through 2015...
October 27, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27775937/bilateral-huge-incidentalomas-of-isolated-adrenal-metastases-from-unknown-primary-melanoma-revealed-by-18f-fdg-pet-ct
#7
Clément Drouet, Olivier Morel, Hatem Boulahdour
FDG PET/CT has high sensitivity and specificity for the detection of distant metastases from cutaneous melanoma. Imaging is recommended for patients with clinical suspicion of metastasis and should be considered for those with confirmed sentinel lymph node metastasis. Metastatic melanoma bears a poor prognosis. Only a complete resection improves survival, which explains the need to detect potentially unresectable disease, and most metastatic patients are ineligible for a curative surgical procedure. Here, FDG PET/CT demonstrated isolated bilateral adrenal metastases from melanoma of unknown primary...
January 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27744612/follow-up-of-patients-with-adrenal-incidentaloma-in-accordance-with-the-european-society-of-endocrinology-guidelines-could-we-be-safe
#8
V Morelli, A Scillitani, M Arosio, I Chiodini
Recently, the European Society of Endocrinology (ESE) published new guidelines on the management of adrenal incidentalomas. At the same time Lopez and coworkers published on the Annals of Internal Medicine an important study showing that even patients with non-functioning adrenal tumors have an increased risk of incident diabetes. In consideration of previous data and of the results of the study of Lopez and coworkers, some points emerge from the ESE Guidelines that deserve attention. Firstly, it must be observed that the term "autonomous cortisol secretion," introduced by the ESE Panel in the place of the commonly used "subclinical hypercortisolism," seems questionable, since the guidelines do not suggest determining the adrenocorticotroph hormone levels that could give the certain proof of a truly autonomous cortisol secretion...
October 15, 2016: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27735216/a-case-of-added-value-of-123-i-mibg-spect-ct-imaging-in-the-diagnosis-of-a-pheochromocytoma-extending-into-the-left-adrenal-vein
#9
Florence Paques, Etienne Hamoir, Pierre Lovinfosse, Roland Hustinx, Nadia Withofs
We present the case of a 48-year-old patient with a left adrenal incidentaloma found on computed tomography (CT) for which the diagnosis of pheochromocytoma was confirmed by a 24-hour urinary dosage of norepinephrine. The (123)I-mIBG scintigraphy showed a high uptake of (123)I-mIBG in the left adrenal gland and, additionally, the single photon emission computed tomography combined with a low-dose CT (SPECT/CT) suggested the extension into the adrenal vein. The diagnostic CT and magnetic resonance images agreed with these findings and the subsequent surgery confirmed the vascular invasion...
October 13, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27727661/profile-of-adrenal-incidentalomas-in-a-tertiary-care-hospital
#10
Nithin Thomas Terence
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27695953/-incidentalomas-on-abdominal-and-pelvic-ct-in-emergency-radiology-literature-review-and-current-management-recommendations
#11
Siavash Behbahani, Sameer Mittal, Michael N Patlas, Mariam Moshiri, Christine O Menias, Douglas S Katz
The purpose of this article is to familiarize radiologists and clinicians with a subset of common and uncommon incidental findings on abdominal and pelvic computed tomography examinations, including hepatic, splenic, renal, adrenal, pancreatic, aortic/iliac arterial, gynecological, and a few other miscellaneous findings, with an emphasis on "incidentalomas" discovered in the emergency setting. In addition, we will review the complex problem of diagnosing such entities, and provide current management recommendations...
September 30, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27684725/markers-of-subclinical-cardiovascular-disease-in-nonfunctional-adrenal-incidentaloma-patients-without-traditional-cardiovascular-risk-factors
#12
G B Cansu, R Sarı, N Yılmaz, S Özdem, M Çubuk
Introduction: Data regarding cardiovascular risk in patients with non-functional adrenal incidentaloma (NFAI) are limited. The objectives of this study are to investigate markers of subclinical cardiovascular disease like carotid intima media thickness (CIMT), pulse wave velocity (PWV), augmentation index (AIx), soluble CD40 ligand (sCD40L) and leptin levels in NFAI patients without traditional cardiovascular risk factors and healthy control group. Methods: This study involved 35 patients with NFAI (11 males, 24 females; mean age, 52...
September 29, 2016: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/27649075/analysis-of-bcli-n363s-and-er22-23ek-polymorphisms-of-the-glucocorticoid-receptor-gene-in-adrenal-incidentalomas
#13
Giuseppe Reimondo, Iacopo Chiodini, Soraya Puglisi, Anna Pia, Valentina Morelli, Darko Kastelan, Salvatore Cannavo, Paola Berchialla, Daniela Giachino, Paola Perotti, Alessandra Cuccurullo, Piero Paccotti, Paolo Beck-Peccoz, Mario De Marchi, Massimo Terzolo
CONTEXT: Patients with adrenal incidentalomas (AI) may experience detrimental consequences due to a minimal cortisol excess sustained by adrenal adenoma. SNPs of the glucocorticoid receptor gene (NR3C1) modulate individual sensitivity to glucocorticoids and may interfere with the clinical presentation. OBJECTIVE: To compare the frequency of N363S, ER22/23EK and BclI SNPs in patients with AI with the general population and to evaluate whether these SNPs are linked to consequences of cortisol excess...
2016: PloS One
https://www.readbyqxmd.com/read/27631846/bilateral-cystic-hemorrhagic-adrenal-incidentalomas
#14
Stavroula A Paschou, Konstantinos Tzioras, Christina Nika, Athanasios Papatheodorou, Vassilis Samaras, Andromachi Vryonidou
No abstract text is available yet for this article.
September 15, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27621243/adrenal-incidentalomas-a-guide-to-assessment-treatment-and-follow-up
#15
REVIEW
Stavroula A Paschou, Andromachi Vryonidou, Dimitrios G Goulis
Adrenal incidentalomas are clinically unsuspected lesions that are detected in adrenal glands during imaging procedures for other causes. With widespread use of imaging - both computed tomography (CT) and magnetic resonance imaging (MRI) - adrenal incidentalomas are now a common clinical problem. The two main clinical issues to be determined in this setting are the risk of malignancy and the hormonal activity of these lesions. The answers to these two questions, along with the clinical characteristics of each individual patient and co-morbidities, will guide the treatment strategy, which can vary from simple follow-up to surgical resection...
October 2016: Maturitas
https://www.readbyqxmd.com/read/27595615/tips-to-facilitate-a-preoperative-diagnosis-of-adrenal-ganglioneuroma-report-of-a-challenging-experience-and-review-of-the-literature
#16
Delia Proposito, Francesca De Lucia, Alessandra Giannella, Francesca Frangella, Giuseppe Pappalardo, Maria Santangelo, Domenico Magagnano
AIM: Ganglioneuroma (GN) is the most uncommon and the most benign tumor among neuroblastic neoplasms, and in 29.7% of cases it finds in an adrenal gland. Usually asymptomatic, this tumor is detected incidentally in the majority of cases. It is generally challenging to obtain a precise diagnosis of adrenal ganglioneuroma (AGN) before surgery. Misdiagnosis rate of AGN on CT and MRI is 64.7% and clinicians and surgeons are often lacking in knowledge of this rare disease. For this reason, we pointed out the clinical, biochemical, radiologic and pathologic features of AGN in an our experience, with the aim to find out if there are some features able to facilitate a preoperative diagnosis...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27592061/-hypertension-etiological-work-up-hormonological-assessment-always-before-imaging
#17
Bernard Chamontin, Florent Seguro, Nicolas Touront, Béatrice Bouhanick
The purpose is to consider the practical management of etiological work up in hypertension, beyond national or international recommendations, leading to consider the prior practice of hormonal assays or renal, renovascular or adrenal imaging. The ease of access to imaging, difficulties to meet the requirements to obtain reliable hormonal assays explain the use of first-line imaging in clinical practice. The renal and adrenal CT angiography provides diagnostic orientation without allowing a formal conclusion...
August 31, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27576286/-giant-adrenal-myelolipoma-right-laparoscopic-adrenalectomy
#18
Ana L Campos Arbulú, Emmanuel E Sadava, Javier Kerman, Juan M Fernández Vila, Norberto A Mezzadri
Adrenal myelolipoma is a rare, benign, non-functioning tumor. It is composed by fat and hematopoietic tissues. We present the case of a 33-year-old woman with diagnosis of a 14 cm diameter non-functioning right adrenal incidentaloma, with imaging features suggestive of myelolipoma. Based on the benign nature of the tumor, laparoscopic resection was performed. Histopathology showed a myelolipoma, weighting 444 grams. The patient evolved with an uneventful postoperative period. Laparoscopic adrenalectomy for a giant myelolipoma was feasible and successful...
2016: Medicina
https://www.readbyqxmd.com/read/27566330/diagnosing-and-managing-primary-aldosteronism-in-hypertensive-patients-a-case-based-approach
#19
REVIEW
Robert M Carey
Primary aldosteronism with a prevalence of 8 % of hypertension and 20 % of pharmacologically resistant hypertension is the most common secondary cause of hypertension. Yet, the diagnosis is missed in the vast majority of patients. Current clinical practice guidelines recommend screening for primary aldosteronism in patients with sustained elevation of blood pressure (BP) ≥150/100 mmHg if possible prior to initiation of antihypertensive therapy, and in patients with resistant hypertension, spontaneous or diuretic-induced hypokalemia, adrenal incidentaloma, obstructive sleep apnea, a family history of early onset of hypertension or cerebrovascular accident <age 40, and first-degree relatives of patients with primary aldosteronism...
October 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27564712/adrenal-gland-new-guidelines-for-adrenal-incidentalomas
#20
Quan-Yang Duh
No abstract text is available yet for this article.
October 2016: Nature Reviews. Endocrinology
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