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adrenal incidentalomas

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
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
Nithin Thomas Terence
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
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
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
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
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
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
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
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
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
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
Quan-Yang Duh
No abstract text is available yet for this article.
October 2016: Nature Reviews. Endocrinology
Hasan Erdem, Süleyman Çetinkünar, Faruk Kuyucu, Hakan Erçil, Mustafa Görür, Selim Sözen
OBJECTIVE: The rate of adrenal incidentalomas detected in routine diagnostic imaging techniques is approximately 4-7%. Although the lesions are generally benign, carcinoma and functional adenomas can be diagnosed with careful clinic and laboratory evaluation. MATERIAL AND METHODS: Data of 13 patients who underwent surgery for an adrenal mass between January 2010-June 2014 were analyzed retrospectively. RESULTS: Seven (54%) patients were male, 6 (46%) were female, and the mean age was 38...
2016: Ulusal Cerrahi Dergisi
Sujit Vakkalanka, Andrew Zhao, Mohammed Samannodi
Primary hyperaldosteronism is one of the most common causes of secondary hypertension but clear differentiation between its various subtypes can be a clinical challenge. We report the case of a 37-year-old African-American woman with refractory hypertension who was admitted to our hospital for palpitations, shortness of breath and headache. Her laboratory results showed hypokalaemia and an elevated aldosterone/renin ratio. An abdominal CT scan showed a nodule in the left adrenal gland but adrenal venous sampling showed elevated aldosterone/renin ratio from the right adrenal vein...
2016: BMJ Case Reports
Iacopo Chiodini, Adriana Albani, Alberto Giacinto Ambrogio, Michela Campo, Maria Cristina De Martino, Giorgia Marcelli, Valentina Morelli, Benedetta Zampetti, Annamaria Colao, Rosario Pivonello
Subclinical Cushing's syndrome is a condition of hypercortisolism in the absence of signs specific of overt cortisol excess, and it is associated with an increased risk of diabetes, hypertension, fragility fractures, cardiovascular events and mortality. The subclinical Cushing's syndrome is not rare, being estimated to be between 0.2-2 % in the adult population. Despite the huge number of studies that have been published in the recent years, several issues remain controversial for the subclinical Cushing's syndrome screening, diagnosis and treatment...
July 12, 2016: Endocrine
Martin Fassnacht, Wiebke Arlt, Irina Bancos, Henning Dralle, John Newell-Price, Anju Sahdev, Antoine Tabarin, Massimo Terzolo, Stylianos Tsagarakis, Olaf M Dekkers
: By definition, an adrenal incidentaloma is an asymptomatic adrenal mass detected on imaging not performed for suspected adrenal disease. In most cases, adrenal incidentalomas are nonfunctioning adrenocortical adenomas, but may also represent conditions requiring therapeutic intervention (e.g. adrenocortical carcinoma, pheochromocytoma, hormone-producing adenoma or metastasis). The purpose of this guideline is to provide clinicians with best possible evidence-based recommendations for clinical management of patients with adrenal incidentalomas based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system...
August 2016: European Journal of Endocrinology
Guido Di Dalmazi
No abstract text is available yet for this article.
September 2016: Endocrine
Márcio Carlos Machado, Maria Candida Barisson Vilares Fragoso, Ayrton Custódio Moreira, César Luiz Boguszewski, Leonardo Vieira, Luciana A Naves, Lucio Vilar, Luiz Antônio de Araújo, Mauro A Czepielewski, Monica R Gadelha, Nina Rosa Castro Musolino, Paulo Augusto C Miranda, Marcello Delano Bronstein, Antônio Ribeiro-Oliveira
Although it is a rare condition, the accurate diagnosis and treatment of Cushing's disease is important due to its higher morbidity and mortality compared to the general population, which is attributed to cardiovascular diseases, diabetes mellitus and infections. Screening for hypercortisolism is recommended for patients who present multiple and progressive clinical signs and symptoms, especially those who are considered to be more specific to Cushing's syndrome, abnormal findings relative to age (e.g., spinal osteoporosis and high blood pressure in young patients), weight gain associated with reduced growth rate in the pediatric population and for those with adrenal incidentalomas...
June 2016: Archives of Endocrinology and Metabolism
Seung Hun Lee, Kee-Ho Song, Jinju Kim, Sooyoun Park, Seong Hee Ahn, Hyeonmok Kim, Yoon Young Cho, Sunghwan Suh, Beom-Jun Kim, Jae Hyeon Kim, Jung-Min Koh
OBJECTIVE: There is no consensus on the biochemical diagnostic criteria for subclinical hypercortisolism (SH). Using parameters related to the hypothalamic-pituitary-adrenal axis, we aimed to develop a diagnostic model of SH for predicting postsurgical hypocortisolism and metabolic complications. DESIGN: Prospective and cross-sectional, observational, multicentre study in Korea. METHODS: After exclusion of overt Cushing's syndrome, adrenal incidentaloma (AI) patients who underwent unilateral adrenalectomy (n = 99) and AI patients (n = 843) were included...
June 24, 2016: Clinical Endocrinology
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