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adrenal incidentalomas

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https://www.readbyqxmd.com/read/28222025/radiology-of-the-adrenal-incidentalomas-review-of-the-literature
#1
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
https://www.readbyqxmd.com/read/28187478/-adrenal-incidentaloma-what-to-do-and-what-not
#2
Martin Fassnacht
No abstract text is available yet for this article.
February 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28181818/recommendations-for-the-management-of-adrenal-incidentalomas-what-is-pertinent-for-radiologists
#3
Anju Sahdev
Adrenal incidentalomas are unsuspected, asymptomatic adrenal masses detected on imaging. Most are non-functioning benign adrenocortical adenomas, but can represent other benign lesions or lesions requiring therapeutic intervention including adrenocortical carcinoma, pheochromocytoma, hormone-producing adenoma or metastasis. This review summarises and highlights radiological recommendations within the recently issued guidelines for the management of adrenal incidentalomas from European Society of Endocrinology Clinical Practice in collaboration with European Network for Study of Adrenal Tumours...
February 9, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28146078/metabolomic-biomarkers-in-urine-of-cushing-s-syndrome-patients
#4
Alicja Kotłowska, Tomasz Puzyn, Krzysztof Sworczak, Piotr Stepnowski, Piotr Szefer
Cushing's syndrome (CS) is a disease which results from excessive levels of cortisol in the human body. The disorder is associated with various signs and symptoms which are also common for the general population not suffering from compound hypersecretion. Thus, more sensitive and selective methods are required for the diagnosis of CS. This follow-up study was conducted to determine which steroid metabolites could serve as potential indicators of CS and possible subclinical hypercortisolism in patients diagnosed with so called non-functioning adrenal incidentalomas (AIs)...
January 29, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28138953/clinical-benefits-of-unilateral-adrenalectomy-in-patients-with-subclinical-hypercortisolism-due-to-adrenal-incidentaloma-results-from-a-single-center
#5
Luigi Petramala, Giuseppe Cavallaro, Matteo Galassi, Cristiano Marinelli, Gianfranco Tonnarini, Antonio Concistrè, Umberto Costi, Maurizio Bufi, Piernatale Lucia, Giuseppe De Vincentis, Gino Iannucci, Giorgio De Toma, Claudio Letizia
INTRODUCTION: This study was designed to evaluate the results of unilateral laparoscopic adrenalectomy in patients with subclinical hypercortisolism (SH) due to adrenal incidentaloma (AI) concerning the main cardiometabolic disorders. METHODS: We have studied between January 2000 to December 2015, 645 patients with AI (283 males and 362 females; mean age 61.9 ± 10 years) and we found 70 patients with SH (27 males and 43 females; mean age 61.9 ± 8.4 years)...
March 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28127186/management-of-adrenal-masses
#6
REVIEW
Hattangadi Sanjay Bhat, Balagopal Nair Tiyadath
An adrenal mass can be either symptomatic or asymptomatic in the form of adrenal incidentalomas (AIs) in up to 8 % in autopsy and 4 % in imaging series. Once a diagnosis of adrenal mass is made, we need to differentiate whether it is functioning or nonfunctioning, benign, or malignant. In this article, we provide a literature review of the diagnostic workup including biochemical evaluation and imaging characteristics of the different pathologies. We also discuss the surgical strategies with laparoscopy as the mainstay with partial adrenalectomy in select cases and adrenalectomy in large masses...
March 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28118677/predicting-malignancy-in-adrenal-incidentaloma-and-evaluation-of-a-novel-risk-stratification-algorithm
#7
Elizabeth Foo, Robin Turner, Kuan-Chi Wang, Adam Aniss, Anthony J Gill, Stanley Sidhu, Roderick Clifton-Bligh, Mark Sywak
BACKGROUND: Incidentally discovered adrenal lesions known as adrenal incidentalomas (AI) are being encountered with increasing frequency due to the widespread use of abdominal computed tomography (CT). The aim of this study was to identify the clinical predictors of malignancy in AI and to evaluate the accuracy of a recently proposed risk stratification algorithm. METHODS: A retrospective analysis of 96 patients presenting with AI between 2004 and 2014 was undertaken; 66 patients underwent adrenalectomy, and 30 were managed non-operatively...
January 24, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28081522/adrenal-giant-cystic-pheochromocytoma-treated-by-posterior-retroperitoneoscopic-adrenalectomy
#8
Carlos E Costa Almeida, Marta Silva, Luis Carvalho, Carlos Manuel Costa Almeida
INTRODUCTION: Giant cystic pheochromocytoma (>10cm) is rare with only a few cases described in the literature. Preoperative diagnosis is very difficult because clinical, biochemical and radiologic finds are usually not consistent with a pheochromocytoma. Open surgery is traditionally the gold standard. CASE PRESENTATION: A 51 year-old male patient resorted to surgery department with an adrenal cystic incidentaloma. He was asymptomatic, mild hypertension easily controlled, with increased plasma fractionated metanephrines...
December 27, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28057157/-clinical-features-and-outcomes-of-congenital-adrenal-hyperplasia-with-adenomatoid-adrenal-gland
#9
Y L Gu, W J Gu, J T Dou, L Zang, J Du, G Q Yang, L J Yang, J M Ba, Z H Lü, Y M Mu, J M Lu
Objective: To analyze the clinical features and outcomes of congenital adrenal hyperplasia (CAH) with adenomatoid adrenal gland. Methods: Nineteen patients clinically confirmed as CAH with adenomatoid adrenal gland, from 2008 to 2015 in Deparment of Endocrinology of Chinese PLA General Hospital, were retrospectively analyzed, and the outcomes of the treatment were followed up. Results: Seventy-six patients were clinically confirmed as CAH, from 2008 to 2015 in PLA hospital. Nineteen of them have accompanied with adenomatoid adrenal gland...
December 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27992961/concomitant-alterations-of-metabolic-parameters-cardiovascular-risk-factors-and-altered-cortisol-secretion-in-patients-with-adrenal-incidentalomas-during-prolonged-follow-up
#10
Labrini Papanastasiou, Krystallenia Ι Alexandraki, Ioannis I Androulakis, Stelios Fountoulakis, Theodora Kounadi, Athina Markou, Vaios Tsiavos, Christianna Samara, Theodoros G Papaioannou, George Piaditis, Gregory Kaltsas
OBJECTIVE: Adrenal incidentalomas (AI) are associated with metabolic and hormonal abnormalities, most commonly autonomous cortisol secretion (ACS). Data regarding alterations of insulin resistance (IR), and ACS after prolonged follow-up are limited. We investigated the evolution of IR, cortisol secretion and ACS development in patients with AI during prolonged follow-up. DESIGN: Prospective study in a tertiary hospital. PATIENTS AND MEASUREMENTS: Seventy-one patients with AI, (51 non-functioning [NFAI], 20 ACS), and 5...
December 19, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27942264/the-relationship-between-increased-epicardial-fat-thickness-and-left-ventricular-hypertrophy-and-carotid-intima-media-thickness-in-patients-with-nonfunctional-adrenal-incidentaloma
#11
Nasiroglu Narin Imga, Ozgul Ucar Elalmis, Mazhar Muslum Tuna, Bercem Aycıcek Dogan, Deniz Sahin, Dilek Berker, Serdar Guler
BACKGROUND: Emerging evidences indicate that patients diagnosed with Adrenal Incidentaloma (AI) may present cardiovascular complications. Epicardial fat thickness (EFT) has recently been described as a new risk factor and an active player in metabolic syndrome and cardiovascular disease. OBJECTIVES: We aimed to evaluate the relationship between EFT and left ventricular hypertrophy and carotid intima-media thickness, which are both strong predictors of cardiovascular morbity and mortality, in patients with nonfunctioning AI...
July 2016: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27869719/targeted-molecular-imaging-in-adrenal-disease-an-emerging-role-for-metomidate-pet-ct
#12
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
#13
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
#14
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
#15
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
#16
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/pheochromocytomas-are-diagnosed-incidentally-and-at-older-age-in-neurofibromatosis-type-1
#17
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 pheochromocytoma (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 characterize and compare parameters of PHEO in patients with NF1 to patients with or without other germline mutations. METHODS: A retrospective chart review of patients with histologically proven PHEO at the Centre hospitalier de l'Université de Montréal from 2000 through 2015...
March 2017: 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
#18
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
#19
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
#20
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
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