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1. Bakshi N, Kunju LP, Giordano T, Shah RB: Expression of renal cell carcinoma antigen (RCC) in renal epithelial and nonrenal tumors: diagnostic Implications. Appl Immunohistochem Mol Morphol; 2007 Sep;15(3):310-5
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  • [Title] Expression of renal cell carcinoma antigen (RCC) in renal epithelial and nonrenal tumors: diagnostic Implications.
  • Antibody to renal cell carcinoma (RCC) antigen, a normal human proximal brush border antigen, has recently become commercially available and reported to be highly specific and a relatively sensitive marker for RCC.
  • Using tissue microarrays, we investigated the use of RCC on a large number of renal epithelial neoplasms (RENs) and nonrenal tumors, especially those potentially confused with REN.
  • Three tissue microarrays containing 241 REN samples, 192 samples of a wide variety of neoplasms and 170 adrenal tumor samples, respectively, were stained with RCC monoclonal antibody.
  • Out of 241 REN, 173 were positive for RCC (sensitivity 72%): clear cell 72%, papillary 95%, chromophobe 91%, unclassified 85%, oncocytoma 75%, sarcomatoid 20%, and metastatic RCC 40%.
  • The overall immunostaining intensity was consistently much higher in papillary and clear cell RCC than in other tumors.
  • These included: adrenocortical neoplasms 37/170 (22%), colonic 11/29 (37.5%), breast 9/27 (33%), prostate 5/18 (27.7%), ovary 2/17 (11.7%), melanoma 3/18 (16.6%), lung 3/21 (14.2%), and parathyroid 3/3 (100%).
  • RCC expression was seen equally among adrenal adenoma and carcinoma group.
  • Eight out of 28 (28.5%) normal adrenal cores also stained for RCC.
  • RCC is a relatively useful marker in the differential diagnosis of REN only if used in a panel with other positive and negative markers.
  • RCC does not reliably differentiate REN, especially classic clear cell type, from adrenocortical neoplasms, which are frequently confused due to close anatomic proximity and similar morphology.
  • RCC also does not reliably differentiate subtypes of renal epithelial neoplasms.
  • [MeSH-major] Antigens, Neoplasm / analysis. Carcinoma, Renal Cell / diagnosis. Kidney Neoplasms / diagnosis. Mitogen-Activated Protein Kinases / analysis
  • [MeSH-minor] Antibodies, Monoclonal / immunology. Diagnosis, Differential. Female. Humans. Immunohistochemistry. Male. Tissue Array Analysis

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  • (PMID = 17721277.001).
  • [ISSN] 1541-2016
  • [Journal-full-title] Applied immunohistochemistry & molecular morphology : AIMM
  • [ISO-abbreviation] Appl. Immunohistochem. Mol. Morphol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antigens, Neoplasm; EC 2.7.11.22 / MOK protein, human; EC 2.7.11.24 / Mitogen-Activated Protein Kinases
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2. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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


3. Gockel I, Heintz A, Kentner R, Werner C, Junginger T: Changing pattern of the intraoperative blood pressure during endoscopic adrenalectomy in patients with Conn's syndrome. Surg Endosc; 2005 Nov;19(11):1491-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Changing pattern of the intraoperative blood pressure during endoscopic adrenalectomy in patients with Conn's syndrome.
  • BACKGROUND: Primary hyperaldosteronism caused by an aldosterone-producing adenoma of the adrenal gland is regarded as the most common type of endocrine hypertension.
  • The aim of this study was to analyze the changing pattern of the intraoperative blood pressure during endoscopic adrenalectomy recorded in patients with Conn's syndrome compared to patients with hormone-inactive incidentaloma and its possible influence by the surgical approach.
  • METHODS: From February 1994 to March 2004, 40 patients underwent endoscopic adrenalectomy for Conn's syndrome.
  • RESULTS: The adrenal gland was resected using the retroperitoneal in 25 and the transperitoneal approach in 15 patients with Conn's syndrome.
  • The increase in intraoperative blood pressure in patients with Conn's syndrome was significantly higher, for both systolic (p < 0.0001) and diastolic (p = 0.0037) readings, compared to that in patients with incidentaloma undergoing endoscopic adrenalectomy during the same period of time.
  • CONCLUSION: Our results demonstrate that relevant intraoperative increases in blood pressure occur in patients with Conn's syndrome despite prior therapy with an aldosterone antagonist, necessitating specific precautionary measures during anesthesia.

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  • [ErratumIn] Surg Endosc. 2006 Jan;20(1):180. Wetner, C [corrected to Werner, C]
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  • (PMID = 16222471.001).
  • [ISSN] 1432-2218
  • [Journal-full-title] Surgical endoscopy
  • [ISO-abbreviation] Surg Endosc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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4. Gianotti L, Tassone F, Pia A, Bovio S, Reimondo G, Visconti G, Terzolo M, Borretta G: May an altered hypothalamo-pituitary-adrenal axis contribute to cortical bone damage in primary hyperparathyroidism? Calcif Tissue Int; 2009 Jun;84(6):425-9
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  • [Title] May an altered hypothalamo-pituitary-adrenal axis contribute to cortical bone damage in primary hyperparathyroidism?
  • Our aim was to evaluate circulating and urinary cortisol levels and the relationships with biochemical and bone parameters in patients with PHPT at the time of diagnosis.
  • We studied 180 consecutive patients with PHPT (mean age +/- SD 60.0 +/- 13.2 years; F/M 140/40, BMI 25.8 +/- 4.8 kg/m(2)) and 56 subjects with incidentally discovered adrenal adenoma who served as controls (age 56.2 +/- 12.8 years, F/M 40/16, BMI 25.7 +/- 3.9 kg/m(2)).
  • Our findings show increased midnight cortisol levels in patients with PHPT, indicating a subtle alteration of the hypothalamo-pituitary-adrenal axis dynamics that is unrelated to the degree of disease activity; further data are needed to demonstrate the supplementary effect of this subtle alteration to bone damage in this condition.
  • [MeSH-major] Hydrocortisone / secretion. Hyperparathyroidism, Primary / metabolism. Hypothalamo-Hypophyseal System / secretion. Osteoporosis / metabolism. Pituitary-Adrenal System / secretion
  • [MeSH-minor] Adrenal Gland Neoplasms / blood. Adrenal Gland Neoplasms / metabolism. Adrenocorticotropic Hormone / blood. Aged. Female. Humans. Male. Middle Aged. Multivariate Analysis. Regression Analysis

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  • (PMID = 19381429.001).
  • [ISSN] 1432-0827
  • [Journal-full-title] Calcified tissue international
  • [ISO-abbreviation] Calcif. Tissue Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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5. Tiryakioglu O, Ugurlu S, Yalin S, Yirmibescik S, Caglar E, Yetkin DO, Kadioglu P: Screening for Cushing's syndrome in obese patients. Clinics (Sao Paulo); 2010;65(1):9-13
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Etiologic reasons for Cushing's syndrome were pituitary microadenoma (9 patients), adrenocortical adenoma (3 patients), and adrenocortical carcinoma (1 patient).
  • [MeSH-major] Cushing Syndrome / diagnosis. Obesity / complications

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  • (PMID = 20126340.001).
  • [ISSN] 1980-5322
  • [Journal-full-title] Clinics (São Paulo, Brazil)
  • [ISO-abbreviation] Clinics (Sao Paulo)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Glucocorticoids; 7S5I7G3JQL / Dexamethasone; WI4X0X7BPJ / Hydrocortisone
  • [Other-IDs] NLM/ PMC2815288
  • [Keywords] NOTNLM ; Adrenocorticorticotropic hormone / Cortisol / Cushing’s syndrome / Obesity / Screening
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6. Przybylik-Mazurek E, Buziak-Bereza M, Fedorowicz A, Kuźniarz-Rymarz S, Stochmal E, Hubalewska-Dydejczyk A: [Retrospective hormonal analysis of incidentally discovered and operated adrenal tumors for subclinical Cushing's syndrome]. Przegl Lek; 2010;67(12):1270-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Retrospective hormonal analysis of incidentally discovered and operated adrenal tumors for subclinical Cushing's syndrome].
  • In the last twenty years the introduction of new imaging techniques has caused increasing incidence of accidental detection of adrenal tumors, which are usually mild and in most cases are hormonally inactive adenomas.
  • Among hormonal disorders in patients with adrenal incidentalomas the hypercortisolism is often described, which, if not treated properly, leads to multiple organ complications, and further to the patient's death.
  • The aim of the study was the retrospective analysis of the group of patients with adrenal incidentaloma, verified by histopathology for assessment of subclinical Cushing's syndrome.
  • Among the group of 225 patients: 62 men and 163 women with incidentally detected adrenal tumors in age from 19 to 81 years diagnosed and treated in the Department of Clinical Endocrinology, University Hospital in Krakow, 59 patients was sent to surgery: 15 men and 42 women.
  • Group A consisted of patients with adrenal cortical adenoma: 38 people (11 men and 27 women).
  • In group B there were people with so-called other hormonal inactive adrenal tumors - 17 people (4 men and 13 women).
  • In group A the mean morning level of cortisol was 18.23 +/- 6.42 ug/dl and did not differ statistically significantly from the results of group B (mean morning cortisol level of 15.86 +/- 4.6 ug/dl).
  • A detailed analysis of the clinical signs, meticulously carried out and repeated hormonal diagnosis with the use of functional tests should be focused on the detection of subclinical hormonal disorders, which is crucial in preventing organ damage and making a decision of the right treatment of the patient, which is surgical.
  • [MeSH-major] Adrenal Gland Neoplasms / blood. Adrenal Gland Neoplasms / surgery. Hydrocortisone / blood

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  • (PMID = 21591352.001).
  • [ISSN] 0033-2240
  • [Journal-full-title] Przegla̧d lekarski
  • [ISO-abbreviation] Prz. Lek.
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone; Adrenal incidentaloma
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7. Maurea S, Imbriaco M, D'Angelillo M, Mollica C, Camera L, Salvatore M: Diagnostic accuracy of chemical-shift MR imaging to differentiate between adrenal adenomas and non adenoma adrenal lesions. Radiol Med; 2006 Aug;111(5):674-86
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnostic accuracy of chemical-shift MR imaging to differentiate between adrenal adenomas and non adenoma adrenal lesions.
  • PURPOSE: The objective of this study was to evaluate the diagnostic accuracy of chemical-shift (CS) magnetic resonance (MR) imaging in the differential diagnosis of adenoma and nonadenoma adrenal masses.
  • MATERIALS AND METHODS: We enrolled 36 patients (9 men, 27 women, mean age 51.3+14.4 years) with unilateral (n=31) or bilateral (n=5) adrenal masses incidentally discovered during imaging examinations [ultrasound (US), computed tomography (CT)] performed for other indications.
  • A total of 41 adrenal lesions were evaluated (mean diameter 3.0+2.2 cm).
  • Histology (n=19), biopsy (n=3) or clinical-imaging follow-up (n=19) demonstrated 29 adenomas, five pheochromocytomas, three cysts and four carcinomas.
  • MR images were qualitatively assessed for signal intensity of the adrenal mass relative to the liver on T1, T2, CS and T1-Gd scans; diagnostic criteria for adenomas were isointensity or hypointensity on both T1 and T2 scans, out-of-phase CS signal loss and mild transient enhancement after Gd.
  • CONCLUSIONS: CS MR imaging significantly improves characterization of adrenal masses compared with conventional T1-T2-weighted images, providing accuracy similar to that of the T1 sequence after Gd.
  • Therefore, the CS sequence is strongly recommended for MR study of adrenal masses, and its use might obviate the need for Gd administration.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenal Gland Diseases / diagnosis. Adrenocortical Adenoma / diagnosis. Magnetic Resonance Imaging
  • [MeSH-minor] Adrenal Gland Neoplasms / diagnosis. Adult. Aged. Contrast Media. Cysts / diagnosis. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Pheochromocytoma / diagnosis. Predictive Value of Tests. Sensitivity and Specificity

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  • (PMID = 16791464.001).
  • [ISSN] 0033-8362
  • [Journal-full-title] La Radiologia medica
  • [ISO-abbreviation] Radiol Med
  • [Language] eng; ita
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Contrast Media
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8. 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


9. Yener S, Ertilav S, Secil M, Demir T, Akinci B, Kebapcilar L, Comlekci A, Bayraktar F, Yesil S: Prospective evaluation of tumor size and hormonal status in adrenal incidentalomas. J Endocrinol Invest; 2010 Jan;33(1):32-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prospective evaluation of tumor size and hormonal status in adrenal incidentalomas.
  • BACKGROUND: Because of the increased use of imaging interventions, more subjects have been diagnosed with adrenal incidentaloma in recent years.
  • AIM: To evaluate the risk of mass enlargement, hormone hypersecretion and development of adrenal carcinomas during short-term followup.
  • SUBJECTS AND METHODS: There were 317 subjects with incidentally discovered adrenal tumors in the registry.
  • Forty subjects were excluded because of clinically overt hormone secretion at diagnosis and subjects with complete data were included in radiological (no.
  • There were 143 subjects with adrenal adenomas and 7 subjects with other tumor types (cyst or myelolipoma).
  • RESULTS: Increase in tumor size was detected in 25 subjects (17.4%) with adenomas and 1 subject with adrenal myelolipoma (14.3%).
  • Decrease in tumor size was found in 7 subjects (4.8%) with adrenal adenomas.
  • One patient was diagnosed with adrenocortical carcinoma during follow-up.
  • In subjects with non-functioning adrenal adenoma (NFA, no.
  • CONCLUSION: In conclusion, we demonstrated that, despite being infrequent, adrenal tumors may increase in size, develop overt or subclinical hormone secretion or feature malignant transformation.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnostic imaging. Incidental Findings
  • [MeSH-minor] Adrenocortical Adenoma / diagnostic imaging. Adrenocorticotropic Hormone / analysis. Adult. Aged. Cushing Syndrome / diagnostic imaging. Dehydroepiandrosterone Sulfate / analysis. Dexamethasone. Female. Humans. Hydrocortisone / analysis. Male. Metanephrine / urine. Middle Aged. Myelolipoma / diagnostic imaging. Normetanephrine / urine. Prospective Studies. Tomography, X-Ray Computed

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  • (PMID = 19542759.001).
  • [ISSN] 1720-8386
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0J45DE6B88 / Normetanephrine; 5001-33-2 / Metanephrine; 57B09Q7FJR / Dehydroepiandrosterone Sulfate; 7S5I7G3JQL / Dexamethasone; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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10. Mete O, Kapran Y, Güllüoğlu MG, Kiliçaslan I, Erbil Y, Senyürek YG, Dizdaroğlu F: Anti-CD10 (56C6) is expressed variably in adrenocortical tumors and cannot be used to discriminate clear cell renal cell carcinomas. Virchows Arch; 2010 May;456(5):515-21
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  • [Title] Anti-CD10 (56C6) is expressed variably in adrenocortical tumors and cannot be used to discriminate clear cell renal cell carcinomas.
  • In the evaluation of retroperitoneal masses, the practicing pathologist faces a dilemma when making a diagnosis based on histology given the often overlapping morphologic appearances of the adrenocortical carcinoma, renal cell carcinoma (RCC), and hepatocellular carcinoma (HCC).
  • CD10 is expressed in a membranous fashion in the vast majority of clear cell RCCs; therefore, it is widely used for distinction from its mimics.
  • However, its expression is not well-investigated in adrenal cortical tumors.
  • We examined CD10 expression in 47 surgically resected adrenocortical tumors (26 adenomas and 21 carcinomas) and compared with 20 clear cell RCCs and 25 HCCs.
  • Twenty HCCs (80%), 18 RCCs (90%), 11 adrenocortical carcinomas (52%), and 18 adrenocortical adenomas (69%) were positive for CD10.
  • HCCs were characterized by a canalicular staining, and clear cell RCCs exhibited membranous or mixed membranous-cytoplasmic staining.
  • Adrenocortical tumors displayed mainly cytoplasmic staining.
  • Four adrenocortical carcinomas and one adenoma also displayed the membranous staining pattern.
  • Despite the relatively small number of samples, our preliminary results revealed that adrenocortical tumors may express CD10 (Clone: 56C6).
  • The most important point from this paper is the fact that anti-CD10 expression has not been previously reported in adrenocortical carcinomas.
  • This suggests that CD10 does not seem to be a useful marker for discriminating clear cell RCCs from adrenocortical tumors since CD10 expression does not rule out the possibility of adrenocortical tumors.
  • This feature should be kept in mind when constructing an antibody panel for an epithelial tumor that involves the adrenal gland and kidney, especially in small biopsy specimens.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Carcinoma, Renal Cell / diagnosis. Kidney Neoplasms / diagnosis. Neprilysin / biosynthesis
  • [MeSH-minor] Adult. Antigens, Neoplasm / analysis. Carcinoma, Hepatocellular / diagnosis. Carcinoma, Hepatocellular / immunology. Female. Humans. Liver Neoplasms / diagnosis. Liver Neoplasms / immunology. Male. Middle Aged

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  • [Cites] Histopathology. 2008 Jan;52(2):119-29 [17825057.001]
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  • (PMID = 20390424.001).
  • [ISSN] 1432-2307
  • [Journal-full-title] Virchows Archiv : an international journal of pathology
  • [ISO-abbreviation] Virchows Arch.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; EC 3.4.24.11 / Neprilysin
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11. Feng C, Li HZ, Xiao H, Yan WG, Li YQ, Xu WF: [Subclinical Cushing's syndrome:analysis of diagnosis and surgical effect]. Zhonghua Wai Ke Za Zhi; 2007 Dec 15;45(24):1691-3
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  • [Title] [Subclinical Cushing's syndrome:analysis of diagnosis and surgical effect].
  • All the cases were found adrenal tumors by CT scan, 10 cases in left adrenal and 14 cases in right adrenal.
  • All the patients underwent retroperitoneal laparoscopic operation and were pathologic diagnosed to adrenal adenomas.
  • CT scan, assays of plasma cortisol, urinary free cortisol and dexamethasone suppression test are most useful in the diagnosis.
  • The potential benefit of surgery should be considered in those who have a definite diagnosis of subclinical Cushing's syndrome.
  • [MeSH-major] Cushing Syndrome / diagnosis. Cushing Syndrome / surgery
  • [MeSH-minor] Adrenal Cortex Neoplasms / complications. Adrenal Cortex Neoplasms / surgery. Adrenalectomy / methods. Adrenocortical Adenoma / complications. Adrenocortical Adenoma / surgery. Adult. Female. Follow-Up Studies. Humans. Laparoscopy. Male. Middle Aged. Retrospective Studies. Treatment Outcome

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  • (PMID = 18476528.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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12. Castillo OA, Vitagliano G, Cortes O, Kerkebe M, Pinto I, Arellano L: Bilateral laparoscopic adrenalectomy. J Endourol; 2007 Sep;21(9):1053-8
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  • BACKGROUND AND PURPOSE: Laparoscopic adrenalectomy has become the gold standard in the surgical management of adrenal pathology.
  • Bilateral adrenalectomy is indicated in patients with Cushing's disease secondary to macroadenoma or hypophysial hyperplasia in whom medical treatment and transsphenoid surgery have failed.
  • Also, it is the first choice for bilateral benign tumors and metastatic neoplasia.
  • There were 6 cases of bilateral pheochromocytoma, 6 patients with Cushing's disease, 3 cases of metastasis, 3 congenital adrenal hyperplasias, 2 hyperaldosteronisms, and a single case each of adrenal adenoma and myelolipoma.
  • There was only one intraoperative complication (2.2%), a renal-vein injury that was controlled with intracorporeal suturing.

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  • (PMID = 17941786.001).
  • [ISSN] 0892-7790
  • [Journal-full-title] Journal of endourology
  • [ISO-abbreviation] J. Endourol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. Kajor M, Ziaja J, Król R, Ciupińska-Kajor M, Dobrosz Z, Heitzman M, Cierpka L: [Analysis of adrenocortical tumors morphology as regards their structure and potential malignancy]. Endokrynol Pol; 2006 Mar-Apr;57(2):136-42
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  • [Title] [Analysis of adrenocortical tumors morphology as regards their structure and potential malignancy].
  • [Transliterated title] Analiza morfologii guzów kory nadnerczy pod wzgledem ich struktury i potencjalnej złośliwości.
  • INTRODUCTION: A consequence of diagnosis of adrenocortical carcinoma (ACC) is introduction of pharmacological therapy, precise monitoring of the patients and in some cases re-operation.
  • The aim of the study is to analyse morphology of adrenocortical tumours as regards their malignancy by use of criteria proposed by Weiss.
  • MATERIAL AND METHODS: 110 adrenocortical tumours in 107 patients were analysed (M 27.1%, F 72.9%; age 32 to 77 years, mean 55.2 +/- 9.7).
  • Conn syndrome was diagnosed in 16 patients (14.9%), Cushing syndrome in 12 (11.2%), and virilisation in 3 (2.8%).
  • RESULTS: In routine histopatological examination ACC was diagnosed in 6 tumours (5.4%), adrenocortical adenoma (ACA) in 92 (83.6%) and adrenocortical hyperplasia in 12 (10.9%).
  • CONCLUSION: The structure and cell arrangement in adrenocortical adenoma are heterogeneous.
  • Application of criteria proposed by Weiss in histopathological examination of adrenocortical tumours can be useful in differentiating adrenocortical adenoma from carcinoma.
  • [MeSH-major] Adrenal Cortex Neoplasms / ultrastructure. Adrenocortical Adenoma / ultrastructure. Adrenocortical Carcinoma / ultrastructure. Biomarkers, Tumor / analysis. Neoplasm Invasiveness / pathology. Neoplasm Invasiveness / ultrastructure

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  • (PMID = 16773589.001).
  • [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] 0 / Biomarkers, Tumor
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14. Ammoury RF, Heptulla RA, Tatevian N, Elenberg E: Laparoscopic adrenalectomy of an adrenal adenoma with myelolipoma relieves severe hypertension in a 16-year-old patient. Pediatr Nephrol; 2006 Mar;21(3):433-6
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  • [Title] Laparoscopic adrenalectomy of an adrenal adenoma with myelolipoma relieves severe hypertension in a 16-year-old patient.
  • Adrenal adenoma with myelolipoma is extremely rare in pediatrics.
  • A 16-year-old patient was diagnosed with severe hypertension associated with a right adrenal mass.
  • MRI of the abdomen showed a heterogeneous adrenal mass 4.2x3.3 cm.
  • Laparoscopic resection of the mass was done, and the pathology revealed an adrenal adenoma with myelolipoma.
  • This is a case in which an adrenal adenoma with myelolipoma, a benign and usually asymptomatic tumor, presented as severe hypertension resolving with surgical resection of the tumor.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy. Adrenocortical Adenoma / surgery. Hypertension / etiology. Laparoscopy. Myelolipoma / surgery. Neoplasms, Multiple Primary / surgery


15. Martins AC, Cologna AJ, Tucci S Jr, Suaid HJ, Falconi RA: Clinical features and immunoexpression of p53, MIB-1 and proliferating cell nuclear antigen in adrenal neoplasms. J Urol; 2005 Jun;173(6):2138-42
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  • [Title] Clinical features and immunoexpression of p53, MIB-1 and proliferating cell nuclear antigen in adrenal neoplasms.
  • PURPOSE: We evaluated the clinical features and immunoreactivity of p53 protein, MIB-1 antigen and proliferating cell nuclear antigen (PCNA) in adrenal neoplasms.
  • MATERIALS AND METHODS: A total of 26 patients with adrenocortical adenoma and 24 patients with carcinoma were treated with adrenalectomy.
  • RESULTS: There was a bimodal age distribution of carcinomas and adenomas, with a first peak occurring before age 5 years.
  • Carcinoma and adenoma occurring in children presented more commonly as the virilizing syndrome, while in adults Cushing's syndrome was more common.
  • All adenomas in adults were p53 negative, while in children 4 of 11 adenomas (36%) were p53 positive.
  • Histological Weiss criteria were the most reliable pathological features to distinguish adenoma from carcinoma.
  • Other pathological features, including tumor weight, rate of mitotic figures and immunoexpression of p53 protein, MIB-1 antigen and PCNA, exhibited a striking difference in adenomas and carcinomas but none demonstrated sensitivity or specificity of 100%.
  • Of all the computerized tomographic characteristics analyzed, including tumor size, shape, necrosis/hemorrhage, attenuation and contrast enhancement, only tumor size (greater than 5 cm) showed sensitivity and specificity of 100% in the differential diagnosis.
  • The role of p53 protein, MIB-1 antigen and proliferating cell nuclear antigen in discrimination of adenomas from carcinomas is unclear.
  • [MeSH-major] Adenoma / pathology. Adrenal Gland Neoplasms / pathology. Biomarkers, Tumor / analysis. Carcinoma / pathology. Ki-67 Antigen / analysis. Proliferating Cell Nuclear Antigen / analysis. Tumor Suppressor Protein p53 / analysis
  • [MeSH-minor] Adolescent. Adrenal Glands / pathology. Adrenalectomy. Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Cell Cycle Proteins. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Drosophila Proteins. Female. Humans. Image Processing, Computer-Assisted. Immunoenzyme Techniques. Infant. Male. Middle Aged. Mitotane / administration & dosage. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / mortality. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery. Neoplasm Staging

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  • (PMID = 15879867.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cell Cycle Proteins; 0 / Drosophila Proteins; 0 / Ki-67 Antigen; 0 / Proliferating Cell Nuclear Antigen; 0 / Tumor Suppressor Protein p53; 147979-57-5 / mitotic 15 protein, Drosophila; 78E4J5IB5J / Mitotane
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16. O'Neill CJ, Spence A, Logan B, Suliburk JW, Soon PS, Learoyd DL, Sidhu SB, Sywak MS: Adrenal incidentalomas: risk of adrenocortical carcinoma and clinical outcomes. J Surg Oncol; 2010 Oct 1;102(5):450-3
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  • [Title] Adrenal incidentalomas: risk of adrenocortical carcinoma and clinical outcomes.
  • INTRODUCTION: The number of incidentally discovered adrenal lesions is increasing due to the widespread use of abdominal imaging.
  • Although most incidentalomas are benign, larger suspicious lesions will require adrenalectomy.
  • The aim of this study is to determine the risk of malignancy in patients undergoing surgery for adrenal incidentaloma; and to compare clinical outcomes in those with adrenocortical carcinoma (ACC) based on the mode of presentation.
  • Data were retrieved from a prospectively maintained adrenal tumor database.
  • Those with adrenal incidentaloma were selected and histopathology reviewed.
  • Benign, non-functioning adrenocortical adenoma was the most common histopathological finding (46 patients, 63%).
  • CONCLUSIONS: Adrenal incidentalomas have a small but important risk of malignancy.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology. Adrenocortical Carcinoma / pathology. Incidental Findings

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  • [Copyright] J. Surg. Oncol. 2010;102:450-453. © 2010 Wiley-Liss, Inc.
  • (PMID = 20734420.001).
  • [ISSN] 1096-9098
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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17. Zwermann O, Beuschlein F, Lalli E, Klink A, Sassone-Corsi P, Reincke M: Clinical and molecular evidence for DAX-1 inhibition of steroidogenic factor-1-dependent ACTH receptor gene expression. Eur J Endocrinol; 2005 May;152(5):769-76
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  • In non-functional adrenal adenomas and adrenocortical carcinomas, ACTH-R expression is low.
  • DAX-1 (dosage-sensitive sex reversal, adrenal hypoplasia congenita, critical region on the X chromosome, gene-1) is a general repressor of steroid production, inhibiting steroidogenic factor-1 (SF-1)-dependent expression of multiple steroidogenic enzymes.
  • The aim of this study was to investigate whether ACTH-R gene transcription is affected by DAX-1 and whether this mechanism is involved in down-regulation of ACTH-R expression in adrenocortical tumors.
  • METHODS: We screened 22 adrenocortical tumors for ACTH-R and DAX-1 mRNA expression by Northern blot.
  • For in vitro analyses we co-transfected mouse Y1 adrenocortical carcinoma cells with the luciferase reporter gene vector pGL3 containing full-length constructs of human (h) or mouse (m) ACTH-R promoter together with a DAX-1 expression plasmid.
  • DAX-1 inhibition was also present in the shortest construct of a series of 5'-deletion constructs of the human promoter extending from -64 to +40 bp relative to the transcription start site.
  • Mutation of the SF-1-binding sites within the hACTH-R promoter resulted in reduced or abolished DAX-1 inhibition, arguing for a mechanism that involves SF-1 for DAX-1 inhibition.

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  • (PMID = 15879363.001).
  • [ISSN] 0804-4643
  • [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 / DAX-1 Orphan Nuclear Receptor; 0 / DNA-Binding Proteins; 0 / Homeodomain Proteins; 0 / NR0B1 protein, human; 0 / NR5A1 protein, human; 0 / Nr0b1 protein, mouse; 0 / Receptors, Corticotropin; 0 / Receptors, Cytoplasmic and Nuclear; 0 / Receptors, Retinoic Acid; 0 / Repressor Proteins; 0 / Steroidogenic Factor 1; 0 / Transcription Factors; 0 / steroidogenic factor 1, mouse; 1F7A44V6OU / Colforsin
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18. Prochazkova K, Pavlikova K, Minarik M, Sumerauer D, Kodet R, Sedlacek Z: Somatic TP53 mutation mosaicism in a patient with Li-Fraumeni syndrome. Am J Med Genet A; 2009 Feb;149A(2):206-11
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  • We present a girl who developed adrenocortical adenoma at the age of 1 year and osteosarcoma at the age of 5 years.
  • The substitution was found in neither of her parents, which indicated a possibility of a de novo mutation.
  • To our knowledge this is the first description of somatic mosaicism for a de novo TP53 mutation in LFS.


19. Aliaev IuG, Akhvlediani ND, Blokhin PS: [Ipsilateral adrenalectomy is not obligatory in nephrectomy for renal cell carcinoma]. Urologiia; 2008 Mar-Apr;(2):16-22
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  • [Title] [Ipsilateral adrenalectomy is not obligatory in nephrectomy for renal cell carcinoma].
  • To analyse the necessity of obligatory ipsilateral adrenalectomy (IA) for renal cell carcinoma (RCC), we made a study of 329 RCC patients operated from 2002 to 2007.
  • Nephrectomy was conducted in 208 (63.2%) patients, renal resection--in 121 (36.8%), adrenalectomy--in 19 (5.8%) patients.
  • Preoperative HCMCT detected adrenal lesions in 62 (18.84%) patients.
  • Adrenal adenoma was suspected in 39 (11.8%) patients: ipsilateral in 19 (48.77%), contralateral in 11 (28.23%), bilateral in 9 (23%) patients.
  • Adrenal hyperplasy was diagnosed in 11 (3.34%) patients.
  • The tumor invaded the ipsilateral adrenal in 4 (1.2%) patients.
  • A RCC metastasis into the adrenal was suspected in 8 (2.4%) patients.
  • RCC invaded the ipsilateral adrenal in 1.2% patients with RCC, its adrenal metastasis was detected in 1.5% RCC patients.
  • In preservation of the adrenal in adenoma or hyperplasy 5-year follow-up registered no changes.
  • Neither pathological processes were diagnosed for 5 years in preservation of unaffected adrenal.
  • [MeSH-major] Adrenalectomy. Carcinoma, Renal Cell / surgery. Kidney Neoplasms / surgery. Nephrectomy / methods
  • [MeSH-minor] Adenoma / pathology. Adenoma / radiography. Adenoma / surgery. Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / radiography. Adrenal Gland Neoplasms / secondary. Adrenal Gland Neoplasms / surgery. Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Male. Middle Aged. Retrospective Studies. Tomography, X-Ray Computed

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  • (PMID = 18574876.001).
  • [ISSN] 1728-2985
  • [Journal-full-title] Urologii︠a︡ (Moscow, Russia : 1999)
  • [ISO-abbreviation] Urologiia
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Russia (Federation)
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20. 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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21. Cazabat L, Ragazzon B, Groussin L, Bertherat J: PRKAR1A mutations in primary pigmented nodular adrenocortical disease. Pituitary; 2006;9(3):211-9
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  • [Title] PRKAR1A mutations in primary pigmented nodular adrenocortical disease.
  • Primary Pigmented Nodular Adrenocortical Disease (PPNAD) is a rare primary bilateral adrenal defect causing corticotropin-independent Cushing's syndrome.
  • Macroscopic appearance of the adrenals is characteristic with small pigmented micronodules observed in the cortex.
  • Somatic inactivating mutations of PRKAR1A have been observed in macronodules of PPNAD and in sporadic cortisol secreting adrenal adenomas.
  • Isolated PPNAD is a genetic heterogenous disease, and recently inactivating mutations of the gene of the phosphodiesterase 11A4 (PDE11A4) located at 2q31-2q35 have been identified in patients without PRKAR1A mutations.
  • [MeSH-major] Adrenal Cortex Diseases / genetics. Cushing Syndrome / genetics. Cyclic AMP-Dependent Protein Kinase RIalpha Subunit / genetics. Mutation. Pigmentation Disorders / genetics
  • [MeSH-minor] Animals. Cyclic AMP / metabolism. Cyclic AMP-Dependent Protein Kinases / metabolism. Gene Expression Regulation, Enzymologic. Genetic Predisposition to Disease. Hormones / metabolism. Humans. Multiple Endocrine Neoplasia / enzymology. Multiple Endocrine Neoplasia / genetics. Signal Transduction / genetics

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  • (PMID = 17036196.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cyclic AMP-Dependent Protein Kinase RIalpha Subunit; 0 / Hormones; 0 / PRKAR1A protein, human; E0399OZS9N / Cyclic AMP; EC 2.7.11.11 / Cyclic AMP-Dependent Protein Kinases
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22. de Bruin C, Feelders RA, Lamberts SW, Hofland LJ: Somatostatin and dopamine receptors as targets for medical treatment of Cushing's Syndrome. Rev Endocr Metab Disord; 2009 Jun;10(2):91-102
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  • Increasing knowledge of specific subtype expression within these tumours and the ability to target these receptor subtypes with high-affinity compounds, has driven the search for new SS- or DA-based medical therapies for the various forms of CS.
  • In Cushing's disease, corticotroph adenomas mainly express dopamine receptor subtype 2 (D(2)) and somatostatin receptor subtype 5 (sst(5)), whereas sst(2) is expressed at lower levels.
  • Activation of these receptors can inhibit ACTH-release in primary cultured corticotroph adenomas and compounds that target either sst(5) (pasireotide, or SOM230) or D(2) (cabergoline) have shown significant efficacy in subsets of patients in recent clinical studies.
  • In both normal adrenal tissue as well as in adrenal adenomas and carcinomas that cause CS, sst and DA receptor expression has been demonstrated.
  • Although selected cases of adrenal CS may benefit from sst or DA-targeted treatment, its total contribution to the treatment of these patients is likely to be low as surgery is effective in most cases.
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / drug therapy. Adrenocorticotropic Hormone / metabolism. Animals. Antineoplastic Agents / therapeutic use. Humans

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  • (PMID = 18642088.001).
  • [ISSN] 1573-2606
  • [Journal-full-title] Reviews in endocrine & metabolic disorders
  • [ISO-abbreviation] Rev Endocr Metab Disord
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Receptors, Dopamine D2; 0 / Receptors, Somatostatin; 9002-60-2 / Adrenocorticotropic Hormone
  • [Number-of-references] 115
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23. Catena C, Colussi G, Nadalini E, Chiuch A, Baroselli S, Lapenna R, Sechi LA: Cardiovascular outcomes in patients with primary aldosteronism after treatment. Arch Intern Med; 2008 Jan 14;168(1):80-5
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  • Fifty-four patients with or without evidence of adrenal adenomas were prospectively followed up for a mean of 7.4 years after treatment with adrenalectomy or spironolactone.
  • RESULTS: At baseline, the prevalence of cardiovascular events was greater in primary aldosteronism (35%) than in essential hypertension (11%) (odds ratio, 4.61; 95% confidence interval, 2.38-8.95; P< .001), with odds ratios of 4.93, 4.36, and 2.80 for sustained arrhythmias, cerebrovascular events, and coronary heart disease, respectively.
  • [MeSH-major] Aldosterone / blood. Cardiovascular Diseases / etiology. Hyperaldosteronism / complications

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  • (PMID = 18195199.001).
  • [ISSN] 0003-9926
  • [Journal-full-title] Archives of internal medicine
  • [ISO-abbreviation] Arch. Intern. Med.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Mineralocorticoid Receptor Antagonists; 27O7W4T232 / Spironolactone; 4964P6T9RB / Aldosterone
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24. Majnik J, Patócs A, Balogh K, Luczay A, Török D, Szabó V, Borgulya G, Gergics P, Szappanos A, Bertalan R, Belema B, Toke J, Sereg M, Nagy ZZ, Sólyom J, Tóth M, Gláz E, Rácz K, Németh J, Fekete G, Tulassay Z: [Nucleotide sequence variants of the glucocorticoid receptor gene and their significance in determining glucocorticoid sensitivity]. Orv Hetil; 2006 Nov 5;147(44):2107-15
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  • The physiologic response and sensitivity to glucocorticoids may significantly differ among species, individuals, tissues and cell types.
  • In their own studies the authors found, that the N363S polymorphism, which increases glucocorticoid sensitivity, may play a role in the pathogenesis of bilateral adrenal adenomas, it may modify the clinical phenotype of patients with congenital adrenal hyperplasia, and may have an impact on steroid-induced ocular hypertension.
  • It is presumed that further research in other diseases will continue to complete our knowledge on the pathophysiology of glucocorticoid receptor gene polymorphisms.
  • [MeSH-minor] Adenoma / genetics. Adrenal Gland Neoplasms / genetics. Adrenal Hyperplasia, Congenital / genetics. Asparagine. Base Sequence. Female. Humans. Lasers, Excimer. Male. Ocular Hypertension / chemically induced. Ocular Hypertension / genetics. Ocular Hypertension / metabolism. Ocular Hypertension / surgery. Phenotype. Photorefractive Keratectomy. Protein Isoforms. Retrospective Studies. Serine

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  • (PMID = 17209299.001).
  • [ISSN] 0030-6002
  • [Journal-full-title] Orvosi hetilap
  • [ISO-abbreviation] Orv Hetil
  • [Language] hun
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Hungary
  • [Chemical-registry-number] 0 / Glucocorticoids; 0 / Protein Isoforms; 0 / Receptors, Glucocorticoid; 452VLY9402 / Serine; 7006-34-0 / Asparagine
  • [Number-of-references] 47
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25. Vesin C, Chabre O, Mallion JM, Chaffanjon P, Sturm N, Baguet JP: [Diagnosis and post-operative evolution of patients operated for adrenal adenoma (Conn syndrome). A 12-years retrospective study]. Arch Mal Coeur Vaiss; 2007 Feb;100(2):121-5
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  • [Title] [Diagnosis and post-operative evolution of patients operated for adrenal adenoma (Conn syndrome). A 12-years retrospective study].
  • [Transliterated title] Diagnostic et évolution postopératoire des patients opérés d'un adénome de Conn. Etude rétrospective sur 12 ans.
  • The prevalence and characteristics of patients operated for adrenal adenoma (Conn syndrome) as well as their post-operative arterial pressure evolution are varying through literature.
  • From 1993 to 2005, 24 patients (mean age = 46 +/-11 years) presented the biological criteria of primary hyperaldosteronism and benefited from adrenalectomy with confirmation of adrenal adenoma.
  • All adenomas measured more than 10 mm in scanner imaging.
  • Post-operative spontaneous normotensive patients had, at the diagnosis of adrenal adenoma, a more recent and non-refractory hypertension, with a lower number of antihypertensive drugs, a better response to spirinolactone and higher aldosterone plasmatic levels.
  • 1) Whether 70% of patients operated for adrenal adenoma are normotensive (with or without treatement) post-operatively, only 25% are definitely cured after 4 years.
  • Factors associated to a post-operative cure highlight the interest of an ealy diagnosis.
  • 2) There is probably an underdiagnosis of adrenal adenoma (Conn syndrome) because neither adenomas with normokaliemia, nor adenomas <10 mm in scanner imaging have ever been diagnosed or at least, sent to surgery.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / surgery. Adrenocortical Adenoma / diagnosis. Adrenocortical Adenoma / surgery

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  • (PMID = 17474497.001).
  • [ISSN] 0003-9683
  • [Journal-full-title] Archives des maladies du coeur et des vaisseaux
  • [ISO-abbreviation] Arch Mal Coeur Vaiss
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
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26. Barzon L, Masi G, Pacenti M, Trevisan M, Fallo F, Remo A, Martignoni G, Montanaro D, Pezzi V, Palù G: Expression of aromatase and estrogen receptors in human adrenocortical tumors. Virchows Arch; 2008 Feb;452(2):181-91
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  • [Title] Expression of aromatase and estrogen receptors in human adrenocortical tumors.
  • We recently demonstrated that adrenocortical carcinoma cells express aromatase and estrogen receptors (ERs) and that 17beta-estradiol enhances adrenocortical cell proliferation.
  • To provide a clue to the role of estrogens in adrenal tumorigenesis, we investigated the expression profile of genes involved in sex steroid hormone production and activity in a large series of normal and neoplastic human adrenocortical tissues.
  • Quantitative reverse transcriptase-polymerase chain reaction, Western blotting, and immunohistochemistry showed that ERalpha and ERbeta, androgen receptor (AR), and aromatase were expressed in the adrenal cortex and in adrenocortical tumors.
  • ERbeta was the predominant ER subtype and was mainly expressed in the zona glomerulosa and fasciculata.
  • Western blot analysis revealed the presence of a truncated form of AR in adrenocortical tissues.
  • With respect to the normal adrenal cortex and adrenocortical adenomas, carcinomas were characterized by significantly lower ERbeta levels, ERalpha upregulation, and aromatase overexpression.
  • In agreement with our in vitro findings, the results of this study suggest that estrogens, locally produced by aromatase, could enhance adrenocortical cell proliferation though autocrine/paracrine mechanisms.
  • [MeSH-major] Adrenal Cortex Neoplasms / metabolism. Adrenocortical Adenoma / metabolism. Adrenocortical Carcinoma / metabolism. Aromatase / metabolism. Receptors, Estrogen / metabolism
  • [MeSH-minor] Adrenal Cortex / embryology. Adrenal Cortex / metabolism. Adult. Aged. Biomarkers, Tumor / metabolism. Blotting, Western. Female. Gene Expression. Humans. Male. Middle Aged. RNA, Messenger / metabolism. RNA, Neoplasm / analysis

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  • [CommentIn] Virchows Arch. 2008 Aug;453(2):221-2 [18553103.001]
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  • (PMID = 18157729.001).
  • [ISSN] 0945-6317
  • [Journal-full-title] Virchows Archiv : an international journal of pathology
  • [ISO-abbreviation] Virchows Arch.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / RNA, Messenger; 0 / RNA, Neoplasm; 0 / Receptors, Estrogen; EC 1.14.14.1 / Aromatase
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27. Ashizawa N, Takagi M, Seto S, Suzuki S, Yano K: Serum adiponectin and leptin in a patient with Cushing's syndrome before and after adrenalectomy. Intern Med; 2007;46(7):383-5
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  • We measured the serum adiponectin and leptin concentrations before and after successful removal of a left adrenal adenoma in a 46-year-old woman with Cushing's syndrome.
  • [MeSH-major] Adenoma / surgery. Adiponectin / blood. Adrenal Gland Neoplasms / surgery. Cushing Syndrome / surgery. Leptin / blood

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  • (PMID = 17409602.001).
  • [ISSN] 1349-7235
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Adiponectin; 0 / Biomarkers; 0 / Leptin
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28. Kimura H, Sato K, Nishimaki M, Miki N, Ono M, Takano K: Symptomatic hypercalcemia due to painless thyroiditis after unilateral adrenalectomy in a patient with Cushing's syndrome. Intern Med; 2008;47(8):751-6
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  • We report a 53-year-old woman with Cushing's syndrome due to an adrenocortical adenoma, who underwent unilateral adrenalectomy and developed symptomatic hypercalcemia during the thyrotoxic period of painless thyroiditis, while tapering off a daily supplemented dose of cortisol.
  • [MeSH-major] Adrenalectomy. Cushing Syndrome / surgery. Hypercalcemia / diagnosis. Hypercalcemia / etiology. Thyroiditis / complications
  • [MeSH-minor] Adrenal Cortex Neoplasms / complications. Adrenal Cortex Neoplasms / surgery. Adrenocortical Adenoma / complications. Adrenocortical Adenoma / surgery. Bone Resorption / metabolism. Calcium / urine. Female. Humans. Middle Aged

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  • (PMID = 18421193.001).
  • [ISSN] 1349-7235
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] SY7Q814VUP / Calcium
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29. Faria JF, Goldman SM, Szejnfeld J, Melo H, Kater C, Kenney P, Huayllas MP, Demarchi G, Francisco VV, Andreoni C, Srougi M, Ortiz V, Abdalla N: Adrenal masses: characterization with in vivo proton MR spectroscopy--initial experience. Radiology; 2007 Dec;245(3):788-97
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  • [Title] Adrenal masses: characterization with in vivo proton MR spectroscopy--initial experience.
  • PURPOSE: To prospectively determine the accuracy of in vivo proton ((1)H) magnetic resonance (MR) spectroscopy in distinguishing adrenal adenomas, pheochromocytomas, adrenocortical carcinomas, and metastases, with histologic or computed tomographic findings and follow-up data as the reference standards.
  • Sixty consecutive patients (24 male and 36 female patients; mean age, 53 years) harboring adrenal tumors larger than 2 cm in diameter (mean diameter, 4.6 cm +/- 3.4 [standard deviation]) entered the study and were examined with a 1.5-T MR imaging system and point-resolved multivoxel (1)H MR spectroscopy.
  • Thirty-eight patients had adenomas; 10, pheochromocytomas; five, carcinomas; and seven, metastases.
  • Metabolite ratios (choline-creatine, choline-lipid, lipid-creatine, and 4.0-4.3 ppm/creatine) and cutoff values (obtained by using receiver operating characteristic analyses) were obtained and compared for each type of adrenal mass, which was identified previously on the basis of clinical, hormonal, and pathologic evidence.
  • RESULTS: Cutoff values of 1.20 for the choline-creatine ratio (92% sensitivity, 96% specificity; P < .01), 0.38 for the choline-lipid ratio (92% sensitivity, 90% specificity; P < .01), and 2.10 for the lipid-creatine ratio (45% sensitivity, 100% specificity) enabled adenomas and pheochromocytomas to be distinguished from carcinomas and metastases.
  • A 4.0-4.3 ppm/creatine ratio greater than 1.50 enabled distinction of pheochromocytomas and carcinomas from adenomas and metastases (87% sensitivity, 98% specificity; P < .01).
  • CONCLUSION: (1)H MR spectroscopy can be used to characterize adrenal masses on the basis of spectral findings for benign adenomas, carcinomas, pheochromocytomas, and metastases.
  • [MeSH-major] Adenoma / diagnosis. Adrenal Gland Neoplasms / diagnosis. Adrenocortical Carcinoma / diagnosis. Magnetic Resonance Spectroscopy. Pheochromocytoma / diagnosis
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Prospective Studies. Reproducibility of Results

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  • [Copyright] (c) RSNA, 2007.
  • [CommentIn] Radiology. 2009 Mar;250(3):955-6; author reply 955-6; discussion 956 [19244058.001]
  • (PMID = 18024453.001).
  • [ISSN] 1527-1315
  • [Journal-full-title] Radiology
  • [ISO-abbreviation] Radiology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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30. Spinazzi R, Rucinski M, Neri G, Malendowicz LK, Nussdorfer GG: Preproorexin and orexin receptors are expressed in cortisol-secreting adrenocortical adenomas, and orexins stimulate in vitro cortisol secretion and growth of tumor cells. J Clin Endocrinol Metab; 2005 Jun;90(6):3544-9
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  • [Title] Preproorexin and orexin receptors are expressed in cortisol-secreting adrenocortical adenomas, and orexins stimulate in vitro cortisol secretion and growth of tumor cells.
  • We previously found that orexin-A, via the OX1-R, stimulates cortisol secretion from dispersed human adrenocortical cells.
  • In this study, we demonstrate that six of eight cortisol-secreting adenomas expressed preproorexin mRNA, and seven of 10 adenomas contained measurable amounts of orexin-A but not orexin-B.
  • Normal adrenal cortexes neither expressed preproorexin nor contained orexins.
  • All adenomas expressed OX1-R and OX2-R mRNAs, and real-time PCR showed that the expression of both receptors was up-regulated in adenomas, compared with normal adrenal cortex.
  • Orexin-A concentration-dependently raised basal cortisol secretion from freshly dispersed normal and adenomatous cells, minimal and maximal effective concentrations being 10(-10) and 10(-8) m, and the peptide efficacy (percent increase elicited by 10(-8) m orexin-A) was significantly higher in adenomas than in the normal adrenal cortex.
  • Collectively, our findings allow us to conclude that the orexin system is overexpressed in cortisol-secreting adenomas and suggest that orexin-A may act as an autocrine-paracrine regulator of the secretory activity and growth of some of these adrenal tumors.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Adrenocortical Adenoma / genetics. Hydrocortisone / secretion. Receptors, Neuropeptide / genetics

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  • (PMID = 15797953.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA Primers; 0 / DNA, Complementary; 0 / HCRT protein, human; 0 / Intracellular Signaling Peptides and Proteins; 0 / Neuropeptides; 0 / Orexin Receptors; 0 / Orexins; 0 / RNA, Messenger; 0 / Receptors, G-Protein-Coupled; 0 / Receptors, Neuropeptide; WI4X0X7BPJ / Hydrocortisone
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31. Volante M, Sperone P, Bollito E, Frangipane E, Rosas R, Daffara F, Terzolo M, Berruti A, Papotti M: Matrix metalloproteinase type 2 expression in malignant adrenocortical tumors: Diagnostic and prognostic significance in a series of 50 adrenocortical carcinomas. Mod Pathol; 2006 Dec;19(12):1563-9
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  • [Title] Matrix metalloproteinase type 2 expression in malignant adrenocortical tumors: Diagnostic and prognostic significance in a series of 50 adrenocortical carcinomas.
  • The differential diagnosis of adrenocortical carcinoma from adrenocortical adenoma is based on different pathological parameters, usually incorporated in scoring systems, which unfortunately lack a 100% sensitivity and specificity.
  • Little is known on the molecular mechanisms leading to the malignant phenotype in adrenocortical tumors.
  • Therefore, we aimed to investigate metalloproteinases and their inhibitors expression in a series of 50 adrenocortical carcinomas and 50 control adrenocortical adenomas, diagnosed according to the Weiss histological criteria.
  • Metalloproteinase type 2 gave the most significant result, being detected in neoplastic cells in 1/50 adrenocortical adenomas (2%) and 37/50 adrenocortical carcinomas (74%) (P < 0.001), with a focal (score 1, <20% of positive cells--two-thirds of cases) or diffuse (score 2, >20% of positive cells--one-third of cases) pattern.
  • In addition, diffuse (score 2) metalloproteinase type 2 protein expression, as compared to focal or negative immunostaining, correlated with shorter survival (P < 0.02) and disease-free interval (P = 0.05).
  • Our data indicate that metalloproteinase type 2 immunohistochemical localization in tumor cells is significantly restricted to malignant adrenocortical tumors, with high specificity but low sensitivity.
  • In addition, a strong metalloproteinase type 2 expression in adrenocortical carcinoma was for the first time recognized as an unfavorable prognostic factor.
  • [MeSH-major] Adrenal Cortex Neoplasms / enzymology. Adrenocortical Adenoma / enzymology. Adrenocortical Carcinoma / enzymology. Matrix Metalloproteinase 2 / metabolism
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / metabolism. Diagnosis, Differential. Female. Humans. Immunoenzyme Techniques. Male. Middle Aged. Prognosis. Reproducibility of Results. Sensitivity and Specificity. Survival Rate

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  • (PMID = 16980949.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; EC 3.4.24.24 / Matrix Metalloproteinase 2
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32. Pugeat M, Déchaud H, Raverot V, Denuzière A, Cohen R, Boudou P, French Endocrine Society: Recommendations for investigation of hyperandrogenism. Ann Endocrinol (Paris); 2010 Feb;71(1):2-7
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  • DHEAS is primarily of cortico-adrenal origin in women.
  • Thus, a DHEAS level over 600 mg/dl indicates a diagnosis of androgen-secreting adrenal cortical adenoma..
  • If DHEAS is normal, the diagnosis could be either ovarian hyperthecosis, normally associated with insulin resistance, or androgen-secreting ovarian tumour.
  • 4. More rarely, elevated testosterone is associated with a marked elevation of SHBG possibly as the result of use of medication having an estrogenic effect (tamoxifen, raloxifene, Op'DDD), or of hyperthyroidism or liver disease.

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  • [Copyright] Copyright (c) 2010. Published by Elsevier Masson SAS.
  • (PMID = 20096825.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] eng
  • [Publication-type] Guideline; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 3XMK78S47O / Testosterone; 409J2J96VR / Androstenedione; 57B09Q7FJR / Dehydroepiandrosterone Sulfate
  • [Number-of-references] 24
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33. Merkle EM, Schindera ST: MR imaging of the adrenal glands: 1.5T versus 3T. Magn Reson Imaging Clin N Am; 2007 Aug;15(3):365-72, vii
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  • [Title] MR imaging of the adrenal glands: 1.5T versus 3T.
  • MR imaging at 1.5T is considered the prime cross-sectional imaging modality for characterization of adrenal lesions.
  • This is of utmost clinical importance, because non-functioning adenoma and adrenal metastasis are fairly common.
  • This article reviews the current literature regarding adrenal imaging at 3.0 T with a focus on the chemical shift technique.
  • [MeSH-major] Adrenal Gland Diseases / diagnosis. Image Enhancement / methods. Magnetic Resonance Imaging / methods
  • [MeSH-minor] Adrenal Gland Neoplasms / diagnosis. Echo-Planar Imaging / methods. Humans

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  • (PMID = 17893056.001).
  • [ISSN] 1064-9689
  • [Journal-full-title] Magnetic resonance imaging clinics of North America
  • [ISO-abbreviation] Magn Reson Imaging Clin N Am
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 34
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34. Song JH, Lee KH, Kim SD, Cho BS: Long-term Follow up of Congenital Adrenal Hyperplasia Patients with Hyponatremia. Electrolyte Blood Press; 2007 Dec;5(2):140-6
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  • [Title] Long-term Follow up of Congenital Adrenal Hyperplasia Patients with Hyponatremia.
  • Congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency is an autosomal recessive disease, which leads to cortisol and aldosterone deficiency and hyperandrogenism.
  • Typical medical treatment includes oral glucocorticoid and mineralocorticoid administration to suppress adrenal androgens and to compensate for adrenal steroid deficiencies.
  • Among these patients, four cases of CAH patients showing the presence of hyponatremia as an initial electrolyte disorder were found with adrenal adenoma.
  • Hypersecretion of adrenocorticotrophic hormone and chronic poor compliance to therapy appears to be associated with the development of the adrenal tumor.
  • Two cases were managed with adrenalectomy because of increasing adrenal tumor size and virilization.
  • Therefore, it is important that patients with CAH maintain steroid medication to avoid the appearance of adrenal tumor.

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  • (PMID = 24459514.001).
  • [ISSN] 1738-5997
  • [Journal-full-title] Electrolyte & blood pressure : E & BP
  • [ISO-abbreviation] Electrolyte Blood Press
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC3894515
  • [Keywords] NOTNLM ; 21-hydroxylase deficiency / Adrenal tumor / Congenital adrenal hyperplasia / Hyponatremia
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35. Pereira JM, Sirlin CB, Pinto PS, Casola G: CT and MR imaging of extrahepatic fatty masses of the abdomen and pelvis: techniques, diagnosis, differential diagnosis, and pitfalls. Radiographics; 2005 Jan-Feb;25(1):69-85
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  • [Title] CT and MR imaging of extrahepatic fatty masses of the abdomen and pelvis: techniques, diagnosis, differential diagnosis, and pitfalls.
  • The differential diagnosis of extrahepatic abdominopelvic masses is wide.
  • Demonstration of fat within a lesion at noninvasive imaging is an important clue for narrowing the differential diagnosis.
  • Lesions with predominantly microscopic fat include adrenal adenoma and some teratomas.
  • [MeSH-major] Abdominal Neoplasms / diagnosis. Magnetic Resonance Imaging. Tomography, X-Ray Computed
  • [MeSH-minor] Adenoma / diagnosis. Angiomyolipoma / diagnosis. Diagnosis, Differential. Humans. Teratoma / diagnosis

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  • [Copyright] (c) RSNA, 2005.
  • (PMID = 15653588.001).
  • [ISSN] 1527-1323
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 55
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36. Foti G, Faccioli N, Manfredi R, Mantovani W, Mucelli RP: Evaluation of relative wash-in ratio of adrenal lesions at early biphasic CT. AJR Am J Roentgenol; 2010 Jun;194(6):1484-91
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  • [Title] Evaluation of relative wash-in ratio of adrenal lesions at early biphasic CT.
  • OBJECTIVE: The purpose of this study was to retrospectively evaluate the accuracy of unenhanced attenuation and relative percentage wash-in ratio in early, that is, arterial and portal venous phase, biphasic CT in differentiating adrenal adenomas from metastatic lesions.
  • MATERIALS AND METHODS: One hundred seven adrenal masses in 86 consecutively registered patients (45 men, 41 women; mean age, 56 years) were evaluated.
  • Diagnosis was achieved with percutaneous biopsy (n = 6), surgery (n = 13), and at least 1 year of imaging follow-up (n = 88).
  • Diameter and absolute attenuation values in each phase of CT were measured in a region of interest covering one to two thirds of a lesion.
  • Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in differentiation of adenomas from metastatic lesions were calculated for unenhanced attenuation and for wash-in ratio.
  • RESULTS: The final diagnosis was metastasis in 51 cases and adenoma in 56 cases.
  • A significant difference was found between benign and malignant lesions in regard to diameter (p = 0.001), unenhanced CT attenuation (p = 0.001), and relative percentage wash-in ratio from the arterial to the portal venous scan (p = 0.014).
  • In the differentiation of benign from malignant lesions, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of unenhanced CT attenuation (at an 11-HU threshold) were 98%, 86%, 86%, 98%, and 92%, and those of relative percentage wash-in ratio from the arterial to the portal venous phase were 94%, 77%, 79%, 93%, and 85%.
  • CONCLUSION: Relative percentage wash-in ratio may help in differentiating adenoma from metastasis and in guiding the decision to perform CT directed at the adrenal glands when unenhanced CT is not available.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Adrenocortical Adenoma / radiography. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Algorithms. Biopsy. Chi-Square Distribution. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Neoplasm Metastasis. Predictive Value of Tests. Radiographic Image Interpretation, Computer-Assisted. Retrospective Studies. Sensitivity and Specificity. Statistics, Nonparametric

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  • (PMID = 20489087.001).
  • [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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37. Leitolf H, Dixit KC, Higham CE, Brabant G: Licorice - or more? Exp Clin Endocrinol Diabetes; 2010 Apr;118(4):250-3
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  • Abdominal imaging with US and MRI showed a 2.7 cmx2.2 cmx1.7 cm left adrenal mass.
  • He underwent laparoscopic left adrenalectomy and histology confirmed aldosterone producing adrenal adenoma.
  • [MeSH-major] Adrenal Cortex Neoplasms / ultrasonography. Adrenocortical Adenoma / ultrasonography. Aldosterone / blood. Glycyrrhiza / adverse effects. Hypokalemia / etiology
  • [MeSH-minor] Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Potassium, Dietary. Treatment Outcome

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  • [Copyright] (c) J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart. New York.
  • (PMID = 20213599.001).
  • [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] 0 / Potassium, Dietary; 4964P6T9RB / Aldosterone
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38. 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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39. Aydin A, Okmen E, Erdinler I, Sanli A, Cam N: Adrenal adenoma presenting with ventricular fibrillation. Tex Heart Inst J; 2005;32(1):85-7
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  • [Title] Adrenal adenoma presenting with ventricular fibrillation.
  • We report the case of a 58-year-old man who presented with ventricular fibrillation.
  • Computed tomography then revealed a right adrenal mass.
  • The patient was treated with surgical resection of the adenoma.

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  • (PMID = 15902830.001).
  • [ISSN] 0730-2347
  • [Journal-full-title] Texas Heart Institute journal
  • [ISO-abbreviation] Tex Heart Inst J
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC555832
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40. Desmarchelier M, Lair S, Dunn M, Langlois I: Primary hyperaldosteronism in a domestic ferret with an adrenocortical adenoma. J Am Vet Med Assoc; 2008 Oct 15;233(8):1297-301
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  • [Title] Primary hyperaldosteronism in a domestic ferret with an adrenocortical adenoma.
  • CLINICAL FINDINGS: On initial examination, nonregenerative anemia, mild azotemia, and a large left adrenal gland mass were identified.
  • Plasma aldosterone concentration was >3329 pmol/L, confirming a provisional diagnosis of hyperaldosteronism.
  • Histologic examination revealed a large left adrenal gland adenoma, progressive chronic nephropathy, severe pulmonary edema, and focal fibrosis in the left ventricle.
  • Immunohistochemical staining of the adrenal gland mass revealed aldosterone within neoplastic adrenocortical cells.
  • CLINICAL RELEVANCE: Findings suggested that primary hyperaldosteronism should be considered as a possible cause in ferrets with hypokalemia, hypertension, and an adrenal gland mass.
  • [MeSH-major] Adrenal Cortex Neoplasms / veterinary. Adrenocortical Adenoma / veterinary. Aldosterone / blood. Hyperaldosteronism / veterinary
  • [MeSH-minor] Animals. Fatal Outcome. Female. Ferrets. Gonadal Steroid Hormones / blood. Hydrocortisone / blood. Hypertension / blood. Hypertension / diagnosis. Hypertension / etiology. Hypertension / veterinary. Hypokalemia / blood. Hypokalemia / diagnosis. Hypokalemia / etiology. Hypokalemia / veterinary

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  • (PMID = 19180717.001).
  • [ISSN] 0003-1488
  • [Journal-full-title] Journal of the American Veterinary Medical Association
  • [ISO-abbreviation] J. Am. Vet. Med. Assoc.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Gonadal Steroid Hormones; 4964P6T9RB / Aldosterone; WI4X0X7BPJ / Hydrocortisone
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41. Yoon JH, Kim SH, Kim MA, Han JK, Choi BI: MDCT and Gd-EOB-DTPA enhanced MRI findings of adrenal adenoma arising from an ectopic adrenal gland within the liver: radiologic-pathologic correlation. Korean J Radiol; 2010 Jan-Feb;11(1):126-30
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  • [Title] MDCT and Gd-EOB-DTPA enhanced MRI findings of adrenal adenoma arising from an ectopic adrenal gland within the liver: radiologic-pathologic correlation.
  • We report a case of an adenoma arising from an ectopic adrenal gland mimicking a hepatocellular carcinoma in a heavy alcohol abuser.
  • A tumorectomy was performed and adrenal adenoma from an ectopic adrenal gland within the liver was confirmed.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenocortical Adenoma / diagnosis. Choristoma / diagnosis. Contrast Media. Gadolinium DTPA. Liver Neoplasms / diagnosis. Magnetic Resonance Imaging. Tomography, X-Ray Computed
  • [MeSH-minor] Adrenal Glands. Carcinoma, Hepatocellular / diagnosis. Diagnosis, Differential. Humans. Male. Middle Aged

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  • (PMID = 20046505.001).
  • [ISSN] 2005-8330
  • [Journal-full-title] Korean journal of radiology
  • [ISO-abbreviation] Korean J Radiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Korea (South)
  • [Chemical-registry-number] 0 / Contrast Media; 0 / gadolinium ethoxybenzyl DTPA; K2I13DR72L / Gadolinium DTPA
  • [Other-IDs] NLM/ PMC2799643
  • [Keywords] NOTNLM ; Adrenal adenoma / Ectopic adrenal gland / Liver / Magnetic resonance (MR) / Multi-detector computed tomography (MDCT)
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42. Sangwaiya MJ, Boland GW, Cronin CG, Blake MA, Halpern EF, Hahn PF: Incidental adrenal lesions: accuracy of characterization with contrast-enhanced washout multidetector CT--10-minute delayed imaging protocol revisited in a large patient cohort. Radiology; 2010 Aug;256(2):504-10
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  • [Title] Incidental adrenal lesions: accuracy of characterization with contrast-enhanced washout multidetector CT--10-minute delayed imaging protocol revisited in a large patient cohort.
  • A multidetector computed tomography (CT) adrenal protocol (unenhanced, dynamic contrast material-enhanced, and 10-minute delayed CT) was used in 314 consecutive patients (201 women, 113 men; mean age, 63.6 years) for the period from January 2006 through February 2009.
  • The mean adrenal attenuation during all three CT phases was measured by two readers, and the relative percentage washout (RPW) and absolute percentage washout (APW) values were calculated.
  • RESULTS: There were 323 adrenal lesions (213 left, 110 right) consisting of 307 adenomas and 16 nonadenomas.
  • Areas under the ROC curve were 0.85 (95% confidence interval: 0.75, 0.95) and 0.91 (95% confidence interval: 0.85, 0.97) for the APW and RPW tests, respectively, to detect adenomatous disease.
  • CONCLUSION: The 10-minute delayed adrenal enhancement washout test has reduced sensitivity for the characterization of adrenal adenomas compared with results from prior studies.
  • [MeSH-major] Adrenal Gland Neoplasms / epidemiology. Adrenal Gland Neoplasms / radiography. Adrenocortical Adenoma / epidemiology. Adrenocortical Adenoma / radiography. Iopamidol / administration & dosage. Tomography, X-Ray Computed / statistics & numerical data

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  • [CommentIn] Radiology. 2012 May;263(2):619; author reply 619-20 [22517967.001]
  • (PMID = 20656838.001).
  • [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; JR13W81H44 / Iopamidol
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43. 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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44. 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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45. 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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46. 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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47. 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


48. 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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49. 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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50. 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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51. 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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52. 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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53. 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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  • 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.


54. 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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55. 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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56. 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


57. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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58. 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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59. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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60. 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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61. 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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62. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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


63. 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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64. 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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66. 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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67. 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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68. 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


69. 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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70. 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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71. 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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72. 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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73. 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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74. 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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75. 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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76. 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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77. 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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78. 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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79. 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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80. 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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81. 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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82. 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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83. 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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84. 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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85. 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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86. 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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87. 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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88. 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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89. 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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90. 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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91. Ong K, Tan KB, Putti TC: Myelolipoma within a non-functional adrenal cortical adenoma. Singapore Med J; 2007 Jul;48(7):e200-2
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  • [Title] Myelolipoma within a non-functional adrenal cortical adenoma.
  • Myelolipoma within an adrenal cortical adenoma is a very rare cause of adrenal incidentaloma, and only nine cases have been reported in the English and Japanese literature.
  • Clinical history, physical examination and laboratory results did not show any evidence to suggest metabolic disorder such as Cushing's syndrome, hyperaldosteronism or catecholamine hypersecretion.
  • The patient underwent a left adrenalectomy, and a histopathological study confirmed the mass to be a non-functional adrenal cortical adenoma containing myelolipoma.
  • To the best of our knowledge, this is the first non-functional adrenal cortical adenoma reported; in the nine cases of myelolipoma within an adrenal cortical adenoma reported previously, all the patients had Cushing's syndrome.
  • The literature on synchronous myelolipoma with adrenal adenoma, and myelolipoma within functional adrenal adenoma, is reviewed.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology. Adrenocortical Adenoma / pathology. Myelolipoma / pathology

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  • (PMID = 17609815.001).
  • [ISSN] 0037-5675
  • [Journal-full-title] Singapore medical journal
  • [ISO-abbreviation] Singapore Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Singapore
  • [Number-of-references] 11
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92. 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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93. 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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94. 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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95. 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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96. 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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97. Thorin-Savouré A, Tissier-Rible F, Guignat L, Pellerin A, Bertagna X, Bertherat J, Lefebvre H: Collision/composite tumors of the adrenal gland: a pitfall of scintigraphy imaging and hormone assays in the detection of adrenal metastasis. J Clin Endocrinol Metab; 2005 Aug;90(8):4924-9
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  • [Title] Collision/composite tumors of the adrenal gland: a pitfall of scintigraphy imaging and hormone assays in the detection of adrenal metastasis.
  • CONTEXT: In patients with a history of extraadrenal tumor, incidental discovery of an adrenal mass necessitates excluding the possibility of metastatic malignancy.
  • Detection of the malignant tissue is a difficult challenge when metastasis occurs in an adrenal adenoma, forming a collision/composite tumor.
  • OBJECTIVE, DESIGN, AND SETTING: We report two patients with adrenal collision/composite tumors referred to two French university hospitals.
  • PATIENTS AND RESULTS: Two patients with histories of mammary and sigmoid carcinomas, respectively, presented with adrenal mass discovered 8 and 3 yr after surgical removal of the primary tumor.
  • In the two cases, computerized tomographic scan showed that the adrenal tumor contained two components with low and high attenuation values, respectively.
  • Uptake of iodocholesterol by the adrenal tumor in case 1 and elevated plasma ACTH-stimulated 17-hydroxyprogesterone values in case 2 strongly argued for the diagnosis of primary adrenocortical tumors.
  • Enlargement of the adrenal mass during follow-up in case 1 and association of the adrenal lesion with a hepatic mass in case 2 led to adrenalectomy.
  • In both cases, histological examination of the tumor demonstrated the presence of metastatic carcinoma tissue in an adrenocortical adenoma, allowing classification of the neoplasia as a collision/composite tumor.
  • CONCLUSION: These observations show that collision/composite tumors of the adrenal gland formed by carcinoma metastasis in benign adenomas are a pitfall of iodocholesterol scintigraphy and/or plasma steroid assays to exclude the diagnosis of adrenal metastasis.
  • Conversely, computerized tomographic scan is a useful tool for the distinction between the benign and malignant tissues in adrenal collision/composite tumors.
  • [MeSH-major] Adenoma / pathology. Adenoma / radionuclide imaging. Adrenal Gland Neoplasms / radionuclide imaging. Adrenal Gland Neoplasms / secondary. Breast Neoplasms / pathology. Sigmoid Neoplasms / pathology
  • [MeSH-minor] 19-Iodocholesterol. Adrenocorticotropic Hormone / blood. Diagnosis, Differential. Female. Humans. Magnetic Resonance Imaging. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 15914530.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 30461-91-7 / 19-Iodocholesterol; 9002-60-2 / Adrenocorticotropic Hormone
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98. 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.


99. 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


100. 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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