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adrenal incidentalomas

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https://www.readbyqxmd.com/read/28625027/-a-case-of-bilateral-adrenal-incidentaloma-in-which-mtx-related-lymphoproliferative-disease-could-be-diagnosed-by-computed-tomography-guided-biopsy-and-mtx-administration-history
#1
Hiroaki Kitakaze, Makoto Matsushita, Koichi Okada, Noriko Minato, Naoki Mori, Toshiaki Yoshioka
The patient was a 76-year-old man. Because bilateral adrenal tumor (right adrenal gland 7 cm, left adrenal gland 1.5 cm) was detected in by computed tomography (CT) in methotrexate (MTX) administration for articular rheumatism from 2011, he was referred to this hospital in February, 2016. An endocrine examination, and imaging study did not lead to a definitive diagnosis and CT-guided lower needle biopsy was performed. The pathological diagnosis was diffuse large B cell lymphoma. Also, in situ hybridization revealed EBER-positive and the diagnosis of MTX-related lymphoproliferative disease (MTXLPD) was made in conjunction with the medical history...
May 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28609594/incidental-adrenal-masses-a-primary-care-approach
#2
Rasha Gendy, Prem Rashid
BACKGROUND: The common use of cross-sectional imaging for the investigation of abdominal and thoracic illness has resulted in the rise of the incidentally identified adrenal mass, or incidentaloma, which presents a diagnostic and management dilemma for the primary care physician. OBJECTIVE: This article provides a framework for the investigation and management of incidental adrenal masses. DISCUSSION: Adrenal incidentalomas are found in approximately 3-4% of abdominal computed tomography (CT) scans...
June 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28601234/comparison-of-echocardiographic-findings-in-patients-with-nonfunctioning-adrenal-incidentalomas
#3
Narin Nasıroglu Imga, Ozgul Ucar Elalmıs, Mazhar Muslum Tuna, Bercem Aycıcek Dogan, Deniz Sahın, Tugba Gursoy, Yavuz Yalcın, Dilek Berker, Serdar Guler
Adrenal incidentalomas (AIs) are usually discovered incidentally after imaging unrelated to adrenal glands. We aimed to evaluate standard risk factors for systemic atherosclerosis and echocardiographic changes in patients with nonfunctioning AIs and compare them with normal subjects. We evaluated 70 patients diagnosed with AIs and 51 healthy controls. Mean levels were determined for HbA1c, LDL, uric acid, fasting plasma insulin, HOMA, and neutrophil-to-lymphocyte ratio (NLR), and these values were found to be significantly higher in the patients than the controls...
June 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/28585681/glucose-metabolism-disorders-in-patients-with-non-functioning-adrenal-adenomas-single-centre-experience
#4
Katarzyna Krzyżewska, Ewa Niemczuk, Bartosz Jakub Myśliwiec, Roman Junik
INTRODUCTION: The presence of glucose metabolism disorders and their possible correlation with degree of cortisol secretion were evaluated in patients with non-functioning adrenal incidentalomas (NFAIs). MATERIAL AND METHODS: The study group consisted of 131 patients with hormonally inactive adrenal incidentalomas. In each patient, besides hormonal and radiological evaluation, was assessed for fasting glucose and insulin concentrations, and the oral glucose tolerance test (OGTT) was performed in all participants without previous history of glucose disturbances...
June 6, 2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28585593/incidentaloma-from-general-practice-to-specific-endocrine-frame
#5
Ancuta Augustina Gheorghisan-Galateanu, Mara Carsote, Ana Valea
Incidentaloma, a modern concept connected to technology progress, represents an accidentally discovered tumour, usually used for hypophysis and adrenals, and rarely for thyroid, parathyroids, and ovaries. This is a narrative review based on PubMed research, between 2012 and 2016 focusing on general and endocrine approach and current controversies. Main dilemma is the terminology itself: randomly imagery finding is enough or non-functioning profile and low-growth rate (not requiring surgery) should be mandatory? The controversies refers to best time framing of re-scanning pituitary and adrenal incidentaloma and setting of clear criteria for subclinical Cushing's syndrome...
June 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28582552/lower-bone-mass-and-higher-bone-resorption-in-pheochromocytoma-importance-of-sympathetic-activity-on-human-bone
#6
Beom-Jun Kim, Mi Kyung Kwak, Seong Hee Ahn, Hyeonmok Kim, Seung Hun Lee, Kee-Ho Song, Sunghwan Suh, Jae Hyeon Kim, Jung-Min Koh
Context: Despite the apparent biological importance of sympathetic activity on bone metabolism in rodents, its role in humans remains questionable. Objective: To clarify the link between the sympathetic nervous system and the skeleton in humans. Design, Setting, and Patients: Among 620 consecutive subjects with newly diagnosed adrenal incidentaloma, 31 patients with histologically confirmed pheochromocytoma (a catecholamine-secreting neuroendocrine tumor) and 280 patients with nonfunctional adrenal incidentaloma were defined as cases and controls, respectively...
June 5, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28469946/a-normotensive-patient-with-primary-aldosteronism
#7
Xiao Lin, Xiaoyu Miao, Pengli Zhu, Fan Lin
This study was to report a case of normotensive patient with primary aldosteronism who was admitted to our department recently. The patient was a 33-year-old male with right adrenal incidentaloma, but without any symptom. He has no history of hypertension, and blood pressure was normal when measured at multiple time points during hospitalization stay. The 24-hour ambulatory blood pressure prompted a normal blood pressure with the existence of circadian rhythm. The patient was diagnosed with primary aldosteronism by screening and confirmatory test...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28468767/cardiovascular-events-in-patients-with-mild-autonomous-cortisol-secretion-analysis-with-artificial-neural-networks
#8
Valentina Morelli, Serena Palmieri, Andrea Lania, Alberto Tresoldi, Sabrina Corbetta, Elisa Cairoli, Cristina Eller-Vainicher, Maura Arosio, Massimiliano Copetti, Enzo Grossi, Iacopo Chiodini
BACKGROUND: The independent role of mild autonomous cortisol secretion (ACS) in influencing the cardiovascular event (CVE) occurrence is a topic of interest. We investigated the role of mild ACS in the CVE occurrence in patients with adrenal incidentaloma (AI) by standard statistics and artificial neural networks (ANNs). METHODS: We analyzed a retrospective record of 518 AI patients. Data regarding cortisol levels after 1 mg dexamethasone suppression (1 mg DST) and the presence of obesity (OB), hypertension (AH), type-2 diabetes (T2DM), dyslipidemia (DL), familial CVE history, smoking habit and CVE were collected...
July 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28450405/unique-and-novel-urinary-metabolomic-features-in-malignant-versus-benign-adrenal-neoplasms
#9
Dhaval Patel, Matthew D Thompson, Soumen K Manna, Kristopher W Krausz, Lisa Zhang, Naris Nilbuol, Frank J Gonzalez, Electron Kebebew
Purpose: <p>Adrenal incidentalomas must be differentiated from adrenocortical cancer (ACC). Currently, size, growth, and imaging characteristics determine the potential for malignancy but are imperfect. The aim was to evaluate whether urinary small molecules (<800 Da) are associated with ACC.</p> <p>Experimental Design:</p> <p>Preoperative fasting urine specimens from patients with ACC (n=19) and benign adrenal tumors (n=46) were analyzed by unbiased ultra performance liquid chromatography/mass spectrometry...
April 27, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28401898/a-unique-haplotype-of-rccx-copy-number-variation-from-the-clinics-of-congenital-adrenal-hyperplasia-to-evolutionary-genetics
#10
Márton Doleschall, Andrea Luczay, Klára Koncz, Kinga Hadzsiev, Éva Erhardt, Ágnes Szilágyi, Zoltán Doleschall, Krisztina Németh, Dóra Török, Zoltán Prohászka, Balázs Gereben, György Fekete, Edit Gláz, Péter Igaz, Márta Korbonits, Miklós Tóth, Károly Rácz, Attila Patócs
There is a difficulty in the molecular diagnosis of congenital adrenal hyperplasia (CAH) due to the c.955C>T (p.(Q319*), formerly Q318X, rs7755898) variant of the CYP21A2 gene. Therefore, a systematic assessment of the genetic and evolutionary relationships between c.955C>T, CYP21A2 haplotypes and the RCCX copy number variation (CNV) structures, which harbor CYP21A2, was performed. In total, 389 unrelated Hungarian individuals with European ancestry (164 healthy subjects, 125 patients with non-functioning adrenal incidentaloma and 100 patients with classical CAH) as well as 34 adrenocortical tumor specimens were studied using a set of experimental and bioinformatic methods...
June 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/28376845/rare-adrenal-gland-incidentaloma-an-unusual-ewing-s-sarcoma-family-of-tumor-presentation-and-literature-review
#11
Hui Guo, Shuaiqi Chen, Shukun Liu, Kaixuan Wang, Erpeng Liu, Faping Li, Yuchuan Hou
BACKGROUND: Members of the Ewing's sarcoma family of tumor (ESFT) are malignant neoplasms and rarely observed in the adrenal gland. CASE PRESENTATION: We report an extremely exceptional case of ESFT rising from the adrenal gland in a 57-year-old Chinese man. The patient was hospitalized with abdominal swelling for 2 months. Computed tomography (CT) scan revealed a nearly-circular mass measuring about 8.1 × 10.6 cm in the right adrenal region. The patient underwent right adrenal resection...
April 4, 2017: BMC Urology
https://www.readbyqxmd.com/read/28356253/adrenocortical-carcinoma-masquerading-as-cushing-s-disease
#12
Kush Dev Jarial, Rama Walia, Santosh Kumar, Anil Bhansali
Cushing's syndrome (CS) can be classified as adrenocorticotropic hormone (ACTH)-dependent or ACTH-independent depending on the ACTH levels. However, 30% of the patients with CS have ACTH levels in the 'grey zone' (5-20 pg/mL), thereby posing a challenge in establishing the aetiological diagnosis. In a patient with full-blown features of Cushing's syndrome with equivocal ACTH levels, and a pituitary microadenoma on contrast-enhanced MRI sella, can falsely lead to a diagnosis of Cushing's disease. Pituitary microadenoma, if <6 mm in size, may be an incidental finding (incidentaloma) in this scenario and can be present in ∼3-27% of the healthy population...
March 29, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28348073/from-benign-adrenal-incidentaloma-to-adrenocortical-carcinoma-an-exceptional-random-event
#13
Ines Belmihoub, Stephane Silvera, Mathilde Sibony, Bertrand Dousset, Paul Legmann, Xavier Bertagna, Jerome Bertherat, Guillaume Assie
New European guidelines for the management of adrenal incidentalomas were recently released. One of the most novel recommendations is to stop following patients when they present a typical, small and non-secreting adenoma. We report here the case of a 71-year-old man with such an adenoma, who developed an adrenocortical carcinoma (ACC) fourteen years later, with subsequent metastases and death. Clinically he had a normal blood pressure and no sign of hormonal hypersecretion. The hormonal work-up showed no hormone excess: urinary free cortisol level was normal, the diurnal cortisol rhythm was respected and urinary catecholamine metabolites levels were normal...
March 27, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28266298/laparoscopic-partial-adrenalectomy
#14
Adrian Miron, Cosmin Giulea, Mihai Nădrăgea, Octavian Enciu
Laparoscopic adrenalectomy became the gold standard for adrenal disease, from incidentaloma to cancer. Partial adrenalectomy is difficult to accept due to its technical difficulties as well as hemorrhagic risk and a consensus has not been reached. On the other hand, in selected cases of benign adrenal tumors, adrenalectomy may be futile, partial resections being perfectly justified and with lower hemorrhagic risks. For functioning tumors smaller than 3 cm with an anterior or lateral location, partial adrenalectomy may be indicated...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28255974/thyroid-lesions-in-patients-with-acromegaly-case-control-study-and-update-to-the-meta-analysis
#15
Kosma Woliński, Adam Stangierski, Edyta Gurgul, Barbara Bromińska, Agata Czarnywojtek, Martha Lodyga, Marek Ruchała
INTRODUCTION: Acromegaly results from oversecretion of growth hormone and subsequently insulin growth factor-1. According to some authors, the disease can cause increased prevalence of nodular goitre and thyroid cancer (TC). However, the number of studies comparing acromegalic patients with control groups is low. We aimed to assess the prevalence of thyroid lesions in patients with acromegaly in comparison to an age- and sex-matched control group and to update the meta-analysis previously performed in our department by the same authors...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28255146/large-adrenal-leiomyoma-presented-as-adrenal-incidentaloma-in-an-aids-patient-a-rare-entity
#16
T J Huei, H T Lip, M S Rahman, A Sarojah
The literature on adrenal gland tumour in HIV-infected patients is scarce. We report a 46-year-old Malay man with HIV and Hepatitis C infection presenting with a large nonfunctioning adrenal tumour. Computed tomography showed a large right adrenal tumour with heterogeneous enhancement and central necrosis. A high index of suspicion of a malignant tumour or pheochromocytoma led us to surgical removal of the adrenal gland. In this case report, we highlight important features to look for during pre-op evaluation of a large adrenal mass...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28248753/update-on-the-risks-of-benign-adrenocortical-incidentalomas
#17
Guido Di Dalmazi
PURPOSE OF REVIEW: Recent studies highlighted the association between adrenocortical incidentalomas and several comorbidities. This review summarizes the most recent evidence showing the potential risks related to adrenocortical tumors classified as nonfunctioning adrenal incidentalomas (NFAIs) or associated with clinically autonomous cortisol secretion (ACS). RECENT FINDINGS: Alterations in glucose metabolism are a common finding in patients with ACS (30% of the cases)...
June 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28247312/interference-in-acth-immunoassay-negatively-impacts-the-management-of-subclinical-hypercortisolism
#18
Serkan Yener, Leyla Demir, Mustafa Demirpence, Mustafa Mahmut Baris, Ilgin Yildirim Simsir, Secil Ozisik, Abdurrahman Comlekci, Tevfik Demir
PURPOSE: Low plasma corticotropin is considered a useful parameter for the diagnosis of subclinical hypercortisolism in patients with an adrenal incidentaloma. However, immunoassays are vulnerable to interference from endogenous antibodies. In this study, subjects who underwent Hypothalamus-pituitary-adrenal axis evaluation for the assessment of subclinical hypercortisolism were evaluated. The objective of the study was to ascertain whether antibody interference in corticotropin immunoassay affected the diagnostic work-up and clinical decisions...
February 28, 2017: Endocrine
https://www.readbyqxmd.com/read/28247215/first-line-screening-tests-for-cushing-s-syndrome-in-patients-with-adrenal-incidentaloma-the-role-of-urinary-free-cortisol-measured-by-lc-ms-ms
#19
F Ceccato, G Antonelli, A C Frigo, D Regazzo, M Plebani, M Boscaro, C Scaroni
INTRODUCTION AND AIM: Patients with adrenal incidentaloma present a wide range of cortisol secretion, which is not always properly defined by first-line screening tests recommended to rule out Cushing's syndrome (CS), such as 1-mg dexamethasone suppression test (1-mg DST), late night salivary cortisol (LNSC), or 24-h urinary free cortisol (UFC). Therefore, we examined the diagnostic performance of each screening test in patients with adrenal incidentaloma. MATERIALS AND METHODS: In a series of 164 consecutive patients with adrenal incidentaloma, we measured serum cortisol after 1-mg DST, LNSC, and UFC (with LC-MS/MS)...
February 28, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28222025/radiology-of-the-adrenal-incidentalomas-review-of-the-literature
#20
F A Farrugia, G Martikos, C Surgeon, P Tzanetis, E Misiakos, N Zavras, A Charalampopoulos
The term "adrenal incidentaloma" is a radiological term. Adrenal incidentalomas are adrenal tumors discovered in an imaging study that has been obtained for indications exclusive to adrenal conditions (Udelsman 2001; Linos 2003; Bulow et al. 2006; Anagnostis et al. 2009). This definition excludes patients undergoing imaging testing as part of staging and work-up for cancer (Grumbach et al. 2003; Anagnostis et al. 2009). Papierska et al. (2013) have added the prerequisite that the size of a tumor must be "greater than 1cm in diameter", in order to be called incidentaloma...
January 1, 2017: Endocrine Regulations
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