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1. Calsyn JD, Green RA, Davis GJ, Reilly CM: Adrenal pheochromocytoma with contralateral adrenocortical adenoma in a cat. J Am Anim Hosp Assoc; 2010 Jan-Feb;46(1):36-42
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  • [Title] Adrenal pheochromocytoma with contralateral adrenocortical adenoma in a cat.
  • An ultrasound revealed bilateral adrenal gland enlargement.
  • Histopathology was consistent with a cortical adenoma in the right adrenal gland and a pheochromocytoma in the left adrenal gland.
  • [MeSH-major] Adrenal Gland Neoplasms / veterinary. Adrenocortical Adenoma / veterinary. Cat Diseases / diagnosis. Pheochromocytoma / veterinary

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  • (PMID = 20045835.001).
  • [ISSN] 1547-3317
  • [Journal-full-title] Journal of the American Animal Hospital Association
  • [ISO-abbreviation] J Am Anim Hosp Assoc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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2. Inan N, Arslan A, Akansel G, Anik Y, Balci NC, Demirci A: Dynamic contrast enhanced MRI in the differential diagnosis of adrenal adenomas and malignant adrenal masses. Eur J Radiol; 2008 Jan;65(1):154-62
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  • [Title] Dynamic contrast enhanced MRI in the differential diagnosis of adrenal adenomas and malignant adrenal masses.
  • OBJECTIVE: To evaluate the value of dynamic MR imaging in the differential diagnosis of adrenal adenomas and malignant tumors, especially in cases with atypical adenomas.
  • MATERIALS AND METHODS: Sixty-four masses (48 adenomas, 16 malignant tumors) were included in this prospective study.
  • RESULTS: Chemical shift MR imaging was able to differentiate 44 out of 48 adenomas (91.7%) from non-adenomas.
  • The 4 adenomas (8.3%) which could not be differentiated from non-adenomas by this technique did not exhibit signal loss on out-of-phase images.
  • With a cut-off value of 30, SI indices of adenomas had a sensitivity of 93.8%, specificity of 100% and a positive predictive value of 100%.
  • On visual evaluation of dynamic MR imaging, early phase contrast enhancement patterns were homogeneous in 75% and punctate in 20,83% of the adenomas; while patchy in 56.25% and peripheral in 25% of the malignant tumors.
  • On the late phase images 58.33% of the adenomas showed peripheral ring-shaped enhancement and 10.41% showed heterogeneous enhancement.
  • At the 25th second, the SIs and wash-in rates of the adenomas were significantly higher than those of the malignant masses (p=0.010).
  • Time-to-peak enhancement of the malignant masses was significantly longer than that of the adenomas.
  • CONCLUSION: Chemical shift MR has a high sensitivity and specificity in the differential diagnosis of adenomas and malignant adrenal masses.
  • However, taking into consideration only the atypical adenomas, chemical shift MRI is of no diagnostic value.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenocortical Adenoma / diagnosis. Magnetic Resonance Imaging / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Contrast Media. Diagnosis, Differential. Female. Humans. Image Interpretation, Computer-Assisted. Male. Middle Aged. ROC Curve. Sensitivity and Specificity. Statistics, Nonparametric

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  • (PMID = 17466481.001).
  • [ISSN] 0720-048X
  • [Journal-full-title] European journal of radiology
  • [ISO-abbreviation] Eur J Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Contrast Media
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3. Zhang W, Tang ZY, Wang WQ, Ning G: [Metabolic syndrome in patients with adrenocortical adenoma]. Zhonghua Yi Xue Za Zhi; 2006 Dec 26;86(48):3397-400
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  • [Title] [Metabolic syndrome in patients with adrenocortical adenoma].
  • OBJECTIVE: To investigate the prevalence and characteristics of metabolic syndrome (MS) in patients of adrenocortical adenoma.
  • METHODS: MS-related indexes, including waist circumference (WC), blood pressure, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting plasma glucose, plasma and urinary aldosterone, plasma potassium, basic and upright plasma renin activity (PRA), plasma and urinary cortisol, and plasma ACTH, were examined among 61 patients of aldosterone producing adenoma (APA, Group 1), 23 patients of cortisol-secreting adenoma (CSA, Group 2), 24 patients of nonfunctional adrenal adenoma (NAA, Group 3), and 26 healthy controls (Group 4).
  • CONCLUSION: Patients with adrenocortical adenoma have a significantly high prevalence of metabolic syndrome, especially the patients of CSA and NAA.
  • [MeSH-major] Adrenocortical Adenoma / pathology. Metabolic Syndrome X / pathology

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  • (PMID = 17313850.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / Lipids; 4964P6T9RB / Aldosterone; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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4. Arima K, Yamakado K, Suzuki R, Matsuura H, Nakatsuka A, Takeda K, Sugimura Y: Image-guided radiofrequency ablation for adrenocortical adenoma with Cushing syndrome: outcomes after mean follow-up of 33 months. Urology; 2007 Sep;70(3):407-11
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  • [Title] Image-guided radiofrequency ablation for adrenocortical adenoma with Cushing syndrome: outcomes after mean follow-up of 33 months.
  • OBJECTIVES: To evaluate the feasibility, safety, and therapeutic effects of image-guided radiofrequency (RF) ablation used for the treatment of adrenocortical adenoma with Cushing syndrome.
  • METHODS: From February 2003 to May 2005, 4 consecutive patients with adrenocortical adenoma and Cushing syndrome received percutaneous RF ablation.
  • All tumors were in the left adrenal gland, with a mean tumor size of 2.7 +/- 0.6 cm (range 2.0 to 3.5).
  • Both the serum cortisol and adrenocorticotropic hormone levels returned to normal and the symptoms related to Cushing syndrome had disappeared at the end of follow-up (range 20 to 46 months, mean 33) for a clinical success rate of 100%.
  • CONCLUSIONS: Using RF ablation for adrenocortical adenoma with Cushing syndrome is a feasible, safe, and promising treatment method in selected patients.
  • [MeSH-major] Adenoma / surgery. Adrenal Cortex Neoplasms / surgery. Catheter Ablation / methods. Cushing Syndrome / surgery. Fluoroscopy / methods. Radiography, Interventional / methods. Surgery, Computer-Assisted / methods

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  • (PMID = 17905083.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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5. Rohana AG, Ming W, Norlela S, Norazmi MK: Functioning adrenal adenoma in association with congenital adrenal hyperplasia. Med J Malaysia; 2007 Jun;62(2):158-9
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  • [Title] Functioning adrenal adenoma in association with congenital adrenal hyperplasia.
  • We report a case of a young hypertensive male who was first seen in 1998 with a right thalamic haemorrhage and uncontrolled hypertension.
  • CT abdomen showed a right adrenal tumour and a hyperplastic left adrenal gland.
  • Laparoscopic adrenalectomy performed followed by histopathological examination confirmed the diagnosis of adrenal adenoma.
  • This was confirmed to be due to partial or late-onset congenital adrenal hyperplasia (CAH).
  • We discuss the association of partial CAH and adrenal tumours and the unmasking of the mineralocorticoid deficiency following adrenalectomy.
  • [MeSH-major] Adenoma / etiology. Adrenal Gland Neoplasms / etiology. Adrenal Hyperplasia, Congenital / complications


6. Szentirmai O, Winston KR, Jedlicka P, Lum GM: Spontaneous intracerebral hemorrhage in a child with systemic hypertension and adrenal adenoma. Case report. J Neurosurg; 2007 Oct;107(4 Suppl):328-9
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  • [Title] Spontaneous intracerebral hemorrhage in a child with systemic hypertension and adrenal adenoma. Case report.
  • [MeSH-major] Adenoma / complications. Adrenal Gland Neoplasms / complications. Basal Ganglia / blood supply. Cerebral Hemorrhage / etiology. Hypertension / complications. Hypertension / etiology


7. Sawazaki H, Segawa T, Yoshida K, Kawahara T, Inoue T, Soda T, Kamba T, Yoshimura K, Takahashi T, Nakamura E, Nishiyama H, Ito N, Kamoto T, Ogawa O: [Hemorrhagic adrenocortical adenoma with myelolipoma: a case report]. Hinyokika Kiyo; 2006 Oct;52(10):785-8
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  • [Title] [Hemorrhagic adrenocortical adenoma with myelolipoma: a case report].
  • We present a case of hemorrhagic adrenocortical adenoma with myelolipoma.
  • Based on abdominal computed tomography, magnetic resonance imaging and blood tests, preoperative diagnosis was a sarcoma of renal capsule origin.
  • En bloc resection of adrenal gland, tumor, and the kidney with lymph node dissection was performed.
  • Histologically, the mass was diagnosed as hemorrhagic adrenocortical adenoma with myelolipomatous foci.
  • [MeSH-major] Adrenal Cortex Neoplasms / complications. Adrenal Gland Neoplasms / etiology. Adrenocortical Adenoma / complications. Myelolipoma / etiology. Neoplasms, Multiple Primary

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  • (PMID = 17131868.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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8. Kaspareit J, Friderichs-Gromoll S, Buse E, Habermann G: Spontaneous neoplasms observed in cynomolgus monkeys (Macaca fascicularis) during a 15-year period. Exp Toxicol Pathol; 2007 Nov;59(3-4):163-9
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  • The great majority of neoplasms was benign (23 benign neoplasms versus 10 malignant tumors).
  • Most of the tumors (22) in the cynomolgus monkeys were seen in endocrine organs (adrenal cortical adenoma, adrenal hemangioma, C-cell carcinoma, follicular adenoma), respiratory system (nasal cavity adenoma, pulmonary squamous cell carcinoma, bronchio-alveolar carcinoma, bronchiolar papilloma, chondromatous hamartoma) and female genital system (uterine polyp, uterine adenoma, uterine leiomyoma and teratoma of the ovary).
  • [MeSH-major] Macaca fascicularis. Monkey Diseases / pathology. Neoplasms / veterinary

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  • (PMID = 17869495.001).
  • [ISSN] 0940-2993
  • [Journal-full-title] Experimental and toxicologic pathology : official journal of the Gesellschaft für Toxikologische Pathologie
  • [ISO-abbreviation] Exp. Toxicol. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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9. Groussin L, Cazabat L, René-Corail F, Jullian E, Bertherat J: Adrenal pathophysiology: lessons from the Carney complex. Horm Res; 2005;64(3):132-9
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  • [Title] Adrenal pathophysiology: lessons from the Carney complex.
  • Adrenocorticotropic hormone independent Cushing's syndrome due to primary pigmented nodular adrenocortical disease (PPNAD) is a main characteristic of CNC.
  • PPNAD is a very rare cause of Cushing's syndrome due to a primary bilateral adrenal defect that can be also observed in some patients without other CNC manifestations nor familial history.
  • Interestingly, patients with isolated PPNAD and no familial history of CNC can also present a germline de novo mutation of PRKAR1A.
  • Somatic mutations of PRKAR1A have been found in PPNAD as a mechanism of inactivation of the wild-type allele, in a patient already presenting a germline mutation, and in a subset of sporadic secreting adrenocortical adenomas with clinical, hormonal, and pathological features quite similar to PPNAD.
  • This review will summarize the recent findings on CNC from the perspective of the pathophysiology of adrenal Cushing's syndrome and PPNAD.
  • [MeSH-major] Adrenal Cortex Diseases / physiopathology. Adrenal Glands / physiopathology. Multiple Endocrine Neoplasia / physiopathology

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  • [Copyright] Copyright (c) 2005 S. Karger AG, Basel.
  • (PMID = 16192737.001).
  • [ISSN] 0301-0163
  • [Journal-full-title] Hormone research
  • [ISO-abbreviation] Horm. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Cyclic AMP-Dependent Protein Kinase RIalpha Subunit; 0 / PRKAR1A protein, human; 0 / Proteins; E0399OZS9N / Cyclic AMP; EC 2.7.11.11 / Cyclic AMP-Dependent Protein Kinases
  • [Number-of-references] 31
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10. 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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11. Stratakis CA, Carney JA: The triad of paragangliomas, gastric stromal tumours and pulmonary chondromas (Carney triad), and the dyad of paragangliomas and gastric stromal sarcomas (Carney-Stratakis syndrome): molecular genetics and clinical implications. J Intern Med; 2009 Jul;266(1):43-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • A number of other lesions have been described in the condition including pheochromocytomas, oesophageal leiomyomas and adrenocortical adenomas; CT is a novel form of multiple endocrine neoplasia (MEN), a genetic condition with a female predilection.
  • We recently reported an international series of patients with CT, 34 females and three males (median age of presentation 21 years) who did not carry SDHA, SDHB, SDHC, SDHD, KIT or PDGFRA gene mutations.
  • The above have clinical implications (i) for patients with GISTs that are cKIT- and PDGFRA-mutation negative: these tumours are usually resistant to treatment with currently available tyrosine kinase inhibitors and may be part of a syndrome such as CT or CSS; and (ii) for patients with an inherited PGL syndrome, family history should be explored to identify any other tumours in the family, and in particular other endocrine lesions and GISTs.


12. Arai H, Kobayashi N, Nakatsuru Y, Masuzaki H, Nambu T, Takaya K, Yamanaka Y, Kondo E, Yamada G, Fujii T, Miura M, Komatsu Y, Kanamoto N, Ariyasu H, Moriyama K, Yasoda A, Nakao K: A case of cortisol producing adrenal adenoma without phenotype of Cushing's syndrome due to impaired 11beta-hydroxysteroid dehydrogenase 1 activity. Endocr J; 2008 Aug;55(4):709-15
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  • [Title] A case of cortisol producing adrenal adenoma without phenotype of Cushing's syndrome due to impaired 11beta-hydroxysteroid dehydrogenase 1 activity.
  • This report concerns a case of cortisol-producing adrenocortical adenoma without the phenotype of Cushing's syndrome.
  • A left adrenal tumor was incidentally detected in this patient.
  • A diagnosis of adrenal Cushing's syndrome was based on the results of endocrinological and radiological examinations, although she showed none of the physical signs of Cushing's syndrome, glucose intolerance, hypertension or dyslipidermia.
  • After a successful laparoscopic left adrenalectomy, the pathological diagnosis was adrenocortical adenoma.
  • Slow tapering of glucocorticoids was needed to prevent adrenal insufficiency after surgery, and the plasma ACTH level remained high even though the serum cortisol level had reached the upper limit of the normal range.
  • [MeSH-major] 11-beta-Hydroxysteroid Dehydrogenase Type 1 / metabolism. Adrenal Cortex Neoplasms / physiopathology. Adrenocortical Adenoma / physiopathology

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  • (PMID = 18493111.001).
  • [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] EC 1.1.1.146 / 11-beta-Hydroxysteroid Dehydrogenase Type 1; WI4X0X7BPJ / Hydrocortisone
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13. Terzolo M, Bovio S, Pia A, Osella G, Borretta G, Angeli A, Reimondo G: Subclinical Cushing's syndrome. Arq Bras Endocrinol Metabol; 2007 Nov;51(8):1272-9
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  • Subclinical Cushing's syndrome (CS) is attracting increasing interest since the serendipitous discovery of an adrenal mass has become a rather frequent event owing to the routine use of sophisticated radiologic techniques.
  • Cortical adenoma is the most frequent type of adrenal incidentaloma accounting for approximately 50% of cases in surgical series and even greater shares in medical series.
  • Incidentally discovered adrenal adenomas may secrete cortisol in an autonomous manner that is not fully restrained by pituitary feedback, in 5 to 20% of cases depending on study protocols and diagnostic criteria.
  • The criteria for qualifying subclinical cortisol excess are controversial and presently there is no consensus on a gold standard for the diagnosis of this condition.
  • [MeSH-major] Cushing Syndrome / diagnosis
  • [MeSH-minor] Adrenal Cortex Neoplasms / complications. Adrenal Cortex Neoplasms / surgery. Adrenalectomy. Adrenocortical Adenoma / complications. Adrenocortical Adenoma / surgery. Diabetes Mellitus, Type 2 / diagnosis. Diabetes Mellitus, Type 2 / epidemiology. Humans. Hypertension / diagnosis. Hypertension / epidemiology. Hypothalamo-Hypophyseal System / physiopathology. Incidental Findings. Pituitary-Adrenal System / physiopathology

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  • (PMID = 18209865.001).
  • [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] 48
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14. Wosnitzer B, Gadiraju R: The role of nuclear imaging in multiple endocrine neoplasia 1 (MEN 1). Radiol Case Rep; 2010;5(4):452
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  • Multiple endocrine neoplasia 1 (MEN 1) is a rare genetic disorder classically characterized by a predisposition to tumors of the parathyroid glands, anterior pituitary gland, and pancreatic islet cells (1).
  • In addition to exhibiting these characteristic tumors, MEN 1 patients also have an increased propensity for other tumors such as carcinoids, adrenal adenomas, angiofibromas, and lipomas (1, 2, 3).
  • The tumors of MEN 1 are usually benign; however, malignancy of some carcinoid, islet cell, and gastrointestinal tract tumors can cause mortality (5, 6, 7, 8).
  • Diagnosis of MEN 1 is usually made by a combination of history and physical examination, biochemical serum testing, and various imaging modalities (9, 10).
  • We present a classic case of MEN 1 with unique presentation and diagnosis using predominantly nuclear imaging in order to emphasize the role of nuclear imaging in diagnosing and treating MEN 1.

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  • (PMID = 27307880.001).
  • [ISSN] 1930-0433
  • [Journal-full-title] Radiology case reports
  • [ISO-abbreviation] Radiol Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
  • [Other-IDs] NLM/ PMC4901017
  • [Keywords] NOTNLM ; CT, computed tomography / EGD, esophagogastroduodenoscopy / MEN 1, multiple endocrine neoplasia 1 / MRI, magnetic resonance imaging
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15. de Matos LL, Trufelli DC, das Neves-Pereira JC, Danel C, Riquet M: Cushing's syndrome secondary to bronchopulmonary carcinoid tumor: report of two cases and literature review. Lung Cancer; 2006 Sep;53(3):381-6
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  • Neither of these patients had hypophysary microadenomas, adrenal adenomas or recurrence of CS after surgical treatment, demonstrating that CS was caused solely by the presence of the bronchopulmonary carcinoid tumors.
  • [MeSH-major] Bronchial Neoplasms / complications. Bronchial Neoplasms / diagnosis. Carcinoid Tumor / complications. Carcinoid Tumor / diagnosis. Cushing Syndrome / complications. Cushing Syndrome / diagnosis. Lung Neoplasms / complications. Lung Neoplasms / diagnosis


16. Halefoglu AM, Yasar A, Bas N, Ozel A, Erturk SM, Basak M: Comparison of computed tomography histogram analysis and chemical-shift magnetic resonance imaging for adrenal mass characterization. Acta Radiol; 2009 Nov;50(9):1071-9
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  • [Title] Comparison of computed tomography histogram analysis and chemical-shift magnetic resonance imaging for adrenal mass characterization.
  • BACKGROUND: Computed tomography (CT) histogram analysis and chemical-shift magnetic resonance imaging (MRI) are currently used modalities for adrenal mass characterization.
  • However, it is not yet clear which modality can be regarded as most sensitive in terms of adrenal mass characterization.
  • PURPOSE: To prospectively compare CT histogram analysis and chemical-shift MRI in the characterization of adrenal masses.
  • MATERIAL AND METHODS: Between May 2007 and November 2008, 93 patients (45 males, 48 females; mean age 56.7 years, range 22-85 years) with 109 adrenal masses prospectively underwent both unenhanced CT and chemical-shift MRI examinations.
  • These masses consisted of 67 adenomas and 42 metastases.
  • Histogram analysis was applied with a circular region of interest (ROI) that recorded mean attenuation, total number of pixels, number of negative pixels, and the percentage of negative pixels on unenhanced CT images for each adrenal mass.
  • In chemical-shift MRI, signal intensity drop between in-phase and opposed-phase images was quantitatively calculated so that adrenal-to-spleen chemical-shift ratios and adrenal signal intensity indexes were determined for each of the adrenal masses.
  • A mass was regarded as an adenoma if it contained more than 10% negative pixels by CT histogram analysis, showed an adrenal-to-spleen chemical-shift ratio of less than 0.71, and had an adrenal signal intensity index of more than 16.5% by chemical-shift MRI.
  • The results were compared to reveal which method was most sensitive in the diagnosis of adrenal masses and whether or not a correlation exists between these two modalities.
  • Final diagnoses were based on imaging follow-up of minimum 6 months, biopsy, surgery, and adrenal washout study.
  • RESULTS: On unenhanced CT examinations, all of the 67 adenomas and 21 out of 42 metastases exhibited negative pixels.
  • CT histogram analysis using a 10% negative pixel threshold gave a 91% sensitivity and 100% specificity for the diagnosis of an adenoma.
  • On chemical-shift MRI, for an adrenal-to-spleen chemical-shift ratio of less than 0.71, a 97% sensitivity and 100% specificity were achieved, while a 97% sensitivity and 93% specificity were obtained for an adrenal signal intensity index of more than 16.5% for adenoma diagnosis.
  • CONCLUSION: CT histogram analysis method using a 10% negative pixel threshold on unenhanced CT had a good sensitivity and perfect specificity for the differentiation of adrenal adenomas from non-adenomas.
  • In spite of the good results obtained with the CT histogram analysis method, chemical-shift MRI using adrenal-to-spleen chemical-shift ratio and adrenal signal intensity index formulas had a higher sensitivity and could help in the characterization of adrenal masses appearing indeterminate by CT histogram analysis.
  • [MeSH-major] Adenoma / diagnosis. Adrenal Gland Neoplasms / diagnosis. Magnetic Resonance Imaging / methods. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Prospective Studies. Sensitivity and Specificity

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  • (PMID = 19863419.001).
  • [ISSN] 1600-0455
  • [Journal-full-title] Acta radiologica (Stockholm, Sweden : 1987)
  • [ISO-abbreviation] Acta Radiol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
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17. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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18. Wolf A, Willenberg HS, Cupisti K, Schott M, Geddert H, Raffel A, Bornstein SR, Scherbaum WA, Knoefel WT: Adrenal pheochromocytoma with contralateral cortisol-producing adrenal adenoma: diagnostic and therapeutic management. Horm Metab Res; 2005 Jun;37(6):391-5
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  • [Title] Adrenal pheochromocytoma with contralateral cortisol-producing adrenal adenoma: diagnostic and therapeutic management.
  • There is evidence for a close interrelation between the adrenomedullary and adrenocortical tissues, and there are well-characterized models of their paracrine interaction.
  • To contribute to the studies of systemic interactions between these tissues, we studied a 52-year-old female patient with a pheochromocytoma and a contralateral cortisol-producing adenoma.
  • Due to a misunderstanding, she presented to her family doctor to have an inherited kidney disease ruled out.
  • An adrenal mass was discovered incidentally by ultrasound.
  • A computerized tomography of the abdomen revealed bilateral adrenal masses.
  • Laboratory work-up, selective adrenal venous sampling and magnetic resonance imaging studies established the diagnosis of a pheochromocytoma in the right-hand adrenal gland and a cortisol-producing adenoma on the left.
  • Immunohistochemistry showed positive staining against chromogranin A in a histological specimen obtained from the right-hand adrenal gland, while the left was negative; the left-hand adrenal gland stained positive against the ACTH receptor (MC2R) while the right was negative.
  • Genetically, the patient was negative for MEN2, von Hippel-Lindau disease, and mutations in subunits B, C, and D of the succinate dehydrogenase gene.
  • Although presence of bilateral adrenal adenomas or bilateral adrenal pheochromocytomas in certain inherited disorders are possible, this rare case of an adrenal pheochromocytoma combined with a contralateral cortisol-producing adrenal adenoma may further underline the wide range of complex interactions between the two endocrine systems.
  • [MeSH-major] Adrenal Cortex Neoplasms / radiography. Adrenocortical Adenoma / radiography. Pheochromocytoma / radiography

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  • (PMID = 16001333.001).
  • [ISSN] 0018-5043
  • [Journal-full-title] Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et métabolisme
  • [ISO-abbreviation] Horm. Metab. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone
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19. Broome JT, Gauger P: Surgical techniques for adrenal tumors. Minerva Endocrinol; 2009 Jun;34(2):185-93
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  • [Title] Surgical techniques for adrenal tumors.
  • As technology has advanced, the options for the surgical management of adrenal disorders have also increased.
  • An understanding of the basic evaluation of adrenal tumors, patient specific factors, and the risks and benefits of available techniques will allow the clinician to select an appropriate treatment for each individual.
  • Surgery remains the mainstay of treatment for functional adrenocortical adenomas including aldosteronomas, cortisol-producing adenomas, and pheochromocytomas.
  • While minimally-invasive techniques offer shorter recovery times and less potential morbidity, more traditional approaches remain necessary for management of known or suspected adrenocortical carcinoma.
  • Except in the case of pheochromocytoma, large adrenal tumors >6 cm should not be removed laparoscopically due to the risk of adrenocortical carcinoma.
  • This article will review basic surgical adrenal disorders, operative approaches, and delineate principles of patient and procedure selection.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Pheochromocytoma / surgery
  • [MeSH-minor] Adrenal Cortex Neoplasms / surgery. Adrenocortical Adenoma / surgery. Adrenocortical Carcinoma / surgery. Humans. Laparoscopy / methods. Length of Stay. Patient Selection. Risk Assessment. Risk Factors. Treatment Outcome

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  • (PMID = 19471241.001).
  • [ISSN] 0391-1977
  • [Journal-full-title] Minerva endocrinologica
  • [ISO-abbreviation] Minerva Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 30
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21. Tissier F, Cavard C, Groussin L, Perlemoine K, Fumey G, Hagneré AM, René-Corail F, Jullian E, Gicquel C, Bertagna X, Vacher-Lavenu MC, Perret C, Bertherat J: Mutations of beta-catenin in adrenocortical tumors: activation of the Wnt signaling pathway is a frequent event in both benign and malignant adrenocortical tumors. Cancer Res; 2005 Sep 1;65(17):7622-7
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  • [Title] Mutations of beta-catenin in adrenocortical tumors: activation of the Wnt signaling pathway is a frequent event in both benign and malignant adrenocortical tumors.
  • Adrenocortical cancer is a rare cancer with a very poor prognosis.
  • The genetic alterations identified to date in adrenocortical tumors are limited.
  • We investigated whether Wnt pathway activation is involved in adrenocortical tumorigenesis.
  • In a series of 39 adrenocortical tumors, immunohistochemistry revealed abnormal cytoplasmic and/or nuclear accumulation of beta-catenin in 10 of 26 adrenocortical adenomas and in 11 of 13 adrenocortical carcinomas.
  • An activating somatic mutation of the beta-catenin gene was shown in 7 of 26 adrenocortical adenomas and in 4 of 13 adrenocortical carcinomas; these mutations were observed only in adrenocortical tumors with abnormal beta-catenin accumulation and most were point mutations altering the Ser45 of exon 3 (in the consensus GSK3-beta/CK1 phosphorylation site).
  • Functional studies showed that the activating Ser45 beta-catenin mutation found in the adrenocortical cancer H295R cell line leads to constitutive activation of T-cell factor-dependent transcription.
  • This is the first molecular defect to be reported with the same prevalence in both benign (27%) and malignant (31%) adrenocortical tumors. beta-Catenin mutations are also the most frequent genetic defect currently known in adrenocortical adenomas.
  • In adrenocortical adenomas, beta-catenin alterations are more frequent in nonfunctioning tumors, suggesting that beta-catenin pathway activation might be mostly involved in the development of nonsecreting adrenocortical adenomas and adrenocortical carcinomas.
  • The very frequent and substantial accumulation of beta-catenin in adrenocortical carcinomas suggests that other alterations might also be involved.
  • This finding may contribute to new therapeutic approaches targeting the Wnt pathway in malignant adrenocortical tumors, for which limited medical therapy is available.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Adrenocortical Carcinoma / genetics. Cytoskeletal Proteins / genetics. Intercellular Signaling Peptides and Proteins / genetics. Trans-Activators / genetics
  • [MeSH-minor] Adult. Aged. Cell Line, Tumor. Female. Humans. Immunohistochemistry. Male. Middle Aged. Mutation. Signal Transduction. Wnt Proteins. beta Catenin

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  • (PMID = 16140927.001).
  • [ISSN] 0008-5472
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / CTNNB1 protein, human; 0 / Cytoskeletal Proteins; 0 / Intercellular Signaling Peptides and Proteins; 0 / Trans-Activators; 0 / Wnt Proteins; 0 / beta Catenin
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22. Abdullah N, Khawaja K, Hale J, Barrett AM, Cheetham TD: Primary hyperaldosteronism with normokalaemia secondary to an adrenal adenoma (Conn's syndrome) in a 12 year-old boy. J Pediatr Endocrinol Metab; 2005 Feb;18(2):215-9
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  • [Title] Primary hyperaldosteronism with normokalaemia secondary to an adrenal adenoma (Conn's syndrome) in a 12 year-old boy.
  • Investigations revealed primary hyperaldosteronism secondary to an adrenal adenoma (Conn's syndrome).
  • The hypertension resolved following excision of the adrenal tumour.
  • Normokalaemia with potassium >4.0 mmol/l is very unusual in patients with Conn's syndrome and has not been described in childhood before.
  • [MeSH-major] Adrenal Gland Neoplasms / complications. Adrenal Gland Neoplasms / diagnosis. Adrenocortical Adenoma / complications. Adrenocortical Adenoma / diagnosis. Hyperaldosteronism / etiology. Hypertension / etiology. Potassium / blood


23. Araki A, Shinohara M, Yamakawa J, Tanaka M, Natsui S, Izumi Y: Gastric diverticulum preoperatively diagnosed as one of two left adrenal adenomas. Int J Urol; 2006 Jan;13(1):64-6
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  • [Title] Gastric diverticulum preoperatively diagnosed as one of two left adrenal adenomas.
  • A 47-year-old man was diagnosed with primary aldosteronism due to two left adrenal adenomas, suggested on computed tomography (CT) to be located at the upper and lower adrenal portion.
  • However, adosterol scintigraphy revealed negligible uptake at the upper portion of the left adrenal.
  • Laparoscopic left adrenalectomy was performed, but macroscopic examination of the specimen revealed only one adrenal tumor.
  • Postoperatively, aldosteronism resolved and repeat CT revealed staining of the adrenal pseudotumor when oral contrast was administered.
  • Since organs located near the adrenals can simulate adrenal tumors, caution must be exercised in interpreting suprarenal masses on CT.
  • To our knowledge, this is the first reported case of concurrent pseudotumor and true tumor of the ipsilateral adrenal.
  • [MeSH-major] Adrenocortical Adenoma / diagnosis. Diverticulum, Stomach / diagnosis. Preoperative Care
  • [MeSH-minor] Adrenalectomy / methods. Diagnosis, Differential. Humans. Hyperaldosteronism / diagnosis. Hyperaldosteronism / etiology. Laparoscopy. Male. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 16448434.001).
  • [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] Case Reports; Journal Article
  • [Publication-country] Australia
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24. Almeida MQ, Fragoso MC, Lotfi CF, Santos MG, Nishi MY, Costa MH, Lerario AM, Maciel CC, Mattos GE, Jorge AA, Mendonca BB, Latronico AC: Expression of insulin-like growth factor-II and its receptor in pediatric and adult adrenocortical tumors. J Clin Endocrinol Metab; 2008 Sep;93(9):3524-31
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  • [Title] Expression of insulin-like growth factor-II and its receptor in pediatric and adult adrenocortical tumors.
  • BACKGROUND: Adrenocortical tumors are heterogeneous neoplasms with incompletely understood pathogenesis.
  • IGF-II overexpression has been consistently demonstrated in adult adrenocortical carcinomas.
  • OBJECTIVES: The objective of the study was to analyze expression of IGF-II and its receptor (IGF-IR) in pediatric and adult adrenocortical tumors and the effects of a selective IGF-IR kinase inhibitor (NVP-AEW541) on adrenocortical tumor cells.
  • PATIENTS: Fifty-seven adrenocortical tumors (37 adenomas and 20 carcinomas) from 23 children and 34 adults were studied.
  • Cell proliferation and apoptosis were analyzed in NCI H295 cells and a new cell line established from a pediatric adrenocortical adenoma.
  • RESULTS: IGF-II transcripts were overexpressed in both pediatric adrenocortical carcinomas and adenomas.
  • Otherwise, IGF-II was mainly overexpressed in adult adrenocortical carcinomas (270.5 +/- 130.2 vs. 16.1 +/- 13.3; P = 0.0001).
  • IGF-IR expression was significantly higher in pediatric adrenocortical carcinomas than adenomas (9.1 +/- 3.1 vs. 2.6 +/- 0.3; P = 0.0001), whereas its expression was similar in adult adrenocortical carcinomas and adenomas.
  • IGF-IR expression was a predictor of metastases in pediatric adrenocortical tumors in univariate analysis (hazard ratio 1.84; 95% confidence interval 1.28-2.66; P = 0.01).
  • Furthermore, NVP-AEW541 blocked cell proliferation in a dose- and time-dependent manner in both cell lines through a significant increase of apoptosis.
  • CONCLUSION: IGF-IR overexpression was a biomarker of pediatric adrenocortical carcinomas.
  • Additionally, a selective IGF-IR kinase inhibitor had antitumor effects in adult and pediatric adrenocortical tumor cell lines, suggesting that IGF-IR inhibitors represent a promising therapy for human adrenocortical carcinoma.
  • [MeSH-major] Adenoma / genetics. Adrenal Cortex Neoplasms / genetics. Carcinoma / genetics. Insulin-Like Growth Factor II / genetics. Receptor, IGF Type 2 / genetics

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  • (PMID = 18611974.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Receptor, IGF Type 2; 67763-97-7 / Insulin-Like Growth Factor II
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25. Papotti M, Volante M, Duregon E, Delsedime L, Terzolo M, Berruti A, Rosai J: Adrenocortical tumors with myxoid features: a distinct morphologic and phenotypical variant exhibiting malignant behavior. Am J Surg Pathol; 2010 Jul;34(7):973-83
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  • [Title] Adrenocortical tumors with myxoid features: a distinct morphologic and phenotypical variant exhibiting malignant behavior.
  • Myxoid changes have been rarely reported both in adrenocortical adenomas and carcinomas.
  • The recent observation by our group of an adrenal myxoid tumor with morphologically borderline features, but aggressive clinical behavior prompted us to review a series of 196 adrenocortical lesions, comprising 122 carcinomas and 74 adenomas, to define the morphologic, phenotypical and clinical characteristics of adrenocortical tumors with myxoid features.
  • Fourteen cases, including 12 carcinomas and 2 borderline tumors, formed the basis of this report, and were characterized by a variably abundant myxoid component (from 5% to 90% of tumor) and 2 distinct cellular growth patterns: the first (10 cases), mostly associated with a predominant myxoid stromal component, was made of small cells with mild atypia arranged in cords and microcysts; the second (4 cases) was characterized by focal myxoid changes in tumors otherwise similar to conventional adrenocortical carcinoma, with large atypical cells having an eosinophilic cytoplasm and a diffuse or nodular architecture.
  • The above mentioned patterns were absent in all adenomas reviewed.
  • A peculiar reactivity to neurofilaments was seen, mostly associated to the presence of predominant rather that focal myxoid stromal changes, and in 40% of conventional adrenocortical carcinomas, thus representing an undescribed potential pitfall in the differential diagnosis of adrenal lesions.
  • Myxoid adrenocortical tumors probably represent a rare but histologically and phenotipically distinct entity and, although rare cases of benign lesions are on record, they seem to be generally associated to morphologic and clinical features of malignancy.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology. Adrenocortical Adenoma / pathology. Adrenocortical Carcinoma / secondary. Mucins / metabolism
  • [MeSH-minor] Adrenal Glands / embryology. Adrenal Glands / metabolism. Adult. Aged. Biomarkers, Tumor / metabolism. Fatal Outcome. Female. Fetal Development. Humans. Male. Middle Aged

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  • (PMID = 20534995.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Mucins
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26. Okosieme OE, Suruliram P, Brade L, Campbell A, Evans LM: Diuretic-induced hypokalaemia in patients with hypertension. Int J Clin Pract; 2006 Dec;60(12):1673-4
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  • Investigations revealed primary hyperaldosteronism due to an adrenal adenoma, and normal blood pressure was restored after surgical removal of the tumour.
  • [MeSH-minor] Adrenal Cortex Neoplasms / complications. Adrenocortical Adenoma / complications. Female. Humans. Hyperaldosteronism / complications. Middle Aged

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  • (PMID = 16669823.001).
  • [ISSN] 1368-5031
  • [Journal-full-title] International journal of clinical practice
  • [ISO-abbreviation] Int. J. Clin. Pract.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Diuretics
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27. Bourne AE, Bell SW, Wayment RO, Schwartz BF: Primary Hodgkin lymphoma of the adrenal gland: a unique case presentation. Can J Urol; 2009 Jun;16(3):4694-6
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  • [Title] Primary Hodgkin lymphoma of the adrenal gland: a unique case presentation.
  • Adrenal "incidentalomas" are commonly found on body imaging, and treatment of these lesions 4 cm-6 cm in size is controversial.
  • Most of these lesions are benign adrenal cortical adenomas.
  • Lymphoma is a rare disease manifestation in the adrenal gland, and the overwhelming majority are metastatic lesions.
  • Hodgkin lymphoma has never been reported as a primary adrenal lesion.
  • We present a very unique case report of a 5 cm adrenal "incidentaloma" that represents the first reported case of primary Hodgkin lymphoma in the adrenal gland.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Hodgkin Disease / surgery


28. López Martín L, García Cardoso JV, Gómez Muñoz J, González Enguita C: Adrenal myelolipoma. Contribution of a case and bibliographic review. Arch Esp Urol; 2010 Dec;63(10):880-3
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  • [Title] Adrenal myelolipoma. Contribution of a case and bibliographic review.
  • OBJECTIVE: We report the case of adrenal gland myelolipoma.
  • METHODS/RESULTS: The patient was a 29 year old who is diagnosed with an adrenal adenoma during an endocrinology review.
  • The pathological study confirmed the diagnosis of adrenal myelolipoma.
  • [MeSH-major] Adrenal Gland Neoplasms. Myelolipoma

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  • (PMID = 21187573.001).
  • [ISSN] 1576-8260
  • [Journal-full-title] Archivos españoles de urología
  • [ISO-abbreviation] Arch. Esp. Urol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Spain
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29. Sawada K, Maehara T, Inaji M, Toriyama H, Okada T, Nariai T, Aoyagi M, Doi M, Ohno K: [Case of ruptured multiple cerebral aneurysms associated with primary aldosteronism]. No Shinkei Geka; 2010 Apr;38(4):347-51
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  • Primary aldosteronism (PA) has been recognized as a relatively benign form of hypertension associated with a low incidence of vascular complications.
  • The initial intervention was aneurysm clipping for a ruptured aneurysm at the bifurcation of the right middle cerebral artery.
  • She was diagnosed with PA on the basis of elevated plasma aldosterone, suppressed plasma rennin, and a right adrenal tumor detected by abdominal CT scanning.
  • Histological examination revealed an adrenal adenoma.
  • [MeSH-minor] Adenoma / complications. Adenoma / surgery. Adrenal Gland Neoplasms / complications. Adrenal Gland Neoplasms / surgery. Adrenalectomy. Female. Humans. Middle Aged. Vascular Surgical Procedures

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  • (PMID = 20387576.001).
  • [ISSN] 0301-2603
  • [Journal-full-title] No shinkei geka. Neurological surgery
  • [ISO-abbreviation] No Shinkei Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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30. Nugent M, Waterman GS: An adrenal adenoma presenting with psychosis. Psychosomatics; 2006 Mar-Apr;47(2):175-7
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  • [Title] An adrenal adenoma presenting with psychosis.
  • [MeSH-major] Adenoma / diagnosis. Adenoma / psychology. Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / psychology. Psychotic Disorders / diagnosis. Psychotic Disorders / etiology
  • [MeSH-minor] Adult. Antipsychotic Agents / therapeutic use. Diagnosis, Differential. Dibenzothiazepines / therapeutic use. Female. Humans. Quetiapine Fumarate

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  • (PMID = 16508033.001).
  • [ISSN] 0033-3182
  • [Journal-full-title] Psychosomatics
  • [ISO-abbreviation] Psychosomatics
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antipsychotic Agents; 0 / Dibenzothiazepines; 2S3PL1B6UJ / Quetiapine Fumarate
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31. Ziaja J, Cholewa K, Mazurek U, Cierpka L: [Molecular basics of aldosterone and cortisol synthesis in normal adrenals and adrenocortical adenomas]. Endokrynol Pol; 2008 Jul-Aug;59(4):330-9
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  • [Title] [Molecular basics of aldosterone and cortisol synthesis in normal adrenals and adrenocortical adenomas].
  • [Transliterated title] Molekularne podstawy syntezy aldosteronu i kortyzolu w prawidlowych nadnerczach i w gruczolakach kory nadnerczy.
  • The aim of the study is to present genes encoding enzymatic proteins of aldosterone and cortisol synthesis pathway, methods of their transcriptional activity measurement, mRNA expression of the genes in normal adrenal cortex, in adrenocortical adenomas excised from patients with Conn and Cushing syndromes, as well as in adrenocortical adenomas excised from patients, in which hormonal activity of the tumour was not confirmed.
  • According to presented papers mRNA expression of analyzed genes is best known in tissue obtained from tumours excised from patients with Conn syndrome.
  • On the other hand transcriptional activity of the genes within the other adrenocortical adenomas is documented in lesser degree.
  • It concerns particularly analyses of tissue material obtained from patients, in which hormonal activity of adrenal tumours was not confirmed with biochemical tests.
  • It should be also considered, that the frame of reference for the majority of molecular analyses of adrenocortical tumour tissues was material obtained from little number of normal adrenals, what decreases in some degree credibility of obtained results.
  • Mentioned above remarks may be the basis for conduction of further investigations based on larger material, obtained both from normal adrenals and adrenocortical adenomas.
  • [MeSH-major] Adrenal Cortex Neoplasms / enzymology. Adrenal Glands / metabolism. Adrenocortical Adenoma / enzymology. Aldosterone / biosynthesis. Gene Expression Regulation, Enzymologic. Hydrocortisone / biosynthesis. Mixed Function Oxygenases / genetics
  • [MeSH-minor] Adrenal Cortex / metabolism. Cushing Syndrome / genetics. Cushing Syndrome / metabolism. Cytochrome P-450 CYP11B2 / genetics. Humans. Hyperaldosteronism / genetics. Hyperaldosteronism / metabolism. RNA, Messenger / analysis. Reference Values. Transcription, Genetic

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  • (PMID = 18777504.001).
  • [ISSN] 0423-104X
  • [Journal-full-title] Endokrynologia Polska
  • [ISO-abbreviation] Endokrynol Pol
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / RNA, Messenger; 4964P6T9RB / Aldosterone; EC 1.- / Mixed Function Oxygenases; EC 1.14.15.4 / Cytochrome P-450 CYP11B2; WI4X0X7BPJ / Hydrocortisone
  • [Number-of-references] 76
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32. Mlika M, Farah F, Jarboui S, Abdessalem M, Zaouche A, Jilani SB, Zermani R: A benign cystic mass of the pancreas mimicking a malignant lesion. Pathologica; 2009 Dec;101(6):261-2
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  • [Title] A benign cystic mass of the pancreas mimicking a malignant lesion.
  • The case thus demonstrates a rare association between a cystic form of chronic pancreatitis and adrenal adenoma.
  • We report the case of a 46-year-old patient with no particular past medical history who presented with long lasting symptoms consisting in an abdominal pain and deterioration in general health.
  • Imaging findings (ultrasound, CT-scan, MRI) showed a 3-cm cystic lesion of the tail of the pancreas associated with a 3-cm adrenal mass.
  • Because of the suspicion of a malignant disease, surgical treatment was performed.
  • Pathological findings consisted in fibrotic chronic pancreatitis with canal dilatation and an adrenal adenoma.
  • Final diagnosis must be based on pathological features.
  • [MeSH-minor] Adenoma / complications. Adenoma / pathology. Adrenal Gland Neoplasms / complications. Adrenal Gland Neoplasms / pathology. Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 20387716.001).
  • [ISSN] 0031-2983
  • [Journal-full-title] Pathologica
  • [ISO-abbreviation] Pathologica
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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33. Lau SK, Weiss LM: The Weiss system for evaluating adrenocortical neoplasms: 25 years later. Hum Pathol; 2009 Jun;40(6):757-68
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  • [Title] The Weiss system for evaluating adrenocortical neoplasms: 25 years later.
  • The evaluation and categorization of adrenocortical neoplasms remain among the most challenging areas in adrenal pathology.
  • The Weiss system, first introduced 25 years ago, provides specific guidelines for differentiating adrenocortical adenoma from adrenocortical carcinoma and is considered the standard for determining malignancy in tumors of the adrenal cortex.
  • Considerable advances in the understanding of the pathology of adrenocortical neoplasia have occurred since delineation of the Weiss system, offering alternative approaches to the contemporary assessment of adrenocortical tumors.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology
  • [MeSH-minor] Adrenal Cortex / pathology. Adrenocortical Adenoma / pathology. Adrenocortical Carcinoma / pathology. Adult. Biopsy, Fine-Needle. Cell Nucleus / pathology. Child. Genes, Neoplasm. Humans. Immunohistochemistry. Mitosis. Necrosis. Neoplasm Invasiveness / pathology. Prognosis

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  • (PMID = 19442788.001).
  • [ISSN] 1532-8392
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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34. Gockel I, Heintz A, Polta M, Junginger T: Long-term results of endoscopic adrenalectomy for Conn's syndrome. Am Surg; 2007 Feb;73(2):174-80
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  • [Title] Long-term results of endoscopic adrenalectomy for Conn's syndrome.
  • The long-term effect of adrenalectomy on aldosterone-producing adenomas of the adrenal gland is controversially discussed.
  • The aim of this study was to analyze the long-term course, with special consideration of factors of persisting hypertension after endoscopic adrenalectomy, for Conn's syndrome.
  • Between February 1994 and March 2004, 40 patients with Conn's syndrome underwent endoscopic adrenalectomy.
  • Endoscopic adrenalectomy for Conn's syndrome leads to an immediate normalization of the electrolyte balance postoperatively, whereas hypertension resolves in 60.5 per cent of patients in the long-term course.

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  • (PMID = 17305298.001).
  • [ISSN] 0003-1348
  • [Journal-full-title] The American surgeon
  • [ISO-abbreviation] Am Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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35. Alam MM, Rahman MA, Naser MF, Hossain MS, Islam MA: Testosterone secreting adrenal adenoma in an adult female patient. Mymensingh Med J; 2010 Oct;19(4):632-5
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  • [Title] Testosterone secreting adrenal adenoma in an adult female patient.
  • Adrenal tumours that secrete testosterone are extremely rare and we describe such a case in a 35 years old female with virilization.
  • She had left adrenal adenoma 7.5 X 6.4 cm in size, her ovaries were normal.
  • Histopathological examination confirmed the diagnosis of adrenal adenoma.

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  • (PMID = 20956912.001).
  • [ISSN] 1022-4742
  • [Journal-full-title] Mymensingh medical journal : MMJ
  • [ISO-abbreviation] Mymensingh Med J
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Bangladesh
  • [Chemical-registry-number] 3XMK78S47O / Testosterone; 57B09Q7FJR / Dehydroepiandrosterone Sulfate
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36. Kamiyama T, Fukukura Y, Yoneyama T, Takumi K, Nakajo M: Distinguishing adrenal adenomas from nonadenomas: combined use of diagnostic parameters of unenhanced and short 5-minute dynamic enhanced CT protocol. Radiology; 2009 Feb;250(2):474-81
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  • [Title] Distinguishing adrenal adenomas from nonadenomas: combined use of diagnostic parameters of unenhanced and short 5-minute dynamic enhanced CT protocol.
  • PURPOSE: To retrospectively examine the diagnostic values of individual parameters obtained from unenhanced and 35-second and 5-minute contrast material-enhanced (enhanced) computed tomography (CT) in distinguishing adenomas, particularly lipid-poor adenomas, from nonadenomas and to determine the best diagnostic method by using these parameters.
  • The study population consisted of 61 patients (20 men and 41 women; mean age, 58 years) with 68 adrenal masses (53 adenomas and 15 nonadenomas).
  • Adenomas were classified as 30 lipid-rich (<or=10 HU) and 23 lipid-poor (>10 HU) adenomas by using unenhanced attenuation.
  • The sensitivity, specificity, and accuracy for diagnosing adenomas were calculated by using a threshold level of each parameter determined by the least sum of false-positive and false-negative cases and a combination of the threshold levels with 100% specificity.
  • RESULTS: The best results were obtained by using a combination of the threshold levels with 100% (15 of 15) specificity (presence of at least one of the following criteria for diagnosing adenomas: unenhanced attenuation of <or=19 HU, 5-minute attenuation of <or=50 HU, PEW of >or=45%, and RPEW of >or=31%).
  • Sensitivity was 94% (50 of 53) or 87% (20 of 23) and accuracy was 96% (65 of 68) or 92% (35 of 38) for diagnosing total adrenal adenomas or lipid-poor adenomas, respectively.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Adrenocortical Adenoma / radiography. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Chi-Square Distribution. Contrast Media. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Radiographic Image Interpretation, Computer-Assisted. Retrospective Studies. Sensitivity and Specificity. Statistics, Nonparametric

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  • (PMID = 19037020.001).
  • [ISSN] 1527-1315
  • [Journal-full-title] Radiology
  • [ISO-abbreviation] Radiology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media
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37. Chen KT: Extraneous cells of hepatic origin in adrenal fine needle aspiration as a diagnostic pitfall: a case report. Acta Cytol; 2005 Jul-Aug;49(4):449-51
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  • [Title] Extraneous cells of hepatic origin in adrenal fine needle aspiration as a diagnostic pitfall: a case report.
  • BACKGROUND: The fine needle aspiration (FNA) cytologic evaluations of most adrenal lesions are straightforward.
  • After delivery, computed tomography-guided FNA showed bland epithelial cells, and a diagnosis of adrenal cortical adenoma was made.
  • However, subsequent resection showed a myelolipoma of the adrenal gland.
  • CONCLUSION: This case illustrated 2 cytodiagnostic pitfalls in adrenal fine needle aspirates.
  • First, the myeloid cells characteristic of a myelolipoma were not present in the FNA smears because a large portion of the lesion was composed of fibroadipose tissue.
  • Second, extraneous, benign cells of hepatic origin were misinterpreted as adrenal cortical adenoma cells.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Hepatocytes / pathology. Myelolipoma / diagnosis. Pregnancy Complications, Neoplastic / diagnosis
  • [MeSH-minor] Adrenal Cortex Neoplasms / diagnosis. Adrenal Glands / pathology. Adrenocortical Adenoma / diagnosis. Adult. Biopsy, Fine-Needle. Diagnosis, Differential. Diagnostic Errors. Female. Humans. Pregnancy. Tomography, X-Ray Computed

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  • (PMID = 16124179.001).
  • [ISSN] 0001-5547
  • [Journal-full-title] Acta cytologica
  • [ISO-abbreviation] Acta Cytol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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38. Soon PS, Libe R, Benn DE, Gill A, Shaw J, Sywak MS, Groussin L, Bertagna X, Gicquel C, Bertherat J, McDonald KL, Sidhu SB, Robinson BG: Loss of heterozygosity of 17p13, with possible involvement of ACADVL and ALOX15B, in the pathogenesis of adrenocortical tumors. Ann Surg; 2008 Jan;247(1):157-64
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  • [Title] Loss of heterozygosity of 17p13, with possible involvement of ACADVL and ALOX15B, in the pathogenesis of adrenocortical tumors.
  • OBJECTIVE: To determine the minimal common region of loss on 17p13 in a cohort of adrenocortical carcinomas (ACCs) (defined by a Weiss score > or =3) and adrenocortical adenomas (ACAs) (defined by a Weiss score <3) and subsequently to assess 3 genes in this region that could be involved in adrenocortical tumorigenesis.
  • METHODS: Using 12 microsatellite markers across 17p13, LOH analysis was performed on 37 paired blood and adrenocortical tumor samples (23 ACC and 14 ACA samples) to determine the minimal common region of loss for ACCs and ACAs.
  • [MeSH-major] Acyl-CoA Dehydrogenases / genetics. Adrenal Cortex Neoplasms / genetics. Arachidonate 12-Lipoxygenase / genetics. Chromosomes, Human, Pair 17. Genes, Tumor Suppressor. Loss of Heterozygosity

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  • (PMID = 18156936.001).
  • [ISSN] 0003-4932
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Genetic Markers; EC 1.13.11.31 / Arachidonate 12-Lipoxygenase; EC 1.3.- / Acyl-CoA Dehydrogenases
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39. Chen W, Chen GY, Tsai SJ, Wang PW, Sheu HM, Shen YS, Chen FF: Mild cutaneous manifestation in two young women with extraordinary hyperandrogenemia. Dermatology; 2005;210(1):49-52
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  • Hyperandrogenism with hyperandrogenemia should be considered in those with severe acne of sudden onset or conspicuous male-pattern baldness with hairline recession, although the majority of female patients with acne or androgenetic alopecia possess no endocrine disorder.
  • The first one presenting vertical alopecia had an elevated level of serum dehydroepiandrosterone sulfate (>800 microg/dl) and was suspected to be a case of late-onset, non-classical adrenal hyperplasia.
  • The second case with mild acne had a soaring serum level of total testosterone >9,000 ng/dl derived from an androgen-secreting adrenal adenoma overexpressing steroidogenic acute regulatory protein, P450 side-chain cleavage enzyme and aromatase.
  • The possibility of adrenal tumor should be explored in patients with escalated circulating testosterone.
  • [MeSH-major] Acne Vulgaris / complications. Adrenal Gland Neoplasms / diagnosis. Alopecia / complications. Hyperandrogenism / diagnosis
  • [MeSH-minor] Adolescent. Adult. Diagnosis, Differential. Female. Humans. Tomography, X-Ray Computed

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  • (PMID = 15604546.001).
  • [ISSN] 1018-8665
  • [Journal-full-title] Dermatology (Basel, Switzerland)
  • [ISO-abbreviation] Dermatology (Basel)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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40. Peppa M, Pikounis V, Papaxoinis G, Macheras A, Economopoulos T, Raptis SA, Hadjidakis D: Adrenocortical carcinoma secreting cortisol, androgens and aldosterone: a case report. Cases J; 2009;2:8951
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  • [Title] Adrenocortical carcinoma secreting cortisol, androgens and aldosterone: a case report.
  • INTRODUCTION: Adrenocortical carcinoma is a rare malignancy with a poor prognosis and presents with mass effects and less often with signs of hormone excess (approximately 60% of all adrenocortical carcinoma's).
  • Hormonally active adrenocortical carcinomas most commonly secrete cortisol while the co-secretion of multiple steroid hormones is rare.
  • CASE PRESENTATION: We report the case of a 59 year-old woman with a medical history of hyperaldosteronism due to a right adrenal adenoma.
  • During follow up, she showed symptoms of hypercortisolism and hyperandrogenemia and a rapid growth of the adrenal mass.
  • She underwent right adrenalectomy and the histology revealed the presence of an adrenocortical carcinoma.
  • Six months post-operatively being on treatment with mitotane, she was diagnosed of metastatic disease to the liver.
  • CONCLUSION: The hormonal status should be carefully investigated in all cases of suspected adrenocortical carcinoma, as the pattern of hormone secretion may be a clue to the malignancy of an adrenal lesion.
  • In addition, more data are needed to clarify the clinical and prognostic significance of the combined production of all adrenocortical hormones affecting either the survival or the quality of life of adrenocortical carcinoma patients.

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  • (PMID = 20181215.001).
  • [ISSN] 1757-1626
  • [Journal-full-title] Cases journal
  • [ISO-abbreviation] Cases J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2827070
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41. 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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42. 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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43. Hennings J, Sundin A, Hägg A, Hellman P: 11C-metomidate positron emission tomography after dexamethasone suppression for detection of small adrenocortical adenomas in primary aldosteronism. Langenbecks Arch Surg; 2010 Sep;395(7):963-7
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  • [Title] 11C-metomidate positron emission tomography after dexamethasone suppression for detection of small adrenocortical adenomas in primary aldosteronism.
  • PURPOSE: To evaluate whether dexamethasone suppression treatment can improve (11) C-metomidate positron emission tomography (MTO-PET) detection of small adrenocortical adenomas in primary aldosteronism (PA).
  • MATERIALS AND METHODS: Eleven patients with proven PA and two patients with non-hyperfunctioning adrenocortical incidentalomas and small adrenocortical tumours observed on CT underwent MTO-PET before and 3 days after administration of oral dexamethasone suppression treatment.
  • RESULTS: All tumours were detected and categorised as adrenocortical by MTO-PET.
  • SUVhs as well as SUVmax were higher in PA compared to nonfunctional adenomas.
  • Normal adrenal cortex was suppressed after dexamethasone (p < 0.05), but tumour SUV was not significantly decreased after suppression in either PA or nonfunctional tumours (p > 0.05).
  • However, these changes caused no significant increase in the tumour-to-normal adrenal ratio (p > 0.05).
  • CONCLUSION: MTO-PET is a highly sensitive method for detecting and categorising even small adrenocortical tumours in PA.
  • In this series, dexamethasone-suppressed MTO-PET was unable to increase the tumour-to-normal adrenal ratio to further facilitate detection of small adenomas in PA as an alternative to adrenal venous sampling.
  • [MeSH-major] Adrenocortical Adenoma / diagnostic imaging. Adrenocortical Adenoma / drug therapy. Dexamethasone / therapeutic use. Hyperaldosteronism / diagnostic imaging. Hyperaldosteronism / drug therapy. Positron-Emission Tomography / methods

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  • (PMID = 20644954.001).
  • [ISSN] 1435-2451
  • [Journal-full-title] Langenbeck's archives of surgery
  • [ISO-abbreviation] Langenbecks Arch Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 5377-20-8 / metomidate; 7S5I7G3JQL / Dexamethasone; Z22628B598 / Etomidate
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44. Iihara M, Obara T: [Diagnosis and surgical treatment of adrenal tumors]. Nihon Geka Gakkai Zasshi; 2005 Aug;106(8):479-83
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  • [Title] [Diagnosis and surgical treatment of adrenal tumors].
  • Adrenal surgery is necessary for the management of functioning adrenal tumors, such as aldosterone-producing adenoma, cortisol-producing adenoma, and pheochromocytoma.
  • The role of adrenal imaging in primary hyperaldosteronism is to separate the surgically resectable unilateral aldosteronoma from bilateral hyperplasia.
  • Once the clinical diagnosis of primary hyperaldosteronism is confirmed, adrenal computed tomography (CT) with 3-mm sections should be the first imaging study.
  • If the results of CT and NP-59 scintigraphy are equivocal, adrenal venous sampling is necessary.
  • Cortisol-producing adrenocortical adenomas are seen as adrenal masses 2.5 cm or larger in diameter in CT scanning.
  • When an adrenal mass measures more than 5 cm in diameter, a functioning adrenal carcinoma should be considered.
  • In the past decade, laparoscopic adrenalectomy has replaced open adrenalectomy as a standard operative procedure for benign adrenal tumors.
  • Adrenal-sparing laparoscopic surgery has recently become a feasible option in patients with hereditary bilateral pheochromocytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery
  • [MeSH-minor] Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / surgery. Adrenal Medulla. Humans

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  • (PMID = 16119111.001).
  • [ISSN] 0301-4894
  • [Journal-full-title] Nihon Geka Gakkai zasshi
  • [ISO-abbreviation] Nihon Geka Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 17
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45. Waalkes MP, Liu J, Ward JM, Powell DA, Diwan BA: Urogenital carcinogenesis in female CD1 mice induced by in utero arsenic exposure is exacerbated by postnatal diethylstilbestrol treatment. Cancer Res; 2006 Feb 1;66(3):1337-45
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  • Arsenic alone induced some urogenital system tumors, including mostly benign tumors of the ovary and uterus, and adrenal adenoma.
  • Arsenic plus diethylstilbestrol increased ovarian, uterine, and vaginal tumors, and urinary bladder proliferative lesions, including three transitional cell carcinomas.

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  • (PMID = 16452187.001).
  • [ISSN] 0008-5472
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CO / N01 CO 12400; United States / Intramural NIH HHS / /
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Estrogen Receptor alpha; 094ZI81Y45 / Tamoxifen; 731DCA35BT / Diethylstilbestrol; N712M78A8G / Arsenic
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46. 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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47. Alexandraki KI, Grossman AB: Medical therapy of Cushing's disease: where are we now? Front Horm Res; 2010;38:165-73
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  • [Title] Medical therapy of Cushing's disease: where are we now?
  • The goals of ideal medical therapy for Cushing's disease should be to target the aetiology of the disorder, and thus surgery is the current 'gold standard' treatment.
  • However, no effective drug that directly and effectively targets the adrenocorticotropin-secreting pituitary adenoma has been found to date, and treatments to control the hypercortisolaemic state by adrenal-based therapy are frequently used.
  • Inhibitors of adrenal steroidogenesis, adrenolytic agents, compounds with neuromodulatory properties, and ligands of different nuclear hormone receptors involved in hypothalamo-pituitary regulation currently used have been reviewed.
  • The somatostatin analogue pasireotide and the dopamine agonist cabergoline, as well as their combination, show some therapeutic promise, while retinoic acid analogues should be further investigated in the pituitary-targeted medical therapy of Cushing's disease.
  • Since a percentage of patients treated with surgery are not cured, or improve and subsequently relapse, there is an urgent need for effective medical therapies for this disorder.
  • At present, only cabergoline and pasireotide are under active investigation, while adrenal steroidogenesis inhibitors are still the mainstay treatments for the control of the hypercortisolaemic state.

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  • [Copyright] Copyright (c) 2010 S. Karger AG, Basel.
  • (PMID = 20616508.001).
  • [ISSN] 0301-3073
  • [Journal-full-title] Frontiers of hormone research
  • [ISO-abbreviation] Front Horm Res
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Dopamine Agonists; 320T6RNW1F / Mifepristone; 51110-01-1 / Somatostatin; 78E4J5IB5J / Mitotane; R9400W927I / Ketoconazole; WI4X0X7BPJ / Hydrocortisone; ZS9KD92H6V / Metyrapone
  • [Number-of-references] 50
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48. Gaujoux S, Pinson S, Gimenez-Roqueplo AP, Amar L, Ragazzon B, Launay P, Meatchi T, Libé R, Bertagna X, Audebourg A, Zucman-Rossi J, Tissier F, Bertherat J: Inactivation of the APC gene is constant in adrenocortical tumors from patients with familial adenomatous polyposis but not frequent in sporadic adrenocortical cancers. Clin Cancer Res; 2010 Nov 1;16(21):5133-41
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  • [Title] Inactivation of the APC gene is constant in adrenocortical tumors from patients with familial adenomatous polyposis but not frequent in sporadic adrenocortical cancers.
  • PURPOSE: In adrenocortical tumors (ACT), Wnt/β-catenin pathway activation can be explained by β-catenin somatic mutations only in a subset of tumors.
  • EXPERIMENTAL DESIGN: ACTs from patients with FAP and sporadic adrenocortical carcinomas (ACC) with abnormal β-catenin localization on immunohistochemistry but no somatic β-catenin mutations were studied.
  • RESULTS: Four ACTs were observed in three patients with FAP and were ACC, adrenocortical adenoma, and bilateral macronodular adrenocortical hyperplasia, all with abnormal β-catenin localization.
  • [MeSH-major] Adenomatous Polyposis Coli / genetics. Adrenal Cortex Neoplasms / genetics. Adrenocortical Carcinoma / genetics. Gene Silencing. Genes, APC

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  • [Copyright] ©2010 AACR.
  • (PMID = 20978149.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / AMER1 protein, human; 0 / Adaptor Proteins, Signal Transducing; 0 / Adenomatous Polyposis Coli Protein; 0 / Tumor Suppressor Proteins; 0 / beta Catenin
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49. Ikarashi T, Kamoi K, Asakawa K, Tanaka M, Miyakoshi M, Komeyama T, Morishita H, Usuda H, Emura I, Sasano H: A case of preclinical Cushing's syndrome associated with diurnal rhythms of ACTH and cortisol in blood: correlation with histological findings. Endocr J; 2006 Oct;53(5):609-13
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  • We describe a case of adrenocortical adenoma with preclinical Cushing's syndrome demonstrating diurnal rhythms of ACTH and cortisol in blood.
  • A 50-year-old man was admitted to the hospital for the evaluation of incidental right adrenal mass with hyperglycemia and hypertension.
  • Ultrasonogram, CT and scintiscan of (131)I adosterol all demonstrated an enlarged adrenal mass in the right adrenal gland.
  • The right adrenal gland was subsequently resected by laparoscopic surgery.
  • Histopathological findings of resected adrenal tumor were consistent with adrenocortical adenoma.
  • Adjacent non-neoplastic adrenal tissue demonstrated adrenocortical atrophy but DHEA-sulfotransferase immunoreactivity in the zona reticularis was detected.
  • [MeSH-major] Adrenocorticotropic Hormone / blood. Cushing Syndrome / blood. Cushing Syndrome / diagnosis. Hydrocortisone / blood
  • [MeSH-minor] Adrenal Cortex Neoplasms / blood. Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / pathology. Adrenal Glands / pathology. Adrenocortical Adenoma / blood. Adrenocortical Adenoma / diagnosis. Adrenocortical Adenoma / pathology. Circadian Rhythm. Humans. Male. Middle Aged

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  • (PMID = 16896266.001).
  • [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] 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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50. Chiou TT, Chiang PH, Fuh M, Liu RT, Lee WC, Lee WC, Ng HY, Tsai YC, Chuang FR, Huang CC, Lee CT: Factors determining cardiovascular and renal outcomes after adrenalectomy in patients with aldosterone-producing adrenal adenoma. Tohoku J Exp Med; 2009 May;218(1):17-24
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  • [Title] Factors determining cardiovascular and renal outcomes after adrenalectomy in patients with aldosterone-producing adrenal adenoma.
  • Primary aldosteronism is an important cause of secondary hypertension, because it is potentially curable, especially in case of unilateral aldosterone-producing adrenal adenoma (APA).
  • However, the information is limited concerning the cardiovascular and renal outcomes in this patient population.
  • We studied 52 patients with APA in order to determine the pre-operative and post-operative factors predicting cardiovascular and renal outcomes.
  • Patients whose renal function worsened after adrenalectomy had significantly higher pre-operative plasma active renin levels.
  • Thus, in patients with APA, the presence of LVH is correlated with impaired renal function (lower eGFR).
  • In conclusion, pre-operative BP and post-operative plasma aldosterone are important in predicting post-adrenalectomy hypertension, and a lower pre-operative plasma renin predicts the improvement in renal function after adrenalectomy.
  • [MeSH-major] Adrenal Cortex Neoplasms. Adrenalectomy. Adrenocortical Adenoma. Aldosterone / blood. Cardiovascular System / metabolism. Hypertension. Kidney

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  • (PMID = 19398869.001).
  • [ISSN] 1349-3329
  • [Journal-full-title] The Tohoku journal of experimental medicine
  • [ISO-abbreviation] Tohoku J. Exp. Med.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 4964P6T9RB / Aldosterone
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51. Herd A, Harman R, Taylor E: Surgical outcomes following laparoscopic adrenalectomy for treatment of Conn's syndrome (primary hyperaldosteronism) between 1999 and 2006. N Z Med J; 2010 Oct 15;123(1324):50-6
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  • [Title] Surgical outcomes following laparoscopic adrenalectomy for treatment of Conn's syndrome (primary hyperaldosteronism) between 1999 and 2006.
  • BACKGROUND: Primary hyperaldosteronism is a recognised cause of secondary hypertension with its aetiology most commonly due to a secreting aldosterone adenoma of the adrenal gland.
  • Laparoscopic resection of the adrenal tumour has now become the accepted form of intervention.
  • CONCLUSION: The results suggest unilateral laparoscopic adrenalectomy is an effective tool in treatment for benign primary hyperaldosteronism caused by aldosterone secreting adenomas.

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  • (PMID = 20953222.001).
  • [ISSN] 1175-8716
  • [Journal-full-title] The New Zealand medical journal
  • [ISO-abbreviation] N. Z. Med. J.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] New Zealand
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52. Blanes A, Diaz-Cano SJ: DNA and kinetic heterogeneity during the clonal evolution of adrenocortical proliferative lesions. Hum Pathol; 2006 Oct;37(10):1295-303
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  • [Title] DNA and kinetic heterogeneity during the clonal evolution of adrenocortical proliferative lesions.
  • Monoclonal adrenocortical lesions show inverse correlation between proliferation and apoptosis, with proliferation being the single most important criterion of malignancy in adrenal lesions.
  • No study yet has evaluated the variability of proliferation regarding the clonal pattern and diagnosis in adrenocortical nodular hyperplasias (ACNHs), adrenocortical adenomas (ACAs), and adrenocortical carcinomas (ACCs).
  • Statistics included analysis of variance/Student t tests regarding the clonal patterns and diagnosis.
  • Only tetraploid percentage (P = .0496) and 5cER (P = .0352) distinguished polyclonal (3.64 +/- 2.20 and 0.14 +/- 0.15) from monoclonal (7.25 +/- 7.52 and 1.00 +/- 1.74) benign lesions.
  • Cell kinetic heterogeneity is the hallmark of adrenocortical neoplasms: tetraploid/hypertetraploid cell accumulation characterizes monoclonal lesions (suggesting nondisjunctional mitoses), whereas heterogeneously distributed mitotic figures and decreased diploid percentage define ACCs.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Adrenocortical Adenoma / genetics. Adrenocortical Carcinoma / genetics. DNA, Neoplasm / analysis
  • [MeSH-minor] Apoptosis. Cell Nucleus / genetics. Cell Nucleus / pathology. Cell Proliferation. Clone Cells. Disease Progression. Flow Cytometry. Humans. Hyperplasia. Image Cytometry. Ki-67 Antigen / metabolism. Kinetics. Mitotic Index. Polyploidy. X Chromosome Inactivation / genetics

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  • (PMID = 16949934.001).
  • [ISSN] 0046-8177
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Neoplasm; 0 / Ki-67 Antigen
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53. Anagnostis P, Karagiannis A, Tziomalos K, Kakafika AI, Athyros VG, Mikhailidis DP: Adrenal incidentaloma: a diagnostic challenge. Hormones (Athens); 2009 Jul-Sep;8(3):163-84
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  • [Title] Adrenal incidentaloma: a diagnostic challenge.
  • The widespread application of abdominal imaging procedures has resulted in an increased frequency of clinically silent adrenal masses.
  • Adrenal incidentaloma (AI) is a term applied to an accidentally discovered adrenal mass on imaging performed for the investigation of an unrelated complaint.
  • Adrenal incidentalomas (AIs) are a cluster of different pathologies, the majority of which are benign and non-functioning adrenal adenomas.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Incidental Findings
  • [MeSH-minor] Adrenocortical Adenoma / diagnosis. Algorithms. Biopsy, Fine-Needle. Cushing Syndrome / diagnosis. Humans. Magnetic Resonance Imaging. Pheochromocytoma / diagnosis. Tomography, X-Ray Computed

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  • (PMID = 19671516.001).
  • [ISSN] 1109-3099
  • [Journal-full-title] Hormones (Athens, Greece)
  • [ISO-abbreviation] Hormones (Athens)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Greece
  • [Number-of-references] 181
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54. Nunes ML, Rault A, Teynie J, Valli N, Guyot M, Gaye D, Belleannee G, Tabarin A: 18F-FDG PET for the identification of adrenocortical carcinomas among indeterminate adrenal tumors at computed tomography scanning. World J Surg; 2010 Jul;34(7):1506-10
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  • [Title] 18F-FDG PET for the identification of adrenocortical carcinomas among indeterminate adrenal tumors at computed tomography scanning.
  • BACKGROUND: 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) has been proposed for the evaluation of adrenal tumors.
  • However, only scarce data are available to evaluate its usefulness for the identification of primary adrenal carcinomas in patients with no previous history of cancer and equivocal tumors on computed tomography (CT) scan.
  • Twenty-three consecutive patients without previous history of cancer investigated for adrenal tumors without features of benign adrenocortical adenoma on CT scan but no obvious ACC underwent 18F-FDG PET.
  • The ratio of maxSUV adrenal tumor on maxSUV liver (adrenal/liver maxSUV ratio) during 18F-FDG PET was compared to Weiss pathological criteria.
  • RESULTS: Seventeen patients had an adrenal adenoma, 2 had small size adrenal carcinomas (<5 cm), 1 had an angiosarcoma, and 3 had noncortical benign lesions.
  • An adrenal/liver maxSUV ratio above 1.6 provided 100% sensitivity, 90% specificity, and 100% negative predictive value for the diagnosis of malignant tumor.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnostic imaging. Adrenal Gland Neoplasms / diagnostic imaging. Fluorodeoxyglucose F18. Positron-Emission Tomography. Radiopharmaceuticals. Tomography, X-Ray Computed
  • [MeSH-minor] Adrenocortical Adenoma / diagnostic imaging. Adult. Aged. Female. Humans. Male. Middle Aged. Retrospective Studies. Sensitivity and Specificity

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  • (PMID = 20396886.001).
  • [ISSN] 1432-2323
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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55. Ctvrtlík F, Herman M, Student V, Tichá V, Minarík J: Differential diagnosis of incidentally detected adrenal masses revealed on routine abdominal CT. Eur J Radiol; 2009 Feb;69(2):243-52
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  • [Title] Differential diagnosis of incidentally detected adrenal masses revealed on routine abdominal CT.
  • PURPOSE: The aim of this study was to compare CT findings of adrenal incidentalomas with a definitive histological diagnosis in order to establish CT features characteristic for individual types of lesions.
  • PATIENTS AND METHODS: The retrospective study comprised of patients with adrenal lesions detected on abdominal CT.
  • The study consisted of 62 adrenal expansions found in 55 patients (in seven patients bilateral lesions were found).
  • According to the definitive histological diagnosis after adrenalectomy, the lesions were divided into the following six groups: primary adrenocortical carcinoma (n=4), metastasis (n=7), adrenocortical adenoma (n=37), pheochromocytoma (n=9), myelolipoma (n=2), and others (n=3).
  • Sensitivity, specificity, accuracy, positive predictive value, negative predictive value for distinguishing adenomas and non-adenomas using a cut-off diameter of 41.5mm were 81.1%, 70.0%, 77.2%, 83.3%, 66.7%, respectively; using the non-contrast density threshold of 23 HU, they were 89.2%, 100%, 93%, 100%, 83.3%, respectively; using the post-contrast density threshold of 47.5 HU, they were 80.6%, 100%, 88.2%, 100%, 76.9%, respectively; using the increase of density threshold of 34.5 HU, they were 74.2%, 70.0%, 72.5%, 79.3%, 63.6%, respectively.
  • A study of receiver operating characteristics (ROC) analyses resulted in the following conclusions: (a) the most accurate parameter for distinguishing adenomas from non-adenomas is the value of non-contrast density, (b) the second most accurate parameter is the post-contrast density, (c) the least suitable parameters are the size of the lesion and increase of density, (d) therefore, in practice, the value of non-contrast density parameter should be used.
  • CONCLUSION: Standard CT of the abdomen (not specifically aimed at adrenal glands) is a suitable method for distinguishing adrenal lesions which need to be operated on from those which are probably benign but need to be monitored.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Radiographic Image Interpretation, Computer-Assisted / methods. Radiography, Abdominal / methods. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adult. Aged. Diagnosis, Differential. Female. Humans. Incidental Findings. Male. Middle Aged. Radiographic Image Enhancement / methods. Reproducibility of Results. Sensitivity and Specificity. Young Adult

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  • (PMID = 18226485.001).
  • [ISSN] 1872-7727
  • [Journal-full-title] European journal of radiology
  • [ISO-abbreviation] Eur J Radiol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
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56. Bourdeau I, Lampron A, Costa MH, Tadjine M, Lacroix A: Adrenocorticotropic hormone-independent Cushing's syndrome. Curr Opin Endocrinol Diabetes Obes; 2007 Jun;14(3):219-25
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  • Primary Cushing's syndrome is most often secondary to adrenocortical adenomas or carcinomas, and more rarely to bilateral adrenal hyperplasias.
  • Corticotropin-independent cortisol-producing hyperplasia is caused by micronodular diseases, including primary pigmented nodular adrenocortical disease and nonpigmented micronodular hyperplasia and adrenocorticotropic hormone-independent macronodular adrenal hyperplasia.
  • Primary pigmented nodular adrenocortical disease can be found either alone or in the context of Carney complex, a multiple endocrine neoplasia syndrome.
  • RECENT FINDINGS: In recent years, the pathophysiology of adrenocortical tumors and hyperplasias became better understood following the identification of genes responsible for syndromes associated with corticotropin-independent Cushing's syndrome and the demonstration of aberrant expression and function of various hormone receptors in adrenocortical adenomas and adrenocorticotropic hormone-independent macronodular adrenal hyperplasia.
  • This article reviews findings on the molecular and genetic aspects of corticotropin-independent Cushing's syndrome including recent gene expression profiling studies of adrenocortical tumors and hyperplasias and animal models that provided clues on the pathogenesis of primary Cushing's syndrome.
  • SUMMARY: A better understanding of molecular mechanisms involved in adrenocortical tumors and hyperplasias may lead to improved diagnostic and prognostic markers and treatment strategies to assist clinicians in the management of corticotropin-independent Cushing's syndrome.
  • [MeSH-major] Adrenal Cortex Diseases / complications. Adrenal Cortex Neoplasms / complications. Adrenocorticotropic Hormone / metabolism. Cushing Syndrome / etiology

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  • (PMID = 17940443.001).
  • [ISSN] 1752-2978
  • [Journal-full-title] Current opinion in endocrinology, diabetes, and obesity
  • [ISO-abbreviation] Curr Opin Endocrinol Diabetes Obes
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
  • [Number-of-references] 63
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57. Yener S, Genc S, Akinci B, Secil M, Demir T, Comlekci A, Ertilav S, Yesil S: Carotid intima media thickness is increased and associated with morning cortisol in subjects with non-functioning adrenal incidentaloma. Endocrine; 2009 Jun;35(3):365-70
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  • [Title] Carotid intima media thickness is increased and associated with morning cortisol in subjects with non-functioning adrenal incidentaloma.
  • Data regarding cardiovascular risk in subjects with non-functioning adrenal adenoma are limited.
  • The objectives of this study are to investigate carotid intima media thickness (IMT) as an indicator of atherosclerosis in subjects with non-functioning adrenal incidentaloma (AI) and to evaluate the factors that could be associated with IMT.
  • Forty-nine subjects without findings of hypercortisolism or other adrenal gland disorders, 34 body mass index (BMI)-unmatched controls (C) and 18 BMI-matched controls (BC) were enrolled.
  • The correlation between morning cortisol and IMT may be associated with the effect of hypothalamus-pituitary-adrenal axis disturbances on vasculature.
  • [MeSH-major] Adenoma / metabolism. Adenoma / pathology. Adrenal Gland Neoplasms / metabolism. Adrenal Gland Neoplasms / pathology. Carotid Arteries / pathology. Hydrocortisone / metabolism. Tunica Intima / pathology
  • [MeSH-minor] Adult. Atherosclerosis / complications. Atherosclerosis / diagnosis. Atherosclerosis / metabolism. Atherosclerosis / pathology. Body Mass Index. Case-Control Studies. Circadian Rhythm / physiology. Female. Humans. Incidental Findings. Male. Middle Aged. Organ Size. Up-Regulation

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  • (PMID = 19277910.001).
  • [ISSN] 1355-008X
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone
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58. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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59. Unger N, Pitt C, Schmidt IL, Walz MK, Schmid KW, Philipp T, Mann K, Petersenn S: Diagnostic value of various biochemical parameters for the diagnosis of pheochromocytoma in patients with adrenal mass. Eur J Endocrinol; 2006 Mar;154(3):409-17
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  • [Title] Diagnostic value of various biochemical parameters for the diagnosis of pheochromocytoma in patients with adrenal mass.
  • This study compared various biochemical parameters for the diagnosis of adrenal pheochromocytoma in patients with adrenal mass.
  • DESIGN: One hundred and fifty subjects were studied, including 24 histologically proven pheochromocytomas, 17 aldosterone-secreting and 21 cortisol-secreting adrenal adenomas and 30 nonfunctioning adrenal masses, 16 patients with essential hypertension and 42 healthy normotensive volunteers.
  • CONCLUSION: Plasma metanephrines measured by RIA are reliable screening parameters for the diagnosis of pheochromocytoma.


60. 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


61. Nigawara T, Sakihara S, Kageyama K, Terui K, Takayasu S, Hatakeyama S, Ohyama C, Sasano H, Suda T: Endothelial cyst of the adrenal gland associated with adrenocortical adenoma: preoperative images simulate carcinoma. Intern Med; 2009;48(4):235-40
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  • [Title] Endothelial cyst of the adrenal gland associated with adrenocortical adenoma: preoperative images simulate carcinoma.
  • A 68-year-old woman was referred for characterization of a left adrenal incidentaloma.
  • Endocrinological examinations indicated subclinical Cushing's syndrome, whereas the large volume (10 cm in diameter) and heterogeneous configuration of the tumor raised a strong suspicion of adrenal carcinoma.
  • Histopathologically, this lesion was a thick hyaline-walled endothelial cyst, flanked with a compressed adrenocortical adenoma.
  • The puzzling image resemblance of a variation of adrenal cyst to carcinoma necessitated histological examination for confirmative diagnosis.
  • This is the first reported case of adrenal endothelial cyst associated with adrenocortical adenoma, the former of which alone is a rarity.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenal Glands / pathology. Adrenocortical Adenoma / diagnosis. Cysts / pathology. Cysts / radionuclide imaging

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  • (PMID = 19218775.001).
  • [ISSN] 1349-7235
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Iodine Radioisotopes
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62. Gupta RT, Ho LM, Marin D, Boll DT, Barnhart HX, Nelson RC: Dual-energy CT for characterization of adrenal nodules: initial experience. AJR Am J Roentgenol; 2010 Jun;194(6):1479-83
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  • [Title] Dual-energy CT for characterization of adrenal nodules: initial experience.
  • OBJECTIVE: The purpose of this study was to determine whether use of dual-energy technique can improve the diagnostic performance of CT in the differential diagnosis of adrenal adenomas and metastatic lesions.
  • SUBJECTS AND METHODS: Thirty-one adrenal nodules were prospectively identified in 17 patients who underwent dual-energy CT at 140 and 80 kVp.
  • The mean attenuation change (increase or decrease) between 140 kVp and 80 kVp was determined for each adrenal nodule.
  • RESULTS: Twenty-six adrenal nodules were benign adenomas (attenuation less than +10 HU or stability for at least 1 year).
  • Five adrenal nodules were classified as metastatic (rapid growth in 1 year and history of extraadrenal malignancy).
  • The mean attenuation change between 140 kVp and 80 kVp was 0.4 +/- 7.1 HU for adenomas and 9.2 +/- 4.3 HU for metastatic lesions (p < 0.003).
  • Fifty percent of adenomas had an attenuation decrease at 80 kVp.
  • With a decrease in attenuation at 80 kVp as an indicator of intracellular lipid within an adenoma, dual-energy CT has 50% sensitivity, 100% specificity, 100% positive predictive value, and 28% negative predictive value in the diagnosis of adenoma.
  • CONCLUSION: A decrease in attenuation of an adrenal lesion between 140 kVp and 80 kVp is a highly specific sign of adrenal adenoma.
  • However, because an increase in attenuation at 80 kVp is seen with metastatic lesions and some adenomas, the sensitivity of this test is low.
  • These data suggest that dual-energy CT can be used to help differentiate some lipid-poor adrenal adenomas from metastatic lesions.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Adrenocortical Adenoma / radiography. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Aged. Diagnosis, Differential. Female. Humans. Male. Neoplasm Metastasis. Predictive Value of Tests. Prospective Studies. Radiographic Image Interpretation, Computer-Assisted. Sensitivity and Specificity

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  • (PMID = 20489086.001).
  • [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
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63. Contesse V, Reznik Y, Louiset E, Duparc C, Cartier D, Sicard F, Laquerriere A, Parmentier F, Kuhn JM, Vaudry H, Lefebvre H: Abnormal sensitivity of cortisol-producing adrenocortical adenomas to serotonin: in vivo and in vitro studies. J Clin Endocrinol Metab; 2005 May;90(5):2843-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Abnormal sensitivity of cortisol-producing adrenocortical adenomas to serotonin: in vivo and in vitro studies.
  • Two patients with incidentally discovered adrenocortical adenomas underwent a series of pharmacological and physiological tests after pretreatment with dexamethasone.
  • In the two cases, 5-HT stimulated cortisol secretion from tumor cells with increased efficacy and/or potency to activate steroidogenesis by comparison with normal adrenocortical cells.
  • In the two adenoma tissues, immunohistochemical studies revealed the presence of 5-HT-like immunoreactivity within clusters of steroidogenic cells, suggesting that 5-HT acted through an autocrine/paracrine mechanism to stimulate steroidogenesis.
  • In conclusion, this study provides the first observation of adrenocortical cortisol-producing adenomas hypersensitive in vivo and in vitro to serotonergic agonists.
  • Our results also show that cortisol-producing adenomas can express simultaneously several illegitimate receptors.
  • [MeSH-major] Adenoma / metabolism. Adrenocortical Adenoma / metabolism. Hydrocortisone / secretion. Serotonin / pharmacology

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  • [CommentIn] Horm Metab Res. 2005 Aug;37(8):528-9 [16138268.001]
  • (PMID = 15705918.001).
  • [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] 158165-40-3 / Receptors, Serotonin, 5-HT4; 333DO1RDJY / Serotonin; WI4X0X7BPJ / Hydrocortisone
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64. Liu XK, Liu XJ, Dong X, Kong CZ: [Clinical research about treatment for adrenal incidentalomas]. Zhonghua Wai Ke Za Zhi; 2008 Jun 1;46(11):832-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Clinical research about treatment for adrenal incidentalomas].
  • OBJECTIVE: To explore the therapeutic methods of adrenal incidentalomas.
  • Pathological results indicated that 34 cases were pheochromocytoma, 83 adrenal cortical adenoma, 5 adrenal cortical carcinoma, 3 metastases carcinoma, and 26 other benign tumors.
  • 3 cases of metastases carcinoma died in 1.5 years, 2 cases of cortical carcinoma died in 2.0 and 2.5 years for recurrence and metastases.
  • CONCLUSIONS: Surgical operations should be performed in malignant tumors, hypersecretion tumors, deuto-clinical adrenal cortical tumors, pheochromocytoma and those whose diameters of tumors are over 3 cm.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery

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  • (PMID = 19035218.001).
  • [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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65. Piaditis GP, Kaltsas GA, Androulakis II, Gouli A, Makras P, Papadogias D, Dimitriou K, Ragkou D, Markou A, Vamvakidis K, Zografos G, Chrousos G: High prevalence of autonomous cortisol and aldosterone secretion from adrenal adenomas. Clin Endocrinol (Oxf); 2009 Dec;71(6):772-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] High prevalence of autonomous cortisol and aldosterone secretion from adrenal adenomas.
  • OBJECTIVES: Previous studies based on standard endocrine testing have shown a variable incidence of autonomous cortisol secretion (ACS) or autonomous aldosterone secretion (AAS) in patients with single adrenal adenomas (SAA).
  • Patients We investigated 151 patients with SAA and 72 matched controls with normal adrenal computerized tomography.
  • [MeSH-major] Adrenocortical Adenoma / blood. Aldosterone / blood. Hydrocortisone / blood
  • [MeSH-minor] Adrenal Glands / drug effects. Adrenal Glands / metabolism. Adrenocorticotropic Hormone / administration & dosage. Adrenocorticotropic Hormone / pharmacology. Case-Control Studies. Dexamethasone / administration & dosage. Dexamethasone / pharmacology. Female. Humans. Male. Middle Aged. Radioimmunoassay

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  • (PMID = 19226269.001).
  • [ISSN] 1365-2265
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 4964P6T9RB / Aldosterone; 7S5I7G3JQL / Dexamethasone; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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66. Reisch N, Scherr M, Flade L, Bidlingmaier M, Schwarz HP, Müller-Lisse U, Reincke M, Quinkler M, Beuschlein F: Total adrenal volume but not testicular adrenal rest tumor volume is associated with hormonal control in patients with 21-hydroxylase deficiency. J Clin Endocrinol Metab; 2010 May;95(5):2065-72
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  • [Title] Total adrenal volume but not testicular adrenal rest tumor volume is associated with hormonal control in patients with 21-hydroxylase deficiency.
  • CONTEXT: Patients with 21-hydroxylase deficiency (21-OHD) have been shown to develop adrenal adenomas and, in males, testicular adrenal rest tumors (TARTs) at a high percentage.
  • OBJECTIVE: The aim of this study was to evaluate the interrelation of adrenal masses and TARTs as well as factors stimulating tumor growth of orthotopic and ectopic adrenal tissue in 21-OHD.
  • Adrenal size and morphology was compared to 26 age-matched controls.
  • RESULTS: Combined adrenal volume of 21-OHD patients was significantly higher (median, 9.3 ml; range, 3.2-124.5 ml) in comparison to controls (median, 7.4 ml; range, 5.5-10.8 ml; P = 0.005).
  • None of the controls, but 42% of 21-OHD patients had an overall adrenal volume higher than 11 ml.
  • Total adrenal volume and tumor size but not TART volume correlated positively with current parameters of hormonal control (androstenedione, morning 17-OHP in serum, pregnanetriol in 24-h urine; P < 0.001 for each).
  • Baseline ACTH was independent of adrenal and TART volume.
  • There was no correlation of total adrenal or adrenal tumor size with TART volume.
  • CONCLUSION: These data provide indirect evidence that different factors regulate the growth of orthotopic adrenal tissue and ectopic adrenal remnants in TARTs.
  • [MeSH-major] Adrenal Glands / anatomy & histology. Adrenal Hyperplasia, Congenital / genetics. Adrenal Rest Tumor / genetics. Adrenal Rest Tumor / pathology. Steroid 21-Hydroxylase / genetics. Testicular Neoplasms / genetics

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  • (PMID = 20190160.001).
  • [ISSN] 1945-7197
  • [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] 7S5I7G3JQL / Dexamethasone; EC 1.14.99.10 / Steroid 21-Hydroxylase; WI4X0X7BPJ / Hydrocortisone
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67. Meyer S, von Mach MA, Ivan D, Schäfer S, Habbe N, Kann B, Kann PH: Color-coded duplex endoscopic ultrasound of the adrenals. J Endocrinol Invest; 2008 Oct;31(10):882-7
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  • Imaging of the adrenals by endoscopic ultrasound (EUS) is a valuable technique for detection and localization of adrenal lesions, but endosonomorphological tumor distinction remains difficult.
  • In this single-center study, the amount of blood flow in common adrenal lesions, such as adrenal adenomas, adrenal hyperplasia, and pheochromocytomas, was visualized by color-coded duplex EUS (CD-EUS) and was retrospectively analysed.
  • Therefore, we reviewed our EUS database to evaluate and correlate the perfusion patterns of common adrenal lesions with histologically confirmed diagnosis, possible malignancy, and endosonomorphological features such as echogeneity, echostructure, and tumor size.
  • In 38 consecutive patients (male=19; female=19; age: mean 53+/-16 yr SD), perfusion patterns of 46 histologically confirmed adrenal, para- or extra-adrenal lesions of adrenal origin (adenoma: no.
  • Compared to adenomas (p=0.003) and nodular hyperplasia (p=0.047), pheochromocytomas showed a significantly higher grade of perfusion.
  • There was no relationship between perfusion patterns and localization of pheochromocytomas (adrenal: 8; paraadrenal: 3; extra-adrenal: 4).
  • CD-EUS is an additional tool for adrenal endosonographic tumor distinction and seems to improve the endosonographic detection of pheochromocytomas by visualization of hypervascularization.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnostic imaging. Adrenal Glands / diagnostic imaging
  • [MeSH-minor] Adenoma / diagnostic imaging. Adrenocortical Adenoma / diagnostic imaging. Adrenocortical Adenoma / pathology. Adult. Aged. Endosonography / methods. Female. Humans. Male. Middle Aged. Pheochromocytoma / diagnostic imaging. Pheochromocytoma / pathology. Ultrasonography, Doppler, Color

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  • (PMID = 19092293.001).
  • [ISSN] 1720-8386
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Italy
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68. Kwon HS, Kim SI, Yoo SJ, Yoon KH, Lee KW, Kang MW, Son HY, Kang SK, Cha BY: Adrenal tuberculosis in Cushing's disease with bilateral macronodular adrenocortical hyperplasia. Endocr J; 2006 Apr;53(2):219-23
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  • [Title] Adrenal tuberculosis in Cushing's disease with bilateral macronodular adrenocortical hyperplasia.
  • Cushing's disease is a disorder of hypercortisolism caused by a pituitary micro- or macro-adenoma.
  • Most patients with Cushing's disease have a bilateral adrenal enlargement, which depends on the duration of the disease, as a result of the long standing ACTH stimulation of both adrenal glands.
  • However, in macronodular adrenocortical hyperplasia (MNH) that is caused by Cushing's disease, if the MNH gains autonomy, a bilateral adrenalectomy, as well as the removal of pituitary adenoma, is often essential.
  • We encountered a patient diagnosed with Cushing's disease with bilateral adrenal tuberculosis simulating MNH.
  • Sellar MRI revealed a pituitary macroadenoma, but adrenal CT showed enlargement in both adrenal glands that appeared to be MNH.
  • A hormonal study and bilateral inferior petrosal sinus sampling revealed Cushing's disease.
  • However, the adrenal mass rapidly enlarged after removing the pituitary tumor without showing evidence of a recurrence or adrenal autonomy of hypercortisolism.
  • The resected left adrenal gland was pathologically determined to have a lesion of tuberculosis with some part of the intact cortex.
  • So we assumed that the cause of rapid adrenal enlargement might be due to adrenal tuberculosis.
  • In summary, to the best of our knowledge, this is the first case of Cushing's disease coexisting with both adrenal tuberculosis simulating a bilateral MNH.
  • [MeSH-major] Adrenal Gland Diseases / microbiology. Adrenal Glands / pathology. Pituitary ACTH Hypersecretion / complications. Tuberculosis, Endocrine / complications. Tuberculosis, Endocrine / diagnosis
  • [MeSH-minor] Adrenalectomy. Adult. Female. Humans. Hyperplasia. Pituitary Gland / radiography

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  • (PMID = 16618981.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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69. Bovio S, Cataldi A, Reimondo G, Sperone P, Novello S, Berruti A, Borasio P, Fava C, Dogliotti L, Scagliotti GV, Angeli A, Terzolo M: Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest; 2006 Apr;29(4):298-302
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  • [Title] Prevalence of adrenal incidentaloma in a contemporary computerized tomography series.
  • Adrenal incidentalomas, defined as masses discovered incidentally during imaging investigation of non-adrenal disorders, have become a rather common finding in clinical practice.
  • The aim of the present study was to perform a prospective evaluation of the prevalence of adrenal incidentalomas among subjects undergoing computerized tomography (CT) scan of the chest in a screening program of lung cancer (Tic TAC study) in Piedmont, a region of Northwestern Italy.
  • Twenty-three patients with adrenal masses were identified: 21 adrenal adenomas, 1 myelolipoma, and 1 metastasis of lung cancer.
  • Therefore, the overall prevalence of adrenal lesions was 4.4%, and that of benign adrenal masses was 4.2%.
  • Another factor that influenced our results is that subject age is skewed towards the decades characterized by a greater occurrence of adrenal masses.
  • The outcome of this study confirms that we are presently able to identify incidentally discovered adrenal masses more often than in early years and that the prevalence of adrenal incidentalomas on CT images is approaching that of autopsy series.
  • The present study provides a reliable estimate of the prevalence of adrenal incidentaloma with currently used CT scanners.
  • Notwithstanding that our subjects were at increased risk of lung cancer, the rate of adrenal metastases was low.
  • We think that the present results can be generalized even if we may disclose the lack of histological diagnosis.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnostic imaging. Adrenal Gland Neoplasms / epidemiology. Incidental Findings. Tomography, X-Ray Computed

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  • (PMID = 16699294.001).
  • [ISSN] 0391-4097
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
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70. Vincent-Dejean C, Cazabat L, Groussin L, Perlemoine K, Fumey G, Tissier F, Bertagna X, Bertherat J: Identification of a clinically homogenous subgroup of benign cortisol-secreting adrenocortical tumors characterized by alterations of the protein kinase A (PKA) subunits and high PKA activity. Eur J Endocrinol; 2008 Jun;158(6):829-39
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  • [Title] Identification of a clinically homogenous subgroup of benign cortisol-secreting adrenocortical tumors characterized by alterations of the protein kinase A (PKA) subunits and high PKA activity.
  • Inactivating PRKAR1A mutations have been observed in Carney complex and a subset of adrenocortical tumors (ACT).
  • METHODS: In this study, 35 ACT (10 non-secreting adrenocortical adenomas (ACA-NS), 13 cortisol-secreting adenomas (ACA-S), and 12 malignant s (ACC)) were studied.
  • RESULTS: A subgroup of ACA-S with a 96% R2B protein decrease by comparison with normal adrenal (4.1%+/-4 vs 100%+/-19, P<0.001) was identified, ACA-S2 (6/13).
  • The ACA-S2 tumors with the loss of the R2B protein presented a homogenous phenotype and were all small benign cortisol-secreting tumors.
  • CONCLUSION: This loss of PRKAR2B protein due to a post-transcriptional mechanism in ACA-S is a new mechanism of cAMP pathway dysregulation in adrenocortical tumorigenesis.
  • It defines a new subtype of secreting adenomas with high basal PKA activity presenting a homogenous clinical phenotype.

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  • (PMID = 18505904.001).
  • [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 / Cyclic AMP-Dependent Protein Kinase RIIbeta Subunit; 0 / PRKAR2B protein, human; E0399OZS9N / Cyclic AMP; EC 2.7.11.11 / Cyclic AMP-Dependent Protein Kinases; WI4X0X7BPJ / Hydrocortisone
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71. Hori T, Taniguchi K, Kurata M, Nakamura K, Kato K, Ogura Y, Iwasaki M, Okamoto S, Yamakado K, Yagi S, Iida T, Kato T, Saito K, Wang L, Kawarada Y, Uemoto S: Carcinoembryonic antigen-producing adrenal adenoma resected using combined lateral and anterior transperitoneal laparoscopic surgery. World J Gastroenterol; 2007 Dec 7;13(45):6094-7
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  • [Title] Carcinoembryonic antigen-producing adrenal adenoma resected using combined lateral and anterior transperitoneal laparoscopic surgery.
  • Computed tomography detected a left adrenal mass measuring 3.5 cm multiply 3.0 cm in diameter.
  • Fluorodeoxyglucose positron emission tomography showed increased uptake in the adrenal tumor only, with a maximum standardized uptake value of 2.8.
  • A diagnosis of CEA-producing benign adenoma was made.
  • Histopathological examination revealed a benign adenoma.
  • We present, to the best of our knowledge, the first case of CEA-producing adrenal adenoma, along with a review of the relevant literature, and discuss our laparoscopic surgery techniques.
  • [MeSH-major] Adenoma / blood. Adrenal Gland Neoplasms / blood. Carcinoembryonic Antigen / blood. Laparoscopy / methods

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  • (PMID = 18023107.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Carcinoembryonic Antigen
  • [Number-of-references] 11
  • [Other-IDs] NLM/ PMC4250898
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72. Carney JA: Carney triad: a syndrome featuring paraganglionic, adrenocortical, and possibly other endocrine tumors. J Clin Endocrinol Metab; 2009 Oct;94(10):3656-62
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  • [Title] Carney triad: a syndrome featuring paraganglionic, adrenocortical, and possibly other endocrine tumors.
  • One also had an adrenal cortical adenoma and the other pulmonary chondroma.
  • Twenty percent of the patients had adrenocortical adenoma(s), and 10% had esophageal leiomyoma(s).
  • The pulmonary tumors were asymptomatic and benign.
  • CONCLUSION: The Carney triad is a chronic, persistent, indolent but sometimes fatal disorder of unknown etiology.
  • [MeSH-major] Adenoma. Adrenal Cortex Neoplasms. Chondroma. Esophageal Neoplasms. Leiomyoma. Lung Neoplasms. Multiple Endocrine Neoplasia. Neoplastic Syndromes, Hereditary / pathology. Paraganglioma
  • [MeSH-minor] Adolescent. Carotid Body Tumor / pathology. Chronic Disease. Female. Follow-Up Studies. Gastrointestinal Stromal Tumors / pathology. Humans. Male. Pheochromocytoma / secondary

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  • (PMID = 19723753.001).
  • [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; Review
  • [Publication-country] United States
  • [Number-of-references] 23
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73. Ziaja J, Chudek J, Król R, Stańczyk A, Pawlicki J, Gasińska T, Kajor M, Wiecek A, Cierpka L: [Long-term consequences of surgical excision of cortisol producing adrenocortical adenoma]. Endokrynol Pol; 2007 May-Jun;58(3):207-12
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  • [Title] [Long-term consequences of surgical excision of cortisol producing adrenocortical adenoma].
  • [Transliterated title] Odległe nastepstwa chirurgicznego usuniecia gruczolaka kory nadnercza wytwarzajacego kortyzol.
  • INTRODUCTION: Surgical excision of adrenocortical tumour in patients with ACTH-independent Cushing syndrome gives a chance for their entire cure.
  • The aim of the study was to analyse long term consequences of surgical excision of cortisol producing adrenocortical adenoma with a special attention on the influence of adrenalectomy on arterial blood pressure.
  • 46.7% of patients required supplementation with adrenal steroids.
  • 40% of patients reported a subjective withdrawal of all symptoms of the disease after surgery and 46.7% only partial remission.
  • CONCLUSION: Surgical excision of cortisol producing adrenocortical adenoma results in improvement of blood pressure control and body weight reduction in a large percentage of patients with Cushing syndrome.
  • [MeSH-major] Adrenal Cortex Neoplasms / surgery. Adrenalectomy. Adrenocortical Adenoma / surgery. Cushing Syndrome / surgery. Hypertension / surgery

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  • (PMID = 17940986.001).
  • [ISSN] 0423-104X
  • [Journal-full-title] Endokrynologia Polska
  • [ISO-abbreviation] Endokrynol Pol
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone
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74. Tanaka K, Morishima Y, Ishii Y, Sakamoto T, Suzuki H, Otsuka F, Hizawa N: [Sarcoidosis presenting after successful treatment for Cushing syndrome]. Nihon Kokyuki Gakkai Zasshi; 2009 Jun;47(6):501-6
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  • She had had a history of Cushing syndrome due to right adrenal adenoma, which was successfully treated by unilateral adrenalectomy two years before her admission to our department; however, the chest radiographic abnormalities and the skin lesions were not apparent at that time.
  • Skin biopsy specimens demonstrated noncaseating epithelioid cell granuloma, which was consistent with the diagnosis of sarcoidosis.
  • An elevated angiotensin-converting enzyme level and increased accumulation of gallium-67 citrate in the pulmonary parenchyma and hilar lymph nodes also supported the diagnosis.
  • We should be aware of the possibility of the condition that steroid-responsive immune diseases such as sarcoidosis might be unmasked and develop after successful treatment for Cushing syndrome.


75. Lamas C, López LM, Lozano E, Atienzar M, Ruiz-Mondéjar R, Alfaro JJ, Botella F: Myelolipomatous adrenal masses causing Cushing's syndrome. Exp Clin Endocrinol Diabetes; 2009 Sep;117(8):440-5
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  • [Title] Myelolipomatous adrenal masses causing Cushing's syndrome.
  • Adrenal myelolipomas are uncommon benign tumors, composed of mature adipose tissue and haematopoietic elements in varying proportions.
  • They are usually asymptomatic, non-functioning adrenal incidentalomas, but there have been a few reports of myelolipomatous masses associated with adrenocortical hypersecretion.
  • We report two cases of large mixed adrenal tumors, with heterogeneous appearance and areas of fat density in imaging techniques, and with autonomous cortisol production leading to Cushing's syndrome.
  • Both underwent adrenalectomy and the histological study showed an adrenocortical adenoma with widespread myelolipomatous metaplasia.
  • We review all the previous reported cases of hypercortisolism associated with adrenal myelolipomas.
  • We also discuss the recommended diagnostic approach and therapeutic management of adrenal masses of lipomatous appearance.
  • [MeSH-major] Adrenal Gland Neoplasms / complications. Cushing Syndrome / etiology. Myelolipoma / complications
  • [MeSH-minor] Adrenal Glands / pathology. Adrenal Glands / surgery. Adrenalectomy. Aged. Fatal Outcome. Female. Humans. Hydrocortisone / blood. Middle Aged. Obesity / complications

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  • [Copyright] J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart.New York.
  • (PMID = 19373749.001).
  • [ISSN] 1439-3646
  • [Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • [ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone
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76. Tsunoda K, Abe K, Yamada M, Kato T, Yaoita H, Taguma Y, Goto Y, Ioridani N: A case of primary aldosteronism associated with renal artery stenosis and preclinical Cushing's syndrome. Hypertens Res; 2008 Aug;31(8):1669-75
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  • [Title] A case of primary aldosteronism associated with renal artery stenosis and preclinical Cushing's syndrome.
  • We identified a left adrenal tumor, left renal atrophy, and left renal artery stenosis (RAS) in a 52-year-old man by MRI/magnetic resonance angiography (MRA) during evaluation of hypertension.
  • An excessive response of aldosterone and cortisol to adorenocorticotrophic hormone (ACTH) was found upon selective sampling of the left adrenal vein.
  • Selective renal venous sampling showed a left/right renal venous PRA ratio of 1.7.
  • We diagnosed this patient as having aldosterone-producing adrenal adenoma (APA) associated with renovascular hypertension (RVH) and preclinical Cushing's syndrome.
  • As an initial treatment, percutaneous transluminal renal angioplasty was performed.
  • The renal dysfuntion that occurred prior to treatment seemed to prevent complete normalization of blood pressure.
  • [MeSH-major] Cushing Syndrome / complications. Hyperaldosteronism / etiology. Hypertension, Renal / etiology. Renal Artery Obstruction / complications
  • [MeSH-minor] Adenoma / complications. Adenoma / pathology. Adenoma / surgery. Adrenal Gland Neoplasms / complications. Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / surgery. Angiography. Blood Pressure. Humans. Magnetic Resonance Imaging. Male. Middle Aged


77. Mantero F, Mattarello MJ, Albiger NM: Detecting and treating primary aldosteronism: primary aldosteronism. Exp Clin Endocrinol Diabetes; 2007 Mar;115(3):171-4
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  • Idiopathic bilateral adrenal hyperplasia (IHA) and aldosterone-producing adrenal adenoma (APA), are the leading causes of primary aldosteronism.
  • If a high ratio is found, a sodium loading test or a captopril test is warranted to confirm the diagnosis.
  • Adrenal gland imaging is important in subtype differentiation (APA vs IHA).
  • Adrenal venous sampling should be used when other tests prove inconclusive.
  • [MeSH-minor] Diagnosis, Differential. Humans. Hypertension / etiology. ROC Curve

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  • (PMID = 17427105.001).
  • [ISSN] 0947-7349
  • [Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • [ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 37
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78. Mahe E, El-Shinnawy I: A "tumour trifecta:" myelolipomata arising within an adrenocortical adenoma ipsilateral to a synchronous clear cell renal cell carcinoma. Malays J Pathol; 2010 Dec;32(2):123-8
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  • [Title] A "tumour trifecta:" myelolipomata arising within an adrenocortical adenoma ipsilateral to a synchronous clear cell renal cell carcinoma.
  • We present an intriguing case of adrenal myelolipomata occurring within an adrenocortical adenoma in concert with an ipsilateral clear cell renal cell carcinoma.
  • Computed tomography indicated a 2.5 cm right renal mass as well as a 5 cm right adrenal mass.
  • Histology of the renal mass was consistent with conventional clear cell renal cell carcinoma, Fuhrman grade III.
  • There was no extra-renal extension or lymphovascular invasion.
  • The adrenal mass was a cortical adenoma with solid and nested patterns, with discrete zones consisting of erythroid, myeloid and megakaryocytic cells intermixed with mature adipocytes.
  • We also present a relevant review of the literature pertaining to adrenal lesions.
  • In particular, we emphasize the epidemiological, histological and immunohistochemical features that are helpful in determining the origin and malignant potential of adrenal lesions.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology. Adrenocortical Adenoma / pathology. Carcinoma, Renal Cell / pathology. Kidney Neoplasms / pathology. Myelolipoma / pathology. Neoplasms, Multiple Primary / pathology


79. Tiu SC, Chan AO, Taylor NF, Lee CY, Loung PY, Choi CH, Shek CC: Use of urinary steroid profiling for diagnosing and monitoring adrenocortical tumours. Hong Kong Med J; 2009 Dec;15(6):463-70
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  • [Title] Use of urinary steroid profiling for diagnosing and monitoring adrenocortical tumours.
  • It has been suggested that urinary steroid profiling may be used to provide information aiding the diagnosis and monitoring of adrenocortical carcinoma.
  • Nonetheless, the abnormal patterns suggestive of adrenal malignancy are not well defined.
  • We retrospectively studied the urinary steroid profiles of five patients with adrenocortical carcinoma at presentation and at follow-up, and compared these results with those from 76 patients with benign adrenocortical adenoma and 172 healthy controls.
  • Three abnormal patterns of urinary steroid excretion were identified in patients with adrenocortical carcinoma at presentation and/or follow-up of residual disease:.
  • These preliminary findings offer ways in which urinary steroid profiling performed using gas chromatography-mass spectrometry can be helpful in the diagnosis and monitoring of adrenocortical carcinoma.

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  • (PMID = 19966352.001).
  • [ISSN] 1024-2708
  • [Journal-full-title] Hong Kong medical journal = Xianggang yi xue za zhi
  • [ISO-abbreviation] Hong Kong Med J
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Steroids
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80. Ercolino T, Becherini L, Valeri A, Maiello M, Gaglianò MS, Parenti G, Ramazzotti M, Piscitelli E, Simi L, Pinzani P, Nesi G, Degl'Innocenti D, Console N, Bergamini C, Mannelli M: Uncommon clinical presentations of pheochromocytoma and paraganglioma in two different patients affected by two distinct novel VHL germline mutations. Clin Endocrinol (Oxf); 2008 May;68(5):762-8
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  • CONTEXT: The von Hippel-Lindau (VHL) syndrome is an inherited multitumour disorder characterized by clinical heterogeneity and high penetrance.
  • Extra-adrenal Pheos (paragangliomas, PGLs) are rare.
  • One patient was studied for the presence of an adrenal incidentaloma and the other for the presence of a neck tumour.
  • We identified two novel VHL point mutations: a L198V missense mutation in a 32-year-old female affected by a right adrenal compound and mixed tumour constituted by an epinephrine secreting Pheo, a ganglioneuroma and an adrenocortical adenoma, and a T152I missense mutation in a 24-year-old female affected by a left carotid body tumour.
  • CONCLUSIONS: These cases enlarge the list of VHL mutations and add new insights in the clinical variability of VHL disease, thus confirming the importance of genetic testing in patients affected by apparently sporadic Pheos or PGLs.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Head and Neck Neoplasms / genetics. Paraganglioma / genetics. Pheochromocytoma / genetics. von Hippel-Lindau Disease / genetics


81. Ilias I, Sahdev A, Reznek RH, Grossman AB, Pacak K: The optimal imaging of adrenal tumours: a comparison of different methods. Endocr Relat Cancer; 2007 Sep;14(3):587-99
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  • [Title] The optimal imaging of adrenal tumours: a comparison of different methods.
  • Computed tomography (CT; unenhanced, followed by contrast-enhanced examinations) is the cornerstone of imaging of adrenal tumours.
  • Attenuation values of <10 Hounsfield units on an unenhanced CT are practically diagnostic for adenomas.
  • Functional nuclear medicine imaging is useful for adrenal lesions that are not adequately characterised with CT and MRI.
  • Scintigraphy with [(131)I]-6-iodomethyl norcholesterol (a labelled cholesterol analogue) can differentiate adrenal cortical adenomas from carcinomas.
  • The specific and useful roles of adrenal imaging include the characterisation of tumours, assessment of true tumour size, differentiation of adenomas from carcinomas and metastases, and differentiation of hyperfunctioning from non-functioning lesions.
  • Adrenal imaging complements and assists the clinical and hormonal evaluation of adrenal tumours.
  • [MeSH-major] Adenoma / diagnosis. Adrenal Gland Neoplasms / diagnosis. Diagnostic Imaging / methods
  • [MeSH-minor] Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / pathology. Adrenal Medulla / pathology. Adrenocortical Hyperfunction / diagnosis. Diagnosis, Differential. Ganglioneuroma / diagnosis. Ganglioneuroma / pathology. Hemangioma / diagnosis. Hemangioma / pathology. Hemangiosarcoma / diagnosis. Hemangiosarcoma / pathology. Humans. Leiomyosarcoma / diagnosis. Leiomyosarcoma / pathology. Lymphoma / diagnosis. Lymphoma / pathology. Magnetic Resonance Imaging. Myelolipoma / diagnosis. Myelolipoma / pathology. Neoplasm Metastasis. Neuroblastoma / diagnosis. Neuroblastoma / pathology. Pheochromocytoma / diagnosis. Pheochromocytoma / pathology. Tomography, X-Ray Computed. Whole Body Imaging

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  • (PMID = 17914090.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 61
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82. Unger N, Petersenn S, Mann K: [Diagnosis and therapy of endocrine hypertension]. Med Klin (Munich); 2006 Mar 22;101 Suppl 1:170-2
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  • [Title] [Diagnosis and therapy of endocrine hypertension].
  • Once the diagnosis of hypertension is established, secondary forms should be considered.
  • Especially hormonally active adrenal tumors may allow specific treatment.
  • A unilateral adrenal adenoma has to be separated from bilateral adrenal hyperplasia.
  • Determinations of 24-h urinary epinephrine and norepinephrine levels are established diagnostic tools for the diagnosis of pheochromocytoma.
  • In conclusion, recently established biochemical methods are reliable screening parameters for the diagnosis of adrenal hypertension.
  • Endocrine hypertension due to adrenal tumors may be treated by minimally invasive surgery or specific antihypertensive treatment.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenocortical Adenoma / diagnosis. Hyperaldosteronism / diagnosis. Hypertension / etiology. Pheochromocytoma / diagnosis. Pituitary ACTH Hypersecretion / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Epinephrine / blood. Humans. Hydrocortisone / blood. Norepinephrine / blood

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  • (PMID = 16802547.001).
  • [ISSN] 0723-5003
  • [Journal-full-title] Medizinische Klinik (Munich, Germany : 1983)
  • [ISO-abbreviation] Med. Klin. (Munich)
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone; X4W3ENH1CV / Norepinephrine; YKH834O4BH / Epinephrine
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83. Fassnacht M, Weismann D, Ebert S, Adam P, Zink M, Beuschlein F, Hahner S, Allolio B: AKT is highly phosphorylated in pheochromocytomas but not in benign adrenocortical tumors. J Clin Endocrinol Metab; 2005 Jul;90(7):4366-70
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  • [Title] AKT is highly phosphorylated in pheochromocytomas but not in benign adrenocortical tumors.
  • OBJECTIVE: The objective of this study was the investigation of the role of AKT in the pathogenesis of pheochromocytomas and adrenocortical tumors.
  • DESIGN, SETTING, AND PARTICIPANTS: Total AKT and phosphorylated AKT (pAKT) in 15 pheochromocytomas, nine aldosterone-producing adenomas, nine cortisol-producing adenomas, eight adrenocortical carcinomas (ACC), and 15 normal adrenals were investigated by Western blot analysis.
  • Immunohistochemistry for total AKT and pAKT was performed in pheochromocytomas (n = 8), ACC (n = 4), and normal adrenal glands (n = 2).
  • MAIN OUTCOME MEASURES: Determination of pAKT/total AKT ratio in adrenal tissues was the main outcome.
  • The pAKT/AKT ratio was significantly increased in pheochromocytomas (338 +/- 49% vs. 100 +/- 11%) but not in ACC, aldosterone-producing adenomas, and cortisol-producing adenomas.
  • CONCLUSION: Our findings provide evidence for increased activation of AKT in pheochromocytomas but not in adrenocortical adenomas.
  • [MeSH-major] Adrenal Cortex Neoplasms / metabolism. Adrenal Gland Neoplasms / metabolism. Pheochromocytoma / metabolism. Protein-Serine-Threonine Kinases / metabolism. Proto-Oncogene Proteins / metabolism

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  • (PMID = 15855265.001).
  • [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 / Proto-Oncogene Proteins; 0 / Tumor Suppressor Proteins; EC 2.7.1.- / Phosphatidylinositol 3-Kinases; EC 2.7.11.1 / AKT1 protein, human; EC 2.7.11.1 / Protein-Serine-Threonine Kinases; EC 2.7.11.1 / Proto-Oncogene Proteins c-akt; EC 3.1.3.- / Phosphoric Monoester Hydrolases; EC 3.1.3.48 / PTEN protein, human; EC 3.1.3.67 / PTEN Phosphohydrolase
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84. Szolar DH, Korobkin M, Reittner P, Berghold A, Bauernhofer T, Trummer H, Schoellnast H, Preidler KW, Samonigg H: Adrenocortical carcinomas and adrenal pheochromocytomas: mass and enhancement loss evaluation at delayed contrast-enhanced CT. Radiology; 2005 Feb;234(2):479-85
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  • [Title] Adrenocortical carcinomas and adrenal pheochromocytomas: mass and enhancement loss evaluation at delayed contrast-enhanced CT.
  • PURPOSE: To retrospectively measure the adrenal gland attenuation and the percentage loss of adrenal gland enhancement at delayed contrast medium-enhanced computed tomography (CT) in patients with adrenocortical carcinomas and pheochromocytomas and to compare these data with those in patients with adenomas and metastases.
  • Eleven patients with proved adrenocortical carcinoma, 17 with proved pheochromocytoma, 23 with adrenal adenoma, and 16 with metastasis to the adrenal gland underwent helical CT.
  • RESULTS: The mean attenuation of adenomas (8 HU +/- 18 [standard deviation]) was significantly lower than those of adrenocortical carcinomas (39 HU +/- 14), pheochromocytomas (44 HU +/- 11), and metastases (34 HU +/- 11) on nonenhanced CT scans (P < .001).
  • Although the mean attenuation values for nonadenomas (ie, adrenocortical carcinomas, pheochromocytomas, and metastases) were significantly higher than the value for adenomas on the 1-minute contrast-enhanced CT scans (P < .001), there was more overlap in attenuation between adenomas and nonadenomas on contrast-enhanced scans than on nonenhanced scans.
  • On the 10-minute delayed contrast-enhanced scans, the mean attenuation of adenomas (32 HU +/- 17) was significantly lower than the mean attenuations of carcinomas (72 HU +/- 15), pheochromocytomas (83 HU +/- 14), and metastases (66 HU +/- 13) (P < .001).
  • At optimal threshold values of 50% for absolute percentage of enhancement loss and 40% for relative percentage of enhancement loss at 10 minutes, both the sensitivity and the specificity for the diagnosis of adenoma were 100% when adenomas were compared with carcinomas, pheochromocytomas, and metastases.
  • CONCLUSION: The enhancement loss in adrenocortical carcinomas and pheochromocytomas is similar to that in adrenal metastases but significantly less than that in adrenal adenomas.
  • The percentage change in contrast material washout is a useful adjunct to absolute CT attenuation values in differentiating adrenal adenomas from adrenocortical carcinomas and pheochromocytomas.
  • [MeSH-major] Adrenal Cortex Neoplasms / radiography. Adrenal Gland Neoplasms / radiography. Adrenocortical Carcinoma / radiography. Pheochromocytoma / radiography. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adenoma / radiography. Adolescent. Adult. Aged. Female. Humans. Male. Middle Aged. Sensitivity and Specificity

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  • [Copyright] (c) RSNA, 2005.
  • [CommentIn] Radiology. 2005 Sep;236(3):1112-3 [16118181.001]
  • [CommentIn] Radiology. 2006 Jan;238(1):373; author reply 373-4 [16373781.001]
  • (PMID = 15671003.001).
  • [ISSN] 0033-8419
  • [Journal-full-title] Radiology
  • [ISO-abbreviation] Radiology
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article
  • [Publication-country] United States
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85. 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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86. Lazúrová I, Dudásová D, Wagnerová H, Dravecká I, Petrásová D: Adrenal incidentalomas and the metabolic syndrome--are there any differences between adenoma and hyperplasia? Neoplasma; 2006;53(4):324-7
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  • [Title] Adrenal incidentalomas and the metabolic syndrome--are there any differences between adenoma and hyperplasia?
  • Authors evaluated the prevalence of symptoms of the metabolic syndrome and insulin resistance in 25 patients with adrenal incidentalomas (10 men, 15 women) of the mean age 57.9+/-15 years.
  • 15 patients had adrenal adenoma determined by CT or MR scan and 10 had unilateral or bilateral hyperplasia.
  • Patients with adrenal adenomas had mildly but significantly higher body mass index (BMI, p<0.05) and insulin resistance calculated as HOMA IR (p<0.05) and FIRI (p<0.05) and significantly higher values of serum ferritin (p<0.01).
  • Plasma cortisol values were slightly but not significantly higher in the group with adrenal adenomas.
  • Authors conclude that adrenal adenomas are probably more related to the metabolic syndrome than adrenal hyperplasia.
  • [MeSH-major] Adenoma / diagnosis. Adrenal Gland Neoplasms / diagnosis. Adrenal Glands / pathology. Metabolic Syndrome X / diagnosis

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  • (PMID = 16830060.001).
  • [ISSN] 0028-2685
  • [Journal-full-title] Neoplasma
  • [ISO-abbreviation] Neoplasma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Slovakia
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
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87. Eto M, Harano M, Koga H, Tanaka M, Naito S: Clinical outcomes and learning curve of a laparoscopic adrenalectomy in 103 consecutive cases at a single institute. Int J Urol; 2006 Jun;13(6):671-6
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  • [Title] Clinical outcomes and learning curve of a laparoscopic adrenalectomy in 103 consecutive cases at a single institute.
  • OBJECTIVE: We examined the clinical outcomes and the learning curve for a laparoscopic adrenalectomy (LA) in 103 consecutive cases performed by three surgeons at our institute, according to the type of adrenal disorder.
  • PATIENTS AND METHODS: One hundred and three patients with adrenal tumors, including 38 cases of primary aldosteronism, 33 cases of Cushing syndrome (including preclinical Cushing syndrome), 15 cases of pheochromocytoma, and nine cases of non-functioning adenoma were evaluated, while focusing on the approaches, intraoperative and postoperative data, and the learning curve of LA, according the type of adrenal disorder.
  • RESULTS: There was no significant difference in the operation time, estimated blood loss, incidence of conversion to open surgery and blood transfusion, or postoperative recovery among the patients treated by LA for aldosteronoma, Cushing adenoma, pheochromocytoma, and non-functioning adenoma.
  • In the cases of aldosteronoma and Cushing adenoma, the learning curve for the operation time and blood loss in each operator tended to decrease as the number of operations increased.
  • On the other hand, in the cases treated by LA for pheochromocytoma, no trends in either the operation time or blood loss were observed.
  • However, there has been neither any conversion to open surgery nor blood transfusion in cases treated by LA since 1998 (our 42nd case), even after the changes in the operators.
  • CONCLUSIONS: Our results clearly indicate that LA is becoming safer than before, probably due to improvements in the technique, education, and training of surgeons, in addition to the increased number of cases now treated by LA.
  • [MeSH-major] Adrenal Gland Neoplasms / therapy. Adrenalectomy / education. Education, Medical, Continuing. Laparoscopy. Medical Staff, Hospital / education

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  • (PMID = 16834640.001).
  • [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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88. 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


89. 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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90. Libé R, Mantovani G, Bondioni S, Lania AG, Pedroni C, Beck-Peccoz P, Spada A: Mutational analysis of PRKAR1A and Gs(alpha) in sporadic adrenocortical tumors. Exp Clin Endocrinol Diabetes; 2005 May;113(5):248-51
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  • [Title] Mutational analysis of PRKAR1A and Gs(alpha) in sporadic adrenocortical tumors.
  • Little is known about the pathogenesis of adrenocortical tumors.
  • The cAMP-dependent pathway is physiologically activated by ACTH in adrenocortical cells and different components of this cascade may be altered in some functioning adrenocortical tumors.
  • Recently, mutations of the gene encoding the PKA type 1 A regulatory subunit (R1 A), PRKAR1A, associated with loss of heterozygosity (LOH) at PRKAR1A locus, have been demonstrated in primary pigmented nodular adrenocortical disease (PPNAD), either isolated or associated with Carney complex.
  • Moreover, activating mutations of the Gs(alpha) gene (the gsp oncogene) have also been found in a small number of adrenocortical cortisol-secreting adenomas.
  • Aim of this study was to investigate the presence of such genetic alterations on a series of 10 ACTH-independent Cushing syndrome due to non-PPNAD adrenocortical adenomas.
  • In one single adenoma gsp mutation was detected.
  • PRKAR1A mutations and gsp oncogene, are a rare event in adrenocortical tumors.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. DNA Mutational Analysis. GTP-Binding Protein alpha Subunits, Gs / genetics. Proteins / genetics

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  • (PMID = 15926108.001).
  • [ISSN] 0947-7349
  • [Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • [ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes
  • [Language] eng
  • [Publication-type] Journal Article; 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 / Proteins; E0399OZS9N / Cyclic AMP; EC 2.7.11.11 / Cyclic AMP-Dependent Protein Kinases; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
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91. Ng VW, Ma RC, So WY, Choi KC, Kong AP, Cockram CS, Chow CC: Evaluation of functional and malignant adrenal incidentalomas. Arch Intern Med; 2010 Dec 13;170(22):2017-20
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  • [Title] Evaluation of functional and malignant adrenal incidentalomas.
  • BACKGROUND: Adrenal incidentalomas are adrenal masses discovered inadvertently.
  • We undertook this study to review the clinical characteristics of patients with adrenal incidentalomas who presented to a tertiary endocrine center in Hong Kong.
  • METHODS: Retrospective review of all 139 cases of adrenal incidentalomas that were referred to the Endocrine Centre of the Prince of Wales Hospital between June 1, 2000, and May 31, 2007.
  • RESULTS: Sixty-one patients (43.9%) had nonfunctional benign adrenal adenomas, 52 (37.4%) had functional lesions, 15 (10.8%) had malignant adrenal lesions, and the remaining 11 (7.9%) had varying adrenal disease.
  • Only 5 of the 27 patients with cortisol-secreting adrenal incidentalomas had symptoms or signs of excess cortisol levels at presentation.
  • CONCLUSIONS: Adrenal incidentaloma is a commonly encountered clinical problem.
  • Functional or primary malignant adrenal incidentalomas can be detected at an earlier stage during hormonal and radiological evaluations, which provides an opportunity for further management.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenocortical Adenoma / diagnosis. Aldosterone / secretion. Catecholamines / secretion. Hydrocortisone / secretion

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  • (PMID = 21149760.001).
  • [ISSN] 1538-3679
  • [Journal-full-title] Archives of internal medicine
  • [ISO-abbreviation] Arch. Intern. Med.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Catecholamines; 4964P6T9RB / Aldosterone; 9015-71-8 / Corticotropin-Releasing Hormone; WI4X0X7BPJ / Hydrocortisone; Adrenal incidentaloma
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92. Hahner S, Stuermer A, Kreissl M, Reiners C, Fassnacht M, Haenscheid H, Beuschlein F, Zink M, Lang K, Allolio B, Schirbel A: [123 I]Iodometomidate for molecular imaging of adrenocortical cytochrome P450 family 11B enzymes. J Clin Endocrinol Metab; 2008 Jun;93(6):2358-65
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [123 I]Iodometomidate for molecular imaging of adrenocortical cytochrome P450 family 11B enzymes.
  • BACKGROUND: Due to advances in conventional imaging, adrenal tumors are detected with increasing frequency.
  • Furthermore, four patients with known adrenal tumors (two metastatic adrenal adenocarcinomas, one bilateral adrenocortical adenoma, and one melanoma metastasis) were investigated with [(123)I]iodometomidate-SPECT.
  • RESULTS: In cell culture experiments, all compounds potently inhibited both Cyp11B1 and Cyp11B2.
  • In patients, adrenocortical tissue showed high and specific tracer uptake in both primary tumor and metastases with short investigation time and low radiation exposure, whereas the non-adrenocortical tumor did not exhibit any tracer uptake.
  • CONCLUSION: We have successfully completed the development of an in vivo detection system of adrenal Cyp11B enzymes by [(123)I]IMTO scintigraphy in both experimental animals and humans.
  • Our findings suggest that [(123)I]IMTO is a highly specific radiotracer for imaging of adrenocortical tissue.
  • Due to the general availability of SPECT technology, we anticipate that [(123)I]IMTO scintigraphy may become a widely used tool to characterize adrenal lesions.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenocortical Carcinoma / diagnosis. Cytochrome P-450 CYP11B2 / analysis. Iodine Radioisotopes. Steroid 11-beta-Hydroxylase / analysis
  • [MeSH-minor] Adrenal Cortex / enzymology. Adrenal Cortex / metabolism. Aged. Animals. Cells, Cultured. Etomidate / analogs & derivatives. Etomidate / chemistry. Female. Gene Expression Regulation, Enzymologic. Gene Expression Regulation, Neoplastic. Humans. Male. Mice. Middle Aged. Molecular Diagnostic Techniques. Multigene Family. Radioactive Tracers. Whole Body Imaging / methods

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  • (PMID = 18397978.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; 0 / Radioactive Tracers; 5377-20-8 / metomidate; EC 1.14.15.4 / Cytochrome P-450 CYP11B2; EC 1.14.15.4 / Steroid 11-beta-Hydroxylase; Z22628B598 / Etomidate
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93. Kamenicky P, Houdoin L, Ferlicot S, Salenave S, Brailly S, Droupy S, Meduri G, Sasano H, Suzuki T, Young J, Chanson P: Benign cortisol-secreting adrenocortical adenomas produce small amounts of androgens. Clin Endocrinol (Oxf); 2007 Jun;66(6):778-88
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  • [Title] Benign cortisol-secreting adrenocortical adenomas produce small amounts of androgens.
  • BACKGROUND: Serum androgen levels are below normal in patients with benign cortisol-secreting adrenocortical adenomas, owing to ACTH suppression.
  • The objective of the study was to analyse the androgen-producing ability of cortisol-secreting adrenocortical adenomas.
  • METHODS: Dehydroepiandrosterone sulfate (DHEAS), Delta4androstenedione and testosterone concentrations were measured before and after adrenalectomy and then at 6-month intervals in 20 women (eight cortisol-secreting adrenocortical adenomas, six subclinical cortisol-secreting adrenocortical adenomas, and six nonfunctional adenomas).
  • RESULTS: Before adrenalectomy, serum androgen concentrations were measurable in all women with clinically apparent and subclinical cortisol-secreting adrenocortical adenomas.
  • Postoperatively, during adrenocortical insufficiency, DHEAS, Delta4androstenedione and testosterone concentrations fell to near the detection limit in all patients with cortisol-secreting adrenocortical adenomas (P = 0.008 for each marker) and showed a similar tendency to fall in all patients with subclinical cortisol-secreting adrenocortical adenomas.
  • Pre- and post-treatment androgen concentrations did not differ in patients with nonfunctional adenomas.
  • The intensity of CYP17 and SULT2A1 expression was stronger in cortisol-secreting adenomas than in their adjacent normal adrenal tissue.
  • CONCLUSION: Both clinically apparent and subclinical cortisol-secreting adrenocortical adenomas appear to show moderate autonomous androgen production.
  • Thus, weak androgen secretion in patients with adrenocortical tumours should not necessarily be considered as a sign of malignancy.
  • [MeSH-major] Adenoma / secretion. Adrenal Cortex Neoplasms / secretion. Androgens / secretion. Hydrocortisone / secretion

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  • (PMID = 17408424.001).
  • [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 / Androgens; 0 / Estrogens; 0 / Gonadotropins, Pituitary; 3XMK78S47O / Testosterone; 409J2J96VR / Androstenedione; 57B09Q7FJR / Dehydroepiandrosterone Sulfate; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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94. Shen WT, Lee J, Kebebew E, Clark OH, Duh QY: Selective use of steroid replacement after adrenalectomy: lessons from 331 consecutive cases. Arch Surg; 2006 Aug;141(8):771-4; discussion 774-6
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  • MAIN OUTCOME MEASURES: Indications for adrenalectomy, operative approach, requirement for postoperative steroid replacement, and episodes of acute adrenocortical insufficiency.
  • The 52 patients with Cushing syndrome included 16 with pituitary tumors who had failed pituitary resection and/or medical therapy, 14 with unilateral adrenal adenomas, 9 with ectopic corticotropin-secreting tumors who had failed resection and/or medical therapy, 7 with incidentalomas and subclinical Cushing syndrome, 4 with macronodular hyperplasia, and 2 with adrenocortical carcinoma.
  • No patients undergoing unilateral adrenalectomy for non-Cushing adrenal disease required steroid replacement.
  • Four (7%) of the 57 patients receiving steroid replacement had episodes of acute adrenocortical insufficiency following operation and required increased steroid supplementation.
  • There were no cases of acute adrenocortical insufficiency in the 274 patients who did not receive steroid replacement.
  • Patients undergoing adrenalectomy for unilateral non-Cushing adrenal tumors do not require postoperative steroid replacement.
  • [MeSH-major] Adrenal Insufficiency / drug therapy. Adrenalectomy / methods. Glucocorticoids / therapeutic use. Hormone Replacement Therapy / methods. Postoperative Care / methods
  • [MeSH-minor] Acute Disease. Adult. Aged. Female. Follow-Up Studies. Humans. Male. Middle Aged. Retrospective Studies. Time Factors. Treatment Outcome

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  • (PMID = 16924084.001).
  • [ISSN] 0004-0010
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Glucocorticoids
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95. Terhune KP, Jagasia S, Blevins LS Jr, Phay JE: Diagnostic and therapeutic dilemmas of hypercortisolemia during pregnancy: a case report. Am Surg; 2009 Mar;75(3):232-4
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  • When they do, it is generally the result of the presence of an adrenal adenoma.
  • We present the case of a 35-year-old woman who was noted to have an adrenal mass before pregnancy, but then during evaluation became pregnant.
  • [MeSH-major] Adenoma / surgery. Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Cushing Syndrome / surgery. Pregnancy Complications / surgery


96. Rodriguez-Justo M, Chan G, McNicol AM: Simultaneous occurrence of adrenal cortical adenoma and ganglioneuroma. Histopathology; 2006 Aug;49(2):206-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Simultaneous occurrence of adrenal cortical adenoma and ganglioneuroma.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology. Adrenocortical Adenoma / pathology. Ganglioneuroma / pathology
  • [MeSH-minor] Adrenal Glands / pathology. Adult. Humans. Male

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  • (PMID = 16879403.001).
  • [ISSN] 0309-0167
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] England
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97. Petramala L, Cotesta D, Sapienza P, Zinnamosca L, Moroni E, di Marzio L, De Toma G, Letizia C: A Case of Acute Aortic Dissection Type B Associated with Cushing's Syndrome. J Clin Med Res; 2009 Apr;1(1):50-2
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  • We report a case of a 63-year-old man, with a previous history of hypertension and glucose intolerance associated troncular obesity that was emergently admitted to our Institution for evaluation of a severe, constant posterior chest pain which radiated anteriorly and dyspnoea with a suspected diagnosis of acute aortic dissection.
  • A CT scan of thorax and abdomen demonstrated a dissection starting just below left succlavian artery and extending downward to the left renal artery, involving the celiac tripod and superior mesenteric artery.
  • The dissection was classified as Stanford B, De Bakey III.
  • Moreover, CT scan of abdomen revealed incidentally a left adrenal tumor of 25 mm of diameter.
  • Furthermore, a diagnostic evaluation of the mass revealed an increase of cortisol production, and a diagnosis of Cushing's syndrome was done and the patient underwent an adrenalectomy via laparotomic approach.
  • KEYWORDS: Cushing's syndrome; Adrenocortical adenoma; Aortic dissection type B.

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  • (PMID = 22505966.001).
  • [ISSN] 1918-3003
  • [Journal-full-title] Journal of clinical medicine research
  • [ISO-abbreviation] J Clin Med Res
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Canada
  • [Other-IDs] NLM/ PMC3318870
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98. Schaefer S, Meyer S, Brueck CC, Weber M, Luedecke D, Wagner HJ, Kann PH: Sarcoidosis following Cushing's syndrome: A report of two cases and review of the literature. Exp Clin Endocrinol Diabetes; 2010 Mar;118(3):147-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • In rare cases, the treatment of Cushing's syndrome may result in unmasking or aggravation of diseases responsive to glucocorticoid medication.
  • A 32 year-old female showed cutaneous sarcoidosis, arthralgia, mediastinal lymphadenopathy and elevation of angiotensin-converting enzyme and interleukin 2-receptor concentrations after traumatic adrenal bleeding, which ceased formerly undiagnosed hypercortisolism caused by an adrenal adenoma.
  • Skin affections were present and suggestive for the diagnosis in all reported cases.
  • As some cases are probably missed when skin affections are lacking, a more frequent evaluation of patients after Cushing's syndrome for the possible diagnosis of sarcoidosis might be necessary.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / surgery. Adenoma / surgery. Cushing Syndrome / surgery. Sarcoidosis / etiology. Skin Diseases / etiology
  • [MeSH-minor] Adult. Arthralgia / diagnosis. Arthralgia / etiology. Female. Humans. Lymphatic Diseases / diagnosis. Lymphatic Diseases / etiology. Male. Mediastinal Diseases / diagnosis. Mediastinal Diseases / etiology. Peptidyl-Dipeptidase A / analysis. Receptors, Interleukin-2 / analysis

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  • [Copyright] J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart * New York.
  • (PMID = 20162506.001).
  • [ISSN] 1439-3646
  • [Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • [ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Receptors, Interleukin-2; EC 3.4.15.1 / Peptidyl-Dipeptidase A
  • [Number-of-references] 13
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99. Kley S, Alt M, Zimmer C, Hoerauf A, Reusch CE: Evaluation of the low-dose dexamethasone suppression test and ultrasonographic measurements of the adrenal glands in cats with diabetes mellitus. Schweiz Arch Tierheilkd; 2007 Nov;149(11):493-500
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evaluation of the low-dose dexamethasone suppression test and ultrasonographic measurements of the adrenal glands in cats with diabetes mellitus.
  • The objectives of the study were to evaluate the low-dose dexamethasone suppression (LDDS) test and the size of the adrenal glands via ultrasonography in cats with diabetes mellitus.
  • The adrenal glands of the diabetic cats were not enlarged compared with those of healthy cats.
  • One cat had a pituitary adenoma and adrenal glands of normal size as determined by ultrasonography.
  • The size of the adrenal glands of the other cat clearly differed; histological examination of the larger adrenal gland revealed an adrenocortical adenoma.
  • In addition, diabetes mellitus does not lead to a measurable increase in the size of the adrenal glands in cats.
  • [MeSH-major] Adenoma / veterinary. Adrenal Gland Neoplasms / veterinary. Adrenal Glands / anatomy & histology. Adrenal Glands / ultrasonography. Cat Diseases / pathology. Hydrocortisone / blood
  • [MeSH-minor] Adrenal Cortex Function Tests / veterinary. Animals. Blood Glucose / metabolism. Case-Control Studies. Cats. Dexamethasone / pharmacology. Diabetes Complications / veterinary. Female. Male

  • MedlinePlus Health Information. consumer health - Adrenal Gland Cancer.
  • Hazardous Substances Data Bank. DEXAMETHASONE .
  • Hazardous Substances Data Bank. HYDROCORTISONE .
  • NCI CPTAC Assay Portal. NCI CPTAC Assay Portal .
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  • (PMID = 18085163.001).
  • [ISSN] 0036-7281
  • [Journal-full-title] Schweizer Archiv für Tierheilkunde
  • [ISO-abbreviation] Schweiz. Arch. Tierheilkd.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Blood Glucose; 7S5I7G3JQL / Dexamethasone; WI4X0X7BPJ / Hydrocortisone
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100. Liu SY, Ng EK, Lee PS, Wong SK, Chiu PW, Mui WL, So WY, Chow FC: Radiofrequency ablation for benign aldosterone-producing adenoma: a scarless technique to an old disease. Ann Surg; 2010 Dec;252(6):1058-64
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radiofrequency ablation for benign aldosterone-producing adenoma: a scarless technique to an old disease.
  • OBJECTIVE: To evaluate the safety and efficacy of radiofrequency ablation (RFA) in treating primary aldosteronism (PA) due to aldosterone-producing adenoma (APA).
  • Its application on benign functional adrenal adenoma has never been prospectively described.
  • [MeSH-major] Adenoma / surgery. Adrenal Gland Neoplasms / surgery. Catheter Ablation. Hyperaldosteronism / etiology

  • MedlinePlus Health Information. consumer health - Adrenal Gland Cancer.
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  • (PMID = 21107117.001).
  • [ISSN] 1528-1140
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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