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1. Yu R, Furmark L, Wong C: Cardiac abnormalities associated with pheochromocytoma and other adrenal tumors. Endocr Pract; 2009 Jan-Feb;15(1):10-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cardiac abnormalities associated with pheochromocytoma and other adrenal tumors.
  • METHODS: In this case-control study, we reviewed pathology records of patients seen at Cedars-Sinai Medical Center between 1997 and 2007; patients with adrenal or extra-adrenal pheochromocytoma and those with nonfunctioning benign or malignant adrenal tumors were identified.
  • Patients with functioning adrenal adenomas that secreted cortisol or aldosterone were excluded.
  • Clinical history, imaging, pathology, biochemical test results, electrocardiographic findings, and echocardiographic findings were compared between patients with pheochromocytoma and patients with nonfunctioning adrenal tumors.
  • RESULTS: The charts of 22 patients with pheochromocytoma and 35 patients with nonfunctioning adrenal tumors were included.
  • The average age of patients with pheochromocytoma was similar to that of control patients (51.9 +/- 3.9 years vs 60.2 +/- 2.5 years, respectively), as was the number of patients with known cardiovascular diseases (2 [9%] in the pheochromocytoma group vs 5 [14%] in the control group).
  • Coronary artery disease should be excluded in patients with significant ST-T changes.
  • [MeSH-major] Adrenal Gland Neoplasms / complications. Adrenal Gland Neoplasms / physiopathology. Heart / physiopathology. Pheochromocytoma / complications. Pheochromocytoma / physiopathology
  • [MeSH-minor] Cardiovascular Diseases / etiology. Cardiovascular Diseases / physiopathology. Case-Control Studies. Echocardiography. Electrocardiography. Female. Humans. Male. Middle Aged. Norepinephrine / blood. Normetanephrine / blood. Retrospective Studies. Ventricular Dysfunction, Left / etiology. Ventricular Dysfunction, Left / physiopathology

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  • (PMID = 19211391.001).
  • [ISSN] 1934-2403
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0J45DE6B88 / Normetanephrine; X4W3ENH1CV / Norepinephrine
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2. Ignaszak-Szczepaniak M, Horst-Sikorska W, Sawicka J, Kaczmarek M, Slomski R: The TP53 codon 72 polymorphism and predisposition to adrenocortical cancer in Polish patients. Oncol Rep; 2006 Jul;16(1):65-71
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  • [Title] The TP53 codon 72 polymorphism and predisposition to adrenocortical cancer in Polish patients.
  • We have analyzed the 72Pro polymorphic variant in patients with adrenocortical tumors to evaluate whether 72G--> C substitution at codon 72 of TP53 gene may be associated with increased risk for malignancy in adrenal cortex in comparison to the control group.
  • DNA extracted from peripheral leucocytes of 46 Polish patients with adrenocortical tumors (17 malignant and 29 benign) and 50 controls was examined by PCR-HD method followed by direct sequencing.
  • TP53 polymorphism in codon 72 was found in 47% of ACC cases, in 28% of patients with adenomas and in 24% of controls.
  • The genotype Arg/Arg, Arg/Pro and Pro/Pro distribution was respectively 53%/35%/12% for cancers, 72%/28%/0% for benign tumors and 76%/24%/0% for controls.
  • High frequency of 72Pro allele in patients with carcinoma (29%) in comparison to the benign tumors (14%) and controls (12%) was statistically analyzed.
  • Our results suggest that the TP53 codon 72 polymorphism could be associated with susceptibility for adrenocortical cancer in the examined Polish patients.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Genetic Predisposition to Disease. Polymorphism, Genetic. Tumor Suppressor Protein p53 / genetics

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  • (PMID = 16786124.001).
  • [ISSN] 1021-335X
  • [Journal-full-title] Oncology reports
  • [ISO-abbreviation] Oncol. Rep.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Codon; 0 / TP53 protein, human; 0 / Tumor Suppressor Protein p53
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3. Lacroix A, Bourdeau I, Lampron A, Mazzuco TL, Tremblay J, Hamet P: Aberrant G-protein coupled receptor expression in relation to adrenocortical overfunction. Clin Endocrinol (Oxf); 2010 Jul;73(1):1-15
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  • [Title] Aberrant G-protein coupled receptor expression in relation to adrenocortical overfunction.
  • The aberrant adrenal expression and function of one or several G-protein coupled receptors can lead to cell proliferation and abnormal regulation of steroidogenesis in unilateral adenomas, carcinomas or in ACTH-independent macronodular adrenal hyperplasia (AIMAH).
  • In recent years, cases of familial AIMAH have been identified, and specific aberrant hormone receptors are functional in the adrenal of affected members.
  • The identification of aberrant receptors can offer specific pharmacological approach to prevent disease progression and control abnormal steroidogenesis; alternatively, unilateral or bilateral adrenalectomy remains the treatment of choice.
  • [MeSH-minor] Adrenal Gland Neoplasms / physiopathology. Adrenal Glands / metabolism. Adrenalectomy. Adrenocorticotropic Hormone / physiology. Angiotensins / physiology. Animals. Catecholamines / physiology. Chorionic Gonadotropin / physiology. Gastric Inhibitory Polypeptide / physiology. Humans. Hydrocortisone / metabolism. Hyperaldosteronism / physiopathology. Hyperplasia / metabolism. Luteinizing Hormone / physiology. Serotonin / physiology

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  • (PMID = 19719763.001).
  • [ISSN] 1365-2265
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Angiotensins; 0 / Catecholamines; 0 / Chorionic Gonadotropin; 0 / Receptors, G-Protein-Coupled; 333DO1RDJY / Serotonin; 59392-49-3 / Gastric Inhibitory Polypeptide; 9002-60-2 / Adrenocorticotropic Hormone; 9002-67-9 / Luteinizing Hormone; WI4X0X7BPJ / Hydrocortisone
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4. Vesin C, Chabre O, Mallion JM, Chaffanjon P, Sturm N, Baguet JP: [Diagnosis and post-operative evolution of patients operated for adrenal adenoma (Conn syndrome). A 12-years retrospective study]. Arch Mal Coeur Vaiss; 2007 Feb;100(2):121-5
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  • [Title] [Diagnosis and post-operative evolution of patients operated for adrenal adenoma (Conn syndrome). A 12-years retrospective study].
  • [Transliterated title] Diagnostic et évolution postopératoire des patients opérés d'un adénome de Conn. Etude rétrospective sur 12 ans.
  • The prevalence and characteristics of patients operated for adrenal adenoma (Conn syndrome) as well as their post-operative arterial pressure evolution are varying through literature.
  • From 1993 to 2005, 24 patients (mean age = 46 +/-11 years) presented the biological criteria of primary hyperaldosteronism and benefited from adrenalectomy with confirmation of adrenal adenoma.
  • All adenomas measured more than 10 mm in scanner imaging.
  • Post-operative spontaneous normotensive patients had, at the diagnosis of adrenal adenoma, a more recent and non-refractory hypertension, with a lower number of antihypertensive drugs, a better response to spirinolactone and higher aldosterone plasmatic levels.
  • 1) Whether 70% of patients operated for adrenal adenoma are normotensive (with or without treatement) post-operatively, only 25% are definitely cured after 4 years.
  • Factors associated to a post-operative cure highlight the interest of an ealy diagnosis.
  • 2) There is probably an underdiagnosis of adrenal adenoma (Conn syndrome) because neither adenomas with normokaliemia, nor adenomas <10 mm in scanner imaging have ever been diagnosed or at least, sent to surgery.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / surgery. Adrenocortical Adenoma / diagnosis. Adrenocortical Adenoma / surgery

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  • (PMID = 17474497.001).
  • [ISSN] 0003-9683
  • [Journal-full-title] Archives des maladies du coeur et des vaisseaux
  • [ISO-abbreviation] Arch Mal Coeur Vaiss
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
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5. Heyerdahl SL, Boikos S, Horvath A, Giatzakis C, Bossis I, Stratakis CA: Protein kinase A subunit expression is altered in Bloom syndrome fibroblasts and the BLM protein is increased in adrenocortical hyperplasias: inverse findings for BLM and PRKAR1A. Horm Metab Res; 2008 Jun;40(6):391-7
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  • [Title] Protein kinase A subunit expression is altered in Bloom syndrome fibroblasts and the BLM protein is increased in adrenocortical hyperplasias: inverse findings for BLM and PRKAR1A.
  • Bloom syndrome is a genetic disorder associated with chromosomal instability and a predisposition to tumors that is caused by germline mutations of the BLM gene, a RecQ helicase.
  • Benign adrenocortical tumors display a degree of chromosomal instability that is more significant than benign tumors of other tissues.
  • Cortisol-producing hyperplasias, such as primary pigmented nodular adrenocortical disease (PPNAD), which has been associated with protein kinase A (PKA) abnormalities and/or PRKAR1A mutations, also show genomic instability.
  • In this study, we have investigated the PRKAR1A expression in primary human Bloom syndrome cell lines with known BLM mutations and examined the BLM gene expression in PPNAD and other adrenal tumor tissues.
  • PRKAR1A and other protein kinase A (PKA) subunits were expressed in Bloom syndrome cells and their level of expression differed by subunit and cell type.
  • Overall, fibroblasts exhibited a significant decrease in protein expression of all PKA subunits except for PRKAR1A, a pattern that has been associated with neoplastic transformation in several cell types.
  • The BLM protein was upregulated in PPNAD and other hyperplasias, compared to samples from normal adrenals and normal cortex, as well as samples from cortisol- and aldosterone-producing adenomas (in which BLM was largely absent).
  • These data reveal an inverse relationship between BLM and PRKAR1A: BLM deficiency is associated with a relative excess of PRKAR1A in fibroblasts compared to other PKA subunits; and PRKAR1A deficiency is associated with increased BLM protein in adrenal hyperplasias.
  • [MeSH-major] Adrenal Cortex Diseases / metabolism. Bloom Syndrome / metabolism. Cyclic AMP-Dependent Protein Kinase RIalpha Subunit / metabolism. DNA Helicases / metabolism. Fibroblasts / metabolism
  • [MeSH-minor] Adrenal Cortex Neoplasms / genetics. Adrenal Cortex Neoplasms / metabolism. Adrenal Cortex Neoplasms / pathology. Adrenal Glands / metabolism. Adrenal Glands / pathology. Cell Line. Gene Expression Regulation. Humans. Hyperplasia. Immunohistochemistry. Pigmentation Disorders / complications. Pigmentation Disorders / genetics. Pigmentation Disorders / metabolism. Pigmentation Disorders / pathology. RNA, Messenger / analysis. RecQ Helicases

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  • (PMID = 18401830.001).
  • [ISSN] 0018-5043
  • [Journal-full-title] Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et métabolisme
  • [ISO-abbreviation] Horm. Metab. Res.
  • [Language] eng
  • [Grant] United States / Intramural NIH HHS / /
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Cyclic AMP-Dependent Protein Kinase RIalpha Subunit; 0 / PRKAR1A protein, human; 0 / RNA, Messenger; EC 3.6.1.- / Bloom syndrome protein; EC 3.6.4.- / DNA Helicases; EC 3.6.4.12 / RecQ Helicases
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6. Ong K, Tan KB, Putti TC: Myelolipoma within a non-functional adrenal cortical adenoma. Singapore Med J; 2007 Jul;48(7):e200-2
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  • [Title] Myelolipoma within a non-functional adrenal cortical adenoma.
  • Myelolipoma within an adrenal cortical adenoma is a very rare cause of adrenal incidentaloma, and only nine cases have been reported in the English and Japanese literature.
  • Clinical history, physical examination and laboratory results did not show any evidence to suggest metabolic disorder such as Cushing's syndrome, hyperaldosteronism or catecholamine hypersecretion.
  • The patient underwent a left adrenalectomy, and a histopathological study confirmed the mass to be a non-functional adrenal cortical adenoma containing myelolipoma.
  • To the best of our knowledge, this is the first non-functional adrenal cortical adenoma reported; in the nine cases of myelolipoma within an adrenal cortical adenoma reported previously, all the patients had Cushing's syndrome.
  • The literature on synchronous myelolipoma with adrenal adenoma, and myelolipoma within functional adrenal adenoma, is reviewed.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology. Adrenocortical Adenoma / pathology. Myelolipoma / pathology

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  • (PMID = 17609815.001).
  • [ISSN] 0037-5675
  • [Journal-full-title] Singapore medical journal
  • [ISO-abbreviation] Singapore Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Singapore
  • [Number-of-references] 11
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7. Pieterman CR, Schreinemakers JM, Koppeschaar HP, Vriens MR, Rinkes IH, Zonnenberg BA, van der Luijt RB, Valk GD: Multiple endocrine neoplasia type 1 (MEN1): its manifestations and effect of genetic screening on clinical outcome. Clin Endocrinol (Oxf); 2009 Apr;70(4):575-81
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  • Patients are divided into two groups: patients with a (i) clinical MEN1 diagnosis and (ii) MEN1 diagnosis by genetic screening.
  • RESULTS: A total of 74 patients was included (median follow-up 5.5 year); 78% had hyperparathyroidism, 46% a pancreatic neuro-endocrine tumour (NET), 38% a pituitary abnormality, 8% a NET of other origin and 16% an adrenal adenoma at the end of follow-up.
  • Compared with patients identified by genetic screening, patients with a clinical MEN1 diagnosis had significantly more manifestations at diagnosis (P < 0.001) and at end of follow-up (P = 0.002).
  • Eleven of 30 patients with a genetic MEN1 diagnosis (mean age at diagnosis 30.0 years) already had manifestations at diagnosis.
  • Genetic diagnosis is associated with less morbidity at diagnosis and at follow-up.
  • Early genetic diagnosis might therefore lead to improvement of long-term outcome.
  • [MeSH-major] Genetic Testing. Multiple Endocrine Neoplasia Type 1 / diagnosis. Multiple Endocrine Neoplasia Type 1 / genetics
  • [MeSH-minor] Adenoma / diagnosis. Adenoma / genetics. Adolescent. Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / genetics. Adult. Aged. Child. Cohort Studies. Female. Follow-Up Studies. Humans. Hyperparathyroidism / diagnosis. Hyperparathyroidism / genetics. Male. Middle Aged. Neuroendocrine Tumors / diagnosis. Neuroendocrine Tumors / genetics. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / genetics. Prognosis. Retrospective Studies. Young Adult


8. Trimeche Ajmi S, Marmouch H, Trabelsi A, Ben Abdelkrim S, Chadli Chaieb M, Ach K, Maaroufi A, Chaieb L: Retroperitonial liposarcoma mimicking pheochromocytoma. Pathologica; 2008 Dec;100(6):470-2
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  • The authors report the case of a 46-year-old woman who presented with a 4 month history of paroxystic and recent hypertension accompagned by headaches, tachycardia and sweating.
  • Magnetic resonance imaging showed an 11 cm x 8.5 cm retroperitoneal mass with an enhanced signal in T2, a hypotrophic non-functional left kidney and no adrenal adenoma.
  • Clinical and hormonal features suggested a diagnosis of pheochromocytoma.
  • Pathologic examination revealed a well-differentiated liposarcoma, without any pheochromocytoma component, and left adrenal hyperplasia.
  • [MeSH-major] Kidney Neoplasms / diagnosis. Liposarcoma / diagnosis
  • [MeSH-minor] Adrenal Cortex / pathology. Adrenal Medulla / pathology. Adrenalectomy. Adrenocortical Hyperfunction / etiology. Anorexia / etiology. Cushing Syndrome / etiology. Female. Flushing / etiology. Humans. Hyperaldosteronism / etiology. Hyperplasia. Hypertension / etiology. Hypokalemia / etiology. Magnetic Resonance Imaging. Middle Aged. Nephrectomy. Pheochromocytoma / diagnosis


9. Owecki M, Majewska KA, Stawny B, Nikisch E, Drews M, Sowiński J: [Adrenal tumours in a selected 10-years surgical material]. Pol Merkur Lekarski; 2006 Jun;20(120):678-81
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  • [Title] [Adrenal tumours in a selected 10-years surgical material].
  • [Transliterated title] Guzy nadnerczy w wybranym 10-letnim materiale operacyjnym.
  • The aim of the study was to analyze the number and proportions of different adrenal tumours resected during the last 10 years in our centre.
  • In 45 (65.22%) cases the right adrenal was affected, in 21 (30.43%)--the left, in 3 (4.35%)--both.
  • RESULTS: 12 adrenocortical cancers, 20 phaeochromocytomas, 9 cortisol-secreting adenomas, 4 aldosteronomas, 18 hormonally inactive adenomas, 6 miscellaneous tumours were found.
  • Malignant tumours where significantly larger than benign (12.20 +/- 6.81 vs 6.71 +/- 5.62 cm, p < 0.005).
  • Most tumours where found in the right adrenal.
  • The malignant tumours where larger than benign ones.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery

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  • (PMID = 17007266.001).
  • [ISSN] 1426-9686
  • [Journal-full-title] Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
  • [ISO-abbreviation] Pol. Merkur. Lekarski
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
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10. Nakamura M, Miki Y, Akahira J, Morimoto R, Satoh F, Ishidoya S, Arai Y, Suzuki T, Hayashi Y, Sasano H: An analysis of potential surrogate markers of target-specific therapy in archival materials of adrenocortical carcinoma. Endocr Pathol; 2009;20(1):17-23
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  • [Title] An analysis of potential surrogate markers of target-specific therapy in archival materials of adrenocortical carcinoma.
  • Adrenocortical carcinoma (ACC) is a rare neoplasm but some of the cases are highly malignant.
  • Therefore, we evaluated expression of potential surrogate markers using immunohistochemistry in archival materials of adrenocortical carcinoma in order to explore the potential application of target specific therapies in ACC in this study.
  • We immunolocalized ten established or potential surrogate markers of target-specific therapies, located in the Ras/extracellular signal-regulated kinase and phosphatidylinositol-3 kinase/Akt pathways, in 41 ACC cases, 54 adrenocortical adenoma (ACA) cases, and five nonpathological adrenal glands and correlated the findings with clinicopathological factors of the patients.
  • [MeSH-major] Adrenal Cortex Neoplasms / metabolism. Adrenocortical Carcinoma / metabolism. Biomarkers, Tumor / analysis. Receptor, Epidermal Growth Factor / biosynthesis
  • [MeSH-minor] Adolescent. Adrenocortical Adenoma. Adult. Aged. Child. Child, Preschool. Extracellular Signal-Regulated MAP Kinases / metabolism. Female. Humans. Immunohistochemistry. Infant. Male. Middle Aged. Phosphatidylinositol 3-Kinases / metabolism. Proto-Oncogene Proteins c-akt / metabolism. Signal Transduction / physiology

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  • (PMID = 19184558.001).
  • [ISSN] 1046-3976
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; EC 2.7.1.- / Phosphatidylinositol 3-Kinases; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; EC 2.7.11.1 / Proto-Oncogene Proteins c-akt; EC 2.7.11.24 / Extracellular Signal-Regulated MAP Kinases
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11. West AN, Neale GA, Pounds S, Figueredo BC, Rodriguez Galindo C, Pianovski MA, Oliveira Filho AG, Malkin D, Lalli E, Ribeiro R, Zambetti GP: Gene expression profiling of childhood adrenocortical tumors. Cancer Res; 2007 Jan 15;67(2):600-8
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  • [Title] Gene expression profiling of childhood adrenocortical tumors.
  • Pediatric adrenocortical tumors (ACT) are rare and often fatal malignancies; little is known regarding their etiology and biology.
  • To provide additional insight into the nature of ACT, we determined the gene expression profiles of 24 pediatric tumors (five adenomas, 18 carcinomas, and one undetermined) and seven normal adrenal glands.
  • Distinct patterns of gene expression, validated by quantitative real-time PCR and Western blot analysis, were identified that distinguish normal adrenal cortex from tumor.
  • Differences in gene expression were also identified between adrenocortical adenomas and carcinomas.
  • In addition, pediatric adrenocortical carcinomas were found to share similar patterns of gene expression when compared with those published for adult ACT.
  • Our findings lay the groundwork for establishing gene expression profiles that may aid in the diagnosis and prognosis of pediatric ACT, and in the identification of signaling pathways that contribute to this disease.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Adrenocortical Adenoma / genetics. Adrenocortical Carcinoma / genetics

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  • (PMID = 17234769.001).
  • [ISSN] 0008-5472
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA21765; United States / NCI NIH HHS / CA / CA63230; United States / NCI NIH HHS / CA / CA71907
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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12. Danilovic DL, Freire DS, Paraíba DB, Brandão Neto RA, Lucon AM, Pereira MA: [Primary aldosteronism caused by aldosteronoma: problems in the etiologic diagnosis]. Arq Bras Endocrinol Metabol; 2007 Apr;51(3):478-87
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  • [Title] [Primary aldosteronism caused by aldosteronoma: problems in the etiologic diagnosis].
  • We present a case of PA caused by an aldosteronoma associated with a contralateral nonfunctioning adrenal adenoma, which resulted in difficulties in the final diagnosis.
  • We discuss the most appropriated tests to screen, confirm the diagnosis of PA and define the etiology of the disorder, especially the adrenal veins sampling to distinguish the aldosteronoma and idiopathic hyperaldosteronism and to guide successful treatment.
  • [MeSH-major] Adenoma / diagnosis. Adrenal Cortex Neoplasms / diagnosis. Adrenocortical Adenoma / diagnosis. Hyperaldosteronism / diagnosis
  • [MeSH-minor] Aldosterone / blood. Diagnosis, Differential. Female. Humans. Hypertension / complications. Middle Aged. Renin / blood. Tomography, X-Ray Computed

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  • (PMID = 17546249.001).
  • [ISSN] 0004-2730
  • [Journal-full-title] Arquivos brasileiros de endocrinologia e metabologia
  • [ISO-abbreviation] Arq Bras Endocrinol Metabol
  • [Language] por
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Brazil
  • [Chemical-registry-number] 4964P6T9RB / Aldosterone; EC 3.4.23.15 / Renin
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13. Lumachi F, Borsato S, Tregnaghi A, Marino F, Fassina A, Zucchetta P, Marzola MC, Cecchin D, Bui F, Iacobone M, Favia G: High risk of malignancy in patients with incidentally discovered adrenal masses: accuracy of adrenal imaging and image-guided fine-needle aspiration cytology. Tumori; 2007 May-Jun;93(3):269-74
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  • [Title] High risk of malignancy in patients with incidentally discovered adrenal masses: accuracy of adrenal imaging and image-guided fine-needle aspiration cytology.
  • AIMS AND BACKGROUND: The incidental finding of nonfunctioning adrenal masses (incidentalomas) is common, but no reliable criteria in differentiating between benign and malignant adrenal masses have been defined.
  • The aim of this preliminary study was to assess the usefulness of adrenal imaging and image-guided fine-needle aspiration cytology in patients with nonfunctioning adrenal incidentalomas with the aim of excluding or confirming malignancy before surgery.
  • METHODS: Forty-two consecutive patients (18 men and 24 women; median age, 54 years; range, 25-75 years) with incidentally discovered adrenal masses of 3 cm or more in the greatest diameter were prospectively enrolled in the study.
  • RESULTS: The revised final pathology showed 30 (71.4%) benign (26 adrenocortical adenomas, of which 3 were atypical, 2 ganglioneuromas, and 2 nonfunctioning benign pheochromocytomas) and 12 (28.6%, 95% CI = 15-42) adrenal malignancies (8 adrenocortical carcinomas and 4 unsuspected adrenal metastases).
  • The definitive diagnosis of adrenocortical carcinoma was made according to Weiss criteria and confirmed on the basis of local invasion at surgery or metastases.
  • CONCLUSIONS: With the aim of selecting for surgery patients with a non-functioning adrenal incidentaloma of 3 cm or more in diameter, the combination of magnetic resonance imaging and fine-needle aspiration cytology should be considered the strategy of choice.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Biopsy, Fine-Needle. Incidental Findings. Magnetic Resonance Imaging
  • [MeSH-minor] 19-Iodocholesterol / analogs & derivatives. Adrenal Gland Diseases / diagnosis. Adrenal Gland Diseases / diagnostic imaging. Adrenal Gland Diseases / metabolism. Adrenal Gland Diseases / pathology. Adrenal Gland Diseases / surgery. Adrenalectomy. Adrenocortical Adenoma / diagnosis. Adrenocortical Adenoma / diagnostic imaging. Adrenocortical Adenoma / metabolism. Adrenocortical Adenoma / pathology. Adrenocortical Adenoma / surgery. Adrenocortical Carcinoma / diagnosis. Adrenocortical Carcinoma / diagnostic imaging. Adrenocortical Carcinoma / metabolism. Adrenocortical Carcinoma / pathology. Adrenocortical Carcinoma / surgery. Adult. Aged. Aldosterone / blood. Epinephrine / urine. Female. Ganglioneuroma / diagnosis. Ganglioneuroma / diagnostic imaging. Ganglioneuroma / metabolism. Ganglioneuroma / pathology. Ganglioneuroma / surgery. Humans. Hydrocortisone / blood. Iodine Radioisotopes. Laparoscopy. Male. Middle Aged. Norepinephrine / urine. Pheochromocytoma / diagnosis. Pheochromocytoma / diagnostic imaging. Pheochromocytoma / metabolism. Pheochromocytoma / pathology. Pheochromocytoma / surgery. Predictive Value of Tests. Prospective Studies. Radiography, Abdominal. Renin / blood. Sensitivity and Specificity. Tomography, X-Ray Computed

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  • (PMID = 17679462.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; 30461-91-7 / 19-Iodocholesterol; 4964P6T9RB / Aldosterone; 6B3QJ94C7P / 6-iodomethylcholesterol; EC 3.4.23.15 / Renin; WI4X0X7BPJ / Hydrocortisone; X4W3ENH1CV / Norepinephrine; YKH834O4BH / Epinephrine
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14. Fukuda T, Takahashi K, Suzuki T, Saruta M, Watanabe M, Nakata T, Sasano H: Urocortin 1, urocortin 3/stresscopin, and corticotropin-releasing factor receptors in human adrenal and its disorders. J Clin Endocrinol Metab; 2005 Aug;90(8):4671-8
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  • [Title] Urocortin 1, urocortin 3/stresscopin, and corticotropin-releasing factor receptors in human adrenal and its disorders.
  • Recently, direct involvement of the locally synthesized CRF family in adrenocortical function has been proposed.
  • OBJECTIVE, DESIGN, AND SETTING: We examined in situ expression of Ucn and CRF receptors in nonpathological human adrenal gland and its disorders using immunohistochemistry and mRNA in situ hybridization.
  • RESULTS: Ucn immunoreactivity was localized in the cortex and medulla of nonpathological adrenal glands.
  • Ucn1 immunoreactivity was marked in the medulla, whereas Ucn3 was immunostained mostly in the cortex.
  • Both CRF type 1 and CRF2 were expressed in the cortex, particularly in the zonae fasciculata and reticularis but very weakly or undetectably in the medulla.
  • Immunohistochemistry in serial tissue sections with mirror images revealed that both Ucn3 and CRF2 were colocalized in more than 85% of the adrenocortical cells. mRNA in situ hybridization confirmed these findings above.
  • In fetal adrenals, Ucn and CRF receptors were expressed in both fetal and definitive zones of the cortex.
  • Ucn and CRF receptors were all expressed in the tumor cells of pheochromocytomas, adrenocortical adenomas, and carcinomas, but its positivity was less than that in nonpathological adrenal glands, suggesting that Ucn1, Ucn3, and CRF receptors were down-regulated in these adrenal neoplasms.
  • CONCLUSIONS: Ucn1, Ucn3, and CRF receptors are all expressed in human adrenal cortex and medulla and may play important roles in physiological adrenal functions.
  • [MeSH-major] Adrenal Cortex / physiology. Adrenal Cortex Neoplasms / physiopathology. Corticotropin-Releasing Hormone / genetics. Pheochromocytoma / physiopathology. Receptors, Corticotropin-Releasing Hormone / genetics
  • [MeSH-minor] Adenoma / metabolism. Adenoma / physiopathology. Adolescent. Adult. Aged. Child. Child, Preschool. Humans. Immunohistochemistry. In Situ Hybridization. Infant. Infant, Newborn. Middle Aged. RNA, Messenger / analysis. Urocortins

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  • (PMID = 15914529.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / CRF receptor type 1; 0 / CRF receptor type 2; 0 / RNA, Messenger; 0 / Receptors, Corticotropin-Releasing Hormone; 0 / UCN3 protein, human; 0 / Urocortins; 9015-71-8 / Corticotropin-Releasing Hormone
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15. Thorin-Savouré A, Tissier-Rible F, Guignat L, Pellerin A, Bertagna X, Bertherat J, Lefebvre H: Collision/composite tumors of the adrenal gland: a pitfall of scintigraphy imaging and hormone assays in the detection of adrenal metastasis. J Clin Endocrinol Metab; 2005 Aug;90(8):4924-9
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  • [Title] Collision/composite tumors of the adrenal gland: a pitfall of scintigraphy imaging and hormone assays in the detection of adrenal metastasis.
  • CONTEXT: In patients with a history of extraadrenal tumor, incidental discovery of an adrenal mass necessitates excluding the possibility of metastatic malignancy.
  • Detection of the malignant tissue is a difficult challenge when metastasis occurs in an adrenal adenoma, forming a collision/composite tumor.
  • OBJECTIVE, DESIGN, AND SETTING: We report two patients with adrenal collision/composite tumors referred to two French university hospitals.
  • PATIENTS AND RESULTS: Two patients with histories of mammary and sigmoid carcinomas, respectively, presented with adrenal mass discovered 8 and 3 yr after surgical removal of the primary tumor.
  • In the two cases, computerized tomographic scan showed that the adrenal tumor contained two components with low and high attenuation values, respectively.
  • Uptake of iodocholesterol by the adrenal tumor in case 1 and elevated plasma ACTH-stimulated 17-hydroxyprogesterone values in case 2 strongly argued for the diagnosis of primary adrenocortical tumors.
  • Enlargement of the adrenal mass during follow-up in case 1 and association of the adrenal lesion with a hepatic mass in case 2 led to adrenalectomy.
  • In both cases, histological examination of the tumor demonstrated the presence of metastatic carcinoma tissue in an adrenocortical adenoma, allowing classification of the neoplasia as a collision/composite tumor.
  • CONCLUSION: These observations show that collision/composite tumors of the adrenal gland formed by carcinoma metastasis in benign adenomas are a pitfall of iodocholesterol scintigraphy and/or plasma steroid assays to exclude the diagnosis of adrenal metastasis.
  • Conversely, computerized tomographic scan is a useful tool for the distinction between the benign and malignant tissues in adrenal collision/composite tumors.
  • [MeSH-major] Adenoma / pathology. Adenoma / radionuclide imaging. Adrenal Gland Neoplasms / radionuclide imaging. Adrenal Gland Neoplasms / secondary. Breast Neoplasms / pathology. Sigmoid Neoplasms / pathology
  • [MeSH-minor] 19-Iodocholesterol. Adrenocorticotropic Hormone / blood. Diagnosis, Differential. Female. Humans. Magnetic Resonance Imaging. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 15914530.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 30461-91-7 / 19-Iodocholesterol; 9002-60-2 / Adrenocorticotropic Hormone
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16. Hirose A, Okada Y, Fukushima A, Tanaka Y: [A rare case of primary aldosteronism caused by bilateral functioning adrenocortical adenomas with renal cell carcinoma]. J UOEH; 2005 Dec 1;27(4):315-23
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  • [Title] [A rare case of primary aldosteronism caused by bilateral functioning adrenocortical adenomas with renal cell carcinoma].
  • We report a rare case of bilateral primary aldosteronism with renal cell carcinoma.
  • Abdominal CT and MRI revealed tumor masses in both adrenal glands, and a large left renal mass.
  • The preoperative diagnosis was primary aldosteronism due to bilateral functioning adrenocortical adenomas and left renal cell carcinoma.
  • The Pathological diagnosis was left renal cell carcinoma and bilateral functioning adrenocortical adenomas.
  • Primary aldosteronism due to bilateral functioning adrenocortical adenomas is relatively rare and its complication with renal cell carcinoma is an extremely rare case.
  • [MeSH-major] Adrenal Cortex Neoplasms / complications. Adrenocortical Adenoma / complications. Carcinoma, Renal Cell / complications. Hyperaldosteronism / etiology. Kidney Neoplasms / complications


17. Willenberg HS, Haase M, Papewalis C, Schott M, Scherbaum WA, Bornstein SR: Corticotropin-releasing hormone receptor expression on normal and tumorous human adrenocortical cells. Neuroendocrinology; 2005;82(5-6):274-81
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  • [Title] Corticotropin-releasing hormone receptor expression on normal and tumorous human adrenocortical cells.
  • Corticotropin-releasing hormone (CRH) is not only the principal regulator of the central hypothalamic-pituitary-adrenal (HPA) axis but also exerts direct actions on peripheral tissues.
  • We analyzed the expression of CRH receptors in microdissected preparations of normal human adrenal glands and in adrenocortical and adrenomedullary tumors, employing immunohistochemistry, quantitative RT-PCR of microdissected adrenal tissues, and in situ hybridization.
  • The effect of CRH on adrenal steroidogenesis was tested in adrenal cells.
  • In addition, we found a higher expression of CRH type-1 and 2 receptors mRNAs in preparations of adrenal cortices as compared to pheochromocytomas, a 6-fold increase in preparations of clinically unapparent adrenocortical adenomas, and a 10- to 60-fold increase in cortisol-producing adrenal adenomas.
  • Stimulation of the adrenal tumor cell line NCI-H295R with CRH elicited a 1.4-fold increase in DHEA secretion.
  • This result could be reproduced in a culture of primary human adrenocortical cells.
  • We conclude that adrenocortical cells exhibit a higher expression of functional CRH receptors than chromaffin cells and that CRH acts on adrenal DHEA production.
  • The data support the assertion of a direct action of CRH on human adrenocortical cells in addition to an intra-adrenal CRH receptor/adrenocorticotropin system.
  • Enhanced CRH1R expression may be involved in adrenocortical tumorigenesis.
  • [MeSH-major] Adrenal Cortex / chemistry. Adrenal Cortex Neoplasms / chemistry. Adrenocortical Adenoma / chemistry. Adrenocortical Carcinoma / chemistry. Pheochromocytoma / chemistry. Receptors, Corticotropin-Releasing Hormone / genetics

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  • (PMID = 16721033.001).
  • [ISSN] 0028-3835
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / CRF receptor type 1; 0 / CRF receptor type 2; 0 / RNA, Messenger; 0 / Receptors, Corticotropin-Releasing Hormone; 9015-71-8 / Corticotropin-Releasing Hormone
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18. Yoon JK, Remer EM, Herts BR: Incidental pheochromocytoma mimicking adrenal adenoma because of rapid contrast enhancement loss. AJR Am J Roentgenol; 2006 Nov;187(5):1309-11
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  • [Title] Incidental pheochromocytoma mimicking adrenal adenoma because of rapid contrast enhancement loss.
  • [MeSH-major] Adenoma / radiography. Adrenal Gland Neoplasms / radiography. Contrast Media. Incidental Findings. Pheochromocytoma / radiography. Tomography, X-Ray Computed
  • [MeSH-minor] Adenocarcinoma / diagnosis. Adenocarcinoma / etiology. Barrett Esophagus / complications. Diagnosis, Differential. Esophageal Neoplasms / diagnosis. Esophageal Neoplasms / etiology. Fluorodeoxyglucose F18. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Positron-Emission Tomography. Radiopharmaceuticals

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  • (PMID = 17056921.001).
  • [ISSN] 1546-3141
  • [Journal-full-title] AJR. American journal of roentgenology
  • [ISO-abbreviation] AJR Am J Roentgenol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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19. Takahashi K, Totsune K, Saruta M, Fukuda T, Suzuki T, Hirose T, Imai Y, Sasano H, Murakami O: Expression of urocortin 3/stresscopin in human adrenal glands and adrenal tumors. Peptides; 2006 Jan;27(1):178-82
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Expression of urocortin 3/stresscopin in human adrenal glands and adrenal tumors.
  • In the present study, we studied expression of Ucn3/SCP in the normal adrenal and adrenal tumors by radioimmunoassay and reverse transcriptase-polymerase chain reaction (RT-PCR).
  • High concentrations of immunoreactive (IR)-Ucn3 were present in the normal portions of adrenal glands (4.2+/-0.51 pmol/g wet weight, mean+/-S.E.M., n = 14), and the levels were higher than those in the brain.
  • IR-Ucn3 was also detected in the tumor tissues of aldosterone-secreting adenomas (6.2+/-0.6 pmol/g wet weight, n = 10), cortisol-secreting adenomas (5.0+/-1.2 pmol/g wet weight, n = 4), and pheochromocytomas (1.9+/-0.4 pmol/g wet weight, n = 7).
  • Reverse phase high performance liquid chromatography showed that IR-Ucn3 in normal portions of adrenal glands and aldosterone-secreting adenomas was eluted mainly in the positions of Ucn3 and SCP with several minor peaks eluting earlier.
  • The RT-PCR showed expression of Ucn3 mRNA in normal portions of adrenal gland (positive ratio; 4/4), aldosterone-secreting adenomas (3/4), cortisol-secreting adenomas (1/3) and pheochromocytomas (6/7).
  • These findings indicate that Ucn3 is produced in normal adrenal and adrenal tumors (both adrenocortical tumors and pheochromocytomas), and suggest that Ucn3 acts as an autocrine or paracrine regulator in normal adrenal and adrenal tumors.
  • [MeSH-major] Adenoma / metabolism. Adrenal Cortex / metabolism. Adrenal Gland Neoplasms / metabolism. Adrenal Medulla / metabolism. Corticotropin-Releasing Hormone / biosynthesis. Pheochromocytoma / metabolism. Urocortins / biosynthesis

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  • (PMID = 16095756.001).
  • [ISSN] 0196-9781
  • [Journal-full-title] Peptides
  • [ISO-abbreviation] Peptides
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / RNA, Messenger; 0 / UCN3 protein, human; 0 / Urocortins; 9015-71-8 / Corticotropin-Releasing Hormone
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20. Solís-López DR, Rodríguez-Hernández Z, Solís-López DH: Incidental adreno-cortical adenoma, why surgery? a case report. P R Health Sci J; 2010 Jun;29(2):130-2
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  • [Title] Incidental adreno-cortical adenoma, why surgery? a case report.
  • INTRODUCTION: Incidental adrenal tumors are commonly benign, but reports demonstrate that if the characteristics of the tumor are not clear, on images surgery is the procedure of choice.
  • Our objective through this case is to show that laparoscopic adrenalectomy is a safe approach for adrenal incidental tumor regardless of radiological findings.
  • She went for check up and a left adrenal mass on MRI described as myelolipoma was found incidentally.
  • The pathological report was adrenal cortical adenoma with central hemorrhage and not a myelolipoma as described in images on magnetic resonance imaging (MRI).
  • CONCLUSION: The use of imaging for diagnosis, clinical management and decision making is very controversial.
  • Laparoscopic surgery for adrenal masses is a safe procedure for tumors of 6 cm regardless of the radiological description.
  • [MeSH-major] Adrenal Cortex Neoplasms / surgery. Adrenocortical Adenoma / surgery

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  • (PMID = 20496530.001).
  • [ISSN] 0738-0658
  • [Journal-full-title] Puerto Rico health sciences journal
  • [ISO-abbreviation] P R Health Sci J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Puerto Rico
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21. Miller FH, Wang Y, McCarthy RJ, Yaghmai V, Merrick L, Larson A, Berggruen S, Casalino DD, Nikolaidis P: Utility of diffusion-weighted MRI in characterization of adrenal lesions. AJR Am J Roentgenol; 2010 Feb;194(2):W179-85
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  • [Title] Utility of diffusion-weighted MRI in characterization of adrenal lesions.
  • OBJECTIVE: The purpose of our study was to evaluate the utility of apparent diffusion coefficient (ADC) values for characterizing adrenal lesions and determine if diffusion-weighted imaging (DWI) can distinguish lipid-rich from lipid-poor adenomas.
  • MATERIALS AND METHODS: We retrospectively evaluated 160 adrenal lesions in 156 patients (96 women and 60 men; mean age, 63 years).
  • ADCs and signal intensity (SI) decrease on chemical shift imaging were measured in adrenal lesions with a wide variety of pathologies.
  • Lipid-rich and lipid-poor adenomas were identified by unenhanced CT.
  • RESULTS: ADCs of adrenal malignancies (median, 1.67 x 10(-3) mm(2)/s; interquartile range, 1.41-1.84 x 10(-3) mm(2)/s) were not different compared with those of benign lesions (1.61 x 10(-3) mm(2)/s; 1.27-1.96 x 10(-3) mm(2)/s; p > 0.05).
  • Cysts (2.93 x 10(-3) mm(2)/s; 2.70-3.09 x 10(-3) mm(2)/s) showed higher ADCs than the remaining adrenal lesions (p < 0.05).
  • The median ADCs of lipid-rich adenomas did not differ from those of lipid-poor ones (p > 0.05).
  • The CT attenuation had no negative or positive correlation with the ADCs of adrenal adenomas (r = -0.05, p = 0.97).
  • CONCLUSION: Unlike lesion size and percentage decrease in SI, the ADCs were not useful in distinguishing benign from malignant adrenal lesions.
  • Lipid-poor adenomas could not be distinguished from lipid-rich adenomas and all other nonfatty lesions of the adrenal gland with DWI.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Diffusion Magnetic Resonance Imaging / methods. Lipoma / diagnosis
  • [MeSH-minor] Adult. Analysis of Variance. Contrast Media. Diagnosis, Differential. Female. Humans. Image Interpretation, Computer-Assisted. Male. Middle Aged. Predictive Value of Tests. ROC Curve. Retrospective Studies. Sensitivity and Specificity. Statistics, Nonparametric

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  • (PMID = 20093571.001).
  • [ISSN] 1546-3141
  • [Journal-full-title] AJR. American journal of roentgenology
  • [ISO-abbreviation] AJR Am J Roentgenol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media
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22. Lee SM, Hahm JR, Jung TS, Jung JH, Kang MY, Kim SJ, Chung SI: A case of Cushing's syndrome presenting as endometrial hyperplasia. Korean J Intern Med; 2008 Mar;23(1):49-52
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  • We describe here the case of a 39-year-old woman with a cortisol-producing adrenal adenoma and she presented with endometrial hyperplasia and hypertension without the specific characteristics of Cushing's syndrome.
  • Adrenal Cushing's syndrome was confirmed on the basis of the elevated urinary free cortisol (454 microg/24h, normal range: 20-70) with a suppressed ACTH level (2.0 pg/mL, normal range: 6.0-76.0) and the loss of circadian cortisol secretion.
  • A CT scan revealed a 3.1 cm, hyperechoic, well-marginated mass in the left adrenal gland.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenocortical Adenoma / diagnosis. Cushing Syndrome / diagnosis. Endometrial Hyperplasia / diagnosis
  • [MeSH-minor] Adrenalectomy. Adrenocorticotropic Hormone / blood. Adult. Circadian Rhythm. Diagnosis, Differential. Female. Humans. Hydrocortisone / secretion. Hydrocortisone / urine

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  • (PMID = 18363281.001).
  • [ISSN] 1226-3303
  • [Journal-full-title] The Korean journal of internal medicine
  • [ISO-abbreviation] Korean J. Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Korea (South)
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
  • [Other-IDs] NLM/ PMC2686950
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23. Gross MD, Korobkin M, Bou Assaly W, Dwamena B, Djekidel M: Contemporary imaging of incidentally discovered adrenal masses. Nat Rev Urol; 2009 Jul;6(7):363-73
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  • [Title] Contemporary imaging of incidentally discovered adrenal masses.
  • The incidental discovery of adrenal masses during modern diagnostic imaging is a common occurrence.
  • These masses form part of a long differential diagnostic list; most often, they are benign adrenal adenomas, but their discovery requires a clinical evaluation that is sufficiently broad to exclude clinically silent endocrine disease, metastases to the adrenal gland in patients with suspected or known malignancies, and rare adrenocortical carcinomas.
  • CT, MRI and nuclear medicine approaches have all been used to evaluate incidentally discovered adrenal masses.
  • Understanding of the modalities used to assess an unanticipated adrenal mass allows for more rapid diagnosis and cost avoidance in a condition that has been referred to as a 'disease' of modern imaging technology.
  • [MeSH-major] Adrenal Gland Diseases / diagnosis. Diagnostic Imaging. Incidental Findings
  • [MeSH-minor] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / etiology. Humans

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  • (PMID = 19506582.001).
  • [ISSN] 1759-4820
  • [Journal-full-title] Nature reviews. Urology
  • [ISO-abbreviation] Nat Rev Urol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 93
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24. Johnson SP, Bagrosky BM, Mitchell EL, McIntyre RC Jr, Grant NG: CT-guided radiofrequency ablation of an aldosterone-secreting primary adrenal tumor in a surgically unfit patient. J Vasc Interv Radiol; 2008 Jul;19(7):1115-7
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  • [Title] CT-guided radiofrequency ablation of an aldosterone-secreting primary adrenal tumor in a surgically unfit patient.
  • Because of the speed and efficiency of laparoscopic adrenalectomy, alternative surgical procedures for adrenal adenomas are uncommon.
  • The present report outlines the case of a young patient with an adrenal adenoma causing Conn syndrome who was a poor candidate for surgical treatment.
  • Computed tomography (CT)-guided radiofrequency ablation of the adenoma was performed with a paraspinal approach and injection of dextrose 5% in water.
  • [MeSH-major] Adenoma / surgery. Adrenal Gland Neoplasms / surgery. Aldosterone / secretion. Catheter Ablation. Hyperaldosteronism / etiology. Radiography, Interventional. Tomography, X-Ray Computed

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  • (PMID = 18589330.001).
  • [ISSN] 1051-0443
  • [Journal-full-title] Journal of vascular and interventional radiology : JVIR
  • [ISO-abbreviation] J Vasc Interv Radiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 4964P6T9RB / Aldosterone
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25. Lenzini L, Seccia TM, Aldighieri E, Belloni AS, Bernante P, Giuliani L, Nussdorfer GG, Pessina AC, Rossi GP: Heterogeneity of aldosterone-producing adenomas revealed by a whole transcriptome analysis. Hypertension; 2007 Dec;50(6):1106-13
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Heterogeneity of aldosterone-producing adenomas revealed by a whole transcriptome analysis.
  • Aldosterone-producing adenomas (APAs) are a common cause of arterial hypertension, but the underlying molecular mechanisms are unknown, although a transcriptional modulation of aldosterone synthase (CYP11B2) has been suggested.
  • We analyzed the whole transcriptome of APAs as compared with a pool of normal human adrenocortical tissues.
  • [MeSH-major] Adenoma / metabolism. Adrenal Cortex Neoplasms / metabolism. Aldosterone / biosynthesis. Gene Expression Profiling

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  • (PMID = 17938379.001).
  • [ISSN] 1524-4563
  • [Journal-full-title] Hypertension (Dallas, Tex. : 1979)
  • [ISO-abbreviation] Hypertension
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 4964P6T9RB / Aldosterone; EC 1.14.15.4 / Cytochrome P-450 CYP11B2; EC 1.14.15.4 / Steroid 11-beta-Hydroxylase; EC 2.7.11.17 / CAMK1 protein, human; EC 2.7.11.17 / Calcium-Calmodulin-Dependent Protein Kinase Type 1; EC 2.7.11.17 / Calcium-Calmodulin-Dependent Protein Kinase Type 2
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26. Ozturk E, Onur Sildiroglu H, Kantarci M, Doganay S, Güven F, Bozkurt M, Sonmez G, Cinar Basekim C: Computed tomography findings in diseases of the adrenal gland. Wien Klin Wochenschr; 2009;121(11-12):372-81
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  • [Title] Computed tomography findings in diseases of the adrenal gland.
  • The adrenal gland is a common site of disease, with an abnormality prevalence as high as 9% in autopsy series.
  • With the increasing use of CT, adrenal lesions are frequently found in the daily practice of radiology and are diagnosed in up to 5% of CT examinations performed for varied reasons.
  • Imaging features on CT can establish a specific diagnosis of many of these lesions, including myelolipoma, hematoma and cysts.
  • Once a diagnostic dilemma, now adenomas can be accurately diagnosed using unenhanced CT, chemical shift magnetic resonance imaging and CT contrast washout analysis.
  • Because the adrenal gland is also a frequent site of metastasis, recent literature has focused on imaging characterization of adrenal masses for differentiation of adenomas from metastases.
  • In patients without known malignancy, most adrenal lesions are benign and a specific diagnosis can now be made on the basis of imaging features.
  • It is important to understand the prevalence of adrenal abnormalities because the gland is a common site of disorders, and the increased use of cross-sectional imaging has increased the frequency of detection of adrenal lesions.
  • The prevalence of disease is important in predicting the risk of malignancy when an adrenal mass is discovered in a patient without known cancer.
  • Detection of adrenal gland diseases has increased substantially with the advent and widespread use of imaging techniques.
  • Although several imaging modalities can be used, CT has a central role in both detection and differential diagnosis of an adrenal lesion.
  • The aim of this article is to review the CT findings of adrenal gland diseases.
  • [MeSH-major] Adrenal Gland Diseases / diagnostic imaging. Adrenal Gland Neoplasms / diagnostic imaging. Image Processing, Computer-Assisted. Radiographic Image Enhancement. Tomography, X-Ray Computed
  • [MeSH-minor] Adrenal Glands / diagnostic imaging. Adrenocortical Adenoma / diagnostic imaging. Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Reference Values. Sensitivity and Specificity

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  • (PMID = 19626294.001).
  • [ISSN] 0043-5325
  • [Journal-full-title] Wiener klinische Wochenschrift
  • [ISO-abbreviation] Wien. Klin. Wochenschr.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Austria
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27. Sangoi AR, McKenney JK: A tissue microarray-based comparative analysis of novel and traditional immunohistochemical markers in the distinction between adrenal cortical lesions and pheochromocytoma. Am J Surg Pathol; 2010 Mar;34(3):423-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A tissue microarray-based comparative analysis of novel and traditional immunohistochemical markers in the distinction between adrenal cortical lesions and pheochromocytoma.
  • We have encountered an increasing number of image-guided adrenal mass biopsies in which the differential diagnosis is adrenal cortical lesion versus pheochromocytoma.
  • In this study, a detailed immunoprofile of 63 adrenal cortical lesions (3 adrenal rests, 6 adrenal cortical hyperplasias, 43 adrenal cortical adenomas, 4 adrenal cortical neoplasms of uncertain malignant potential, and 7 adrenal cortical carcinomas) was compared with 35 pheochromocytomas using traditional (calretinin, chromogranin, inhibin, melanA, and synaptophysin) and novel [steroidogenic factor-1 (SF-1), microtubule-associated protein 2, and mammalian achaete-scute homolog-1] antibodies, using tissue microarray technology to simulate small image-guided biopsies.
  • A comparison of sensitivity and specificity using different intensity thresholds required for a "positive" result (> or = 1+ vs. > or = 2+) was performed.
  • Staining results based on a > or = 1+ and (> or = 2+) intensity threshold were as follows: calretinin-95% (89%) in adrenal cortical lesions and 14% (0%) in pheochromocytomas; chromogranin-0% in adrenal cortical lesions and 100% in pheochromocytomas; inhibin-97% (86%) in adrenal cortical lesions and 6% (0%) in pheochromocytomas; microtubule-associated protein 2-29% (16%) in adrenal cortical lesions and 100% (89%) in pheochromocytomas; mammalian achaete-scute homolog-1-0% in both adrenal cortical lesions and pheochromocytomas; melanA-94% (86%) in adrenal cortical lesions and 6% (0%) in pheochromocytomas; SF-1-87% (86%) in adrenal cortical lesions and 0% in pheochromocytomas; synaptophysin-67% (59%) in adrenal cortical lesions and 100% in pheochromocytomas.
  • Using an antibody panel consisting of chromogranin plus the nuclear antibody SF-1 and either calretinin or inhibin, while requiring a high-staining intensity threshold, helps to eliminate interpretative issues of artifactual or background reactivity, improves diagnostic sensitivity/specificity, and makes for an effective immunohistochemical approach in distinguishing adrenal cortical lesions from pheochromocytomas.
  • [MeSH-major] Adenoma / chemistry. Adrenal Cortex Neoplasms / chemistry. Adrenal Gland Neoplasms / chemistry. Biomarkers, Tumor / analysis. Carcinoma / chemistry. Immunohistochemistry. Pheochromocytoma / chemistry. Tissue Array Analysis
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Artifacts. Biopsy. Calbindin 2. Child. Child, Preschool. Chromogranins / analysis. Diagnosis, Differential. Female. Humans. Infant. Inhibins / analysis. Male. Middle Aged. Predictive Value of Tests. S100 Calcium Binding Protein G / analysis. Sensitivity and Specificity. Steroidogenic Factor 1 / analysis. Young Adult

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  • (PMID = 20154585.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CALB2 protein, human; 0 / Calbindin 2; 0 / Chromogranins; 0 / NR5A1 protein, human; 0 / S100 Calcium Binding Protein G; 0 / Steroidogenic Factor 1; 57285-09-3 / Inhibins
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28. Fuller PJ, Alexiadis M, Jobling T, McNeilage J: Seladin-1/DHCR24 expression in normal ovary, ovarian epithelial and granulosa tumours. Clin Endocrinol (Oxf); 2005 Jul;63(1):111-5
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  • OBJECTIVE: The human DIMINUTO/DWARF1 homolog seladin-1/DHCR24 has been recently reported to be up-regulated in adrenocortical adenomas.
  • Granulosa cell tumours of the ovary (GCT) as with adrenocortical adenomas arise from a steroidogenic tissue, respond to pituitary hormone stimulation and synthesize steroid hormones.
  • [MeSH-major] Granulosa Cell Tumor / genetics. Neoplasm Proteins / genetics. Nerve Tissue Proteins / genetics. Ovarian Neoplasms / genetics. Ovary / metabolism. Oxidoreductases Acting on CH-CH Group Donors / genetics

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  • (PMID = 15963070.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Neoplasm Proteins; 0 / Nerve Tissue Proteins; 0 / Receptors, LH; EC 1.3.- / Oxidoreductases Acting on CH-CH Group Donors; EC 1.3.1.- / 3beta-hydroxysterol delta24-reductase; EC 1.3.1.- / DHCR24 protein, human
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29. Murphy JJ, Tawfeeq M, Chang B, Nadel H: Early experience with PET/CT scan in the evaluation of pediatric abdominal neoplasms. J Pediatr Surg; 2008 Dec;43(12):2186-92
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  • These included Burkitt's lymphoma (8), neuroblastoma (7), rhabdomyosarcoma (6), ovarian tumor (3), Wilms' tumor (2), hepatocellular carcinoma (2), paraganglioma (1), germ cell tumor (1), undifferentiated sarcoma (1), renal primitive neuroectodermal tumor (1), gastrointestinal stromal tumor (1), adrenocortical carcinoma (1), inflammatory pseudotumor (1), and adrenal adenoma (1).
  • These include (1) preoperative staging, (2) selection of appropriate site for biopsy, (3) identification of occult metastatic disease, (4) follow-up for residual or recurrent disease, and (5) assessment of response to chemotherapy.

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  • (PMID = 19040932.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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30. Izaki H, Fukumori T, Takahashi M, Taue R, Kishimoto T, Tanimoto S, Nishitani MA, Kanayama HO: Indications for laparoscopic adrenalectomy for non-functional adrenal tumor with hypertension: usefulness of adrenocortical scintigraphy. Int J Urol; 2006 Jun;13(6):677-81
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  • [Title] Indications for laparoscopic adrenalectomy for non-functional adrenal tumor with hypertension: usefulness of adrenocortical scintigraphy.
  • AIM: Laparoscopic adrenalectomy is currently indicated for biochemically and clinically functional adrenal tumors and potentially malignant tumors of the adrenal glands.
  • Non-functional adenomas greater than 5 cm in diameter of the adrenal gland are generally considered to represent potentially malignant tumors.
  • The present study shows indications of laparoscopic adrenalectomy for non-functional adrenal tumors with hypertension in a retrospective fashion.
  • Forty-five patients underwent laparoscopic adrenalectomy for non-functional adrenal tumors, and [(131)I]6beta-iodomethyl-19-norcholest-5(10)-en-3beta-ol (NP-59) scintigraphy was performed for patients with preoperative hypertension.
  • All adrenal tumors were removed successfully by laparoscopic surgery.
  • Importantly, all patients who improved hypertension after adrenalectomy displayed strong accumulation in adrenal tumors with visualization of the contralateral gland on NP-59 scintigraphy.
  • CONCLUSIONS: The indication of laparoscopic adrenalectomy for non-functional adrenal tumors is generally considered for lesions more than 5 cm diameter.
  • [MeSH-major] Adenoma / radiography. Adenoma / therapy. Adrenal Gland Neoplasms / radiography. Adrenal Gland Neoplasms / therapy. Adrenalectomy. Laparoscopy

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  • (PMID = 16834641.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
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31. Song JH, Chaudhry FS, Mayo-Smith WW: The incidental indeterminate adrenal mass on CT (&gt; 10 H) in patients without cancer: is further imaging necessary? Follow-up of 321 consecutive indeterminate adrenal masses. AJR Am J Roentgenol; 2007 Nov;189(5):1119-23
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The incidental indeterminate adrenal mass on CT (> 10 H) in patients without cancer: is further imaging necessary? Follow-up of 321 consecutive indeterminate adrenal masses.
  • OBJECTIVE: The objective of our study was to determine whether follow-up imaging evaluation is necessary for incidentally discovered indeterminate adrenal lesions (> 10 H) on CT in patients with no known malignancy.
  • MATERIALS AND METHODS: A computer search of CT reports from January 2000 to December 2003 identified patients with incidentally detected, indeterminate, but benign-appearing adrenal lesions who had no known malignancy and no clinical suspicion of hyperfunctioning adrenal mass.
  • Patients with adrenal masses diagnostic on the initial CT or heterogeneous masses were excluded.
  • Each lesion was determined to be benign or malignant based on histopathology, characterization with diagnostic imaging studies, or a minimum of 1 year of stability on imaging follow-up or 2 years of stability on clinical follow-up.
  • RESULTS: Of the 321 lesions, 318 masses (99.1%) were confirmed to be benign and clinically insignificant.
  • These included three (0.9%) histologically confirmed adenomas, 198 (61.7%) adenomas by imaging characterization, five (1.6%) other benign lesions, 71 (22.1%) masses stable on imaging follow-up, and 41 (12.8%) masses with clinical stability.
  • There were three (0.9%) clinically unsuspected functioning masses: one cortisol-producing adenoma and two pheochromocytomas.
  • There were no metastatic adrenal lesions, even among the 13 patients who subsequently developed malignancy elsewhere.
  • CONCLUSION: All of the incidentally detected adrenal masses with a CT attenuation of > 10 H were benign in patients with no known malignancy.
  • Follow-up imaging to characterize an incidental adrenal mass appears to have a limited role in this patient cohort.
  • [MeSH-major] Adrenal Gland Neoplasms / epidemiology. Adrenal Gland Neoplasms / radiography. Adrenocortical Adenoma / epidemiology. Adrenocortical Adenoma / radiography. Risk Assessment / methods. Tomography, X-Ray Computed / statistics & numerical data


32. Rossi E, Foroni M, Regolisti G, Perazzoli F, Negro A, Santi R, Grasselli C, Galli P, Gardini G: Combined Conn's syndrome and subclinical hypercortisolism from an adrenal adenoma associated with homolateral renal carcinoma. Am J Hypertens; 2008 Nov;21(11):1269-72
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Combined Conn's syndrome and subclinical hypercortisolism from an adrenal adenoma associated with homolateral renal carcinoma.
  • [MeSH-major] Adenoma / complications. Adrenal Gland Neoplasms / complications. Carcinoma, Renal Cell / complications. Cushing Syndrome / diagnosis. Hyperaldosteronism / diagnosis. Kidney Neoplasms / complications


33. Hood SJ, Taylor KP, Ashby MJ, Brown MJ: The spironolactone, amiloride, losartan, and thiazide (SALT) double-blind crossover trial in patients with low-renin hypertension and elevated aldosterone-renin ratio. Circulation; 2007 Jul 17;116(3):268-75
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  • BACKGROUND: There is continuing variation in diagnosis and estimated prevalence of primary hyperaldosteronism.
  • The higher estimates encourage search for adrenal adenomas in patients with elevated ratios of plasma aldosterone to renin.
  • However, it is more likely that patients with normal plasma K+ and aldosterone belong to the polygenic spectrum of low-renin hypertension rather than have the same monogenic syndrome as classic Conn's.
  • CONCLUSIONS: In hypertensive patients with a low plasma renin but normal K+, bendroflumethiazide 5 mg was as effective as spironolactone 100 mg in lowering blood pressure, despite patients being selected for a previous large fall in blood pressure on spironolactone.
  • Because this result differs from that expected in primary hyperaldosteronism, our finding argues against low-renin hypertension including a large, undiagnosed pool of primary hyperaldosteronism.


34. Meyer A, Behrend M: Indications and results of surgery for incidentally found adrenal tumors. Urol Int; 2006;77(2):173-8
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  • [Title] Indications and results of surgery for incidentally found adrenal tumors.
  • INTRODUCTION: The accidental discovery of an adrenal mass called incidentaloma has become an increasingly frequent clinical problem with the question of a correct and appropriate therapeutic approach being the subject of controversial discussions.
  • Histopathologic examination ruled out adrenal adenoma in 32 patients, adrenal myelolipoma in 12, unilateral nodular hyperplasia in 4, cystic lesion in 3, and adrenocortical carcinoma in 1 patient.
  • Evaluating the criteria for surgical treatment regarding age of the patients and size of the lesions, 25 patients (48%), including the patient with the adrenocortical carcinoma, were younger than 60 years and had an adrenal lesion exceeding 4 cm in size.
  • Especially in patients younger than 60 years with an adrenal lesion exceeding 4 cm in size, an adrenalectomy, predominantly via an endoscopic approach, should be carried out, because a repeated and life-long close follow-up of an anxious patient who has been informed of the diagnosis will in some cases exceed the cost of a single endoscopic operation.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery. Adrenalectomy

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  • (PMID = 16888426.001).
  • [ISSN] 0042-1138
  • [Journal-full-title] Urologia internationalis
  • [ISO-abbreviation] Urol. Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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35. Park SH, Kim MJ, Kim JH, Lim JS, Kim KW: Differentiation of adrenal adenoma and nonadenoma in unenhanced CT: new optimal threshold value and the usefulness of size criteria for differentiation. Korean J Radiol; 2007 Jul-Aug;8(4):328-35
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  • [Title] Differentiation of adrenal adenoma and nonadenoma in unenhanced CT: new optimal threshold value and the usefulness of size criteria for differentiation.
  • OBJECTIVE: To determine the optimal threshold for the attenuation values in unenhanced computed tomography (CT) and assess the value of the size criteria for differentiating between an adrenal adenoma and a nonadenoma.
  • MATERIALS AND METHODS: The unenhanced CT images of 45 patients at our institution, who underwent a surgical resection of an adrenal masses between January 2001 and July 2005, were retrospectively reviewed.
  • Forty-five adrenal masses included 25 cortical adenomas, 12 pheochromocytomas, three lymphomas, and five metastases confirmed by pathology were examined.
  • The mean attenuation values of an adrenal adenoma and nonadenoma were compared using an unpaired t test.
  • RESULTS: The twenty-five adenomas showed significantly lower (p < 0.05) attenuation values (mean+/-SD; 16.3+/-14.9) than the nonadenomas (38.1+/-6.8).
  • The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for diagnosing adenomas were 36%, 100%, 100%, 56%, and 64%, respectively, at a threshold of 10 HU; 60%, 100%, 100%, 67%, and 78%, respectively, at a threshold of 20 HU; and 72%, 95%, 95%, 73%, and 82%, respectively, at a threshold of 25 HU.
  • The adenomas had a significantly (p < 0.05) smaller diameter (2.44+/-1.24 cm) than the nonadenomas (5.09+/-2.37 cm).
  • CONCLUSION: The threshold attenuation values of 20 or 25 HU in the unenhanced CT appear optimal for discriminating an adrenal adenoma from a nonadenoma.
  • The size criteria are of little value in differentiating adrenal masses because of their low specificity or low sensitivity.
  • [MeSH-major] Adenoma / radiography. Adrenal Gland Neoplasms / radiography

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  • (PMID = 17673844.001).
  • [ISSN] 1229-6929
  • [Journal-full-title] Korean journal of radiology
  • [ISO-abbreviation] Korean J Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2627166
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36. Pawlikowski M, Winczyk K, Sledź B: Immunohistochemical detection of angiotensin receptors AT1 and AT2 in adrenal tumors. Folia Histochem Cytobiol; 2008;46(1):51-5
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  • [Title] Immunohistochemical detection of angiotensin receptors AT1 and AT2 in adrenal tumors.
  • Angiotensin II is well known to affect the adrenal cell growth and function.
  • Angiotensin receptors AT1 and AT2 were found to be present in the normal adrenal gland.
  • However, the data on the expression of the angiotensin receptors in the adrenal tumors are very scarce.
  • To overcome this gap, the paraffin sections of the adrenal cortical tumors and of pheochromocytomas from the archival material were immunostained with antibodies raised against AT1 (sc-1173) and AT2 (sc-9040) receptor proteins.
  • In hyperplasia of the adrenal cortex and in benign adrenocortical adenomas, both functioning and non-functioning, the AT1 immunostaining was present mainly in the cell membranes.
  • A positive immunoreaction was also found in the subpopulation of cell nuclei and within the cytoplasm.
  • In the adrenal cancer, as well as in pheochromocytomas, neither cell membranes nor cell nuclei were immunostained with anti-AT1 antibody.
  • Our data indicates that the expression of AT1 receptors is altered in adrenal cancer and in pheochromocytomas.

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  • (PMID = 18296263.001).
  • [ISSN] 1897-5631
  • [Journal-full-title] Folia histochemica et cytobiologica
  • [ISO-abbreviation] Folia Histochem. Cytobiol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Receptor, Angiotensin, Type 1; 0 / Receptor, Angiotensin, Type 2; 4964P6T9RB / Aldosterone; WI4X0X7BPJ / Hydrocortisone
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37. Sbiera S, Schmull S, Assie G, Voelker HU, Kraus L, Beyer M, Ragazzon B, Beuschlein F, Willenberg HS, Hahner S, Saeger W, Bertherat J, Allolio B, Fassnacht M: High diagnostic and prognostic value of steroidogenic factor-1 expression in adrenal tumors. J Clin Endocrinol Metab; 2010 Oct;95(10):E161-71
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  • [Title] High diagnostic and prognostic value of steroidogenic factor-1 expression in adrenal tumors.
  • CONTEXT: No immunohistochemical marker has been established to reliably differentiate adrenocortical tumors from other adrenal masses.
  • We hypothesized that expression of steroidogenic factor-1 (SF-1), a transcription factor involved in adrenal development, is of value for the differential diagnosis of adrenal masses and predicts prognosis in adrenocortical carcinoma (ACC).
  • PATIENTS AND METHODS: SF-1 protein expression was assessed by immunohistochemistry on tissue samples from 167 ACC, 52 adrenocortical adenomas (ACA), six normal adrenal glands, six normal ovaries and 73 neoplastic nonsteroidogenic tissues.
  • RESULTS: SF-1 protein staining was detectable in 158 of 161 (98%) evaluable ACC samples including 49 (30%) with strong SF-1 staining and in all normal and benign steroidogenic tissues.
  • In addition, SF-1 mRNA expression was present in all 91 analyzed adrenocortical tumors.
  • CONCLUSION: SF-1 is a highly valuable immunohistochemical marker to determine the adrenocortical origin of an adrenal mass with high sensitivity and specificity.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenocortical Adenoma / diagnosis. Adrenocortical Carcinoma / diagnosis. Steroidogenic Factor 1 / genetics
  • [MeSH-minor] Adult. Biomarkers, Tumor / genetics. Biomarkers, Tumor / metabolism. Cohort Studies. Diagnosis, Differential. Female. Gene Expression Regulation, Neoplastic. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Predictive Value of Tests. Prognosis. Sensitivity and Specificity

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  • (PMID = 20660055.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / NR5A1 protein, human; 0 / Steroidogenic Factor 1
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38. Saner-Amigh K, Mayhew BA, Mantero F, Schiavi F, White PC, Rao CV, Rainey WE: Elevated expression of luteinizing hormone receptor in aldosterone-producing adenomas. J Clin Endocrinol Metab; 2006 Mar;91(3):1136-42
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  • [Title] Elevated expression of luteinizing hormone receptor in aldosterone-producing adenomas.
  • CONTEXT: The mechanisms driving steroid production in aldosterone-producing adenomas (APAs) are poorly defined.
  • However, previous studies have shown that steroid production in some cortisol-producing adenomas is regulated by aberrant expression of G protein-coupled receptors.
  • Aberrant adrenal expression of LH receptors has been shown to cause Cushing's syndrome, but the role of LH receptors in Conn's disease (hyperaldosteronism) has not been studied.
  • OBJECTIVE: The objective of the study was to determine whether APAs express elevated LH receptor, compared with normal adrenal (NA).
  • Aldosterone synthase transcription was studied in H295R adrenocortical cells transfected with an LH receptor expression construct and reporter constructs prepared from CYP11B2 5'-flanking DNA.
  • PATIENTS: The patient population consisted of 20 normal control adrenals and 18 adenomas from patients with APAs.
  • MAIN OUTCOME MEASURE: Regulation of CYP11B2 gene expression by aberrant LH receptor expression in aldosterone-producing adrenal adenoma was measured.
  • CONCLUSION: LH receptor expression is elevated in many APAs, which makes LH a potential cause of the excessive production of aldosterone in a subset of these adrenal tumors.
  • [MeSH-major] Adenoma / genetics. Adrenal Cortex Neoplasms / genetics. Aldosterone / metabolism. Receptors, LH / genetics
  • [MeSH-minor] Adrenal Glands / embryology. Adrenal Glands / physiology. Corpus Luteum / physiology. DNA Primers. Female. Gene Expression Regulation, Neoplastic. Humans. Oligonucleotide Array Sequence Analysis. Ovarian Follicle / physiology. Plasmids. RNA, Messenger / genetics. Reverse Transcriptase Polymerase Chain Reaction. Transfection. Tumor Cells, Cultured

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  • (PMID = 16332935.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / DK43140
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA Primers; 0 / RNA, Messenger; 0 / Receptors, LH; 4964P6T9RB / Aldosterone
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39. Zhou G, Wei Y, Chen X, Jiang X, Gu W, Li X, Peng C, Ning G, Li H: Multiple endocrine neoplasia type 1 simultaneous with various types of enteropancreatic endocrine tumors: one case report: lessons learned. Pancreas; 2010 Jul;39(5):680-3
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  • Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant disorder characterized by the development of parathyroid hyperplasia, pancreatic endocrine tumors, pituitary adenomas, and adrenal adenomas.


40. Penezić Z, Zarković M, Vujović S, Ivović M, Beleslin B, Ciric J, Drezgić M: [The value of corticotropin-releasing hormone (CRH) test for differential diagnosis of Cushing's syndrome]. Srp Arh Celok Lek; 2007 Jan-Feb;135(1-2):31-7
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  • [Title] [The value of corticotropin-releasing hormone (CRH) test for differential diagnosis of Cushing's syndrome].
  • INTRODUCTION: Diagnosis and differential diagnosis of Cushing's syndrome (CS) remain considerable challenge in endocrinology.
  • Following the CRH administration, the majority of patients with ACTH secreting pituitary adenoma show a significant rise of plasma cortisol and ACTH, whereas those with ectopic ACTH secretion characteristically do not.
  • OBJECTIVE: The aim of our study was to assess the value of CRF test for differential diagnosis of CS using the ROC (receiver operating characteristic) curve method.
  • ACTH secreting pituitary adenoma was found in 18, ectopic ACTH secretion in 3 and cortisol secreting adrenal adenoma in 9 of all patients with CS.
  • CONCLUSION: Determination of cortisol and ACTH levels in CRH test remains reliable tool in differential diagnosis of Cushing's syndrome.
  • [MeSH-major] Corticotropin-Releasing Hormone. Cushing Syndrome / diagnosis
  • [MeSH-minor] ACTH Syndrome, Ectopic / diagnosis. ACTH-Secreting Pituitary Adenoma / diagnosis. Adenoma / diagnosis. Adrenocorticotropic Hormone / blood. Adult. Diagnosis, Differential. Female. Humans. Hydrocortisone / blood. Male. ROC Curve. Sensitivity and Specificity

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  • (PMID = 17503565.001).
  • [ISSN] 0370-8179
  • [Journal-full-title] Srpski arhiv za celokupno lekarstvo
  • [ISO-abbreviation] Srp Arh Celok Lek
  • [Language] srp
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Serbia and Montenegro
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone; 9015-71-8 / Corticotropin-Releasing Hormone; WI4X0X7BPJ / Hydrocortisone
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41. Mizota M, Tamada I, Hizukuri K, Otsubo K, Arima S, Kawano Y, Ono S, Hayashida Y, Kaji T, Takamatsu H, Sasano H: Bilateral asynchronous adrenocortical adenoma in a girl with beckwith-wiedemann syndrome. Clin Pediatr Endocrinol; 2005;14(1):23-6
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  • [Title] Bilateral asynchronous adrenocortical adenoma in a girl with beckwith-wiedemann syndrome.
  • We report a case of asynchronous occurrence of bilateral adrenocortical adenoma in a 13-yr-old girl with Beckwith-Wiedemann syndrome.
  • A right virilizing adrenal adenoma was surgically removed at age 6, following clinical manifestation of virilization such as acne, voice change, clitoris hypertrophy and overgrowth.
  • Histopathological examination of the resected specimen revealed an adrenocortical adenoma predominantly composed of eosinophilic tumor cells expressing all the steroidogenic enzymes.
  • Abdominal ultrasonography demonstrated the presence of a left adrenocortical adenoma.
  • Pathological examination of the resected specimen revealed a circumscribed and well encapsulated tumor with essentially the same histological features as the tumor previously removed, except that the tumor cells showed a more prominent morphological similarity to the fetal adrenal cortex and did not express 3β HSD.

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  • (PMID = 24790306.001).
  • [ISSN] 0918-5739
  • [Journal-full-title] Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology
  • [ISO-abbreviation] Clin Pediatr Endocrinol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Other-IDs] NLM/ PMC4004928
  • [Keywords] NOTNLM ; Beckwith-Wiedemann syndrome / adrenal tumor / virilizing
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42. Miyoshi T, Otsuka F, Suzuki J, Inagaki K, Kano Y, Ogura T, Kiura K, Saika T, Makino H: Abrupt enlargement of adrenal incidentaloma: a case of isolated adrenal metastasis. Endocr J; 2005 Dec;52(6):785-8
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  • [Title] Abrupt enlargement of adrenal incidentaloma: a case of isolated adrenal metastasis.
  • A 56-year-old Japanese man was referred for examination of right adrenal tumor (3 cm).
  • He had no apparent preexisting cancer by radiological workup and accordingly, the patient was considered as a nonfunctioning adrenocortical adenoma and scheduled for periodic CT scans every 6 months.
  • However, five months after the initial diagnosis the patient complained of severe right back pain with remarkable enlargement of both adrenals (~20-fold volume).
  • Although the origin of adrenal tumor was uncertain by pathological workup, positron emission tomography (PET) scan with (18)F-2-fluoro-D-deoxyglucose (FDG) eventually revealed a hot spot on left upper lung, which was consistent with a lesion of thickened bulla wall observed by chest CT.
  • The present case is a very rare example of abrupt enlargement of bilateral adrenals due to clinically isolated adrenal metastasis, suggesting the requirement of frequent observation with greatest care regarding morphologic changes of adrenal incidentalomas.
  • [MeSH-major] Adenocarcinoma / secondary. Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / secondary. Adrenocortical Adenoma / diagnosis. Lung Neoplasms / pathology
  • [MeSH-minor] Adrenal Glands / pathology. Adrenal Glands / radiography. Adrenal Glands / ultrasonography. Humans. Hydrocortisone / blood. Incidental Findings. Male. Middle Aged. Positron-Emission Tomography

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  • [CommentIn] Endocr J. 2007 Dec;54(5):829 [17878608.001]
  • (PMID = 16410674.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone
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43. Bezerra MG, Latronico AC, Fragoso MC: [Endocrine tumors associated to protein Gsalpha/Gi2alpha mutations]. Arq Bras Endocrinol Metabol; 2005 Oct;49(5):784-90
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  • The G proteins couple an array of seven transmembrane receptors at the cell surface with a variety of intracellular effectors, which produce second messenger molecules.
  • A subset of endocrine tumors, such as GH- or ACTH-secreting pituitary adenomas, functioning thyroid adenomas, adrenocortical and gonadal tumors were associated with somatic activating mutations in the highly conserved codons of the Gs (Arg201 and Gln227) and Gi (Arg179 and Gln205) proteins.
  • [MeSH-major] Endocrine Gland Neoplasms / genetics. GTP-Binding Protein alpha Subunits, Gi-Go / genetics. GTP-Binding Protein alpha Subunits, Gs / genetics. Mutation / genetics. Oncogenes / genetics

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  • (PMID = 16444361.001).
  • [ISSN] 0004-2730
  • [Journal-full-title] Arquivos brasileiros de endocrinologia e metabologia
  • [ISO-abbreviation] Arq Bras Endocrinol Metabol
  • [Language] por
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Brazil
  • [Chemical-registry-number] EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gi-Go; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
  • [Number-of-references] 64
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44. Lee R, Storr M, Hershfield NB: A case of Conn's syndrome revealed after oral sodium phosphate (Fleet) preparation for colonoscopy. J Dig Dis; 2010 Apr;11(2):111-4
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  • [Title] A case of Conn's syndrome revealed after oral sodium phosphate (Fleet) preparation for colonoscopy.
  • The patient was subsequently diagnosed with primary aldosteronism secondary to an adenoma of the adrenal gland.
  • Bilateral adrenal venous sampling revealed excessive levels of aldosterone in the left adrenal vein prior to definitive surgery.
  • This case indicates that an oral sodium phosphate bowel preparation, though safe for most patients, can be complicated by a previously not diagnosed endocrine disease like the primary aldosteronism (Conn's syndrome) reported here.
  • This is the first report of a Conn's syndrome diagnosed after bowel cleansing with a sodium phosphate solution.
  • [MeSH-major] Colonoscopy / methods. Hyperaldosteronism / chemically induced. Hyperaldosteronism / diagnosis. Phosphates / adverse effects
  • [MeSH-minor] Adenoma / complications. Adenoma / diagnosis. Administration, Oral. Adrenal Gland Neoplasms / complications. Adrenal Gland Neoplasms / diagnosis. Aldosterone / blood. Female. Humans. Middle Aged. Renin / blood

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  • (PMID = 20402838.001).
  • [ISSN] 1751-2980
  • [Journal-full-title] Journal of digestive diseases
  • [ISO-abbreviation] J Dig Dis
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Phosphates; 4964P6T9RB / Aldosterone; EC 3.4.23.15 / Renin; SE337SVY37 / sodium phosphate
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45. Kawamata A, Iihara M, Okamoto T, Obara T: Bone mineral density before and after surgical cure of Cushing's syndrome due to adrenocortical adenoma: prospective study. World J Surg; 2008 May;32(5):890-6
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  • [Title] Bone mineral density before and after surgical cure of Cushing's syndrome due to adrenocortical adenoma: prospective study.
  • The aim of the present study was to assess the chronologic effect of surgical cure on bone mineral density (BMD) in patients with Cushing's syndrome due to adrenal adenoma.
  • Surgical cure of hypercortisolism provides significant improvement in BMD in patients with Cushing's syndrome due to adrenal adenoma.
  • [MeSH-major] Adrenal Cortex Neoplasms / surgery. Adrenocortical Adenoma / surgery. Bone Density / physiology. Cushing Syndrome / surgery

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  • (PMID = 18210182.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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46. Surgit O: Clipless and sutureless laparoscopic adrenalectomy carried out with the LigaSure device in 32 patients. Surg Laparosc Endosc Percutan Tech; 2010 Apr;20(2):109-13
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  • BACKGROUND: Laparoscopic adrenalectomy has become the standard procedure for treating patents with adrenal masses.
  • METHODS: The LigaSure device was used in 32 patients undergoing laparoscopic adrenalectomy for adrenal masses.
  • In 1 patient the adrenal tumor had invaded the ipsilateral kidney, so laparoscopic nephrectomy was also carried out during the same operation.
  • In another patient, a renal cell carcinoma in the left kidney had metastasized to the right adrenal gland.
  • Both the kidney and the contralateral adrenal gland were removed laparoscopically during the same operation.
  • RESULTS: Adrenal masses had a mean greatest diameter of 3.48 cm (range 2 to 11 cm).
  • Adrenal tumor types included adrenocortical adenoma (16 patients), pheochromocytoma (13 patients), malignant pheochromocytoma (1 patient), chromophobic carcinoma (1 patient), and metastasis from a renal cell carcinoma (1 patient).
  • For patients with conditions such as renal cell carcinoma combined with metastasis to the contralateral adrenal gland, nephrectomy, and contralateral adrenalectomy can be carried out during the same laparoscopic operation.
  • [MeSH-minor] Adenoma, Chromophobe / surgery. Adrenal Gland Neoplasms / secondary. Adrenal Gland Neoplasms / surgery. Adrenocortical Adenoma / surgery. Adult. Aged. Blood Loss, Surgical. Carcinoma, Renal Cell / secondary. Carcinoma, Renal Cell / surgery. Female. Humans. Kidney Neoplasms / surgery. Male. Middle Aged. Nephrectomy / methods. Pheochromocytoma / surgery

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  • (PMID = 20393338.001).
  • [ISSN] 1534-4908
  • [Journal-full-title] Surgical laparoscopy, endoscopy & percutaneous techniques
  • [ISO-abbreviation] Surg Laparosc Endosc Percutan Tech
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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47. Hamrahian AH, Ioachimescu AG, Remer EM, Motta-Ramirez G, Bogabathina H, Levin HS, Reddy S, Gill IS, Siperstein A, Bravo EL: Clinical utility of noncontrast computed tomography attenuation value (hounsfield units) to differentiate adrenal adenomas/hyperplasias from nonadenomas: Cleveland Clinic experience. J Clin Endocrinol Metab; 2005 Feb;90(2):871-7
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  • [Title] Clinical utility of noncontrast computed tomography attenuation value (hounsfield units) to differentiate adrenal adenomas/hyperplasias from nonadenomas: Cleveland Clinic experience.
  • Radiological characterization of an adrenal tumor as adenoma may decrease the need for follow-up imaging studies, biopsies, and unnecessary adrenalectomies.
  • We retrospectively reviewed 299 adrenalectomies in 290 patients at Cleveland Clinic Foundation over a recent 5-yr period to assess the value of noncontrast Hounsfield units (HU) in characterizing whether an adrenal mass is adenoma or nonadenoma.
  • The mean (+/- SD) HU value for the adrenocortical adenoma/hyperplasia group was 16.2 +/- 13.6 and significantly lower (P < 0.0001) than primary adrenocortical cancers (36.9 +/- 4.1), metastases (39.2 +/- 15.2), and pheochromocytomas (38.6 +/- 8.2).
  • The sensitivity and specificity for 10- and 20-HU cutoff values to differentiate adenomas/hyperplasias from nonadenomas were 40.5 and 100% and 58.2 and 96.9%, respectively.
  • The size of the adrenal tumor had less value with only 40.7 and 81.3% sensitivity and 94.7 and 61.4% specificity for 2- and 4-cm cutoff values.
  • A combination of less than or equal to 4-cm adrenal mass size and noncontrast computed tomography HU less than or equal to 20 had 42.1% sensitivity and 100% specificity.
  • Our study, the largest with surgical histopathology as the gold standard for diagnosis, supports a noncontrast computed tomography attenuation value of 10 HU as a safe cutoff value to differentiate adrenal adenomas/hyperplasias from nonadenomas.
  • [MeSH-major] Adenoma / radiography. Adrenal Gland Neoplasms / radiography. Adrenocortical Hyperfunction / radiography
  • [MeSH-minor] Adolescent. Adult. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Retrospective Studies. Tomography, X-Ray Computed

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  • (PMID = 15572420.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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48. Pittavini L, De Gaetano A, Solano G, Losito A: Resistant arterial hypertension: association with syncronous kidney cancer and adrenal adenoma. J Nephrol; 2010 Sep-Oct;23(5):614-6
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  • [Title] Resistant arterial hypertension: association with syncronous kidney cancer and adrenal adenoma.
  • The coexistence of renal cancer and adrenal adenoma is rare.
  • We report the case of a 60-year-old patient with synchronous hypernephroma and adrenal adenoma.
  • This suggests that the coexistence of kidney cancer and adrenal adenoma may be a curable cause of resistant hypertension.
  • [MeSH-major] Adenoma / complications. Adrenal Gland Neoplasms / complications. Carcinoma, Renal Cell / complications. Hypertension / etiology. Kidney Neoplasms / complications. Neoplasms, Multiple Primary / complications


49. Lamas C, Palma M, Martín D, de Frutos VA, López M, Marco A: [Adrenal incidentalomas: clinical experience in the hospitals of Castilla-La Mancha (Spain)]. Endocrinol Nutr; 2009 Oct;56(8):392-9
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  • [Title] [Adrenal incidentalomas: clinical experience in the hospitals of Castilla-La Mancha (Spain)].
  • [Transliterated title] Incidentalomas suprarrenales: experiencia clínica en los hospitales de Castilla-La Mancha.
  • OBJECTIVE: The management of incidentally discovered adrenal masses (incidentalomas) remains controversial.
  • Our objective was to describe the demographic and clinical characteristics of a series of patients with adrenal incidentalomas attended in several hospitals of Castilla-La Mancha, and their diagnostic and therapeutic management.
  • After a median follow-up of 28.8 months, 6% of nonfunctioning adenomas progressed to subclinical Cushing's syndrome, tumoral enlargement of more than 1 cm was found in 9.4% and a contralateral mass developed in 8.9%.
  • CONCLUSIONS: Our study confirms the favorable outcome in most patients with adrenal incidentalomas and contributes to a better understanding of this clinical entity.
  • [MeSH-major] Adrenal Gland Neoplasms / epidemiology. Carcinoma / epidemiology. Pheochromocytoma / epidemiology
  • [MeSH-minor] Adrenal Cortex Neoplasms / complications. Adrenal Cortex Neoplasms / epidemiology. Adrenal Cortex Neoplasms / secretion. Adrenal Cortex Neoplasms / surgery. Adrenalectomy. Adrenocortical Adenoma / complications. Adrenocortical Adenoma / epidemiology. Adrenocortical Adenoma / secretion. Adrenocortical Adenoma / surgery. Adrenocortical Carcinoma / complications. Adrenocortical Carcinoma / epidemiology. Adrenocortical Carcinoma / secretion. Adrenocortical Carcinoma / surgery. Aged. Comorbidity. Cushing Syndrome / etiology. Female. Glucose Metabolism Disorders / epidemiology. Glucose Metabolism Disorders / etiology. Humans. Hydrocortisone / secretion. Hyperaldosteronism / epidemiology. Hyperaldosteronism / etiology. Hypertension / epidemiology. Hypertension / etiology. Incidental Findings. Male. Middle Aged. Osteoporosis / epidemiology. Osteoporosis / etiology. Overweight / epidemiology. Spain / epidemiology

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  • (PMID = 19959148.001).
  • [ISSN] 1575-0922
  • [Journal-full-title] Endocrinología y nutrición : órgano de la Sociedad Española de Endocrinología y Nutrición
  • [ISO-abbreviation] Endocrinol Nutr
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone
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50. Peverelli E, Ermetici F, Filopanti M, Elli FM, Ronchi CL, Mantovani G, Ferrero S, Bosari S, Beck-Peccoz P, Lania A, Spada A: Analysis of genetic variants of phosphodiesterase 11A in acromegalic patients. Eur J Endocrinol; 2009 Nov;161(5):687-94
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  • The aim of the study was to screen acromegalic patients for the presence of variants of phosphodiesterase type 11A (PDE11A) gene, which have been recently identified in adrenocortical and testicular tumors.
  • Immunohistochemistry for PDE11A was performed in a subgroup of adenomas and normal pituitary samples.

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  • (PMID = 19671705.001).
  • [ISSN] 1479-683X
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA, Neoplasm; EC 3.1.4.- / Phosphoric Diester Hydrolases; EC 3.1.4.35 / PDE11A protein, human
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51. Louiset E, Gobet F, Libé R, Horvath A, Renouf S, Cariou J, Rothenbuhler A, Bertherat J, Clauser E, Grise P, Stratakis CA, Kuhn JM, Lefebvre H: ACTH-independent Cushing's syndrome with bilateral micronodular adrenal hyperplasia and ectopic adrenocortical adenoma. J Clin Endocrinol Metab; 2010 Jan;95(1):18-24
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  • [Title] ACTH-independent Cushing's syndrome with bilateral micronodular adrenal hyperplasia and ectopic adrenocortical adenoma.
  • CONTEXT: Bilateral micronodular adrenal hyperplasia and ectopic adrenocortical adenoma are two rare causes of ACTH-independent Cushing's syndrome.
  • OBJECTIVE: The aim of the study was to evaluate a 35-yr-old woman with ACTH-independent hypercortisolism associated with both micronodular adrenal hyperplasia and ectopic pararenal adrenocortical adenoma.
  • INTERVENTION: Mutations of the PRKAR1A, PDE8B, and PDE11A genes were searched for in leukocytes and adrenocortical tissues.
  • The ability of adrenal and adenoma tissues to synthesize cortisol was investigated by immunohistochemistry, quantitative PCR, and/or cell culture studies.
  • MAIN OUTCOME MEASURE: Detection of 17alpha-hydroxylase and 21-hydroxylase immunoreactivities, quantification of CYP11B1 mRNA in adrenal and adenoma tissues, and measurement of cortisol levels in supernatants by radioimmunological assays were the main outcomes.
  • RESULTS: Histological examination of the adrenals revealed nonpigmented micronodular cortical hyperplasia associated with relative atrophy of internodular cortex.
  • No genomic and/or somatic adrenal mutations of the PRKAR1A, PDE8B, and PDE11A genes were detected.
  • 17alpha-Hydroxylase and 21-hydroxylase immunoreactivities as well as CYP11B1 mRNA were detected in adrenal and adenoma tissues.
  • ACTH and dexamethasone activated cortisol secretion from adenoma cells.
  • CONCLUSION: This case suggests that unknown molecular defects can favor both micronodular adrenal hyperplasia and ectopic adrenocortical adenoma associated with Cushing's syndrome.
  • [MeSH-major] Adrenal Cortex Neoplasms / complications. Adrenal Glands / pathology. Adrenocortical Adenoma / complications. Choristoma / complications. Cushing Syndrome / complications
  • [MeSH-minor] Adrenocorticotropic Hormone / metabolism. Adrenocorticotropic Hormone / pharmacology. Adult. Drug Resistance / genetics. Drug Resistance / physiology. Female. Humans. Hyperplasia / complications. Hyperplasia / genetics. Hyperplasia / radiography. Kidney Diseases / complications. Kidney Diseases / genetics. Kidney Diseases / radiography

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  • (PMID = 19915020.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
  • [Other-IDs] NLM/ PMC2805485
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52. Niizuma S, Nakahama H, Kamide K, Fukuchi K, Iwanaga Y, Nakata H, Yoshihara F, Horio T, Nakamura S, Kawano Y: The cutoff value of aldosterone-to-renin ratio for the diagnosis of primary aldosteronism in patients taking antihypertensive medicine. Clin Exp Hypertens; 2008 Oct;30(7):640-7
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  • [Title] The cutoff value of aldosterone-to-renin ratio for the diagnosis of primary aldosteronism in patients taking antihypertensive medicine.
  • The diagnosis of PA was established with the results of both abdominal computed tomography and adrenal scintigraphy.
  • RESULTS: Of the 55 patients, 27 were found to have PA, including adrenal adenoma (n = 18) and bilateral adrenal hyperplasia (n = 9).
  • [MeSH-major] Aldosterone / blood. Antihypertensive Agents / therapeutic use. Hyperaldosteronism / blood. Hyperaldosteronism / diagnosis. Hypertension / drug therapy. Hypertension / etiology. Renin / blood
  • [MeSH-minor] Adenoma / blood. Adenoma / complications. Adenoma / diagnosis. Adrenal Gland Neoplasms / blood. Adrenal Gland Neoplasms / complications. Adrenal Gland Neoplasms / diagnosis. Adrenal Hyperplasia, Congenital / blood. Adrenal Hyperplasia, Congenital / complications. Adrenal Hyperplasia, Congenital / diagnosis. Aged. Drug Resistance. Female. Humans. Japan. Male. Middle Aged. Predictive Value of Tests. Prospective Studies

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  • (PMID = 18855267.001).
  • [ISSN] 1525-6006
  • [Journal-full-title] Clinical and experimental hypertension (New York, N.Y. : 1993)
  • [ISO-abbreviation] Clin. Exp. Hypertens.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antihypertensive Agents; 4964P6T9RB / Aldosterone; EC 3.4.23.15 / Renin
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53. Bagwan IN, Cook G, Mudan S, Wotherspoon A: Unusual presentation of metastatic adenocarcinoma. World J Surg Oncol; 2007;5:116
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  • BACKGROUND: The most common tumours of the adrenal gland are adenoma, pheochromocytoma, adrenocortical carcinoma, and metastases.
  • Although the imaging features of these tumours are established, the imaging characteristics of uncommon adrenal masses are less well known.
  • In patients with extradrenal tumour, incidental discovery of an adrenal mass necessitates excluding the possibility of metastatic malignancy.
  • Sixteen months later on staging CT scan a 2 x 2 cm adrenal mass was detected, which increased in size over a period of time to 3 x 3 cm in size.
  • Adrenalectomy was performed and histological examination revealed metastatic adenocarcinoma within an adrenal adenoma.
  • CONCLUSION: The present case highlights the unusual behaviour of an oesophageal adenocarcinoma causing metastasis to an adrenocortical adenoma.
  • [MeSH-major] Adenocarcinoma / secondary. Adrenal Gland Neoplasms / secondary. Esophageal Neoplasms / pathology

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  • (PMID = 17949483.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
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54. Doghman M, Arhatte M, Thibout H, Rodrigues G, De Moura J, Grosso S, West AN, Laurent M, Mas JC, Bongain A, Zambetti GP, Figueiredo BC, Auberger P, Martinerie C, Lalli E: Nephroblastoma overexpressed/cysteine-rich protein 61/connective tissue growth factor/nephroblastoma overexpressed gene-3 (NOV/CCN3), a selective adrenocortical cell proapoptotic factor, is down-regulated in childhood adrenocortical tumors. J Clin Endocrinol Metab; 2007 Aug;92(8):3253-60
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  • [Title] Nephroblastoma overexpressed/cysteine-rich protein 61/connective tissue growth factor/nephroblastoma overexpressed gene-3 (NOV/CCN3), a selective adrenocortical cell proapoptotic factor, is down-regulated in childhood adrenocortical tumors.
  • CONTEXT: Childhood adrenocortical tumors (ACTs) have a fetal adrenal phenotype and overexpress steroidogenic factor-1 (SF-1).
  • OBJECTIVE: The objective of the study was to measure NOV protein levels in childhood ACTs and characterize NOV expression regulation and biological function in human adrenocortical cells.
  • DESIGN AND SETTING: Protein extracts from ACT and normal adrenal cortex samples, human adrenocortical carcinoma H295R, primary adrenocortical tumors and fetal adrenal cultures, tissue culture supernatants, and cell lysates from H295R cells overexpressing SF-1 in an inducible fashion were used.
  • RESULTS: NOV mRNA and protein expression is lower in childhood ACTs than in normal adrenal cortex.
  • No significant difference was observed between adenomas and carcinomas.
  • NOV has a selective proapoptotic activity toward human adrenocortical cells.
  • The C-terminal domain of NOV is responsible for its proapoptotic effect.
  • NOV protein is expressed in DAX-1-positive human fetal adrenal cells.
  • CONCLUSIONS: NOV is a selective proapoptotic factor for human adrenocortical cells.
  • Reduced expression of NOV in ACTs may play an important role in the process of childhood ACT tumorigenesis, accounting at least in part for the defect of apoptotic regression of the fetal adrenal that has been proposed to be responsible for tumor formation.
  • [MeSH-major] Adenoma / metabolism. Adrenal Cortex / cytology. Adrenal Cortex Neoplasms / metabolism. Apoptosis / genetics. Apoptosis / physiology. Carcinoma / metabolism. Gene Expression Regulation, Neoplastic / genetics. Immediate-Early Proteins / genetics. Intercellular Signaling Peptides and Proteins / genetics
  • [MeSH-minor] Caspases / metabolism. Cell Line, Tumor. Child. Connective Tissue Growth Factor. DNA, Complementary / biosynthesis. DNA, Complementary / genetics. Down-Regulation / genetics. Down-Regulation / physiology. Enzyme Activation / physiology. Flow Cytometry. Fluorescent Antibody Technique. Homeodomain Proteins / biosynthesis. Homeodomain Proteins / genetics. Humans. Immunoblotting. Luciferases / biosynthesis. Luciferases / genetics. Nephroblastoma Overexpressed Protein. RNA, Messenger / biosynthesis. RNA, Messenger / genetics. RNA, Neoplasm / biosynthesis. RNA, Neoplasm / genetics. Receptors, Cytoplasmic and Nuclear / biosynthesis. Receptors, Cytoplasmic and Nuclear / genetics. Reverse Transcriptase Polymerase Chain Reaction. Steroidogenic Factor 1. Transcription Factors / biosynthesis. Transcription Factors / genetics. Transfection

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  • (PMID = 17566092.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA63230
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / CTGF protein, human; 0 / DNA, Complementary; 0 / Homeodomain Proteins; 0 / Immediate-Early Proteins; 0 / Intercellular Signaling Peptides and Proteins; 0 / NOV protein, human; 0 / NR5A1 protein, human; 0 / Nephroblastoma Overexpressed Protein; 0 / RNA, Messenger; 0 / RNA, Neoplasm; 0 / Receptors, Cytoplasmic and Nuclear; 0 / Steroidogenic Factor 1; 0 / Transcription Factors; 139568-91-5 / Connective Tissue Growth Factor; EC 1.13.12.- / Luciferases; EC 3.4.22.- / Caspases
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55. Reimel B, Zanocco K, Russo MJ, Zarnegar R, Clark OH, Allendorf JD, Chabot JA, Duh QY, Lee JA, Sturgeon C: The management of aldosterone-producing adrenal adenomas--does adrenalectomy increase costs? Surgery; 2010 Dec;148(6):1178-85; discussion 1185
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  • [Title] The management of aldosterone-producing adrenal adenomas--does adrenalectomy increase costs?
  • BACKGROUND: Most experts agree that primary hyperaldosteronism (PHA) caused by an aldosterone-producing adenoma (APA) is best treated by adrenalectomy.
  • Pharmacologic management for all patients with PHA was compared with a strategy of screening for and resecting an aldosterone-producing adenoma.
  • For a reference patient with 41 remaining years of life, the discounted expected cost of the surgical strategy was $27,821.
  • [MeSH-major] Adenoma / surgery. Adrenal Gland Neoplasms / surgery. Aldosterone / biosynthesis


56. Guthoff M, Schnauder G, Kirchhoff K, Kurth R, Horger M, Müssig K: [Normokalaemic primary aldosteronism due to an aldosterone-producing adrenal adenoma--Case 06/2009]. Dtsch Med Wochenschr; 2009 Jul;134(31-32):1582
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  • [Title] [Normokalaemic primary aldosteronism due to an aldosterone-producing adrenal adenoma--Case 06/2009].
  • INVESTIGATIONS: Ultrasound displayed no evidence of renal artery stenosis.
  • Renal function was normal.
  • MRI revealed an adenoma of the right adrenal gland.
  • DIAGNOSIS, TREATMENT AND COURSE: The results were consistent with primary aldosteronism due to an aldosterone-producing adenoma of the adrenal gland.
  • The histological findings confirmed an adenoma of the adrenal gland.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenocortical Adenoma / diagnosis. Hyperaldosteronism / etiology
  • [MeSH-minor] Adrenalectomy / methods. Adult. Aldosterone / blood. Aldosterone / secretion. Diagnosis, Differential. Humans. Hypertension / etiology. Laparoscopy. Magnetic Resonance Imaging. Male. Renin / blood

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  • (PMID = 19629922.001).
  • [ISSN] 1439-4413
  • [Journal-full-title] Deutsche medizinische Wochenschrift (1946)
  • [ISO-abbreviation] Dtsch. Med. Wochenschr.
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 4964P6T9RB / Aldosterone; EC 3.4.23.15 / Renin
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57. Qin ZK, Zhou FJ, Dai YP, Chen W, Hou JH, Han H, Liu ZW, Yu SL, Zhang DZ, Yang JA: [Expression and clinical significance of survivin and PTEN in adrenal tumors]. Ai Zheng; 2007 Oct;26(10):1143-7
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  • [Title] [Expression and clinical significance of survivin and PTEN in adrenal tumors].
  • BACKGROUND & OBJECTIVE: Since the histomorphology of adrenal tumor is very special, it is difficult to assess the malignancy of the tumors.
  • This study was to explore the expression and clinical significance of Survivin and PTEN proteins in adrenal tumors.
  • METHODS: The expression of Survivin and PTEN in 116 specimens of adrenal tumors, including 39 cases of cortex adenoma, 22 cases of cortex adenocarcinoma, 35 cases of pheochromocytoma, and 20 cases of malignant pheochromocytoma, were detected by LSAB immunohistochemistry.
  • The expression intensity of Survivin was correlated to that of PTEN in adrenal tumors (r=-0.486, P<0.05).
  • The expression intensity of Survivin and PTEN in adrenal tumors were not related to patient's age, sex, tumor position, and so on (P>0.05).
  • The expression intensity of Survivin was significantly lower in adrenal cortex adenoma than in adrenal cortex adenocarcinoma (P<0.05), and was significantly lower in pheochromocytoma than in malignant pheochromocytoma (P<0.05).
  • The expression intensity of PTEN was related to the differentiation of adrenal tumor.
  • The expression intensity of PTEN was significantly higher in adrenal cortex adenoma than in adrenal cortex adenocarcinoma (P<0.05), and was significantly higher in pheochromocytoma than in malignant pheochromocytoma (P<0.05).
  • The expression of Survivin protein and PTEN protein was correlated to the prognosis of adrenal cortex adenocarcinoma and malignant pheochromocytoma: the higher the expression intensity of Survivin protein and the lower the expression intensity of PTEN protein, the worse the patient's prognosis (P<0.05).
  • CONCLUSION: The expression of Survivin and PTEN proteins are closely related to the prognosis of adrenal tumors.
  • [MeSH-major] Adrenal Gland Neoplasms / metabolism. Adrenocortical Adenoma / metabolism. Adrenocortical Carcinoma / metabolism. Microtubule-Associated Proteins / metabolism. PTEN Phosphohydrolase / metabolism. Pheochromocytoma / metabolism

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  • (PMID = 17927889.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / BIRC5 protein, human; 0 / Inhibitor of Apoptosis Proteins; 0 / Microtubule-Associated Proteins; EC 3.1.3.48 / PTEN protein, human; EC 3.1.3.67 / PTEN Phosphohydrolase
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58. Groussin L, Bonardel G, Silvéra S, Tissier F, Coste J, Abiven G, Libé R, Bienvenu M, Alberini JL, Salenave S, Bouchard P, Bertherat J, Dousset B, Legmann P, Richard B, Foehrenbach H, Bertagna X, Tenenbaum F: 18F-Fluorodeoxyglucose positron emission tomography for the diagnosis of adrenocortical tumors: a prospective study in 77 operated patients. J Clin Endocrinol Metab; 2009 May;94(5):1713-22
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  • [Title] 18F-Fluorodeoxyglucose positron emission tomography for the diagnosis of adrenocortical tumors: a prospective study in 77 operated patients.
  • CONTEXT: Most adrenal incidentalomas are nonfunctioning adrenocortical adenomas (ACAs).
  • Adrenocortical carcinomas (ACCs) are rare but should be recognized at an early stage.
  • All underwent surgery because of hypersecretory and/or growing benign lesions (n = 18), obvious ACCs (n = 21), or radiologically indeterminate lesions (n = 38).
  • Using a cutoff value above 1.45 for adrenal to liver maxSUV ratio, the sensitivity and specificity to distinguish ACAs from ACCs were, respectively, 1.00 (95% confidence interval 0.85-1.00) and 0.88 (95% confidence interval 0.75-0.96).
  • Among the 38 indeterminate lesions at CT scan, we could analyze a subgroup of 16 adrenocortical tumors with high unenhanced density (>10 HU) and an inappropriate washout: (18)F-FDG PET correctly predicted the benignity in 13 of 15 ACAs.
  • An adrenal to liver maxSUV ratio less than 1.45 is highly predictive of a benign lesion.
  • [MeSH-major] Adrenal Cortex Neoplasms / radionuclide imaging. Adrenal Cortex Neoplasms / surgery. Fluorodeoxyglucose F18


59. Bocca G, Voorhoeve PG, de Delemarre-van Wall HA: [Cushing's syndrome in children]. Ned Tijdschr Geneeskd; 2006 Oct 28;150(43):2345-9
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  • [Transliterated title] Het syndroom van Cushing bij kinderen.
  • In addition, the first showed a decrease in linear growth and weight gain; a pituitary adenoma was found, which was surgically excised.
  • The second girl was examined because of a male body-hair pattern and weight increase.
  • She had an adrenal adenoma, visible on MRI, which was excised during laparoscopy.
  • Cushing's syndrome is a rare disease in childhood.
  • Arriving at an aetiological diagnosis may be difficult and is based on the performance and interpretation of endocrinologic function and laboratory tests such as determination of the cortisol level in blood, saliva and urine, a dexamethasone-suppression test, and a corticotropin assay in blood drawn from the cerebral cavernous sinuses.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / diagnosis. Adenoma / diagnosis. Cushing Syndrome / diagnosis. Hydrocortisone / blood
  • [MeSH-minor] Adolescent. Dexamethasone. Diagnosis, Differential. Female. Growth. Humans. Magnetic Resonance Imaging. Treatment Outcome. Weight Gain

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  • [CommentIn] Ned Tijdschr Geneeskd. 2007 Mar 3;151(9):560; author reply 560-1 [17375397.001]
  • [CommentOn] Ned Tijdschr Geneeskd. 2006 Oct 28;150(43):2365-9 [17100127.001]
  • [CommentOn] Ned Tijdschr Geneeskd. 2006 Oct 28;150(43):2390-3 [17100132.001]
  • [CommentOn] Ned Tijdschr Geneeskd. 2006 Oct 28;150(43):2359-64 [17100126.001]
  • (PMID = 17100122.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] Case Reports; Comment; English Abstract; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 7S5I7G3JQL / Dexamethasone; WI4X0X7BPJ / Hydrocortisone
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60. Jain M, Kapoor S, Mishra A, Gupta S, Agarwal A: Weiss criteria in large adrenocortical tumors: a validation study. Indian J Pathol Microbiol; 2010 Apr-Jun;53(2):222-6
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  • [Title] Weiss criteria in large adrenocortical tumors: a validation study.
  • BACKGROUND: Several systems including pathologic criteria alone or in combination with clinical features have been proposed to differentiate between benign and malignant adrenocortical tumors and assess their prognosis.
  • Since we see large adrenocortical carcinoma (ACC), we attempt to evaluate the diagnostic power of Weiss system in large ACC.
  • MATERIALS AND METHODS: In this study clinicopathological characteristics of 42 adrenocortical neoplasms are studied and classified into adrenocortical adenoma (ACA) and ACC based on Weiss score of less than or equal to three or greater than three.
  • CONCLUSION: Weiss score was found to be a good prognostic factor for tumors of the adrenal cortex.
  • [MeSH-major] Adrenocortical Adenoma / diagnosis. Adrenocortical Adenoma / pathology. Adrenocortical Carcinoma / diagnosis. Adrenocortical Carcinoma / pathology. Histocytochemistry / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Child, Preschool. Diagnosis, Differential. Female. Humans. Infant. Male. Middle Aged. Prognosis. Young Adult

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  • (PMID = 20551521.001).
  • [ISSN] 0974-5130
  • [Journal-full-title] Indian journal of pathology & microbiology
  • [ISO-abbreviation] Indian J Pathol Microbiol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] India
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61. Mannelli M, Colagrande S, Valeri A, Parenti G: Incidental and metastatic adrenal masses. Semin Oncol; 2010 Dec;37(6):649-61
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  • [Title] Incidental and metastatic adrenal masses.
  • In the last decades discoveries of adrenal masses incidentally during the course of diagnostic procedures for unrelated disorders (incidentalomas) have become progressively more frequent.
  • The clinician in this position must answer two main questions: Is the mass benign or malignant?
  • , and To what extent is the adrenal secretion altered?
  • To come to a clinical decision, several diagnostic tools need to be engaged, starting with an accurate and correct radiological evaluation and a hormonal assessment of the adrenal function.
  • Most frequently, adrenal incidentalomas (AIs) are represented by benign cortical adenomas, a subset of which causes a mild hypercortisolism, known as subclinical Cushing's syndrome (SCS).
  • Laparoscopic surgery is the recommended procedure to remove benign masses.
  • The surgical procedure for adrenal malignancies is still debated.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Incidental Findings
  • [MeSH-minor] Adenoma / diagnosis. Adrenal Cortex Hormones / secretion. Adrenal Gland Diseases / diagnosis. Adrenalectomy. Adrenocortical Carcinoma / diagnosis. Algorithms. Diagnosis, Differential. Humans. Myelolipoma / diagnosis. Pheochromocytoma / diagnosis. Tomography, X-Ray Computed / methods

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  • [Copyright] Copyright © 2010 Elsevier Inc. All rights reserved.
  • (PMID = 21167383.001).
  • [ISSN] 1532-8708
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones
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62. Razifar P, Hennings J, Monazzam A, Hellman P, Långström B, Sundin A: Masked volume wise Principal Component Analysis of small adrenocortical tumours in dynamic [11C]-metomidate Positron Emission Tomography. BMC Med Imaging; 2009;9:6
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  • [Title] Masked volume wise Principal Component Analysis of small adrenocortical tumours in dynamic [11C]-metomidate Positron Emission Tomography.
  • METHODS: In this study, MVW-PCA was applied to 14 dynamic 11C-metomidate-PET (MTO-PET) examinations of 7 patients with small adrenocortical tumours.
  • Time activity curves derived from "50% cut-off" ROIs based on an isocontour function whereby the pixels with SUVs between 50 to 100% of the highest radioactivity concentration were delineated, showed a significant decrease of the SUVs in normal adrenal glands and in adrenocortical adenomas after cortisone treatment.
  • [MeSH-major] Adrenal Cortex Neoplasms / radionuclide imaging. Algorithms. Etomidate / analogs & derivatives. Image Interpretation, Computer-Assisted / methods. Imaging, Three-Dimensional / methods. Pattern Recognition, Automated / methods. Positron-Emission Tomography / methods

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  • (PMID = 19386097.001).
  • [ISSN] 1471-2342
  • [Journal-full-title] BMC medical imaging
  • [ISO-abbreviation] BMC Med Imaging
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 5377-20-8 / metomidate; Z22628B598 / Etomidate
  • [Other-IDs] NLM/ PMC2680831
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63. Velázquez-Fernández D, Laurell C, Geli J, Höög A, Odeberg J, Kjellman M, Lundeberg J, Hamberger B, Nilsson P, Bäckdahl M: Expression profiling of adrenocortical neoplasms suggests a molecular signature of malignancy. Surgery; 2005 Dec;138(6):1087-94
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  • [Title] Expression profiling of adrenocortical neoplasms suggests a molecular signature of malignancy.
  • BACKGROUND: Distinguishing between adrenocortical adenomas and carcinomas is often difficult.
  • Our aim was to investigate the differences in transcriptional profiles between benign and malignant adrenocortical neoplasms using complementary DNA microarray techniques.
  • METHODS: We studied 7 patients with adrenocortical carcinomas and 13 with adenomas.
  • RESULTS: Transcriptional profiles were homogeneous among adenomas, while carcinomas were much more heterogeneous.
  • Hierarchical clustering and self-organizing maps could separate clearly carcinomas from adenomas.
  • Among genes that were most significantly downregulated in carcinomas were a cytokine gene (CXCL10), several genes related to cell metabolism (RARRES2, ALDH1A1, CYBRD1 and GSTA4), and the cadherin 2 gene (CDH2).
  • CONCLUSIONS: Through the use of cDNA arrays, adrenocortical adenomas and carcinomas appear to be clearly distinguishable on the basis of their specific molecular signature.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Adrenocortical Adenoma / genetics. Adrenocortical Carcinoma / genetics

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  • (PMID = 16360395.001).
  • [ISSN] 0039-6060
  • [Journal-full-title] Surgery
  • [ISO-abbreviation] Surgery
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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64. Browning L, Bailey D, Parker A: D2-40 is a sensitive and specific marker in differentiating primary adrenal cortical tumours from both metastatic clear cell renal cell carcinoma and phaeochromocytoma. J Clin Pathol; 2008 Mar;61(3):293-6
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  • [Title] D2-40 is a sensitive and specific marker in differentiating primary adrenal cortical tumours from both metastatic clear cell renal cell carcinoma and phaeochromocytoma.
  • BACKGROUND: The morphological similarities between the cells of clear cell renal cell carcinoma (CCRCC) and those of the adrenal cortex impose diagnostic difficulties, for example in the context of a solitary nodule in the adrenal gland in a patient with renal cell carcinoma (RCC).
  • D2-40, an antibody commonly used to highlight lymphatic endothelial cells, is consistently positive in the normal adrenal cortex.
  • AIMS: To investigate the utility of D2-40 in distinguishing neoplastic and non-neoplastic adrenal cortical cells from those of CCRCC, and from phaeochromocytoma.
  • METHODS: D2-40 antibody was applied to tissue sections from 10 normal adrenal glands, 15 renal carcinomas (13 clear cell, 2 papillary variants), 1 metastatic CCRCC in the adrenal gland, 6 adrenal cortical hyperplasias, 5 adrenal cortical adenomas, 3 adrenal cortical carcinomas, and 4 phaeochromocytomas.
  • RESULTS: D2-40 was strongly and diffusely positive in the cells of the neoplastic and non-neoplastic adrenal cortex, but negative in the cells of the CCRCC, both primary and metastatic, in 100% of the cases.
  • The cells of the adrenal medulla, and those of the phaeochromocytomas, were negative for D2-40.
  • CONCLUSIONS: D2-40 may be a useful marker for distinguishing primary adrenal cortical neoplasms from both metastatic CCRCC and phaeochromocytoma.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Antibodies, Monoclonal / analysis. Biomarkers, Tumor / analysis. Carcinoma, Renal Cell / secondary. Kidney Neoplasms / secondary. Pheochromocytoma / diagnosis
  • [MeSH-minor] Adenoma / diagnosis. Adrenal Glands / immunology. Antibodies, Monoclonal, Murine-Derived. Carcinoma / diagnosis. Cytoplasm / immunology. Diagnosis, Differential. Humans. Immunohistochemistry


65. Guerrieri M, De Sanctis A, Crosta F, Arnaldi G, Boscaro M, Lezoche G, Campagnacci R: Adrenal incidentaloma: surgical update. J Endocrinol Invest; 2007 Mar;30(3):200-4
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  • [Title] Adrenal incidentaloma: surgical update.
  • Nowadays, the role of surgery in the treatment of adrenal incidentalomas (AI), considering their biologic behavior, is still debated.
  • Surgery is mandatory in cases of hyperfunctioning adrenal masses, in the presence of suspect radiological malignancy, in cases of discordant computed tomography (CT) and scintigraphy findings and when the maximum diameter is 4 cm or more.
  • The aim of this paper was to evaluate the safety and effectiveness of laparoscopic adrenalectomy (LA) in the treatment of AI by reviewing our experience.
  • Two LA (2.6%) were converted to open surgery.
  • Twenty-one large adrenal lesions (exceeding 6 cm) were removed (27%).
  • Definitive histology resulted as follows: adrenocortical adenoma (63), pheochromocytoma (5), nodular hyperplasia (4), myelolipoma (3), cysts (2), and adrenocortical carcinoma (1, with a size of 3 cm).
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / surgery. Adrenalectomy / trends
  • [MeSH-minor] Adrenal Glands / pathology. Adrenal Glands / surgery. Adult. Aged. Female. Follow-Up Studies. Humans. Male. Middle Aged

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  • (PMID = 17505152.001).
  • [ISSN] 1720-8386
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Italy
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66. Rossi GP, Sticchi D, Giuliani L, Bernante P, Zavattiero S, Pessina AC, Nussdorfer GG: Adiponectin receptor expression in the human adrenal cortex and aldosterone-producing adenomas. Int J Mol Med; 2006 Jun;17(6):975-80
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  • [Title] Adiponectin receptor expression in the human adrenal cortex and aldosterone-producing adenomas.
  • Adiponectin is an adipocyte-derived circulating peptide that plays an important role in adipose tissue metabolism, insulin sensitivity and cardiovascular disease.
  • The adrenal gland, by secreting glucorticoid and mineralocorticoid hormones, intervenes in cardiovascular and glucose metabolism regulation and is surrounded by adipose tissue.
  • Hence, we investigated the hypothesis that adiponectin receptor types 1 and 2 (adipo-R1 and adipo-R2) are expressed in the human adrenal gland and in adrenocortical zona glomerulosa cell-derived aldosterone-producing adenoma (APA) tissue.
  • We used real-time reverse transcription-polymerase chain reaction to demonstrate the mRNA of adipo-R1 and adipo-R2 in 10 histologically normal human adrenal cortexes that were obtained from patients with renal cancer undergoing nephrectomy with ipsilateral adrenalectomy and in 10 APAs.
  • Results consistently showed the expression of specific mRNAs of adiponectin receptors in all histologically normal human adrenal cortexes and APAs.
  • This novel finding suggests that adiponectin could play a regulatory role in adrenocortical function and growth in humans.
  • [MeSH-major] Adrenal Cortex / metabolism. Adrenal Cortex Neoplasms / metabolism. Adrenocortical Adenoma / metabolism. Aldosterone / biosynthesis. Receptors, Cell Surface / genetics

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  • (PMID = 16685404.001).
  • [ISSN] 1107-3756
  • [Journal-full-title] International journal of molecular medicine
  • [ISO-abbreviation] Int. J. Mol. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / ADIPOR1 protein, human; 0 / ADIPOR2 protein, human; 0 / RNA, Messenger; 0 / Receptors, Adiponectin; 0 / Receptors, Cell Surface; 4964P6T9RB / Aldosterone
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67. Adler JT, Mack E, Chen H: Isolated adrenal mass in patients with a history of cancer: remember pheochromocytoma. Ann Surg Oncol; 2007 Aug;14(8):2358-62
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  • [Title] Isolated adrenal mass in patients with a history of cancer: remember pheochromocytoma.
  • BACKGROUND: In a patient with a history of cancer, an isolated adrenal mass is usually thought to be a metastasis.
  • This study was undertaken to determine the incidence of functional adrenal lesions in patients with a history of cancer and examine predictive factors for the type of lesion.
  • METHODS: At a single institution, 33 patients with an isolated adrenal mass and a history of cancer underwent surgical treatment.
  • Patients' records were retrospectively analyzed for type of adrenal lesion and other diagnostic parameters.
  • Of these, 20 (61%) had adrenal metastases, 8 (24%) had pheochromocytomas, and 5 (15%) had adrenal adenomas.
  • CONCLUSIONS: Nearly 1 in 4 resected adrenal masses in patients with a history of cancer were pheochromocytomas.
  • Therefore, remember one thing in patients with an isolated adrenal mass and a history of cancer: pheochromocytoma.
  • [MeSH-major] Adrenal Gland Neoplasms. Medical Records. Pheochromocytoma
  • [MeSH-minor] Adenoma / pathology. Adrenalectomy. Analysis of Variance. Female. Humans. Incidence. Male. Middle Aged. Neoplasm Metastasis. Neoplasms / pathology. Positron-Emission Tomography. Retrospective Studies. Tumor Burden


68. Nicol MR, Papacleovoulou G, Evans DB, Penning TM, Strachan MW, Advani A, Johnson SJ, Quinton R, Mason JI: Estrogen biosynthesis in human H295 adrenocortical carcinoma cells. Mol Cell Endocrinol; 2009 Mar 5;300(1-2):115-20
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  • [Title] Estrogen biosynthesis in human H295 adrenocortical carcinoma cells.
  • Adrenocortical carcinoma is an uncommon malignancy and feminizing symptoms secondary to adrenal estrogen-secretion are extremely rare.
  • The direct secretion of estradiol by adrenocortical tumors requires, in addition to the expression of aromatase (CYP19), the expression of one or more of the reductive 17beta-hydroxysteroid dehydrogenases.
  • The expression of CYP19 transcripts and protein were markedly induced in the H295 adrenocortical carcinoma cell line after treatment with either forskolin or vasoactive intestinal peptide (VIP).
  • Western immunoblotting of an estrogen-secreting adrenal carcinoma revealed notable levels of both aromatase and AKR1C3 expression while an aldosterone-producing adrenal adenoma lacked aromatase expression and showed a reduced level of AKR1C3 expression.
  • Immunohistochemistry of the carcinoma-bearing adrenal revealed localization of AKR1C3 not only in the tumor but also principally in the zona reticularis of the normal adrenal tissue.
  • Adrenal aromatase and AKR1C3 expression therefore appear to be features of adrenocortical malignancies that are associated with biosynthesis of active estrogen.

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  • (PMID = 19026713.001).
  • [ISSN] 0303-7207
  • [Journal-full-title] Molecular and cellular endocrinology
  • [ISO-abbreviation] Mol. Cell. Endocrinol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA090744-07; United States / NCI NIH HHS / CA / R01 CA090744; United States / NCI NIH HHS / CA / R01 CA090744-07; United States / NCI NIH HHS / CA / R01-CA90744
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Estrogens; 1F7A44V6OU / Colforsin; 37221-79-7 / Vasoactive Intestinal Peptide; EC 1.1.- / 17-Hydroxysteroid Dehydrogenases; EC 1.1.- / 3-Hydroxysteroid Dehydrogenases; EC 1.1.1.- / AKR1C3 protein, human; EC 1.1.1.- / Hydroxyprostaglandin Dehydrogenases; EC 1.1.1.145 / 3 beta-hydroxysteroid dehydrogenase type II; EC 1.1.1.145 / Progesterone Reductase; EC 1.14.14.1 / Aromatase; EC 1.14.15.4 / Cytochrome P-450 CYP11B2; EC 1.14.15.4 / Steroid 11-beta-Hydroxylase; EC 1.14.99.9 / Steroid 17-alpha-Hydroxylase
  • [Other-IDs] NLM/ NIHMS99072; NLM/ PMC2673546
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69. Tritos NA: Diagnosis of primary aldosteronism in a patient with an incidentally found adrenal mass. Nat Clin Pract Endocrinol Metab; 2007 Jul;3(7):547-51
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  • [Title] Diagnosis of primary aldosteronism in a patient with an incidentally found adrenal mass.
  • BACKGROUND: A 50-year-old woman who was complaining of abdominal pain was referred to the endocrine clinic after a small (0.8 cm by 0.8 cm) mass was found in her right adrenal gland on CT examination of the abdomen.
  • She had a history of hypertension for 10 years, generalized anxiety disorder for 5 years and a weight increase of 18 kg over the previous 3 years.
  • In addition, measurements of urine aldosterone excretion on a high-salt diet, MRI-examination of the adrenal glands and bilateral adrenal vein sampling were conducted.
  • DIAGNOSIS: An aldosterone-secreting adrenal adenoma.
  • MANAGEMENT: The patient underwent laparoscopic resection of the right adrenal gland, which led to normalization of aldosterone excretion, lowering of her blood pressure on a single antihypertensive medication (50 mg sustained-release metoprolol daily) and resolution of hypokalemia.
  • [MeSH-major] Adenoma / diagnosis. Adrenal Gland Neoplasms / diagnosis. Adrenal Glands / pathology. Hyperaldosteronism / diagnosis
  • [MeSH-minor] Adrenalectomy. Aldosterone / blood. Diagnosis, Differential. Female. Humans. Magnetic Resonance Imaging. Middle Aged

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  • (PMID = 17581624.001).
  • [ISSN] 1745-8374
  • [Journal-full-title] Nature clinical practice. Endocrinology & metabolism
  • [ISO-abbreviation] Nat Clin Pract Endocrinol Metab
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 4964P6T9RB / Aldosterone
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70. Yokoyama H, Konomi I, Miyajima T, Tamaru S, Tanaka M: Interventional ultrasound for adrenal masses. J Med Ultrason (2001); 2006 Dec;33(4):245-9
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  • [Title] Interventional ultrasound for adrenal masses.
  • PURPOSE: To determine the value of interventional ultrasound (US) for adrenal masses, especially incidentally discovered adrenal masses.
  • METHODS: Demographic, clinical, and pathological data were reviewed for eight patients who underwent percutaneous US-guided puncture or biopsy for adrenal masses from September 1994 through March 2002 in our institute.
  • RESULTS: US-guided intervention was successfully performed for seven patients: two with adrenal cysts, two with adrenocortical adenomas, and three with metastatic adrenal tumors (one from prostate cancer, one from lung cancer, and one from renal cell carcinoma).
  • The remaining patient had bilateral adrenal masses, and a biopsy specimen could not be obtained because safe puncture was difficult.
  • CONCLUSIONS: Interventional US using the color Doppler method for adrenal masses is a useful procedure for safe puncture to reveal the orientation of adjacent viscera and blood vessels at the puncture site and to avoid complications including hemorrhage and pneumothorax.
  • In addition, pathological examination of specimens obtained by percutaneous biopsy or fine needle aspiration is useful for avoiding unnecessary surgery in patients with metastatic adrenal masses.

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  • (PMID = 27277982.001).
  • [ISSN] 1346-4523
  • [Journal-full-title] Journal of medical ultrasonics (2001)
  • [ISO-abbreviation] J Med Ultrason (2001)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Keywords] NOTNLM ; adrenal mass / interventional ultrasound
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71. Galac S, Kool MM, Naan EC, Daminet S, Mol JA, Kooistra HS: Expression of the ACTH receptor, steroidogenic acute regulatory protein, and steroidogenic enzymes in canine cortisol-secreting adrenocortical tumors. Domest Anim Endocrinol; 2010 Nov;39(4):259-67
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  • [Title] Expression of the ACTH receptor, steroidogenic acute regulatory protein, and steroidogenic enzymes in canine cortisol-secreting adrenocortical tumors.
  • Studies of human adrenocortical tumors (ATs) causing Cushing's syndrome suggest that hypersecretion of cortisol is caused by altered expression of steroidogenic enzymes and that steroidogenesis can only be maintained when there is expression of the ACTH receptor (ACTH-R).
  • Real-time PCR (RT-PCR) was applied in all samples and was compared with that in normal canine adrenal glands.
  • Messenger-RNA encoding StAR, steroidogenic enzymes, and ACTH-R were present in both normal adrenal glands and cortisol-secreting ATs.
  • The amounts of mRNA encoding StAR and enzymes of the steroidogenic cluster needed for cortisol production did not differ significantly between either adenomas or carcinomas and normal adrenal glands.
  • The amount of mRNA encoding ACTH-R was significantly lower in carcinomas than in normal adrenal glands (P = 0.008).
  • [MeSH-major] Adrenal Cortex Neoplasms / veterinary. Dog Diseases / metabolism. Hydrocortisone / secretion. Phosphoproteins / genetics. Receptors, Corticotropin / genetics. Steroids / biosynthesis

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  • [Copyright] Copyright © 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20920783.001).
  • [ISSN] 1879-0054
  • [Journal-full-title] Domestic animal endocrinology
  • [ISO-abbreviation] Domest. Anim. Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Phosphoproteins; 0 / RNA, Messenger; 0 / Receptors, Corticotropin; 0 / Steroids; 0 / steroidogenic acute regulatory protein; EC 1.1.- / 3-Hydroxysteroid Dehydrogenases; EC 1.14.15.4 / Steroid 11-beta-Hydroxylase; EC 1.14.15.6 / Cholesterol Side-Chain Cleavage Enzyme; EC 1.14.99.10 / Steroid 21-Hydroxylase; EC 1.14.99.9 / Steroid 17-alpha-Hydroxylase; WI4X0X7BPJ / Hydrocortisone
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72. Sahdev A, Reznek RH, Evanson J, Grossman AB: Imaging in Cushing's syndrome. Arq Bras Endocrinol Metabol; 2007 Nov;51(8):1319-28
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  • Once the diagnosis of Cushing's syndrome (CS) has been established, the main step is to differentiate between ACTH dependent and independent disease.
  • In adults, 80% of CS is due to ACTH-dependent causes and 20% due to adrenal causes.
  • These are usually anterior pituitary microadenomas, which result in the classic Cushing's disease.
  • Non-pituitary ectopic sources of ACTH, such as a small-cell lung carcinoma or carcinoid tumours, are the source of the remainder of ACTH-dependent disease.
  • Imaging is essential for determining the source of ACTH in ectopic ACTH production, locating the pituitary tumours and distinguishing adrenal adenomas, carcinomas and hyperplasias.
  • In our chapter we review the adrenal appearances in ACTH-dependent and ACTH-independent CS.
  • We also include a discussion on the use of MRI and CT for the detection and management of pituitary ACTH secreting adenomas.
  • CT of the chest, abdomen and pelvis with intravenous injection of contrast medium is the most sensitive imaging modality for the identification of the ectopic ACTH source and detecting adrenal pathology.
  • MRI is used for characterising adrenal adenomas, problem solving in difficult cases and for detecting ACTH-secreting pituitary adenomas.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / diagnosis. Cushing Syndrome / diagnosis. Pituitary Gland / pathology. Pituitary Neoplasms / diagnosis
  • [MeSH-minor] ACTH Syndrome, Ectopic / diagnosis. Adenoma / diagnosis. Adenoma / radiography. Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / radiography. Carcinoma / diagnosis. Carcinoma / radiography. Humans. Hyperplasia / diagnosis. Hyperplasia / radiography. Lung Neoplasms / diagnosis. Lung Neoplasms / secretion. Magnetic Resonance Imaging. Tomography, X-Ray Computed

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  • (PMID = 18209870.001).
  • [ISSN] 0004-2730
  • [Journal-full-title] Arquivos brasileiros de endocrinologia e metabologia
  • [ISO-abbreviation] Arq Bras Endocrinol Metabol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Brazil
  • [Number-of-references] 36
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73. Nigawara T, Kageyama K, Sakihara S, Takayasu S, Kawahara M, Imai A, Ohyama C, Usui T, Sasano H, Suda T: A male case of nonclassical 21-hydroxylase deficiency first manifested in his sixties with adrenocortical incidentaloma. Endocr J; 2008 May;55(2):291-7
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  • [Title] A male case of nonclassical 21-hydroxylase deficiency first manifested in his sixties with adrenocortical incidentaloma.
  • Nonclassical form of 21-hydroxylase deficiency (NC 21OHD) as a frequent variant on the milder end of the disease spectrum has been widely acknowledged, but its potential contribution to adrenocortical tumorigenesis has not been fully elucidated.
  • We report a 66-year old male case of bilateral adrenocortical incidentaloma, associated with partial 21OHD without any episodes of hypoadrenocorticism in his past history.
  • The two tumors in the left adrenal, which were interpreted as myelolipoma by imaging studies, were followed by sequential observation, whereas the contralateral large solid tumor associated with inhomogeneous radiological appearance was subsequently removed.
  • The resected tumor was diagnosed an adrenocortical adenoma, which was devoid of P450c21 immunoreactivity.
  • 21OHD is often associated with benign adrenocortical tumors, but bilateral adrenal tumors with heterogeneous components in both adrenals have not been reported to the best of our knowledge.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenal Hyperplasia, Congenital / diagnosis. Adrenocortical Adenoma / diagnosis. Incidental Findings. Steroid 21-Hydroxylase / genetics
  • [MeSH-minor] 17-alpha-Hydroxyprogesterone / blood. Adrenal Cortex / metabolism. Adrenal Cortex / pathology. Adrenocorticotropic Hormone / blood. Aged. Humans. Male

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  • (PMID = 18323673.001).
  • [ISSN] 1348-4540
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 68-96-2 / 17-alpha-Hydroxyprogesterone; 9002-60-2 / Adrenocorticotropic Hormone; EC 1.14.99.10 / Steroid 21-Hydroxylase
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74. Andía Melero VM, García Centeno R, Fernández JB, Vigovich C, Sánchez García-Cervigón P, Jara Albarrán A: [Feminizing adrenal tumours in Spain: report of a case and review of the five previously published patients]. Endocrinol Nutr; 2009 Nov;56(9):470-4
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  • [Title] [Feminizing adrenal tumours in Spain: report of a case and review of the five previously published patients].
  • [Transliterated title] Tumores suprarrenales feminizantes en España: aportación de un caso y revisión de los cinco pacientes descritos.
  • Feminizing adrenal tumours are very rare.
  • We report the clinical and hormonal study of a case, a 49 years old male, since his first consultation until his death 6 years after the initial diagnosis, and a review of the other 5 Spanish patients previously published.
  • His initial symptoms were gynecomastia and libido decrease, with increase of plasmatic and urinary oestrogen levels, plasma testosterone near low normal level and a right adrenal gland tumour that, after its removal, showed a benign histology and was classified as an adrenocortical adenoma.
  • The main special feature of this case is the apparently benign initial adrenal tumour with only oestrogen hypersecretion, and its relapse 3 years later with secretion of several steroid hormones, generalized metastasis and no response to medical therapy.
  • [MeSH-major] Adenoma / complications. Adrenal Gland Neoplasms / complications. Feminization / etiology

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  • (PMID = 20096213.001).
  • [ISSN] 1575-0922
  • [Journal-full-title] Endocrinología y nutrición : órgano de la Sociedad Española de Endocrinología y Nutrición
  • [ISO-abbreviation] Endocrinol Nutr
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 12
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75. Takeda Y, Usukura M, Yoneda T, Oda N, Ito Y, Mabuchi H: The expression of messenger RNA for ADP-ribosyl cyclase in aldosterone-producing adenomas. Clin Endocrinol (Oxf); 2005 Apr;62(4):504-8
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  • [Title] The expression of messenger RNA for ADP-ribosyl cyclase in aldosterone-producing adenomas.
  • To determine whether the cADPR system plays a signalling role in angiotensin II (Ang II)-induced aldosterone synthesis in the human adrenal gland, we investigated the effects of Ang II on ADP-ribosyl cyclase activity in human adrenal cortical tissue.
  • In addition, the expression of ADP-ribosyl cyclase messenger RNA was evaluated in aldosterone-producing adenomas (APAs) and compared with normal adrenal tissue and nonfunctioning adenomas.
  • DESIGN: ADP-ribosyl cyclase activity was measured in crude membrane fractions of human adrenocortical tissues with Ang II or with Ang II plus the Ang II receptor (AT(1)R) antagonist losartan or plus the AT(2)R antagonist PD123319.
  • The effect of 8-bromo-cADPR on Ang II-induced aldosterone production from adrenal tissue was estimated.
  • The expression of ADP-ribosyl cyclase, CYP11B2 and AT(1)R mRNA was measured in APAs, nonfunctioning adenomas, adjacent adrenal tissue and normal adrenal tissue.
  • The expression of ADP-ribosyl cyclase, CYP11B2 and AT(1)R mRNA was increased in APAs compared with that of nonfunctioning adenomas, adjacent adrenal tissue or normal adrenal tissue.
  • CONCLUSIONS: These results demonstrated the existence of a signalling pathway from the Ang II receptor to ADP-ribosyl cyclase in the human adrenal gland and suggest that the cADP-ribose signalling system might play an important role in the pathogenesis of APAs.
  • [MeSH-major] ADP-ribosyl Cyclase / genetics. Adenoma / secretion. Adrenal Cortex Neoplasms / secretion. Aldosterone / secretion. Angiotensins / pharmacology. Cyclic ADP-Ribose / analogs & derivatives. RNA, Messenger / analysis

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  • (PMID = 15807884.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / 8-bromo-cyclic-ADP-ribose; 0 / Angiotensins; 0 / Imidazoles; 0 / Pyridines; 0 / RNA, Messenger; 0 / Receptor, Angiotensin, Type 1; 119340-53-3 / Cyclic ADP-Ribose; 130663-39-7 / PD 123319; 4964P6T9RB / Aldosterone; EC 1.14.15.4 / Cytochrome P-450 CYP11B2; EC 3.2.2.5 / ADP-ribosyl Cyclase; JMS50MPO89 / Losartan
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76. Parenti G, Nassi R, Silvestri S, Bianchi S, Valeri A, Manca G, Mangiafico S, Ammannati F, Serio M, Mannelli M, Peri A: Multi-step approach in a complex case of Cushing's syndrome and medullary thyroid carcinoma. J Endocrinol Invest; 2006 Feb;29(2):177-81
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  • The diagnosis of Cushing's syndrome (CS) may sometimes be cumbersome.
  • In particular, in ACTH-dependent CS it may be difficult to distinguish between the presence of an ACTH-secreting pituitary adenoma and ectopic ACTH and/or CRH secretion.
  • We report here the case of a 54-yr-old man affected by ACTH-dependent CS in association with a left adrenal adenoma and medullary thyroid carcinoma (MTC).
  • It was then decided to remove the left adenomatous adrenal gland.
  • [MeSH-major] Carcinoma, Medullary / diagnosis. Cushing Syndrome / diagnosis. Thyroid Neoplasms / diagnosis

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  • (PMID = 16610247.001).
  • [ISSN] 0391-4097
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 9007-12-9 / Calcitonin
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77. Penezić Z, Zarković M, Vujović S, Drezgić M: [Diagnosis and differential diagnosis of Cushing's syndrome]. Srp Arh Celok Lek; 2006 Nov-Dec;134(11-12):558-66
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Diagnosis and differential diagnosis of Cushing's syndrome].
  • Endogenous Cushing's syndrome is a clinical state resulting from prolonged, inappropriate exposure to excessive endogenous secretion of cortisol and hence excess circulating free cortisol, characterized by loss of normal feedback mechanisms of the hypothalamo-pituitary-adrenal axis and normal circadian rhythm of cortisol secretion.
  • The etiology of Cushing's syndrome may be excessive ACTH secretion from the pituitary gland, ectopic ACTH/CRH secretion by non-pituitary tumor, or excessive autonomous secretion of cortisol from hyperfunctioning adrenal adenoma or carcinoma, PPNAD and MAH.
  • Diagnosis of Cushing's syndrome must be made before any attempt at differential diagnosis, and key biochemical characteristics are: excess endogenous cortisol secretion; loss of normal feedback of hypothalamic-pituitary-adrenal axis; and disturbance of normal circadian rhythm of cortisol secretion.
  • Biochemical diagnosis of Cushing's syndrome includes: urinary free cortisol determination, low-dose dexamethasone testing, circadian rhythm assessment, insulin tolerance test, and LDDST/CRH test.
  • Differential diagnosis of Cushing's syndrome involves: plasma ACTH level determination, high dose dexamethasone testing, metyrapone testing, testing with CRH, testing with vasopressin or combination, and finally, bilateral simultaneous petrosal sinus sampling with CRH stimulation.
  • [MeSH-major] Cushing Syndrome / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Humans

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  • (PMID = 17304774.001).
  • [ISSN] 0370-8179
  • [Journal-full-title] Srpski arhiv za celokupno lekarstvo
  • [ISO-abbreviation] Srp Arh Celok Lek
  • [Language] srp
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Serbia and Montenegro
  • [Number-of-references] 56
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78. Tortorella C, Neri G, Nussdorfer GG: Galanin in the regulation of the hypothalamic-pituitary-adrenal axis (Review). Int J Mol Med; 2007 Apr;19(4):639-47
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  • [Title] Galanin in the regulation of the hypothalamic-pituitary-adrenal axis (Review).
  • Findings have been accumulated that galanin regulates neuroendocrine hypothalamic axes, including the hypothalamic-pituitary-adrenal (HPA) one.
  • Galanin and its receptors are expressed in the hypothalamic paraventricular and supraoptic nuclei, anterior pituitary and adrenal medulla.
  • Adrenal cortex does not express galanin, but is provided with GAL-R1 and GAL-R2.
  • The bulk of evidence indicates that galanin stimulates the activity of the central branch of the HPA axis (i.e. the release of corticotropin-releasing hormone and ACTH), thereby enhancing glucocorticoid secretion from the adrenal cortex.
  • Investigations carried out in the rat show that galanin is also able to directly stimulate corticosterone (glucocorticoid) secretion from adrenocortical cells, through GAL-R1 and GAL-R2 coupled to the adenylate cyclase-protein kinase A signaling cascade, and nor-epinephrine release from adrenal medulla.
  • There is indication that galanin may also enhance corticosterone release via an indirect paracrine mechanism involving the local release of catecholamines, which in turn activate beta-adrenoceptors located on adrenocortical cells.
  • There is also evidence that galanin plays a role in the modulation of HPA-axis response to stress, as well as in the pathogenesis of pituitary adenomas and perhaps of pheochromocytomas.
  • [MeSH-major] Galanin / metabolism. Hypothalamo-Hypophyseal System / metabolism. Pituitary-Adrenal System / metabolism. Receptors, Galanin / metabolism
  • [MeSH-minor] Amino Acid Sequence. Animals. Humans. Hypothalamic Diseases / metabolism. Molecular Sequence Data. Rats. Stress, Physiological / metabolism

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  • (PMID = 17334639.001).
  • [ISSN] 1107-3756
  • [Journal-full-title] International journal of molecular medicine
  • [ISO-abbreviation] Int. J. Mol. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Receptors, Galanin; 88813-36-9 / Galanin
  • [Number-of-references] 146
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79. Fallo F, Pezzi V, Sonino N, Altavilla G, Barzon L: Adrenal incidentaloma in pregnancy: clinical, molecular and immunohistochemical findings. J Endocrinol Invest; 2005 May;28(5):459-63
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  • [Title] Adrenal incidentaloma in pregnancy: clinical, molecular and immunohistochemical findings.
  • Adrenal incidentalomas detected during pregnancy are very rare, and the natural history of these tumors during gestation is unknown.
  • We report a case of a pregnant woman with an adrenal mass discovered serendipitously, who was followed-up during gestation and underwent adrenalectomy shortly after delivery.
  • Estrogens may indeed influence the function and proliferation of human adrenal cells, and a state of circulating estrogen excess can represent an in vivo model to test their effect on the adrenals.
  • No evidence of adrenal change in morphology and function was found in our patient throughout pregnancy, as shown by adrenal ultrasound imaging and adrenal hormone measurements.
  • Four months after delivery, the patient underwent laparoscopic right adrenalectomy, and pathologic analysis revealed a 2.7 cm benign adrenocortical adenoma.
  • The diameter of the adrenal mass at ultrasonography correlated highly with post-partum mass diameter measured by abdominal computed tomography (CT).
  • Quantitative expression of both ERalpha and ERbeta by real-time RT-PCR analysis and Western blotting findings did not differ among adenoma, normal adjacent adrenal and normal adrenal control tissues.
  • This case of an adrenal incidentaloma discovered during pregnancy shows that a close observation with endocrine investigations and ultrasonography could be an appropriate approach, delaying the decision of surgical intervention after delivery.
  • Estrogen receptor mRNA levels in the adrenal mass similar to those observed in normal adrenals suggest that estrogen oversecretion during pregnancy was not a risk factor for tumor progression.
  • [MeSH-major] Adrenal Gland Neoplasms / immunology. Adrenal Gland Neoplasms / pathology. Pregnancy Complications, Neoplastic / immunology. Pregnancy Complications, Neoplastic / pathology

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  • (PMID = 16075931.001).
  • [ISSN] 0391-4097
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Estrogen Receptor alpha; 0 / Estrogen Receptor beta
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80. Lim LC, Tan LH, Rajasoorya C: Unravelling the mystery in a case of persistent ACTH-independent Cushing's syndrome. Ann Acad Med Singapore; 2006 Dec;35(12):892-6
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  • INTRODUCTION: We present a rare variety of adrenocorticotrophic hormone (ACTH)-independent Cushing's syndrome known as primary pigmented nodular adrenocortical disease (PPNAD).
  • CLINICAL PICTURE: The patient initially underwent unilateral adrenalectomy for what was thought to be a left adrenal adenoma.
  • OUTCOME: Partial resolution of symptoms and demonstrable persistent hypercortisolism after surgery prompted further evaluation with findings leading to the diagnosis of Carney complex.
  • A review of the adrenal histology was consistent with PPNAD.
  • The diagnosis may not be simple and straightforward, as illustrated in this patient.
  • [MeSH-major] Cushing Syndrome / diagnosis
  • [MeSH-minor] Adrenal Glands / radiography. Adrenalectomy. Adrenocortical Hyperfunction / physiopathology. Adrenocorticotropic Hormone / metabolism. Adult. Bone Density. Female. Humans. Tomography, X-Ray Computed

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  • (PMID = 17219002.001).
  • [ISSN] 0304-4602
  • [Journal-full-title] Annals of the Academy of Medicine, Singapore
  • [ISO-abbreviation] Ann. Acad. Med. Singap.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Singapore
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
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81. Shin NY, Kim MJ, Chung JJ, Chung YE, Choi JY, Park YN: The differential imaging features of fat-containing tumors in the peritoneal cavity and retroperitoneum: the radiologic-pathologic correlation. Korean J Radiol; 2010 May-Jun;11(3):333-45
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  • Some of these fat-containing lesions, such as liposarcoma and retroperitoneal teratoma, have to be resected, although resection can be deferred for others, such as adrenal adenoma, myelolipoma, angiomyolipoma, ovarian teratoma, and lipoma, until the lesions become large or symptomatic.
  • Identifying factors such as whether the fat is macroscopic or microscopic within the lesion, the origin of the lesions, and the presence of combined calcification is important for narrowing the differential diagnosis.
  • The development and wide-spread use of modern imaging modalities make identification of these factors easier so narrowing the differential diagnosis is possible.
  • Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.
  • [MeSH-minor] Abdominal Fat / pathology. Abdominal Fat / radiography. Adult. Aged. Diagnosis, Differential. Female. Humans. Magnetic Resonance Imaging / methods. Male. Middle Aged. Peritoneal Cavity / pathology. Peritoneal Cavity / radiography. Peritoneal Diseases / pathology. Peritoneal Diseases / radiography. Retroperitoneal Space / pathology. Retroperitoneal Space / radiography. Tomography, Spiral Computed / methods. Young Adult

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  • (PMID = 20461188.001).
  • [ISSN] 2005-8330
  • [Journal-full-title] Korean journal of radiology
  • [ISO-abbreviation] Korean J Radiol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Korea (South)
  • [Number-of-references] 35
  • [Other-IDs] NLM/ PMC2864861
  • [Keywords] NOTNLM ; Abdominal cavity / Magnetic resonance (MR) / Neoplasm, adipose tissue / Retroperitoneal space / Tomography, spiral computed
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82. Kita M, Sakalidou M, Saratzis A, Ioannis S, Avramidis A: Cushing's syndrome in pregnancy: report of a case and review of the literature. Hormones (Athens); 2007 Jul-Sep;6(3):242-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cushing's syndrome in pregnancy: report of a case and review of the literature.
  • A provisional diagnosis of CS was made based on plasma cortisol and adrenocorticotropin hormone (ACTH) measurements but the patient did not receive any relevant therapy.
  • A right adrenal adenoma was diagnosed post-labor and was subsequently treated with surgical resection.
  • Six months post-labor the treatment was discontinued after a normal hypothalamic-pituitary-adrenal (HPA) axis was ascertained.
  • [MeSH-major] Cushing Syndrome / diagnosis. Pregnancy Complications / diagnosis


83. Mete O, Asa SL: Aldosterone-producing adrenal cortical adenoma with oncocytic change and cytoplasmic eosinophilic globular inclusions. Endocr Pathol; 2009;20(3):182-5
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  • [Title] Aldosterone-producing adrenal cortical adenoma with oncocytic change and cytoplasmic eosinophilic globular inclusions.
  • We report an interesting morphological alteration in the adrenal of a 72-year-old woman suffering from severe hypertension due to primary hyperaldosteronism.
  • The laparoscopic left adrenalectomy specimen revealed an adrenal cortical adenoma composed of varying proportions of oncocytic and clear cells, predominantly showing central oncocytic change.
  • Oncocytes also exhibited numerous eosinophilic intracytoplasmic globular inclusions, which are not commonly observed in aldosterone-producing adrenal cortical adenomas.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology. Adrenocortical Adenoma / pathology. Aldosterone / secretion. Inclusion Bodies / pathology

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  • (PMID = 19462261.001).
  • [ISSN] 1559-0097
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antihypertensive Agents; 4964P6T9RB / Aldosterone
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84. Hwang WR, Ma WY, Tso AL, Pan CC, Chang YH, Lin HD: Pheochromocytoma and adrenocortical adenoma in the same gland. J Chin Med Assoc; 2007 Jul;70(7):289-93
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pheochromocytoma and adrenocortical adenoma in the same gland.
  • A right adrenal tumor was found incidentally during abdominal computed tomography exam in a 51-year-old female patient, who had had diabetes and hypertension for more than 10 years.
  • Therefore, adrenal cortical adenoma with subclinical Cushing's syndrome was highly suspected; however, further imaging studies, including magnetic resonance image and 131I-6beta-iodomethylnorcholesterol adrenal scintigraphy failed to discriminate an additional tumor.
  • After right adrenalectomy, a small adrenal cortical adenoma and a large pheochromocytoma were noted.
  • This is an extremely rare case of an adrenal incidentaloma consisting of both medullary and cortical tumors in the same gland.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenal Gland Neoplasms / diagnosis. Adrenocortical Adenoma / diagnosis. Neoplasms, Multiple Primary / diagnosis. Pheochromocytoma / diagnosis

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  • (PMID = 17631466.001).
  • [ISSN] 1726-4901
  • [Journal-full-title] Journal of the Chinese Medical Association : JCMA
  • [ISO-abbreviation] J Chin Med Assoc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China (Republic : 1949- )
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
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85. Baldacchino V, Oble S, Décarie PO, Bourdeau I, Hamet P, Tremblay J, Lacroix A: The Sp transcription factors are involved in the cellular expression of the human glucose-dependent insulinotropic polypeptide receptor gene and overexpressed in adrenals of patients with Cushing's syndrome. J Mol Endocrinol; 2005 Aug;35(1):61-71
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  • Recently, it was demonstrated that some cases of primary adrenal Cushing's syndrome were secondary to the ectopic expression of non-mutated GIP receptor (GIP-R) in bilateral adrenal hyperplasias or unilateral adrenal adenomas, resulting in food-dependent steroidogenesis.
  • Using a human multiple-expression tissue array, GIP-R was found to be expressed in a large number of human adult and fetal tissues, but not in the adrenal gland.
  • Data obtained by gene array and semi-quantitative RT-PCR showed an increase in the expression of Sp3 and CRSP9 (co-regulator of Sp1 transcription factor, subunit 9) in the adrenal adenomas or bilateral macronodular hyperplasias of patients with GIP-dependent Cushing's syndrome; they were, however, also increased in some patients with non-GIP-dependent cortisol-secreting adenomas or with ACTH-dependent Cushing's disease.
  • [MeSH-major] Adrenal Glands / metabolism. Cushing Syndrome / genetics. Cushing Syndrome / metabolism. DNA-Binding Proteins / metabolism. Receptors, Gastrointestinal Hormone / genetics. Sp1 Transcription Factor / metabolism. Transcription Factors / metabolism

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  • (PMID = 16087722.001).
  • [ISSN] 0952-5041
  • [Journal-full-title] Journal of molecular endocrinology
  • [ISO-abbreviation] J. Mol. Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA-Binding Proteins; 0 / MED7 protein, human; 0 / Mediator Complex; 0 / Receptors, Gastrointestinal Hormone; 0 / SP3 protein, human; 0 / Sp1 Transcription Factor; 0 / Trans-Activators; 0 / Transcription Factors; 0 / gastric inhibitory polypeptide receptor; 148710-94-5 / Sp3 Transcription Factor; 9007-49-2 / DNA
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86. Freddi S, Arnaldi G, Fazioli F, Scarpelli M, Appolloni G, Mancini T, Kola B, Bertagna X, Mantero F, Collu R, Boscaro M: Expression of growth hormone-releasing hormone receptor splicing variants in human primary adrenocortical tumours. Clin Endocrinol (Oxf); 2005 May;62(5):533-8
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  • [Title] Expression of growth hormone-releasing hormone receptor splicing variants in human primary adrenocortical tumours.
  • Because the overexpression of the IGF-II gene is a frequent feature of adrenal carcinoma, we searched for the presence of GHRH-R SVs in these tumours.
  • METHODS AND RESULTS: The expression of GHRH-R SVs was assessed by nested PCR in 45 human adrenocortical tumours.
  • No PCR products for SV3 or wild-type GHRH-R were found in carcinomas; mRNA for wild-type GHRH-R or SVs of GHRH-R were not observed either in adenomas or in normal adrenal or in NCI-H295R cells.
  • CONCLUSION: This is the first time that the expression of splice variants of GHRH-R has been demonstrated in human adrenal carcinoma.
  • This study raises the possibility that splice variants might play a role in adrenal carcinogenesis and might offer the possibility for new therapeutic strategies at least in a subgroup of adrenal carcinomas.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Alternative Splicing. Carcinoma / genetics. Polymorphism, Genetic. RNA, Messenger / analysis. Receptors, Neuropeptide / genetics. Receptors, Pituitary Hormone-Regulating Hormone / genetics
  • [MeSH-minor] Adenoma / genetics. Adenoma / metabolism. Adolescent. Adult. Aged. Base Sequence. Cell Line, Tumor. Female. Humans. Male. Middle Aged. Molecular Sequence Data. Reverse Transcriptase Polymerase Chain Reaction. Sequence Analysis, DNA. Tumor Cells, Cultured

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  • (PMID = 15853821.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / RNA, Messenger; 0 / Receptors, Neuropeptide; 0 / Receptors, Pituitary Hormone-Regulating Hormone; 0 / somatotropin releasing hormone receptor
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87. Alzahrani AS, Al-Khaldi N, Shi Y, Al-Rijjal RA, Zou M, Baitei EY, Amin T: Diagnosis by serendipity: Cushing syndrome attributable to cortisol-producing adrenal adenoma as the initial manifestation of multiple endocrine neoplasia type 1 due to a rare splicing site MEN1 gene mutation. Endocr Pract; 2008 Jul-Aug;14(5):595-602
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnosis by serendipity: Cushing syndrome attributable to cortisol-producing adrenal adenoma as the initial manifestation of multiple endocrine neoplasia type 1 due to a rare splicing site MEN1 gene mutation.
  • RESULTS: A 16-year-old girl who was not known to have any medical illness and had no known family history of MEN 1 syndrome presented with Cushing syndrome attributable to a cortisol-producing adrenal adenoma.
  • She did not have clinical, biochemical, or radiologic evidence of islet cell pancreatic tumors.
  • Genetic screening confirmed the presence of a MEN1 gene missense G to A mutation in the patient, her father, and her siblings at the splicing site of intron 6 (IVS6+1G>A).
  • Most cases are due to corticotropin-producing pituitary adenomas.
  • [MeSH-major] Adrenocortical Adenoma / pathology. Cushing Syndrome / diagnosis. Hydrocortisone / secretion. Multiple Endocrine Neoplasia Type 1 / pathology


88. Feng C, Li HZ, Xiao H, Yan WG, Li YQ, Xu WF: [Subclinical Cushing's syndrome:analysis of diagnosis and surgical effect]. Zhonghua Wai Ke Za Zhi; 2007 Dec 15;45(24):1691-3
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  • [Title] [Subclinical Cushing's syndrome:analysis of diagnosis and surgical effect].
  • All the cases were found adrenal tumors by CT scan, 10 cases in left adrenal and 14 cases in right adrenal.
  • All the patients underwent retroperitoneal laparoscopic operation and were pathologic diagnosed to adrenal adenomas.
  • CT scan, assays of plasma cortisol, urinary free cortisol and dexamethasone suppression test are most useful in the diagnosis.
  • The potential benefit of surgery should be considered in those who have a definite diagnosis of subclinical Cushing's syndrome.
  • [MeSH-major] Cushing Syndrome / diagnosis. Cushing Syndrome / surgery
  • [MeSH-minor] Adrenal Cortex Neoplasms / complications. Adrenal Cortex Neoplasms / surgery. Adrenalectomy / methods. Adrenocortical Adenoma / complications. Adrenocortical Adenoma / surgery. Adult. Female. Follow-Up Studies. Humans. Laparoscopy. Male. Middle Aged. Retrospective Studies. Treatment Outcome

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  • (PMID = 18476528.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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89. Weismann D, Fassnacht M, Schubert B, Bonfig R, Tschammler A, Timm S, Hahner S, Wunder C, Allolio B: A dangerous liaison--pheochromocytoma in patients with malignant disease. Ann Surg Oncol; 2006 Dec;13(12):1696-701
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  • [Title] A dangerous liaison--pheochromocytoma in patients with malignant disease.
  • BACKGROUND: Adrenal masses in patients with known malignancy may be interpreted as metastasized disease, although a significant proportion of these tumors are of adrenal origin.
  • Despite improved imaging techniques, it remains difficult to distinguish an adrenal metastasis from a pheochromocytoma or a lipid-poor adrenocortical adenoma.
  • PATIENTS AND METHODS: We report a case series of four patients with established or suspected malignant disease (melanoma, transitional cell carcinoma and prostate carcinoma, thyroid carcinoma, colorectal carcinoma) harboring an adrenal mass.
  • None of these patients showed clinical symptoms indicative for a pheochromocytoma.
  • RESULTS: Surgery unrelated to the adrenal lesion (n = 3) or biopsy of the adrenal mass (n = 1) was performed without prior endocrine work-up.
  • CONCLUSION: Our series is a strong reminder of the risks associated with surgery in patients harboring an unsuspected pheochromocytoma and underscores the need to exclude a pheochromocytoma in all patients with an adrenal mass and without a definitive diagnosis of the mass, especially when they are scheduled for surgery or adrenal biopsy.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Colorectal Neoplasms / pathology. Neoplasms, Second Primary / pathology. Pheochromocytoma / diagnosis. Prostatic Neoplasms / pathology. Skin Neoplasms / pathology. Thyroid Neoplasms / pathology
  • [MeSH-minor] Aged. Carcinoma, Transitional Cell / pathology. Carcinoma, Transitional Cell / therapy. Humans. Male. Melanoma / pathology. Melanoma / therapy. Middle Aged


90. Yang JY, Yang MQ, Luo Z, Ma Y, Li J, Deng Y, Huang X: A hybrid machine learning-based method for classifying the Cushing's Syndrome with comorbid adrenocortical lesions. BMC Genomics; 2008;9 Suppl 1:S23
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  • [Title] A hybrid machine learning-based method for classifying the Cushing's Syndrome with comorbid adrenocortical lesions.
  • BACKGROUND: The prognosis for many cancers could be improved dramatically if they could be detected while still at the microscopic disease stage.
  • Because more than one marker must be considered to obtain a classification of cancer or no cancer, and if cancer, to classify it as malignant, borderline, or benign, we must develop an intelligent decision system that can fullfill such an unmet medical need.
  • We have also used immunohistochemistry techniques to measure the gene expression profiles from a number of antigens such as cyclin E, P27KIP1, FHIT, Ki-67, PCNA, Bax, Bcl-2, P53, Fas, FasL and hTERT in several particular types of neuroendocrine tumors such as pheochromocytomas, paragangliomas, and the adrenocortical carcinomas (ACC), adenomas (ACA), and hyperplasia (ACH) involved with Cushing's syndrome.
  • We provided statistical evidence that higher expression levels of hTERT, PCNA and Ki-67 etc. are associated with a higher risk that the tumors are malignant or borderline as opposed to benign.
  • While no significant difference was found between cell-arrest antigens such as P27KIP1 for malignant, borderline, and benign tumors, there was a significant difference between expression levels of such antigens in normal adrenal medulla samples and in adrenomedullary tumors.
  • CONCLUSIONS: Our frame work focused on not only different classification schemes and feature selection algorithms, but also ensemble methods such as boosting and bagging in an effort to improve upon the accuracy of the individual classifiers.
  • [MeSH-major] Adrenal Cortex Neoplasms / classification. Algorithms. Artificial Intelligence. Biomarkers, Tumor / metabolism. Cushing Syndrome / classification
  • [MeSH-minor] China. Gene Expression Profiling. Humans. Immunohistochemistry. In Situ Hybridization. Logistic Models. Proliferating Cell Nuclear Antigen / metabolism. Reverse Transcriptase Polymerase Chain Reaction


91. Lu HS, Gan MF, Chen HS, Huang SQ: Adrenal myelolipoma within myxoid cortical adenoma associated with Conn's syndrome. J Zhejiang Univ Sci B; 2008 Jun;9(6):500-5
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  • [Title] Adrenal myelolipoma within myxoid cortical adenoma associated with Conn's syndrome.
  • The coexistence of myelolipoma within adrenal cortical adenoma is extremely rare, for both tumors present usually as separate entities.
  • To the best of our knowledge, the case we reported here is the first one of myxoid adrenal cortical adenoma associated with myelolipoma reported.
  • Clinical history and laboratory results suggest a metabolic disorder as Conn's syndrome.
  • The patient underwent a left adrenalectomy, and a histopathological study confirmed the mass to be a myxoid adrenal cortical adenoma containing myelolipoma.
  • In the present case report, we also discuss the etiology of simultaneous myelolipoma and adrenal adenoma associated with Conn's syndrome, and the methods of the diagnosis and differential diagnosis.
  • [MeSH-major] Adrenal Cortex Neoplasms / complications. Adrenocortical Adenoma / complications. Hyperaldosteronism / complications. Myelolipoma / complications. Neoplasms, Multiple Primary / complications

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  • (PMID = 18543405.001).
  • [ISSN] 1673-1581
  • [Journal-full-title] Journal of Zhejiang University. Science. B
  • [ISO-abbreviation] J Zhejiang Univ Sci B
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Synaptophysin; 0 / Vimentin; 0 / inhibin-alpha subunit; 57285-09-3 / Inhibins
  • [Number-of-references] 21
  • [Other-IDs] NLM/ PMC2408705
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92. Ye P, Mariniello B, Mantero F, Shibata H, Rainey WE: G-protein-coupled receptors in aldosterone-producing adenomas: a potential cause of hyperaldosteronism. J Endocrinol; 2007 Oct;195(1):39-48
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  • [Title] G-protein-coupled receptors in aldosterone-producing adenomas: a potential cause of hyperaldosteronism.
  • The source of aldosterone in 30-40% of patients with primary hyperaldosteronism (PA) is unilateral aldosterone-producing adenoma (APA).
  • RNA samples from normal adrenals (n = 5), APAs (n = 10), and cortisol-producing adenomas (CPAs; n = 13) were used on 15 genomic expression arrays, each of which included 223 GPCR transcripts presented in at least 1 out of 15 of the independent microarrays.
  • Four GPCR transcripts exhibited a statistically significant increase that was greater than threefold when compared with normal adrenals, suggesting a general increase in expression when compared with normal adrenal glands.
  • [MeSH-major] Adrenal Cortex Neoplasms / secretion. Adrenocortical Adenoma / secretion. Aldosterone / secretion. Hyperaldosteronism / etiology. Receptors, G-Protein-Coupled / genetics

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  • (PMID = 17911395.001).
  • [ISSN] 0022-0795
  • [Journal-full-title] The Journal of endocrinology
  • [ISO-abbreviation] J. Endocrinol.
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / DK43140
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Receptors, G-Protein-Coupled; 4964P6T9RB / Aldosterone
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93. Sheikh A, Haque N, Zuberi L, Jamal A: Laparoscopic adrenalectomy for Conn's syndrome. J Coll Physicians Surg Pak; 2006 Jan;16(1):76-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic adrenalectomy for Conn's syndrome.
  • Laparoscopic adrenalectomy is now used worldwide to resect adrenal adenomas and other adrenal tumors recently introduced in Pakistan.
  • Two cases of endocrine hypertension, due to Conn s syndrome, undergoing laparoscopic adrenalectomy for the first time here, are reported.
  • [MeSH-major] Adrenal Cortex Neoplasms / surgery. Adrenalectomy. Adrenocortical Adenoma / surgery. Hyperaldosteronism / surgery. Laparoscopy

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  • (PMID = 16441999.001).
  • [ISSN] 1022-386X
  • [Journal-full-title] Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
  • [ISO-abbreviation] J Coll Physicians Surg Pak
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Pakistan
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94. Sharma R, Ganpule A, Veeramani M, Sabnis RB, Desai M: Laparoscopic management of adrenal lesions larger than 5 cm in diameter. Urol J; 2009;6(4):254-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic management of adrenal lesions larger than 5 cm in diameter.
  • The incidence of adrenocortical carcinoma increases and technical difficulty of adrenalectomy increases as the size increases.
  • They were compared with patients whose adrenal tumors were smaller than 5 cm.
  • Histopathology of large tumors revealed 16 benign tumors (8 pheochromocytomas, 4 adenomas, 2 ganglioneuromas, 1 pseudocyst, and 1 myelolipoma) and 3 malignancies, of which 1 was primary adrenocortical carcinoma and 2 were metastatic renal cell carcinoma.
  • CONCLUSION: In experienced hands, laparoscopic adrenalectomy is safe and feasible for large functioning adrenal tumors.
  • Large adrenal tumors suspicious of harboring malignancy with no peri-adrenal involvement can be tackled laparoscopically.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy

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  • (PMID = 20027553.001).
  • [ISSN] 1735-546X
  • [Journal-full-title] Urology journal
  • [ISO-abbreviation] Urol J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Iran
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95. Boylu U, Oommen M, Lee BR, Thomas R: Laparoscopic adrenalectomy for large adrenal masses: pushing the envelope. J Endourol; 2009 Jun;23(6):971-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic adrenalectomy for large adrenal masses: pushing the envelope.
  • PURPOSE: To determine the role of laparoscopy for large adrenal tumors in terms of outcomes, pathology, operative time, and morbidity.
  • Pathologic examination revealed eight adrenal cortical adenomas, five myolipomas, four pheochromocytomas, four cysts/pseudocysts, and three adrenocortical hyperplasias.
  • Our findings suggest, however, that laparoscopic adrenalectomy for masses larger than 8 cm can produce comparable results concerning hospital stay, conversion to open surgery rate, and pathologic outcome in comparison with results for adrenal masses smaller than 8 cm.

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  • (PMID = 19456243.001).
  • [ISSN] 1557-900X
  • [Journal-full-title] Journal of endourology
  • [ISO-abbreviation] J. Endourol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
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96. Lubikowski J, Umiński M, Andrysiak-Mamos E, Pynka S, Fuchs H, Wójcicki M, Szajko M, Moleda P, Post M, Zochowska E, Kiedrowicz B, Safranow K, Syrenicz A: From open to laparoscopic adrenalectomy: thirty years' experience of one medical centre. Endokrynol Pol; 2010 Jan-Feb;61(1):94-101
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • INTRODUCTION: Laparoscopic adrenalectomy (LA) has become the standardized treatment of benign adrenal lesions over the last two decades, making the indications to open adrenalectomy (OA) limited.
  • The purpose of this study was to show the thirty years of experience in open (OA) and laparoscopic adrenalectomy (LA) gained in one medical centre as well as to compare the results of OA and LA performed for benign adrenal lesions.
  • Analyzed factors included patients demographic data, ASA score, indication for surgery, tumour size and side, characteristics of the removed tumours, intraoperative and postoperative outcome of LA and OA, postoperative pain sensation, intraoperative and postoperative complications, and conversion rate from LA to OA.
  • The mean operative time was longer in the LA group (137 v. 82 min., p < 0.0001) and the blood loss was lower in LA group (110 v. 254 mL, p < 0.0001).
  • The mean time until resumption of normal diet was shorter after LA (22 v. 44 h), as was the mean time until ambulation (17 v. 36 h), mean length of the hospital stay (4.6 v. 6.8 days), and mean time until return to normal activities (14 v. 23 days, p < 0.0001 for each difference).
  • The analgesic requirement on the first and the second day postoperatively was lower in the LA group (p < 0.0001).
  • The rate of the conversion from LA to OA was 16%.
  • The histopathological diagnosis was adenoma of the adrenal gland in the majority of cases.
  • CONCLUSIONS: This study shows that LA is a safe, effective, and well-tolerated procedure.
  • It may be recommended as a "gold standard" surgery in a case of benign functioning or non-functioning adrenal tumours with diameter less than 8 cm. (Pol J Endocrinol 2010; 61 (1): 94-101).
  • [MeSH-major] Adrenal Gland Diseases / surgery. Adrenalectomy / methods. Laparoscopy / methods
  • [MeSH-minor] Adolescent. Adrenal Gland Neoplasms / surgery. Adult. Aged. Aged, 80 and over. Female. Humans. Length of Stay / statistics & numerical data. Male. Middle Aged. Poland. Treatment Outcome. Young Adult

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  • (PMID = 20205111.001).
  • [ISSN] 0423-104X
  • [Journal-full-title] Endokrynologia Polska
  • [ISO-abbreviation] Endokrynol Pol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Poland
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97. Wang XJ, Shen ZJ, Zhu Y, Zhang RM, Shun FK, Shao Y, Rui WB, He W: Retroperitoneoscopic partial adrenalectomy for small adrenal tumours (&lt; or =1 cm): the Ruijin clinical experience in 88 patients. BJU Int; 2010 Mar;105(6):849-53
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  • [Title] Retroperitoneoscopic partial adrenalectomy for small adrenal tumours (< or =1 cm): the Ruijin clinical experience in 88 patients.
  • OBJECTIVE: To present our experience of retroperitoneoscopic partial adrenalectomy (RPA) for small adrenal tumours, as with modern imaging methods small adrenal lesions are being diagnosed more commonly, and retroperitoneoscopic adrenal surgery for small adrenal tumours (< or =1 cm) can be challenging.
  • PATIENTS AND METHODS: We retrospectively reviewed the records of 389 consecutive retroperitoneoscopic adrenalectomies from September 2005 to December 2008, 88 of which were small adrenal tumours and treated by RPA.
  • We used RPA for adrenal tumours and total adrenalectomy for adrenal cancer.
  • During the surgery, the internal part of the adrenal gland close to the retroperitoneum was freed first, and the whole adrenal tissue was dissected completely.
  • RESULTS: There were no deaths; conversions to open surgery were necessary in four patients (4.5%), the reasons being a missing target in two, massive haemorrhage caused by central adrenal vein injury in one, and severe adhesion in one.
  • The mean (range) size of the adrenal tumours was 0.7 (0.5-1.0) cm, including 69 aldosterone-producing adenomas, 11 nonfunctional adrenal adenomas, three Cushing syndrome, two phaeochromocytomas, two myelolipomas and one melanoma.
  • CONCLUSION: RPA is a safe, effective and minimally invasive therapeutic option for patients with small adrenal tumours.
  • Freeing the internal part of the adrenal gland close to the retroperitoneum first, and exploring the whole adrenal tissue during surgery are the key points of RPA.
  • The location of the small adrenal tumour can be different from that shown on imaging before surgery, and the abnormality of the adrenal gland should be considered.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy

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  • (PMID = 19751254.001).
  • [ISSN] 1464-410X
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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98. Chong S, Lee KS, Kim HY, Kim YK, Kim BT, Chung MJ, Yi CA, Kwon GY: Integrated PET-CT for the characterization of adrenal gland lesions in cancer patients: diagnostic efficacy and interpretation pitfalls. Radiographics; 2006 Nov-Dec;26(6):1811-24; discussion 1824-6
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  • [Title] Integrated PET-CT for the characterization of adrenal gland lesions in cancer patients: diagnostic efficacy and interpretation pitfalls.
  • Integrated fluorine-18 fluorodeoxyglucose positron emission tomography (PET)-computed tomography (CT) for adrenal gland imaging in cancer patients allows early detection and accurate localization of adrenal lesions and differentiation of metastatic nodules from benign lesions, thereby facilitating treatment planning.
  • However, false-positive findings are encountered at integrated PET-CT in approximately 5% of adrenal lesions identified as positive at PET, including adrenal adenomas, adrenal endothelial cysts, and inflammatory and infectious lesions.
  • Moreover, false-negative findings may be seen in adrenal metastatic lesions with hemorrhage or necrosis, small-sized (<10-mm) metastatic nodules, and metastases from pulmonary bronchioloalveolar carcinoma or carcinoid tumors.
  • An awareness of the potential pitfalls of integrated PET-CT enhances the diagnostic efficacy of this modality by allowing differentiation of metastatic adrenal lesions from other abnormalities.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Diagnostic Errors / prevention & control. Image Enhancement / methods. Positron-Emission Tomography / methods. Tomography, X-Ray Computed / methods

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  • [Copyright] RSNA, 2006
  • [ErratumIn] Radiographics. 2007 Nov-Dec;27(6):1594
  • (PMID = 17102052.001).
  • [ISSN] 1527-1323
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 42
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99. Yang L, Cui X, Fan T, Wei Q: Two different adrenal adenomas causing Cushing's syndrome. Saudi Med J; 2010 May;31(5):578-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Two different adrenal adenomas causing Cushing's syndrome.
  • [MeSH-major] Adrenal Cortex Neoplasms / complications. Adrenocortical Adenoma / complications. Cushing Syndrome / etiology. Neoplasms, Multiple Primary / complications

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  • (PMID = 20464053.001).
  • [ISSN] 0379-5284
  • [Journal-full-title] Saudi medical journal
  • [ISO-abbreviation] Saudi Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Saudi Arabia
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100. Soon PS, McDonald KL, Robinson BG, Sidhu SB: Molecular markers and the pathogenesis of adrenocortical cancer. Oncologist; 2008 May;13(5):548-61
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Molecular markers and the pathogenesis of adrenocortical cancer.
  • Adrenal tumors are common, with an estimated incidence of 7.3% in autopsy cases, while adrenocortical carcinomas (ACCs) are rare, with an estimated prevalence of 4-12 per million population.
  • Because the prognoses for adrenocortical adenomas (ACAs) and ACCs are vastly different, it is important to be able to accurately differentiate the two tumor types.
  • Advancement in the understanding of the pathophysiology of ACCs is essential for the development of more sensitive means of diagnosis and treatment, resulting in better clinical outcome.
  • Adrenocortical tumors (ACTs) occur as a component of several hereditary tumor syndromes, which include the Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, multiple endocrine neoplasia 1, Carney complex, and congenital adrenal hyperplasia.
  • The adrenocorticotropic hormone-cAMP-protein kinase A and Wnt pathways are also implicated in adrenocortical tumorigenesis.
  • The aim of this review is to summarize the current knowledge on the molecular mechanisms involved in adrenocortical tumorigenesis, including results of comparative genomic hybridization, loss of heterozygosity, and microarray gene-expression profiling studies.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Adrenocortical Adenoma / genetics. Adrenocortical Carcinoma / genetics. Neoplastic Syndromes, Hereditary / genetics

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  • (PMID = 18515740.001).
  • [ISSN] 1083-7159
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
  • [Number-of-references] 135
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