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1. Hirai T, Tsujihata M, Ueda T, Nonomura N, Okuyama A: A case of polymyositis associated with adrenal carcinoma. Int J Urol; 2007 Oct;14(10):952-3
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  • [Title] A case of polymyositis associated with adrenal carcinoma.
  • The association between idiopathic inflammatory myositis and cancer is well recognized.
  • Most descriptions have been of dermatomyositis-associated cancer, however, a few have been of polymyositis-associated adrenal cancer.
  • Here, we report a 69-year-old man in whom polymyositis-associated adrenal cancer was diagnosed.
  • Imaging studies showed a solid tumor measuring 14 x 9 cm in the retroperitoneum.
  • After surgical excision of the tumor, including the left kidney, the serum levels of creatine kinase and lactic dehydrogenase normalized, and symptoms of myositis disappeared.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Carcinoma / diagnosis. Polymyositis / diagnosis

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  • (PMID = 17880299.001).
  • [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
  • [Chemical-registry-number] EC 1.1.1.27 / L-Lactate Dehydrogenase; EC 2.7.3.2 / Creatine Kinase
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2. Lee J, El-Tamer M, Schifftner T, Turrentine FE, Henderson WG, Khuri S, Hanks JB, Inabnet WB 3rd: Open and laparoscopic adrenalectomy: analysis of the National Surgical Quality Improvement Program. J Am Coll Surg; 2008 May;206(5):953-9; discussion 959-61
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  • RESULTS: Patients undergoing open adrenalectomy were more likely to be older (57.8+/-11.9 years versus 53.5+/-13.2 years, p < 0.0001), harbor malignancy (44.5% versus 13.5%, p < 0.0001), have higher American Society of Anesthesiologists classifications (p=0.0037), smoke (35.4% versus 22.6%, p=0.0003), and have lower serum albumin levels (3.9+/-0.5 g/dL versus 4.0+/-0.5 g/dL, p=0.0241).
  • Open procedures resulted in more pneumonia, unplanned intubation, unsuccessful ventilator wean, systemic sepsis, cardiac arrest, renal insufficiency, and wound infections.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / adverse effects. Adrenalectomy / statistics & numerical data. Quality Assurance, Health Care

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  • (PMID = 18471733.001).
  • [ISSN] 1879-1190
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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3. Nair N, Basu S: Selected cases demonstrating the value of furosemide-primed 18F-FDG PET in identifying adrenal involvement. J Nucl Med Technol; 2005 Sep;33(3):166-71
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  • [Title] Selected cases demonstrating the value of furosemide-primed 18F-FDG PET in identifying adrenal involvement.
  • The adrenals are often a site of metastatic spread of cancer, and evaluation of the adrenals is important in assessing the extent of disease involvement in several malignancies.
  • PET with 18F-FDG has been found extremely effective in detecting adrenal involvement not identified on CT or not meeting the CT size criteria for malignancy.
  • However, evaluation of the adrenals and of retroperitoneal adenopathy or other pathologic conditions with 18F-FDG PET can be complicated at times by normal accumulation of the tracer in the uppermost renal calyx because of its somewhat posterior orientation, particularly when it is dilated.
  • It is not infrequent for physicians to report doubt about adrenal involvement and to suggest that the PET findings be correlated with CT findings.
  • This problem can often be circumvented clinically by administering intravenous furosemide (dosage adjusted according to body weight) to remove 18F-FDG activity from the renal pelvicalyceal system and by rescanning approximately 15-20 min later using 1-2 bed positions that include the renal area.
  • We present 5 case vignettes, with representative illustrations, providing convincing evidence of the usefulness of this simple, noninvasive interventional procedure in ruling out suspected adrenal involvement that is otherwise difficult to assess, thereby obviating any further confirmation.
  • [MeSH-major] Adenocarcinoma / radionuclide imaging. Adenocarcinoma / secondary. Adrenal Gland Neoplasms / radionuclide imaging. Adrenal Gland Neoplasms / secondary. Fluorodeoxyglucose F18. Furosemide. Positron-Emission Tomography / methods

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  • (PMID = 16145224.001).
  • [ISSN] 0091-4916
  • [Journal-full-title] Journal of nuclear medicine technology
  • [ISO-abbreviation] J Nucl Med Technol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Diuretics; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18; 7LXU5N7ZO5 / Furosemide
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4. Miyagawa-Hayashino A, Sonobe M, Kubo T, Yoshizawa A, Date H, Manabe T: Non-specific interstitial pneumonia as a manifestation of graft-versus-host disease following pediatric allogeneic hematopoietic stem cell transplantation. Pathol Int; 2010 Feb;60(2):137-42
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  • Bronchiolitis obliterans (BO) is generally believed to be a marker of pulmonary manifestation of graft-versus-host disease (GVHD) in patients who have undergone bone marrow transplantation for hematological malignancy.
  • Reported herein is a fibrosing non-specific interstitial pneumonia (NSIP) pattern together with BO in both lungs in an 8-year-old girl following a second allogeneic hematopoietic stem cell transplantation for relapsed neuroblastoma of adrenal origin.
  • [MeSH-minor] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / therapy. Bronchiolitis Obliterans / etiology. Bronchiolitis Obliterans / pathology. Child. Female. Humans. Lung Transplantation. Neoplasm Recurrence, Local / therapy. Neuroblastoma / pathology. Neuroblastoma / therapy. Transplantation, Homologous

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  • (PMID = 20398200.001).
  • [ISSN] 1440-1827
  • [Journal-full-title] Pathology international
  • [ISO-abbreviation] Pathol. Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
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5. Talwalkar SS, Shaheen SP 2nd: Extra-adrenal myelolipoma in the renal hilum: a case report and review of the literature. Arch Pathol Lab Med; 2006 Jul;130(7):1049-52
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  • [Title] Extra-adrenal myelolipoma in the renal hilum: a case report and review of the literature.
  • Myelolipoma most commonly arises in the adrenal gland.
  • Extra-adrenal myelolipomas are rare; to our knowledge, approximately 37 previous cases have been reported.
  • We report a myelolipoma presenting as a localized mass in perirenal adipose tissue juxtaposed to the renal hilum in a 65-year-old Caucasian man who presented with back pain, weight loss, hematuria, and flank pain.
  • The most likely diagnostic considerations were pyelonephritis or primary renal malignancy.
  • Perirenal masses such as morphologically identified myelolipomas are rarely, if ever, considered in differential diagnosis.
  • The purpose of this report is to elicit consideration of extra-adrenal myelolipoma when formulating a differential diagnosis for perirenal and retroperitoneal tumors.
  • Although primary and secondary malignant retroperitoneal tumors are much more common and aggressive neoplasms, establishing the correct diagnosis has important therapeutic and prognostic implications.
  • [MeSH-major] Adipose Tissue / pathology. Myelolipoma / pathology. Retroperitoneal Neoplasms / pathology
  • [MeSH-minor] Aged. Angiomyolipoma / diagnosis. Carcinoma, Renal Cell / diagnosis. Carcinoma, Transitional Cell / diagnosis. Diagnosis, Differential. Humans. Kidney Neoplasms / diagnosis. Lipomatosis / diagnosis. Liposarcoma / diagnosis. Male. Neoplasm Metastasis / diagnosis. Nephrectomy. Treatment Outcome

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  • (PMID = 16831034.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
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6. Boyd DT, Hayeri MR, Kadom N: Parotid metastasis from adrenal neuroblastoma. Pediatr Radiol; 2010 Dec;40 Suppl 1:S113-5
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  • [Title] Parotid metastasis from adrenal neuroblastoma.
  • Neuroblastomas are the most common extracranial solid malignancy in children.
  • In contrast, salivary gland tumors are uncommon in children, accounting for only 1% of all pediatric neoplasms.
  • We present a case of a parotid metastasis from a neuroblastoma with in-depth description and discussion of its ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) appearances.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Diagnostic Imaging / methods. Neuroblastoma / diagnosis. Neuroblastoma / secondary. Parotid Neoplasms / diagnosis. Parotid Neoplasms / secondary


7. Björklund P, Cupisti K, Fryknäs M, Isaksson A, Willenberg HS, Akerström G, Hellman P, Westin G: Stathmin as a marker for malignancy in pheochromocytomas. Exp Clin Endocrinol Diabetes; 2010 Jan;118(1):27-30
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  • [Title] Stathmin as a marker for malignancy in pheochromocytomas.
  • Pheochromocytomas of the adrenal medulla may be life-threatening catecholamine-producing tumors which are malignant in about 10% of cases.
  • Differential diagnosis between malignant and benign tumors is dependent on the development of metastasis or extensive local invasion.
  • A number of genetic aberrations have been described in pheochromocytomas, but no marker associated to malignancy has been reported.
  • We applied an expression microarray containing 7770 cDNA clones and analysed the expression profiles in eleven tumors compared to normal adrenal medulla.
  • RT-PCR analysis further confirmed mRNA overexpression, 6 to 8-fold for benign and malignant tumors, and 16-fold for metastases.
  • Stathmin protein overexpression was observed by immunohistochemistry, and distinct differential protein expression between benign and malignant/metastasis specimens was confirmed by Western blot analysis.
  • The results introduce stathmin as a possible diagnostic marker for malignant pheochromocytomas, and further evaluations are warranted.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Biomarkers, Tumor / metabolism. Pheochromocytoma / diagnosis. Stathmin / metabolism
  • [MeSH-minor] Adrenal Medulla / metabolism. Adrenal Medulla / pathology. Adult. Aged. Blotting, Western. Diagnosis, Differential. Female. Gene Expression Profiling. Humans. Immunohistochemistry. Male. Middle Aged. Oligonucleotide Array Sequence Analysis. RNA, Messenger / metabolism. Reverse Transcriptase Polymerase Chain Reaction. Young Adult

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  • [Copyright] J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart, New York.
  • (PMID = 19449284.001).
  • [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] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / RNA, Messenger; 0 / STMN1 protein, human; 0 / Stathmin
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8. Kirshtein B, Yelle JD, Moloo H, Poulin E: Laparoscopic adrenalectomy for adrenal malignancy: a preliminary report comparing the short-term outcomes with open adrenalectomy. J Laparoendosc Adv Surg Tech A; 2008 Feb;18(1):42-6
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  • [Title] Laparoscopic adrenalectomy for adrenal malignancy: a preliminary report comparing the short-term outcomes with open adrenalectomy.
  • BACKGROUND: The laparoscopic approach to adrenal malignancy remains a topic of debate.
  • METHODS: A retrospective analysis of patients who had an open or laparoscopic adrenalectomy for malignancy at a tertiary care center from 1995 to 2005 were included in this study.
  • There was no difference in age, sex, American Society of Anesthesiologists status or diagnosis between the two groups, but patients in the laparoscopic group had a higher body mass index.
  • CONCLUSIONS: Laparoscopic adrenalectomy is both feasible and safe for some malignant tumors of the adrenal gland in experienced hands.
  • Careful selection, preoperative staging, and respect for oncologic principles are important considerations in choosing laparoscopic surgery for primary and secondary adrenal malignancy.
  • [MeSH-major] Adrenal Cortex Neoplasms / surgery. Adrenalectomy / methods. Carcinoma / surgery. Laparoscopy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Blood Loss, Surgical. Female. Humans. Length of Stay. Lymphoma / surgery. Male. Middle Aged. Neoplasm Metastasis. Retrospective Studies. Treatment Outcome

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  • (PMID = 18266573.001).
  • [ISSN] 1092-6429
  • [Journal-full-title] Journal of laparoendoscopic & advanced surgical techniques. Part A
  • [ISO-abbreviation] J Laparoendosc Adv Surg Tech A
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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9. Kim HM, Ikeda M, Okano M, Miyoshi N, Hirose H, Yamashita S, Takemasa I, Mizushima T, Yamamoto H, Sekimoto M, Doki Y, Mori M: [A case of recurrent sigmoid colon cancer with adrenal and para-aortic lymph node metastasis successfully treated by operation and chemotherapy]. Gan To Kagaku Ryoho; 2010 Nov;37(12):2548-50
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  • [Title] [A case of recurrent sigmoid colon cancer with adrenal and para-aortic lymph node metastasis successfully treated by operation and chemotherapy].
  • We report a case of 57-year-old woman suffering from advanced sigmoid colon cancer with adrenal and para-aortic lymph node recurrence.
  • Sigmoidectomy was performed for sigmoid colon cancer in January 2002.
  • However, adrenal and para-aortic lymph node recurrence was detected in February 2007, and mFOLFOX6 was performed as preoperative chemotherapy.
  • She had no recurrence for almost 3 years after a resection of adrenal and para-aortic lymph node metastasis.
  • [MeSH-major] Adrenal Gland Neoplasms / secondary. Adrenal Gland Neoplasms / therapy. Liver Neoplasms / secondary. Liver Neoplasms / therapy. Lymphatic Metastasis. Sigmoid Neoplasms / pathology. Sigmoid Neoplasms / therapy
  • [MeSH-minor] Adrenalectomy. Angiogenesis Inhibitors / administration & dosage. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Humanized. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Aorta. Bevacizumab. Camptothecin / administration & dosage. Camptothecin / analogs & derivatives. Combined Modality Therapy. Female. Fluorouracil / therapeutic use. Hepatectomy. Humans. Leucovorin / therapeutic use. Middle Aged. Neoplasm Recurrence, Local. Organoplatinum Compounds / therapeutic use. Tegafur / administration & dosage. Uracil / administration & dosage

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  • (PMID = 21224635.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Antineoplastic Agents, Phytogenic; 0 / Organoplatinum Compounds; 1548R74NSZ / Tegafur; 2S9ZZM9Q9V / Bevacizumab; 56HH86ZVCT / Uracil; 7673326042 / irinotecan; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; XT3Z54Z28A / Camptothecin; 1-UFT protocol; Folfox protocol
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10. Kasperlik-Zaluska AA, Zgliczynski W, Slapa RZ, Cichocki A: Retroperitoneal hemorrhage from adrenocortical carcinoma as a poor prognostic factor. Int J Biomed Sci; 2008 Mar;4(1):78-81
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  • A sudden retroperitoneal hemorrhage may sometimes be the first symptom of the adrenal cancer.

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  • (PMID = 23675071.001).
  • [ISSN] 1550-9702
  • [Journal-full-title] International journal of biomedical science : IJBS
  • [ISO-abbreviation] Int J Biomed Sci
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC3614665
  • [Keywords] NOTNLM ; adrenal cancer / retroperitoneal hemorrhage / steroids
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11. Kasperlik-Załuska AA, Słowińska-Srzednicka J, Rosłonowska E, Kochman M, Jeske W, Otto M, Cichocki A, Słapa RZ, Zgliczyński W: Bilateral, incidentally found adrenal tumours - results of observation of 1790 patients registered at a single endocrinological centre. Endokrynol Pol; 2010 Jan-Feb;61(1):69-73
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  • [Title] Bilateral, incidentally found adrenal tumours - results of observation of 1790 patients registered at a single endocrinological centre.
  • INTRODUCTION: During the last 22 years we registered 1790 patients with incidentally found adrenal tumours (AI, adrenal incidentalomas).
  • The group of patients with bilateral adrenal tumours included 258 women and 93 men, 25-83 years old.
  • Hormonal investigations and imaging examinations were performed to search for subclinical adrenal hyperfunction and to define the malignant potential of the tumours.
  • Histological findings included malignant tumours: metastases - 9, adrenal cancer - 7, and lymphomas - 5; and non-malignant tumours: adenomas - 24, nodular hyperplasia - 14, myelolipomas - 4, and pheochromocytomas - 4.
  • CONCLUSIONS: Indications for surgery were recommended in 20% of patients with bilateral AI, most frequently for adenomas, nodular hyperplasia, and oncological pathologies, with a good prognosis in the non-malignant group. (Pol J Endocrinol 2010; 61 (1): 69-73).
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / epidemiology. Incidental Findings. Neoplasms, Second Primary / diagnosis. Neoplasms, Second Primary / epidemiology
  • [MeSH-minor] Adenoma / diagnosis. Adenoma / epidemiology. Adenoma / surgery. Adolescent. Adult. Aged. Aged, 80 and over. Carcinoma / diagnosis. Carcinoma / epidemiology. Carcinoma / surgery. Child. Comorbidity. Cushing Syndrome / epidemiology. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Poland / epidemiology. Tomography, X-Ray Computed. Young Adult

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  • (PMID = 20205107.001).
  • [ISSN] 0423-104X
  • [Journal-full-title] Endokrynologia Polska
  • [ISO-abbreviation] Endokrynol Pol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Poland
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12. Tournoy KG, Praet MM, Van Maele G, Van Meerbeeck JP: Esophageal endoscopic ultrasound with fine-needle aspiration with an on-site cytopathologist: high accuracy for the diagnosis of mediastinal lymphadenopathy. Chest; 2005 Oct;128(4):3004-9
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  • [Title] Esophageal endoscopic ultrasound with fine-needle aspiration with an on-site cytopathologist: high accuracy for the diagnosis of mediastinal lymphadenopathy.
  • STUDY OBJECTIVES: To analyze the accuracy of esophageal endoscopic ultrasound (EUS) with real-time, guided fine-needle aspiration (EUS-FNA) with an on-site cytopathologist in patients with (presumed) lung cancer presenting with mediastinal lymphadenopathy (ML) or a suspect left adrenal gland (LAG).
  • PATIENTS: Sixty-seven outpatients with (presumed) lung cancer with ML or a suspect LAG on either CT and/or positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) scan.
  • MEASUREMENTS: EUS with and without fine-needle aspiration (FNA) as compared to FDG-PET was evaluated for accuracy in diagnosing cancer, safety, and rate of avoidance for further surgery.
  • RESULTS: Of 67 consecutive patients (56 men; median age, 64 years), malignant ML or LAG were found in 47 patients (70.1%).
  • In 20 patients (29.9%) without EUS-FNA proof of malignancy, confirmation was obtained by surgical procedure in 13 patients (sarcoidosis [n = 5], infection [n = 1], lung cancer [n = 7]) or by clinical follow-up in 5 patients suggesting benign disease.
  • With malignancy as an end point, the accuracy for EUS-FNA was 100%.
  • When using final histopathologic diagnosis as an end point, the accuracy of EUS-FNA was 92.3%, since EUS-FNA was unable to show noncaseating granulomas in those patients with sarcoidosis diagnosed after mediastinoscopy.

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  • (PMID = 16236979.001).
  • [ISSN] 0012-3692
  • [Journal-full-title] Chest
  • [ISO-abbreviation] Chest
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. Turner DJ, Miskulin J: Management of adrenal lesions. Curr Opin Oncol; 2009 Jan;21(1):34-40
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of adrenal lesions.
  • PURPOSE OF REVIEW: Adrenal lesions are commonly seen on modern imaging modalities, and although the majority are benign, potentially lethal entities necessitate exclusion.
  • The purpose of this review is to summarize recent advances in diagnosis and therapies for adrenal lesions.
  • RECENT FINDINGS: New tumor markers and genetic risk factors continue to be discovered, and improved diagnostic techniques have made adrenal incidentalomas more common than ever before.
  • Laparoscopic approaches for adrenal lesions continue to evolve for functional lesions, and also for lesions 12 cm and larger.
  • Open adrenalectomy continues to be the most appropriate for adrenocortical cancer.
  • SUMMARY: All adrenal lesions should prompt a functional hormonal assessment and additional imaging to determine malignancy employed.
  • [MeSH-major] Adrenal Gland Diseases / diagnosis. Adrenal Gland Diseases / surgery. Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery
  • [MeSH-minor] Biomarkers, Tumor / analysis. Humans

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  • (PMID = 19125016.001).
  • [ISSN] 1531-703X
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 41
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14. Krsek M: [Adrenal incidentalomas]. Vnitr Lek; 2007 Jul-Aug;53(7-8):821-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Adrenal incidentalomas].
  • [Transliterated title] Incidentalomy nadledvin.
  • Adrenal incidentalomas are called as a disease of modern technology because increased availability and accuracy of imaging techniques lead to increased incidence of incidentally discovered adrenal masses.
  • Adrenal incidentalomas are found in about 0.35-4.36% of abdominal CT scans performed for purpose other than suspicion of adrenal diseases.
  • However, in autoptic studies the percentage of incidentally discovered adrenal tumours in much higher, in some of then being even more than 20%.
  • Important component of differential diagnosis is endocrinological examination aimed to reveal potential autonomous hormonal overproduction.
  • Approximately more than 10% of adrenal incidentalomas is characterized by autonomous cortisol production, 5-10% is phaeochromocytomas and 5-7% is aldosteron producing adenomas.
  • Vast majority of adrenal incidentalomas are nonfunctioning tumours, mainly adenomas.
  • Rational ways and recommendations for screening of hormonal activity of adrenal incidentalomas is discussed.
  • Very important issue is to distinguish between benign and malignant lesions and between adenomas and non-adenomas.
  • Particular characteristics of particular adrenal tumours are discussed.
  • From the relationship between the tumour size and probability of malignancy, current recommendations are derived, that non-functioning tumours smaller than 4 cm are indicated for further follow-up, size over 6 cm is indication for adrenalectomy and in tumours between 4-6 cm decision process is complex.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis

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  • (PMID = 17915426.001).
  • [ISSN] 0042-773X
  • [Journal-full-title] Vnitr̆ní lékar̆ství
  • [ISO-abbreviation] Vnitr Lek
  • [Language] cze
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Czech Republic
  • [Number-of-references] 15
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15. DeWitt J, Alsatie M, LeBlanc J, McHenry L, Sherman S: Endoscopic ultrasound-guided fine-needle aspiration of left adrenal gland masses. Endoscopy; 2007 Jan;39(1):65-71
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  • [Title] Endoscopic ultrasound-guided fine-needle aspiration of left adrenal gland masses.
  • BACKGROUND AND STUDY AIM: Although the left adrenal gland is readily visible by endoscopic ultrasound (EUS), there are few published data on the utility of EUS-guided fine-needle aspiration (EUS-FNA) of this site.
  • The aim of this study was to report our experience of EUS-FNA of left adrenal gland masses.
  • PATIENTS AND METHODS: In this retrospective case series, we reviewed our EUS and cytology databases to identify consecutive patients who underwent EUS-FNA of the left adrenal gland between January 1997 and January 2004.
  • RESULTS: Our searches resulted in the identification of a series of 38 consecutive patients who underwent EUS for the evaluation of a lung mass (n = 14), a pancreatic mass (n = 14), obstructive jaundice (n = 1), dysphagia (n = 2), an ampullary adenoma (n = 1), celiac block (n = 1), or a left adrenal gland mass (n = 5).
  • The mean maximal left adrenal mass diameter was 24 mm (range 7-66 mm).
  • Diagnoses after EUS-FNA (the mean number of passes was 3.6) were: metastatic lung cancer (n = 2), esophageal adenocarcinoma (n = 1), melanoma (n = 1), renal cell carcinoma (n = 1), and pancreatic neuroendocrine tumor (n = 1); primary pheochromocytoma (n = 1); benign adrenal tissue (n = 21); and granulomatous inflammation (n = 1).
  • The absence of a discrete adrenal mass on EUS occurred more frequently in patients with nondiagnostic biopsies than in those with diagnostic biopsies (56 % vs. 7 %; odds ratio 23.4, 95 %CI 3.5 - 157.0; P = 0.004).
  • CONCLUSIONS: EUS-FNA of the left adrenal gland is safe and can be useful for the evaluation and staging of suspected malignancy.
  • Nondiagnostic biopsies are more common when sampling diffusely enlarged glands, compared with glands with a focal mass.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Biopsy, Fine-Needle / methods. Endoscopy. Ultrasonography


16. Hevia Suárez M, Abascal Junquera JM, Boix P, Dieguez M, Delgado E, Abascal García JM, Abascal García R: [Management of adrenal mass: What urologists should know]. Actas Urol Esp; 2010 Jul;34(7):586-91
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  • [Title] [Management of adrenal mass: What urologists should know].
  • [Transliterated title] Manejo de la masa suprarrenal: lo que el urólogo debe saber.
  • Adrenal incidentaloma's prevalence is rising because of the big volume of radiologic explorations that we daily do.
  • No comprehensive guidelines have been published by professional societies to guide the evaluation of patients with adrenal incidentalomas.
  • All adrenal masses should be inspected for malignancy or hypersecreting disorders.
  • In our point of view, adrenal surgery should be performed by the urologist, because it's the medical speciality which knows the best this anatomical region.
  • The objective of this review is to present the main points that the urologist may know in the management of adrenal masses.
  • Together with the department of Endocrinology of our hospital, we describe the main studies to perform in front of adrenal mass diagnosis and the current therapeutical diagram utilized in our center.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / therapy

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  • (PMID = 20540874.001).
  • [ISSN] 1699-7980
  • [Journal-full-title] Actas urologicas españolas
  • [ISO-abbreviation] Actas Urol Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Spain
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17. Maru S, Yamashita N, Shinno Y: [Adrenal multilocular echinococcosis: a case report]. Nihon Hinyokika Gakkai Zasshi; 2007 May;98(4):643-5
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  • [Title] [Adrenal multilocular echinococcosis: a case report].
  • A 79-year-old man was consulted to our hospital for further examination of right adrenal tumor shown by computed tomography.
  • 131I-adosterol scintigram showed decreased uptake on the right adrenal.
  • Right adrenalectomy was done in consider to adrenal cancer.
  • By the pathological findings and the serological tests (ELISA, and Western Blot examination), the tumor was diagnosed as an adrenal multilocular echinococcosis.
  • In Europe, the primary hydatid cyst is found in the adrenal in only 0.05% of the total case.
  • Moreover, adrenal multilocular echinococcosis is extremely rare case, and is not presented yet in the world.
  • By the patient' s residential history, echinococcosis shoud be considered to differential diagnosis of the adrenal tumor in urology.
  • [MeSH-major] Adrenal Gland Diseases / diagnosis. Adrenalectomy. Echinococcosis / diagnosis
  • [MeSH-minor] Adrenal Gland Neoplasms / diagnosis. Aged. Animals. Diagnosis, Differential. Echinococcus multilocularis / isolation & purification. Humans. Male

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  • (PMID = 17564109.001).
  • [ISSN] 0021-5287
  • [Journal-full-title] Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • [ISO-abbreviation] Nippon Hinyokika Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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18. Kanczkowski W, Tymoszuk P, Ehrhart-Bornstein M, Wirth MP, Zacharowski K, Bornstein SR: Abrogation of TLR4 and CD14 expression and signaling in human adrenocortical tumors. J Clin Endocrinol Metab; 2010 Dec;95(12):E421-9
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  • CONTEXT: Adrenocortical carcinoma (ACC) is a rare tumor with poor prognosis.
  • The expression of innate immunity receptor Toll-like receptor 4 (TLR4) was recently reported in various human tumors, and TLR4 was shown to regulate tumor immune escape processes, proliferation, and resistance to chemotherapeutical agents.
  • OBJECTIVE: The aim of this study was to investigate TLR4 expression, signaling, and function in the process of tumorigenesis in the human adrenal cortex.
  • MEASUREMENTS AND MAIN RESULTS: Real-time PCR analysis of human ACC (n=8), adenoma (n=8), and ACC cell lines (SW13, NCI-H295R, and HAC15) revealed a significant down-regulation of TLR4, MD2 (myeloid differentiation protein-2), and cluster of differentiation 14 (CD14) mRNA compared with normal human adrenal cortex and adrenocortical cells in primary culture.
  • Furthermore, our data show that reintroduction of TLR4 expression in ACCs may provide a novel therapeutic strategy for adrenal cancer.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Antigens, CD14 / genetics. Toll-Like Receptor 4 / genetics
  • [MeSH-minor] Adenoma / genetics. Adenoma / pathology. Adrenal Cortex / pathology. Adrenal Cortex / physiology. Adult. Animals. Blotting, Western. Cell Division. Cell Line, Tumor. Down-Regulation. Female. Gene Expression Regulation. Humans. Immunohistochemistry. Male. Middle Aged. Polymerase Chain Reaction / methods. RNA, Messenger / genetics. Reference Values


19. Wang CH, Chen SJ, Yang LY, Tang RB: Neonatal adrenal hemorrhage presenting as a multiloculated cystic mass. J Chin Med Assoc; 2008 Sep;71(9):481-4
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  • [Title] Neonatal adrenal hemorrhage presenting as a multiloculated cystic mass.
  • Neonatal adrenal hemorrhage presenting as an abdominal mass in the newborn is not uncommon.
  • However, judging the nature of a suprarenal mass is sometimes difficult, especially when the structure is more complex with unusual clinical course.
  • We report a male newborn with neonatal adrenal hemorrhage presenting as a multiloculated cystic mass.
  • All laboratory data including complete blood cell count, serum electrolytes, liver function, renal function, blood sugar, alpha-fetoprotein, beta-human chorionic gonadotropin, urinalysis, and 24-hour urine vanillylmandelic acid were within normal limits.
  • Surgical exploration was performed to exclude the possibility of malignancy.
  • This case highlights the diagnostic problems that arise when a space-occupying lesion is found near or at the adrenal gland in the neonate.
  • We suggest that early surgical intervention for the suprarenal mass without sufficient evidence of malignancy would not be prudent.
  • [MeSH-major] Adrenal Gland Diseases / diagnosis. Cysts / diagnosis. Hemorrhage / diagnosis

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  • (PMID = 18818143.001).
  • [ISSN] 1726-4901
  • [Journal-full-title] Journal of the Chinese Medical Association : JCMA
  • [ISO-abbreviation] J Chin Med Assoc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China (Republic : 1949- )
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20. Mannelli M, Castellano M, Schiavi F, Filetti S, Giacchè M, Mori L, Pignataro V, Bernini G, Giachè V, Bacca A, Biondi B, Corona G, Di Trapani G, Grossrubatscher E, Reimondo G, Arnaldi G, Giacchetti G, Veglio F, Loli P, Colao A, Ambrosio MR, Terzolo M, Letizia C, Ercolino T, Opocher G, Italian Pheochromocytoma/Paraganglioma Network: Clinically guided genetic screening in a large cohort of italian patients with pheochromocytomas and/or functional or nonfunctional paragangliomas. J Clin Endocrinol Metab; 2009 May;94(5):1541-7
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  • Patients were divided into different groups according to their family history, the presence of lesions outside adrenals/paraganglia considered syndromic for VHL disease, MEN2, and NF1, and the number and types of pheochromocytomas and/or paragangliomas.
  • RESULTS: Germline mutations were detected in 32.1% of cases, but frequencies varied widely depending on the classification criteria and ranged from 100% in patients with associated syndromic lesions to 11.6% in patients with a single tumor and a negative family history.
  • The types and number of pheochromocytomas/paragangliomas as well as age at presentation and malignancy suggest which gene should be screened first.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Paraganglioma / genetics. Pheochromocytoma / genetics

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  • (PMID = 19223516.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 9007-49-2 / DNA
  • [Investigator] Mariotti S; Montalto A; Parenti G; Ragghianti B; Zampetti B; Pacini F; Nassi R; Fagiano A; Milone F; Cordisco EL; Demattè S; Cecchini E; Bertola G; Giambona S; Milanese G; Bertuccio A; Pierani P; Fabrizzi B; Grego F; Piazza M; Trabalzini F; Toniato A; Boschin IM; Agliozzo E; Tiberio G; Nicolai P; Mulatero P; Sechi L
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21. Lakemeier S, Westhoff CC, Fuchs-Winkelmann S, Schofer MD: Odontoid process metastasis of bronchial carcinoma as a rare cause for nonmechanical neck pain: a case report. Cases J; 2009;2:8173
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  • Unknown lung cancer with adrenal and pancreatic metastases was revealed by further investigations.
  • CONCLUSION: Detailed pain characterization can already indicate the correct diagnosis.

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22. Bernini GP, Moretti A, Oriandini C, Bardini M, Taurino C, Salvetti A: Long-term morphological and hormonal follow-up in a single unit on 115 patients with adrenal incidentalomas. Br J Cancer; 2005 Mar 28;92(6):1104-9
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  • [Title] Long-term morphological and hormonal follow-up in a single unit on 115 patients with adrenal incidentalomas.
  • We investigated the natural course of adrenal incidentalomas in 115 patients by means of a long-term endocrine and morphological (CT) follow-up protocol (median 4 year, range 1-7 year).
  • In particular, 57 endocrine alterations found in 43 patients (37.2%) were no longer confirmed at follow-up, while 35 new alterations in 31 patients (26.9%) appeared de novo.
  • In no case were the variations in mass dimension associated with the appearance of radiological criteria of malignancy.
  • In conclusion, mass enlargement and the presence or occurrence over time of subclinical endocrine alterations are frequent and not correlated, can appear at any time, are not associated with any basal predictor and, finally, are not necessarily indicative of malignant transformation or of progression toward overt disease.
  • [MeSH-major] Adrenal Gland Neoplasms / metabolism. Adrenal Gland Neoplasms / pathology. Hormones / blood

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  • (PMID = 15770213.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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23. Rais-Bahrami S, Varkarakis IM, Lujan G, Jarrett TW: Primary retroperitoneal teratoma presenting as an adrenal tumor in an adult. Urology; 2007 Jan;69(1):185.e1-2
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  • [Title] Primary retroperitoneal teratoma presenting as an adrenal tumor in an adult.
  • We describe a case of mature cystic teratoma that was clinically suggestive of an adrenal myelolipoma.
  • Because of the risk of malignancy, follow-up radiographic studies were performed to ensure the oncologic efficacy of resection.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Myelolipoma / diagnosis. Retroperitoneal Neoplasms / diagnosis. Teratoma / diagnosis
  • [MeSH-minor] Adult. Diagnosis, Differential. Humans. Male

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  • (PMID = 17270653.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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24. Meyer S, von Mach MA, Ivan D, Schäfer S, Habbe N, Kann B, Kann PH: Color-coded duplex endoscopic ultrasound of the adrenals. J Endocrinol Invest; 2008 Oct;31(10):882-7
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  • [Title] Color-coded duplex endoscopic ultrasound of the adrenals.
  • Imaging of the adrenals by endoscopic ultrasound (EUS) is a valuable technique for detection and localization of adrenal lesions, but endosonomorphological tumor distinction remains difficult.
  • In this single-center study, the amount of blood flow in common adrenal lesions, such as adrenal adenomas, adrenal hyperplasia, and pheochromocytomas, was visualized by color-coded duplex EUS (CD-EUS) and was retrospectively analysed.
  • Therefore, we reviewed our EUS database to evaluate and correlate the perfusion patterns of common adrenal lesions with histologically confirmed diagnosis, possible malignancy, and endosonomorphological features such as echogeneity, echostructure, and tumor size.
  • In 38 consecutive patients (male=19; female=19; age: mean 53+/-16 yr SD), perfusion patterns of 46 histologically confirmed adrenal, para- or extra-adrenal lesions of adrenal origin (adenoma: no.
  • There was no relationship between perfusion patterns and localization of pheochromocytomas (adrenal: 8; paraadrenal: 3; extra-adrenal: 4).
  • Vascularization was not statistically associated with tumor echogeneity, echostructure, malignancy or tumor size.
  • CD-EUS is an additional tool for adrenal endosonographic tumor distinction and seems to improve the endosonographic detection of pheochromocytomas by visualization of hypervascularization.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnostic imaging. Adrenal Glands / diagnostic imaging

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  • (PMID = 19092293.001).
  • [ISSN] 1720-8386
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Italy
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25. Patey M: [Pheochromocytoma and the diagnosis of malignancy: recent data and the role of the pathologist]. Ann Pathol; 2008 Nov;28 Spec No 1(1):S42-4
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  • [Title] [Pheochromocytoma and the diagnosis of malignancy: recent data and the role of the pathologist].
  • [Transliterated title] Phéochromocytome et diagnostic de malignité : données récentes et place du pathologiste.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Pathology, Clinical. Pheochromocytoma / diagnosis
  • [MeSH-minor] Biomarkers, Tumor. Humans. Neoplasm Invasiveness. Neoplasm Metastasis. Neoplastic Syndromes, Hereditary / genetics. Neoplastic Syndromes, Hereditary / pathology. Physician's Role. Severity of Illness Index


26. Schmid H, Mussack T, Wörnle M, Pietrzyk MC, Banas B: Clinical management of large adrenal cystic lesions. Int Urol Nephrol; 2005;37(4):767-71
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  • [Title] Clinical management of large adrenal cystic lesions.
  • The widespread use of ultrasonography and computed tomography has resulted in an increased diagnosis of large sized adrenal cysts with diameters of more than 5 cm.
  • Most of these adrenal cystic lesions are clinically silent and are therefore often diagnosed incidentally.
  • Since up to 7% of adrenal cysts are malignant, a careful hormonal, morpho-functional and instrumental evaluation is mandatory.
  • In particular, functioning adrenal carcinomas or pheochromocytomas have to be ruled out.
  • Fine needle aspiration cytology as well as examination of a punch biopsy specimen of the cystic wall are of limited value, as there is considerable overlap in cytologic and histologic features of benign and malignant adrenal cystic lesions.
  • Immediate surgical excision is indicated in the presence of symptoms, suspicion of malignancy, increase in the size or detection of a functioning adrenal cyst.
  • [MeSH-major] Adrenal Gland Diseases / diagnosis. Cysts / diagnosis
  • [MeSH-minor] Adrenal Gland Neoplasms / diagnosis. Adrenalectomy. Female. Humans. Male. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 16362596.001).
  • [ISSN] 0301-1623
  • [Journal-full-title] International urology and nephrology
  • [ISO-abbreviation] Int Urol Nephrol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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27. Cho M, Choi CS, Seo GS, Kim TH, Choi SC, Yun KJ, Kim HC: [A case of metastatic cutaneous nodules of recurrent hepatocellular carcinoma]. Korean J Hepatol; 2007 Jun;13(2):234-8
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  • Common metastatic sites of hepatocellular carcinoma include lung, peritoneum, adrenal gland and bone, but rarely, skin can be metastatic sites.
  • Although hepatocellular carcinoma is the third commonest malignancy in Korea, cutaneous metastasis from hepatocellular carcinoma was rarely reported.
  • Cutaneous metastasis from malignant neoplasm of the internal organ occur at the variable stage and the growth pattern of cutaneous lesions is nonspecific and various, so the differential diagnosis of skin lesions must be considered to other malignant condition.
  • [MeSH-major] Carcinoma, Hepatocellular / diagnosis. Carcinoma, Hepatocellular / secondary. Liver Neoplasms / diagnosis. Neoplasm Recurrence, Local / diagnosis. Skin Neoplasms / secondary

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  • (PMID = 17585197.001).
  • [ISSN] 1738-222X
  • [Journal-full-title] The Korean journal of hepatology
  • [ISO-abbreviation] Korean J Hepatol
  • [Language] kor
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Korea (South)
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28. Duenschede F, Bittinger F, Heintz A, Musholt T, Korenkov M, Kann P, Ewald P, Gockel I, Junginger T: Malignant and unclear histological findings in incidentalomas. Eur Surg Res; 2008;40(2):235-8
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  • [Title] Malignant and unclear histological findings in incidentalomas.
  • BACKGROUND: The management of incidentalomas with tumor size 3 cm and larger is still under controversial discussion.
  • Indications for surgery were tumor size equal and larger than 3 cm, recurrent pain, hormone status and patients' fear of malignancy.
  • In 45 patients, the adenomas did not meet the defined criteria of malignancy.
  • There were 9 cases of adrenal hyperplasia, and two cysts and two hematomas were found in 4 patients.
  • In 1 patient, an adrenal cortical carcinoma of 10.0 cm in diameter was operated.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery. Adrenalectomy. Incidental Findings
  • [MeSH-minor] Diagnostic Techniques, Endocrine. Female. Hormones / metabolism. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Staging. Tomography, X-Ray Computed. Ultrasonography

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  • [Copyright] Copyright 2008 S. Karger AG, Basel.
  • (PMID = 18032908.001).
  • [ISSN] 1421-9921
  • [Journal-full-title] European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes
  • [ISO-abbreviation] Eur Surg Res
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Hormones
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29. Wang Q, Huang LL, Yue MG, Qin SL, Wang Y, Nie YX, Zhang CQ, Liang TJ, Zhao YM: [18F-FDG imaging by coincidence circuit SPECT with low-dose CT in preoperative assessment of pulmonary lesions]. Zhonghua Zhong Liu Za Zhi; 2006 Dec;28(12):924-7
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  • OBJECTIVE: To assess the clinical diagnostic value of 18F-FDG imaging by coincidence circuit SPECT with low-dose CT in differential diagnosis of pulmonary lesions and mediastinal lymph node involvement, which can not be definitely diagnosed based on regular CT image in patients with non-small-cell lung cancer (NSCLC).
  • METHODS: By using GE-Millennium VG with Hawkeye, 18F-FDG imaging was carried out in 48 patients with suspected lung cancer.
  • Clinical value of 18F-FDG imaging for diagnosing malignancy was evaluated through comparison with the final pathological results.
  • Correct diagnosis were made in 34 malignancies and 6 false positive lesions were excluded based on morphology and 18F-FDG uptake status of the lesion.
  • Furthermore, extrathoracic metastases which were not showed on previous CT image in 4 patients including one in the adrenal gland and 3 in the bone were detected by 18F-FDG imaging.
  • The sensitivity, specificity and accuracy of the 18F-FDG imaging for differentiating malignant tumor from benign was 94.4%, 50.0% and 83.3%, respectively.
  • CONCLUSION: 18F-FDG imaging by coincidence circuit SPECT with low-dose CT is quite helpful in differential diagnosis for patient with undetermined lesion on regular CT image, but it is limited for staging of lung cancer in the patients with non-small cell lung cancer.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / diagnosis. Fluorodeoxyglucose F18. Lung Neoplasms / diagnosis. Pneumonia / diagnosis. Tomography, Emission-Computed, Single-Photon / methods
  • [MeSH-minor] Adult. Aged. Diagnosis, Differential. Female. Humans. Lung / pathology. Lung / radiography. Lung / radionuclide imaging. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Preoperative Care. Radiation Dosage. Radiopharmaceuticals. Retrospective Studies. Sensitivity and Specificity. Tomography, X-Ray Computed. Tuberculosis, Pulmonary / diagnosis. Tuberculosis, Pulmonary / radiography. Tuberculosis, Pulmonary / radionuclide imaging

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  • (PMID = 17533745.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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30. Aguilera Bazán A, Pérez Utrilla M, Alvarez Escolá C, Reinoso J, Fernández Martínez A, Cisneros Ledo J, de la Peña Barthel J: [Laparoscopic adrenalectomy. Five-year experience]. Actas Urol Esp; 2010 Feb;34(2):181-5
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  • [Transliterated title] Suprarrenalectomía laparoscópica. Experiencia de 5 años.
  • OBJECTIVE: Adrenal conditions requiring surgery are uncommon and are usually seen in several surgical departments.
  • Our experience in laparoscopic management of adrenal pathology after almost five years of use of laparoscopy for retroperitoneal conditions at our center is reported.
  • MATERIALS AND METHODS: A total of 37 laparoscopic adrenalectomies were performed over 53 months for benign and malignant conditions.
  • A malignancy was found in 4 patients (10%), while all other patients (90%) had a benign condition, including 8 pheochromocytomas.
  • CONCLUSIONS: Laparoscopy is considered to be the gold standard for benign adrenal conditions.
  • When the malignant mass is a single metastasis from a primary tumor, the laparoscopic approach appears to be reliable.
  • When the malignant lesion is a primary adrenal tumor, laparoscopic management is more controversial, although the results reported by experienced surgeons in their series appear to be adequate.
  • [MeSH-minor] Adenoma / surgery. Adrenal Gland Diseases / surgery. Adrenal Gland Neoplasms / secondary. Adrenal Gland Neoplasms / surgery. Adult. Aged. Carcinoma / secondary. Carcinoma / surgery. Cushing Syndrome / surgery. Cysts / surgery. Female. Humans. Hyperaldosteronism / surgery. Male. Middle Aged. Myelolipoma / surgery. Pheochromocytoma / surgery. Pregnancy. Pregnancy Complications / surgery. Retrospective Studies

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  • (PMID = 20403283.001).
  • [ISSN] 1699-7980
  • [Journal-full-title] Actas urologicas españolas
  • [ISO-abbreviation] Actas Urol Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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31. Chrisoulidou A, Kaltsas G, Ilias I, Grossman AB: The diagnosis and management of malignant phaeochromocytoma and paraganglioma. Endocr Relat Cancer; 2007 Sep;14(3):569-85
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  • [Title] The diagnosis and management of malignant phaeochromocytoma and paraganglioma.
  • Malignant phaeochromocytomas are rare tumours accounting for ~10% of all phaeochromocytomas; the prevalence of malignancy among paragangliomas is higher, especially those associated with succinate dehydrogenase subunit B gene mutations.
  • Although a subset of these tumours has metastatic disease at initial presentation, a significant number develops metastases during follow-up after excision of an apparently benign tumour.
  • Clinical, biochemical and histological features cannot reliably distinguish malignant from benign tumours.
  • Several imaging modalities have been utilised for the diagnosis and staging of these tumours.
  • The 5-year mortality rate of patients with malignant phaeochromocytomas and paragangliomas greater than 50% indicates that there is considerable room for the improvement of currently available therapies.
  • The main therapeutic target is tumour reduction and control of symptoms of excessive catecholamine secretion.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / therapy. Paraganglioma / diagnosis. Paraganglioma / therapy. Pheochromocytoma / diagnosis. Pheochromocytoma / therapy
  • [MeSH-minor] Algorithms. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / analysis. Chromaffin Cells / pathology. Combined Modality Therapy. Endocrine Surgical Procedures. Humans. Radiopharmaceuticals / therapeutic use. Radiotherapy / trends

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  • (PMID = 17914089.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Radiopharmaceuticals
  • [Number-of-references] 159
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32. Gill AJ, Benn DE, Chou A, Clarkson A, Muljono A, Meyer-Rochow GY, Richardson AL, Sidhu SB, Robinson BG, Clifton-Bligh RJ: Immunohistochemistry for SDHB triages genetic testing of SDHB, SDHC, and SDHD in paraganglioma-pheochromocytoma syndromes. Hum Pathol; 2010 Jun;41(6):805-14
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  • Genetic testing allows familial counseling and identifies subjects at high risk of malignancy (SDHB mutations) or significant multiorgan disease (RET, VHL, or NF1).
  • One VHL associated tumor showed weak diffuse staining.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Membrane Proteins / genetics. Paraganglioma / genetics. Pheochromocytoma / genetics. Succinate Dehydrogenase / genetics

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  • [Copyright] Crown Copyright 2010. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20236688.001).
  • [ISSN] 1532-8392
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Membrane Proteins; 0 / SDHC protein, human; 0 / SDHD protein, human; EC 1.3.5.1 / SDHB protein, human; EC 1.3.99.1 / Succinate Dehydrogenase
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33. Ansquer C, Scigliano S, Mirallié E, Taïeb D, Brunaud L, Sebag F, Leux C, Drui D, Dupas B, Renaudin K, Kraeber-Bodéré F: 18F-FDG PET/CT in the characterization and surgical decision concerning adrenal masses: a prospective multicentre evaluation. Eur J Nucl Med Mol Imaging; 2010 Aug;37(9):1669-78
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  • [Title] 18F-FDG PET/CT in the characterization and surgical decision concerning adrenal masses: a prospective multicentre evaluation.
  • PURPOSE: This prospective multicentre study assesses the usefulness of FDG PET/CT in characterizing and making the therapeutic decision concerning adrenal tumours that are suspicious or indeterminate in nature after conventional examinations (CE).
  • METHODS: Seventy-eight patients (37 men, 41 women, 81 adrenal lesions) underwent FDG PET/CT after CE including CT scan, biological tests and optionally (131)I-metaiodobenzylguanidine (MIBG) and/or (131)I-norcholesterol scans.
  • FDG adrenal uptake exceeding that of the liver was considered positive.
  • RESULTS: Following the gold standard (histology analysis or >or=9 months follow-up), 49 lesions potentially qualified for surgery (malignant = 27, benign secreting = 22) and 32 benign non-secreting lesions did not.
  • PET was negative in 97% of non-surgical lesions and positive in 73% of potentially surgical ones which included all the malignant lesions, except 3 renal cell metastases, and 12 of 22 benign secreting lesions.
  • The negative predictive value for malignancy was 93% (41/44) and positive predictive value for detecting surgical lesions was 97% (36/37).
  • A high FDG uptake (maximum standardized uptake value >or= 10) was highly predictive of malignancy.
  • CONCLUSION: Adrenal FDG uptake is a good indicator of malignancy and/or of secreting lesions and should lead one to discuss surgery.
  • If there is no prior history of poorly FDG-avid cancer, the absence of FDG uptake should avoid unnecessary removal of benign adrenal lesions.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery. Fluorodeoxyglucose F18. Positron-Emission Tomography / methods. Tomography, X-Ray Computed / methods

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  • (PMID = 20490488.001).
  • [ISSN] 1619-7089
  • [Journal-full-title] European journal of nuclear medicine and molecular imaging
  • [ISO-abbreviation] Eur. J. Nucl. Med. Mol. Imaging
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study
  • [Publication-country] Germany
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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34. Giordano TJ: Adrenocortical tumors: an integrated clinical, pathologic, and molecular approach at the University of Michigan. Arch Pathol Lab Med; 2010 Oct;134(10):1440-3
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  • CONTEXT: The University of Michigan Health System has a rich tradition in the study and treatment of endocrine neoplasia.
  • Recently, an integrated clinical and research program focused on primary cancer of the adrenal gland has been developed.
  • OBJECTIVE: To discuss the foundation of the University of Michigan Adrenal Cancer Program that consists of 3 components:.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Adrenal Cortex Neoplasms / pathology

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  • (PMID = 20923297.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] EC 2.7.10.1 / Receptor, IGF Type 1
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35. Okamoto T, Suzuki Y, Sugiyama N, Kudo S, Yoneyama T, Hashimoto Y, Koie T, Kamimura N, Oyama C: [Ganglioneuroma with calcification mimicking adrenal tumor: a case report]. Hinyokika Kiyo; 2010 Nov;56(11):621-3
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  • [Title] [Ganglioneuroma with calcification mimicking adrenal tumor: a case report].
  • Computed tomography revealed a 30 mm solid tumor with calcification in the left adrenal gland and a 8 mm nodule in the right adrenal gland.
  • Endocrinological examinations revealed no activity of either adrenal mass.
  • The left adrenal tumor was extirpated, because malignancy of the tumor was not ruled out.
  • Histopathological examination proved that the tumor was ganglioneuroma arising from the extra-adrenal retroperitoneum.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Glands / pathology. Calcinosis / pathology. Ganglioneuroma / pathology. Retroperitoneal Neoplasms / pathology
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Humans

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  • (PMID = 21187706.001).
  • [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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36. Brouwers FM, Elkahloun AG, Munson PJ, Eisenhofer G, Barb J, Linehan WM, Lenders JW, De Krijger R, Mannelli M, Udelsman R, Ocal IT, Shulkin BL, Bornstein SR, Breza J, Ksinantova L, Pacak K: Gene expression profiling of benign and malignant pheochromocytoma. Ann N Y Acad Sci; 2006 Aug;1073:541-56
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  • [Title] Gene expression profiling of benign and malignant pheochromocytoma.
  • There are currently no reliable diagnostic and prognostic markers or effective treatments for malignant pheochromocytoma.
  • This study used oligonucleotide microarrays to examine gene expression profiles in pheochromocytomas from 90 patients, including 20 with malignant tumors, the latter including metastases and primary tumors from which metastases developed.
  • Other subgroups of tumors included those defined by tissue norepinephrine compared to epinephrine contents (i.e., noradrenergic versus adrenergic phenotypes), adrenal versus extra-adrenal locations, and presence of germline mutations of genes predisposing to the tumor.
  • Correcting for the confounding influence of noradrenergic versus adrenergic catecholamine phenotype by the analysis of variance revealed a larger and more accurate number of genes that discriminated benign from malignant pheochromocytomas than when the confounding influence of catecholamine phenotype was not considered.
  • Seventy percent of these genes were underexpressed in malignant compared to benign tumors.
  • Similarly, 89% of genes were underexpressed in malignant primary tumors compared to benign tumors, suggesting that malignant potential is largely characterized by a less-differentiated pattern of gene expression.
  • The present database of differentially expressed genes provides a unique resource for mapping the pathways leading to malignancy and for establishing new targets for treatment and diagnostic and prognostic markers of malignant disease.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Gene Expression Profiling. Pheochromocytoma / genetics

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  • (PMID = 17102123.001).
  • [ISSN] 0077-8923
  • [Journal-full-title] Annals of the New York Academy of Sciences
  • [ISO-abbreviation] Ann. N. Y. Acad. Sci.
  • [Language] eng
  • [Grant] United States / Intramural NIH HHS / / Z99 CT999999; United States / Intramural NIH HHS / /
  • [Publication-type] Journal Article; Research Support, N.I.H., Intramural
  • [Publication-country] United States
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37. Péter S, Rácz K, Tulassay Z, Igaz P: [Possible applications of functional genomics in the study of the pathogenesis of adrenal and pituitary tumors]. Orv Hetil; 2006 Jul 9;147(27):1267-71
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  • [Title] [Possible applications of functional genomics in the study of the pathogenesis of adrenal and pituitary tumors].
  • By comparing gene expression profiles of different tumour tissues or to their healthy counterparts, large amounts of information can be obtained that was unfeasible even until recently.
  • There are only few data available on the pathogenesis of sporadic adrenal and pituitary tumours.
  • Some of these genes may even be applicable in clinical practice, e.g. for the study of malignancy, determination of prognosis or the choice of therapy.
  • In this short review, the authors attempt to present a synopsis of the possible applications of functional genomics in the field of endocrine tumours by summarizing recent studies on adrenal and pituitary tumours.
  • [MeSH-major] Adrenal Gland Neoplasms / metabolism. Genomics. Pituitary Neoplasms / metabolism

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  • (PMID = 16927882.001).
  • [ISSN] 0030-6002
  • [Journal-full-title] Orvosi hetilap
  • [ISO-abbreviation] Orv Hetil
  • [Language] hun
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Hungary
  • [Number-of-references] 33
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38. Conzo G, Tricarico A, Belli G, Candela S, Corcione F, Del Genio G, Ferulano GP, Giardiello C, Livrea A, Marzano LA, Porcelli A, Sperlongano P, Vincenti R, Palazzo A, De Martino C, Musella M: Adrenal incidentalomas in the laparoscopic era and the role of correct surgical indications: observations from 255 consecutive adrenalectomies in an Italian series. Can J Surg; 2009 Dec;52(6):E281-5
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  • [Title] Adrenal incidentalomas in the laparoscopic era and the role of correct surgical indications: observations from 255 consecutive adrenalectomies in an Italian series.
  • We analyzed the results of a multi-centre trial that was performed to evaluate the effectiveness of imaging (computed tomography and magnetic resonance imaging) to obtain a correct preoperative diagnosis.
  • METHODS: We obtained our data from the results of a questionnaire that was distributed by mail or email in May 2005 to several surgical units operating in the Campania Region, Italy.
  • RESULTS: The distribution of pathologic findings demonstrates that the number of lesions caused by cancer discovered from a preoperative indication of incidentaloma has been even smaller (1/114, 0.8%) than the previous numbers reported in the literature.
  • Moreover, whereas most patients with adrenal cancer had lesions larger than 6 cm (7/8, 87.5%), the majority of patients with adrenal metastases had lesions 6 cm or smaller (10/12, 83.3%).
  • Adrenal malignancies when metastatic are often 6 cm or smaller.
  • If they are single and they originated from a non-small lung cancer, they must be removed.
  • The endocrine surgery unit remains the best setting to evaluate and treat adrenal gland surgical pathology.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods

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  • (PMID = 20011165.001).
  • [ISSN] 1488-2310
  • [Journal-full-title] Canadian journal of surgery. Journal canadien de chirurgie
  • [ISO-abbreviation] Can J Surg
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39. Brauckhoff M, Dralle H: [Recurrent operations on the adrenal glands]. Chirurg; 2005 Mar;76(3):227-37
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  • [Title] [Recurrent operations on the adrenal glands].
  • Repeat adrenalectomy may be required due to ipsilateral recurrence of benign or malignant adrenal tumors after previous total or subtotal adrenalectomy.
  • Even for multivisceral resection in patients with adrenocortical carcinoma, complete resection of local recurrent tumor offers results similar to those of primary resection (5-year survival 40-60%).
  • In contrast, since no benefit on long-term survival has been shown so far by tumor debulking, palliative tumor resection should only be performed individually for control of severe endocrine symptoms.
  • The effect of endoscopic adrenalectomy in patients with large tumors (>5 cm) or suspected malignancy has still not been well examined.
  • In any case, during open or endoscopic approach, tumor spillage must be avoided to prevent local tumor cell implantation.
  • Following subtotal adrenalectomy, the risk of ipsilateral recurrence correlates with disease, follow-up, localization, size of the adrenal remnant, and, in case of familial pheochromocytoma, probably with genotype.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Adrenocortical Carcinoma / surgery. Neoplasm Recurrence, Local / surgery. Pheochromocytoma / surgery
  • [MeSH-minor] 3-Iodobenzylguanidine / therapeutic use. Adult. Antineoplastic Agents, Hormonal / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Lymph Node Excision. Male. Middle Aged. Mitotane / therapeutic use. Octreotide / therapeutic use. Palliative Care. Paraneoplastic Endocrine Syndromes / diagnosis. Paraneoplastic Endocrine Syndromes / mortality. Paraneoplastic Endocrine Syndromes / surgery. Radiotherapy, Adjuvant. Reoperation

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  • (PMID = 15739057.001).
  • [ISSN] 0009-4722
  • [Journal-full-title] Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen
  • [ISO-abbreviation] Chirurg
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 35MRW7B4AD / 3-Iodobenzylguanidine; 78E4J5IB5J / Mitotane; RWM8CCW8GP / Octreotide
  • [Number-of-references] 45
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40. Gaul C, Hanisch F, Neureiter D, Behrmann C, Neundörfer B, Winterholler M: Intravascular lymphomatosis mimicking disseminated encephalomyelitis and encephalomyelopathy. Clin Neurol Neurosurg; 2006 Jul;108(5):486-9
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  • Premortal biopsy of lesions in liver and right suprarenal gland showed no further characterized malignancy.
  • Tumour cells were seen disseminated in extranodal sites including heart, lung, adrenal gland, spleen, thyroid gland and brain.
  • A biopsy of different organs including the brain and leptomeninges should not be delayed to ensure ante mortem diagnosis and to initiate chemotherapy.
  • [MeSH-major] Encephalomyelitis, Acute Disseminated / diagnosis. Leigh Disease / diagnosis. Lymphoma, B-Cell / pathology. Vascular Neoplasms / pathology
  • [MeSH-minor] Aged. Diagnosis, Differential. Fatal Outcome. Humans. L-Lactate Dehydrogenase / blood. Magnetic Resonance Imaging. Male. Middle Aged. Severity of Illness Index

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  • (PMID = 16720222.001).
  • [ISSN] 0303-8467
  • [Journal-full-title] Clinical neurology and neurosurgery
  • [ISO-abbreviation] Clin Neurol Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] EC 1.1.1.27 / L-Lactate Dehydrogenase
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41. Lin GB, Xu M, Wang H: [Diagnosis and treatment of adrenal cyst: report of 15 cases]. Zhonghua Yi Xue Za Zhi; 2009 Feb 17;89(6):409-11
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  • [Title] [Diagnosis and treatment of adrenal cyst: report of 15 cases].
  • OBJECTIVE: To discuss the diagnosis and treatment of adrenal cyst.
  • METHODS: The clinical data of 15 patients with adrenal cyst, 9 males and 6 females, aged 42 (32 - 65), diagnosed and treated 1995 - 2005 were reviewed.
  • Nine cysts were in the left adrenal gland and 6 cysts in the right.
  • CONCLUSION: MR is much more useful in diagnosis of adrenal cyst.
  • The indications of surgery include the presence of symptoms, suspicion of malignancy, increase in the cyst size, and detection of functioning adrenal cyst.
  • [MeSH-major] Adrenal Gland Diseases / diagnosis. Adrenal Gland Diseases / surgery. Cysts / diagnosis. Cysts / surgery

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  • (PMID = 19567122.001).
  • [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
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42. de Krijger RR, van Nederveen FH, Korpershoek E, Dinjens WN: New developments in the detection of the clinical behavior of pheochromocytomas and paragangliomas. Endocr Pathol; 2006;17(2):137-41
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  • Pheochromocytomas (PCC) are catecholamine-producing tumors that are, by definition, located in the adrenal medulla.
  • Extra-adrenal catecholamine-producing tumors are called paragangliomas (PGL), which should be distinguished from head and neck paragangliomas, which are of parasympathetic origin.
  • The relative rarity of PCC and PGL combined with a frequency of malignancy from as low as 2% up to 25% has hampered the power of past research and can only be overcome by multicenter collaborative efforts.
  • In this article, recent attempts at marker detection, such as those mentioned above, as well as emerging knowledge on the molecular abnormalities in benign and malignant PCC and PGL will be presented.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Paraganglioma / diagnosis. Pheochromocytoma / diagnosis
  • [MeSH-minor] Biomarkers, Tumor / analysis. Diagnosis, Differential. Gene Expression Profiling. Humans. Nucleic Acid Hybridization. Prognosis

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  • (PMID = 17159246.001).
  • [ISSN] 1046-3976
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 18
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43. Nemcek AA: Complications of radiofrequency ablation of neoplasms. Semin Intervent Radiol; 2006 Jun;23(2):177-87
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  • [Title] Complications of radiofrequency ablation of neoplasms.
  • At the present time RFA is among the most widely used and investigated of local therapies and has shown promise in oncological therapy for a variety of tissue types and anatomic locations, the latter including liver, kidney, bone, lung, and adrenal gland.

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  • (PMID = 21326761.001).
  • [ISSN] 0739-9529
  • [Journal-full-title] Seminars in interventional radiology
  • [ISO-abbreviation] Semin Intervent Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC3036367
  • [Keywords] NOTNLM ; Radiofrequency ablation / complications / interventional radiology / malignancy / neoplasm / review
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44. Erem C, Ucuncu O, Nuhoglu I, Cinel A, Cobanoglu U, Demirel A, Koc E, Kocak M, Guvendi GF: Adrenal ganglioneuroma: report of a new case. Endocrine; 2009 Jun;35(3):293-6
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  • [Title] Adrenal ganglioneuroma: report of a new case.
  • Although adrenal ganglioneuroma (GN) is a rare tumor originating from the neural crest tissue of the sympathetic nervous system, detection of this tumor has increased, as imaging procedures such as ultrasonography (US) and computed tomography (CT) have become prevalent.
  • We describe a case of adrenal GN incidentally diagnosed in a 68-year-old female patient.
  • Abdominal CT and magnetic resonance imaging showed a solid oval tumor approximately 6 x 4 cm in the left adrenal gland without remarkable signs of malignancy.
  • Histological diagnosis of the tumor was a ganglioneuroma originating from the adrenal medulla.
  • Adrenal GN occurs rarely in adults and preoperative diagnosis is difficult, especially in asymptomatic cases.
  • According to our knowledge, this is the fifth case of adrenal GN in an adult patient from Turkey in English literature.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Ganglioneuroma / diagnosis

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  • (PMID = 19367379.001).
  • [ISSN] 1355-008X
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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45. Valeri A, Bergamini C, Manca G, Mannelli M, Presenti L, Peri A, Borrelli A, Tonelli P: Adrenal incidentaloma: the influence of a decision-making algorithm on the short-term outcome of laparoscopy. J Laparoendosc Adv Surg Tech A; 2005 Oct;15(5):451-9
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  • [Title] Adrenal incidentaloma: the influence of a decision-making algorithm on the short-term outcome of laparoscopy.
  • BACKGROUND: At the present time, the precise indications for laparoscopic surgery of adrenal incidentaloma (AI) have yet to be completely clarified.
  • The most controversial issue is the role of laparoscopy in the treatment of potentially malignant and large adrenal masses.
  • RESULTS: Patients in the DS group had a higher risk for malignancy.
  • The definitive pathology revealed a malignant biology in 26.6% of DS vs. 0% of IS cases.
  • CONCLUSION: Our study shows that laparoscopy is feasible and safe for AIs, regardless of the preoperative probability of malignancy.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Decision Support Techniques. Laparoscopy

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  • (PMID = 16185116.001).
  • [ISSN] 1092-6429
  • [Journal-full-title] Journal of laparoendoscopic & advanced surgical techniques. Part A
  • [ISO-abbreviation] J Laparoendosc Adv Surg Tech A
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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46. Karanikola E, Tsigris C, Kontzoglou K, Nikiteas N: Laparoscopic adrenalectomy: where do we stand now? Tohoku J Exp Med; 2010 Apr;220(4):259-65
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  • Laparoscopic adrenalectomy (LA) has become the procedure of choice for the surgical removal of the vast majority of small sized adrenal tumors (<or= 6 cm), because of its significant and multiple advantages: reduced hospital stay and wound morbidity, decreased transfusion requirements, postoperative pain and complications.
  • The role of LA in patients with large adrenal lesions or potential malignancy remains controversial.
  • The aim of this article is to review the current and up-to-date surgical approaches for LA, which include:.
  • The choice of each of these techniques is determined particularly by the preference and the experience of the surgeon, but other objective criteria must be taken into consideration, such as the size of the adrenal and history of previous abdominal surgeries.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy / methods

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  • (PMID = 20383036.001).
  • [ISSN] 1349-3329
  • [Journal-full-title] The Tohoku journal of experimental medicine
  • [ISO-abbreviation] Tohoku J. Exp. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 46
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47. Kook PH, Grest P, Raute-Kreinsen U, Leo C, Reusch CE: Addison's disease due to bilateral adrenal malignancy in a dog. J Small Anim Pract; 2010 Jun;51(6):333-6
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  • [Title] Addison's disease due to bilateral adrenal malignancy in a dog.
  • Adrenal insufficiency was diagnosed with hyponatraemia, hyperkalaemia and undetectable resting and post-ACTH cortisol and aldosterone concentrations.
  • The owners opted for euthanasia and allowed only removal of both adrenal glands.
  • Microscopically, infiltrative polymorphic proliferations of densely packed tumour cells arranged as nests, intermingled with multifocal areas of necrosis and inflammatory cells were found.
  • The final diagnosis was highly anaplastic bilateral adrenal neoplasia.
  • This is the first report of bilateral adrenal malignancy presenting as clinical hypoadrenocorticism in a dog.
  • [MeSH-major] Addison Disease / veterinary. Adrenal Gland Neoplasms / veterinary. Dog Diseases / diagnosis


48. Rosoff JS, Raman JD, Del Pizzo JJ: Laparoscopic adrenalectomy for large adrenal masses. Curr Urol Rep; 2008 Jan;9(1):73-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic adrenalectomy for large adrenal masses.
  • Open adrenalectomy has been the gold-standard therapy for adrenal neoplasms.
  • The traditional benefits of laparoscopy, including reduced blood loss, shorter hospital duration, and improved convalescence, extend to adrenal disease without compromising the oncologic efficacy of the surgery.
  • Contemporary series suggest that minimally invasive surgery is also a reasonable therapeutic modality for larger adrenal masses.
  • Neither size criteria, suspicion of malignancy, nor locally invasive disease should be considered an absolute contraindication to laparoscopic adrenalectomy.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy

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  • (PMID = 18366978.001).
  • [ISSN] 1534-6285
  • [Journal-full-title] Current urology reports
  • [ISO-abbreviation] Curr Urol Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 41
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49. McNicol AM: A diagnostic approach to adrenal cortical lesions. Endocr Pathol; 2008;19(4):241-51
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  • [Title] A diagnostic approach to adrenal cortical lesions.
  • The adrenal gland is not a common specimen in surgical pathology practice as, until recently, adrenal tumors were recognized in life only if associated with hypersecretion of hormones or evidence of malignancy.
  • However, adrenal nodules are not uncommon at autopsy, and the number of these found in life is now increasing as they are identified when the abdomen is scanned for the investigation of other diseases using computed tomography or magnetic resonance imaging.
  • It is therefore becoming increasingly important for the surgical pathologist to be aware of the range of pathology in the gland and to understand how to approach the specimens.
  • This short review will deal with lesions of the adrenal cortex.
  • [MeSH-major] Adrenal Cortex / pathology. Adrenal Cortex Neoplasms / diagnosis. Adrenocortical Adenoma / diagnosis. Adrenocortical Carcinoma / diagnosis
  • [MeSH-minor] Adrenal Medulla / pathology. Carcinoma, Hepatocellular / diagnosis. Carcinoma, Renal Cell / diagnosis. Diagnosis, Differential. Humans. Kidney Neoplasms / diagnosis. Liver Neoplasms / diagnosis. Pheochromocytoma / diagnosis

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  • (PMID = 19089656.001).
  • [ISSN] 1046-3976
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 88
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50. Beuschlein F: Adrenal incidentalomas: presentation and clinical work-up. Horm Res; 2007;68 Suppl 5:191-4
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  • [Title] Adrenal incidentalomas: presentation and clinical work-up.
  • BACKGROUND: Through the widespread use of imaging techniques with great sensitivity, adrenal tumours are often diagnosed as an incidental finding.
  • The majority of these adrenal lesions are benign and without evidence of endocrine activity or malignancy.
  • However, in addition to the classic forms of overt adrenal hypersecretion, it has become evident in recent years that even modest adrenal hormonal autonomy, as exhibited in clinically silent phaeochromocytoma, normokalaemic primary aldosteronism and subclinical Cushing syndrome, is associated with significant morbidity.
  • CONCLUSIONS: Detection and differential diagnosis of subtle changes in adrenal hormone secretion can pose a diagnostic challenge to the clinician, and accurate diagnosis is dependent on use of tests with reliable sensitivity and specificity.
  • [MeSH-major] Adrenal Gland Neoplasms / complications. Adrenal Gland Neoplasms / diagnosis. Incidental Findings
  • [MeSH-minor] Adrenocortical Carcinoma / complications. Adrenocortical Carcinoma / diagnosis. Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Pheochromocytoma / complications. Pheochromocytoma / diagnosis. Tomography, X-Ray Computed

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  • [Copyright] Copyright (c) 2007 S. Karger AG, Basel.
  • (PMID = 18174744.001).
  • [ISSN] 1423-0046
  • [Journal-full-title] Hormone research
  • [ISO-abbreviation] Horm. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 42
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51. Del Pizzo JJ: Radiographic evaluation of the incidental adrenal lesion. Curr Urol Rep; 2006 Jan;7(1):69-72
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  • [Title] Radiographic evaluation of the incidental adrenal lesion.
  • The detection of incidental adrenal masses has increased substantially with the advent and widespread use of high-resolution cross-sectional imaging techniques such as CT and MRI.
  • The work-up and treatment of these incidentally found adrenal masses continue to be a clinical challenge for radiologists, endocrinologists, and adrenal surgeons.
  • The approach to the evaluation of most of these adrenal masses depends on the radiologic appearance of the lesion, and whether the patient has a known underlying malignancy.
  • The aim of this article is to review imaging features of pathologic abnormalities of the adrenal gland.
  • Recent advances in noninvasive imaging methods that attempt to differentiate benign from malignant lesions also are addressed.
  • [MeSH-major] Adrenal Gland Diseases / diagnosis

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  • (PMID = 16480675.001).
  • [ISSN] 1527-2737
  • [Journal-full-title] Current urology reports
  • [ISO-abbreviation] Curr Urol Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 28
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52. Bednarek-Tupikowska G, Bucyk B, Daroszewski J, Bidzińska-Speichert B, Bohdanowicz-Pawlak A, Szymczak J, Bednorz W, Podgórski F, Zareba-Bogdał E, Kuliczkowska-Płaksej J, Lenarcik A, Filus A, Kałuzny M, Kubicka E, Syrycka J, Tupikowska M, Lizurej O, Bolanowski M, Milewicz A: [Pheochromocytoma in 8-year observation at a single endocrinological center in Wroclaw]. Endokrynol Pol; 2009 May-Jun;60(3):189-98
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  • INTRODUCTION: Pheochromocytoma is rare tumor with a highly variable clinical presentation.
  • Computed tomography was the most widely used method for tumor localization.
  • Adrenal pheochromocytoma was detecting by CT in all patients, predominated in right adrenal, in 1 case in urinary bladder.
  • Malignancy was reported in 2 cases, 1 woman died after surgery.
  • CONCLUSIONS: The diagnosis of pheochromocytma is usually made after long duration of the disease.
  • The study confirms that clinical presentation of pheochromocytoma is variable and nonspecific, this finding makes the diagnosis very difficult.
  • CT was almost always successful in localizing the tumor.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / therapy. Pheochromocytoma / diagnosis. Pheochromocytoma / therapy

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  • (PMID = 19569019.001).
  • [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] 5001-33-2 / Metanephrine
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53. Oishi Y, Nagai S, Yoshida M, Fujisawa S, Sazawa A, Shinohara N, Nonomura K, Matsuno K, Shimizu C: Mutation analysis of the SDHB and SDHD genes in pheochromocytomas and paragangliomas: identification of a novel nonsense mutation (Q168X) in the SDHB gene. Endocr J; 2010;57(8):745-50
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  • [Title] Mutation analysis of the SDHB and SDHD genes in pheochromocytomas and paragangliomas: identification of a novel nonsense mutation (Q168X) in the SDHB gene.
  • The former is a tumor that occurs in only adrenal glands, and the latter can be found in the head and neck or in the thorax and abdomen.
  • A number of studies have reported that SDHB mutation-associated disease demonstrates a higher rate of malignancy.
  • However, all seven patients diagnosed with malignancy in this study did not have genetic mutation of SDHB and only one patient with no malignant sign had genetic mutation of SDHB.
  • Further accumulation of cases is necessary to confirm the association between SDHB mutation and malignant potential.
  • [MeSH-minor] Adolescent. Adrenal Gland Neoplasms / genetics. Adult. Aged. DNA Mutational Analysis. Female. Humans. Male. Middle Aged. Polymerase Chain Reaction. Polymorphism, Single Nucleotide. Sequence Analysis, DNA

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  • (PMID = 20505258.001).
  • [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] 0 / Codon, Nonsense; 0 / SDHD protein, human; EC 1.3.5.1 / SDHB protein, human; EC 1.3.99.1 / Succinate Dehydrogenase
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54. Gupta RT, Ho LM, Marin D, Boll DT, Barnhart HX, Nelson RC: Dual-energy CT for characterization of adrenal nodules: initial experience. AJR Am J Roentgenol; 2010 Jun;194(6):1479-83
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  • [Title] Dual-energy CT for characterization of adrenal nodules: initial experience.
  • OBJECTIVE: The purpose of this study was to determine whether use of dual-energy technique can improve the diagnostic performance of CT in the differential diagnosis of adrenal adenomas and metastatic lesions.
  • SUBJECTS AND METHODS: Thirty-one adrenal nodules were prospectively identified in 17 patients who underwent dual-energy CT at 140 and 80 kVp.
  • The mean attenuation change (increase or decrease) between 140 kVp and 80 kVp was determined for each adrenal nodule.
  • RESULTS: Twenty-six adrenal nodules were benign adenomas (attenuation less than +10 HU or stability for at least 1 year).
  • Five adrenal nodules were classified as metastatic (rapid growth in 1 year and history of extraadrenal malignancy).
  • With a decrease in attenuation at 80 kVp as an indicator of intracellular lipid within an adenoma, dual-energy CT has 50% sensitivity, 100% specificity, 100% positive predictive value, and 28% negative predictive value in the diagnosis of adenoma.
  • CONCLUSION: A decrease in attenuation of an adrenal lesion between 140 kVp and 80 kVp is a highly specific sign of adrenal adenoma.
  • These data suggest that dual-energy CT can be used to help differentiate some lipid-poor adrenal adenomas from metastatic lesions.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Adrenocortical Adenoma / radiography. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Aged. Diagnosis, Differential. Female. Humans. Male. Neoplasm Metastasis. Predictive Value of Tests. Prospective Studies. Radiographic Image Interpretation, Computer-Assisted. Sensitivity and Specificity

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  • (PMID = 20489086.001).
  • [ISSN] 1546-3141
  • [Journal-full-title] AJR. American journal of roentgenology
  • [ISO-abbreviation] AJR Am J Roentgenol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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55. Pecina-Slaus N, Nikuseva-Martic T, Gall-Troselj K, Radic K, Hrascan R: Replication error-positive samples found in pheochromocytomas. In Vivo; 2005 Mar-Apr;19(2):359-65
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  • Adenomatous polyposis coli, (APC) and E-cadherin (CDH1) tumor suppressor genes were investigated in human pheochromocytoma.
  • Detection of c-myc protein was performed using immunohistochemistry.
  • Immunohistochemistry showed increased levels of c-myc in comparison to normal adrenal tissue.
  • Increased expression of c-myc protein as well as allelic imbalances of APC and CDH 1 genes suggest that the wnt signalling pathway may have a role in this malignancy.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Cadherins / genetics. Genes, APC. Genomic Instability. Pheochromocytoma / genetics
  • [MeSH-minor] Adult. Aged. DNA, Neoplasm / genetics. Female. Humans. Loss of Heterozygosity. Male. Middle Aged. Proto-Oncogene Proteins c-myc / biosynthesis

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  • (PMID = 15796198.001).
  • [ISSN] 0258-851X
  • [Journal-full-title] In vivo (Athens, Greece)
  • [ISO-abbreviation] In Vivo
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Cadherins; 0 / DNA, Neoplasm; 0 / Proto-Oncogene Proteins c-myc
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56. Subramanian S, Goldstein DP, Parlea L, Thabane L, Ezzat S, Ibrahim-Zada I, Straus S, Brierley JD, Tsang RW, Gafni A, Rotstein L, Sawka AM: Second primary malignancy risk in thyroid cancer survivors: a systematic review and meta-analysis. Thyroid; 2007 Dec;17(12):1277-88
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  • [Title] Second primary malignancy risk in thyroid cancer survivors: a systematic review and meta-analysis.
  • OBJECTIVE: To determine the risk of second primary malignancies (SPMs) in thyroid cancer survivors.
  • DESIGN: We performed a systematic review and meta-analysis examining the standardized incidence ratios (SIRs) of SPMs in thyroid cancer survivors (compared to individuals without thyroid cancer).
  • The incidence of SPMs in thyroid cancer survivors was increased with an SIR of 1.20 (95% confidence interval 1.17, 1.24) (based on pooled data from six studies of 70,844 thyroid cancer survivors).
  • The SIR of the following SPMs was significantly increased: salivary gland, stomach, colon/colorectal, breast, prostate, kidney, brain/central nervous system, soft tissue sarcoma, non-Hodgkin's lymphoma, multiple myeloma, leukemia, bone/joints, and adrenal.
  • A significantly reduced risk of lung and cervical cancers was observed.
  • CONCLUSIONS: Thyroid cancer survivors are at increased risk of SPMs, which may be related to disease-specific treatments or genetic predisposition.
  • [MeSH-major] Neoplasms, Second Primary / epidemiology. Thyroid Neoplasms

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  • (PMID = 18020916.001).
  • [ISSN] 1050-7256
  • [Journal-full-title] Thyroid : official journal of the American Thyroid Association
  • [ISO-abbreviation] Thyroid
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 43
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57. Gazymov MM, Filipov DS: [Adrenal tumors: topical diagnosis and surgical outcomes]. Urologiia; 2005 Sep-Oct;(5):9-12
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  • [Title] [Adrenal tumors: topical diagnosis and surgical outcomes].
  • A total of 128 adrenalectomies were made for catechol-producing tumor (n = 69), mineralocorticism (n = 27), primary and metastatic adrenal cancer (n = 20), other tumors (n = 12).
  • The rest patients improved, i.e. their malignant hypertension converted to a benign one.
  • If cancer involves the upper segment of the kidney, the tumor often invades the adrenal.
  • Therefore, pre- and intraoperative search for adrenal tumor must be made.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery. Adrenalectomy. Hypertension / surgery

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  • (PMID = 16281831.001).
  • [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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58. Schalk E, Mohren M, Koenigsmann M, Buhtz P, Franke A, Jentsch-Ullrich K: Metastatic adrenal neuroblastoma in an adult. Onkologie; 2005 Jun;28(6-7):353-5
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  • [Title] Metastatic adrenal neuroblastoma in an adult.
  • BACKGROUND: Neuroblastoma (NB) is a common malignancy in children, but rarely occurs in adults.
  • In adults, abdomen/retroperitoneum are the primary sites and in children the adrenal gland.
  • Tumour resection revealed adrenal NB grade III.
  • The patient died 9 months after diagnosis.
  • Collection and evaluation of data in adult patients with this tumour are warranted in order to optimise treatment strategies.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Neuroblastoma / pathology. Neuroblastoma / secondary


59. Kazarian AM, Marangos IP, Røsok BI, Rosseland AR, Edwin B: [Laparoscopic resection of primary and metastatic malignant tumors of the adrenals]. Vestn Khir Im I I Grek; 2010;169(4):80-5
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  • [Title] [Laparoscopic resection of primary and metastatic malignant tumors of the adrenals].
  • An analysis was made of experience with treatment of 24 patients who underwent laparoscopic adrenalectomy for adrenocortical carcinomas (in 7 patients) and metastases in adrenals (in 17 cases).
  • Laparoscopic adrenalectomy was shown to be a safe and effective method of treatment of primary and metastatic tumors of the adrenals.
  • The method can replace open operative intervention in the majority of patients with metastases to adrenals and primary cancer of the adrenals.
  • [MeSH-major] Adrenal Cortex Neoplasms / secondary. Adrenal Cortex Neoplasms / surgery. Adrenalectomy / methods. Adrenocortical Carcinoma / secondary. Adrenocortical Carcinoma / surgery. Laparoscopy / methods

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  • (PMID = 20973194.001).
  • [ISSN] 0042-4625
  • [Journal-full-title] Vestnik khirurgii imeni I. I. Grekova
  • [ISO-abbreviation] Vestn. Khir. Im. I. I. Grek.
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Russia (Federation)
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60. Sporny S, Musiał J: [Markers of malignancy in pheochromocytomas]. Endokrynol Pol; 2005 Nov-Dec;56(6):946-51
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  • [Title] [Markers of malignancy in pheochromocytomas].
  • A pheochromocytoma is a neoplasm composed of cells which synthesize and release catecholamines.
  • The pathological picture of pheochromocytomas is varied and nothing but the presence of metastases can determine aggressiveness of this neoplasm.
  • Current studies try to look for other biological markers which can separate malignant tumors before they metastasize.
  • The detection of high expression of telomerase and hTERT and high proliferative activity, measured by immunohistochemistry with the MIB-1 antibody supports most strongly biological malignancy of pheochromocytoma.
  • [MeSH-major] Adrenal Gland Neoplasms / classification. Adrenal Gland Neoplasms / pathology. Biomarkers, Tumor. Pheochromocytoma / classification. Pheochromocytoma / pathology
  • [MeSH-minor] Antibodies, Antinuclear / analysis. Antibodies, Monoclonal / analysis. Catecholamines / analysis. Diagnosis, Differential. Humans. Hypertension / etiology. Neoplasm Metastasis / pathology. Neoplasm Staging. Telomerase / analysis

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  • (PMID = 16821216.001).
  • [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 / Antibodies, Antinuclear; 0 / Antibodies, Monoclonal; 0 / Biomarkers, Tumor; 0 / Catecholamines; 0 / MIB-1 antibody; EC 2.7.7.49 / Telomerase
  • [Number-of-references] 27
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61. Gourley C, Michie CO, Roxburgh P, Yap TA, Harden S, Paul J, Ragupathy K, Todd R, Petty R, Reed N, Hayward RL, Mitchell P, Rye T, Schellens JH, Lubinski J, Carmichael J, Kaye SB, Mackean M, Ferguson M: Increased incidence of visceral metastases in scottish patients with BRCA1/2-defective ovarian cancer: an extension of the ovarian BRCAness phenotype. J Clin Oncol; 2010 May 20;28(15):2505-11
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  • [Title] Increased incidence of visceral metastases in scottish patients with BRCA1/2-defective ovarian cancer: an extension of the ovarian BRCAness phenotype.
  • PURPOSE: To compare the frequency of visceral relapse of BRCA1/2-deficient ovarian cancer to that of nonhereditary controls.
  • PATIENTS AND METHODS: All patients diagnosed in Scotland with epithelial ovarian cancer (EOC) or primary peritoneal cancer (PPC) and a germline BRCA1/2 mutation were identified.
  • Those with previous malignancy were excluded.
  • Fifteen had inadequate clinical data, two had carcinosarcoma, 27 had previous breast cancer, and 16 were in remission.
  • CONCLUSION: Although sporadic EOC commonly remains confined to the peritoneum, BRCA1/2-deficient ovarian cancer frequently metastasizes to viscera.
  • These data extend the ovarian BRCAness phenotype, imply BRCA1/2-deficient ovarian cancer is biologically distinct, and suggest that patients with visceral metastases should be considered for BRCA1/2 sequencing.
  • [MeSH-major] Genes, BRCA1. Genes, BRCA2. Germ-Line Mutation. Ovarian Neoplasms / genetics. Ovarian Neoplasms / pathology
  • [MeSH-minor] Adrenal Gland Neoplasms / genetics. Adrenal Gland Neoplasms / secondary. Adult. Aged. Aged, 80 and over. Brain Neoplasms / genetics. Brain Neoplasms / secondary. Female. Genetic Predisposition to Disease. Humans. Incidence. Liver Neoplasms / genetics. Liver Neoplasms / secondary. Lung Neoplasms / genetics. Lung Neoplasms / secondary. Middle Aged. Neoplasm Metastasis. Pancreatic Neoplasms / genetics. Pancreatic Neoplasms / secondary. Phenotype. Scotland. Splenic Neoplasms / genetics. Splenic Neoplasms / secondary

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  • (PMID = 20406939.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United Kingdom / Cancer Research UK / / ; United Kingdom / Chief Scientist Office / /
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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62. Jhala NC, Eltoum IA, Eloubeidi MA, Meara R, Chhieng DC, Crowe DR, Jhala D: Providing on-site diagnosis of malignancy on endoscopic-ultrasound-guided fine-needle aspirates: should it be done? Ann Diagn Pathol; 2007 Jun;11(3):176-81
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  • [Title] Providing on-site diagnosis of malignancy on endoscopic-ultrasound-guided fine-needle aspirates: should it be done?
  • BACKGROUND: Rapid and accurate tissue diagnosis for a deep-seated malignancy would allow treating physicians to provide disease-specific interventions and help patients make early informed management decisions.
  • Providing on-site tissue diagnosis for fine-needle aspirate samples obtained with endosonography would help develop such efficient patient management issues.
  • Here we report our experience of prospectively providing on-site diagnosis on 485 endoscopic ultrasound fine-needle aspirate samples.
  • METHODS: Four hundred eighty-five endoscopic ultrasound fine-needle aspirates from the pancreas (n= 305), lymph nodes (n = 91), biliary tree (n = 47), liver (n = 15), gastrointestinal tract (n = 19), and adrenal gland (n = 8) were reviewed.
  • For all aspirates, the cytologic diagnoses, both preliminary and final, were categorized into the following: positive for malignancy, positive for neoplastic process, suspicious for malignancy, atypical cells, reactive process, and nondiagnostic.
  • RESULTS: Of the 485 cases, 163 (33.6%) were diagnosed as benign, 43 (8.8%) as atypical, 21 (4.3%) as suspicious, 18 (3.7%) as positive for neoplasm, and 230 (47.4%) as malignant after final cytologic interpretation.
  • A significantly (P < .001) higher degree of concordance was noted for unequivocal diagnosis of malignancy (196/198, 98.9%) vs nonmalignancy (200/250, 67.2%) between on-site and final cytologic diagnosis.
  • Of the 52 discordant cases, 12 (2.6%) diagnoses were downgraded and 40 (8.9%) were upgraded from preliminary on-site diagnosis.
  • Our overall sensitivity (87 vs 92), specificity (95% vs 100%), and accuracy (90% vs 94%) improved for final cytologic diagnosis.
  • CONCLUSION: On-site diagnosis of malignancy could be used to initiate informed patient management decisions.
  • Cases where a diagnosis of malignancy is not rendered at on-site interpretation need further cytologic evaluation.
  • [MeSH-major] Biopsy, Fine-Needle / methods. Endosonography / methods. Neoplasms / diagnosis
  • [MeSH-minor] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / pathology. Adult. Aged. Aged, 80 and over. Gastrointestinal Neoplasms / diagnosis. Gastrointestinal Neoplasms / pathology. Humans. Liver Neoplasms / diagnosis. Liver Neoplasms / pathology. Middle Aged. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / pathology. Retrospective Studies. Sensitivity and Specificity

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  • (PMID = 17498591.001).
  • [ISSN] 1092-9134
  • [Journal-full-title] Annals of diagnostic pathology
  • [ISO-abbreviation] Ann Diagn Pathol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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63. Powari M, Rajesh L, Joshi K: Clinically unsuspected bilateral malignant pheochromocytoma. Indian J Pathol Microbiol; 2007 Apr;50(2):313-4
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  • [Title] Clinically unsuspected bilateral malignant pheochromocytoma.
  • Pheochromocytoma is an uncommon tumor and occurrence of bilateral malignant tumor is extremely rare.
  • Herein we describe one such case ofbilateral malignant pheochromocytoma, which was clinically silent except for pain and mass in hypochondrium.
  • Histopathology showed features of malignancy along with hyaline globules, which are less described with malignant tumors.
  • Electron microscopy showed neurosecretory granules in tumor cells.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Neoplasms, Multiple Primary / pathology. Pheochromocytoma / pathology


64. Schteingart DE: Adjuvant mitotane therapy of adrenal cancer - use and controversy. N Engl J Med; 2007 Jun 7;356(23):2415-8
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  • [Title] Adjuvant mitotane therapy of adrenal cancer - use and controversy.
  • [MeSH-major] Adrenal Cortex Neoplasms / drug therapy. Adrenocortical Carcinoma / drug therapy. Antineoplastic Agents, Hormonal / therapeutic use. Mitotane / therapeutic use

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  • [CommentIn] N Engl J Med. 2007 Sep 20;357(12):1257-8; author reply 1259 [17891838.001]
  • [CommentOn] N Engl J Med. 2007 Jun 7;356(23):2372-80 [17554118.001]
  • (PMID = 17554125.001).
  • [ISSN] 1533-4406
  • [Journal-full-title] The New England journal of medicine
  • [ISO-abbreviation] N. Engl. J. Med.
  • [Language] eng
  • [Publication-type] Comment; Editorial
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 78E4J5IB5J / Mitotane
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65. Bouaziz H, Kaffel N, Charfi N, Fourati M, Abid H, Abid M: [Panhypopituitarism revealing metastasis of small-cell lung carcinoma associated with sarcoidosis]. Ann Endocrinol (Paris); 2006 Jun;67(3):259-64
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  • A 49 year-old smoking patient with type 2 diabetes was admitted for acute adrenal failure with polyuria polydipsia syndrome and a pituitary tumor syndrome.
  • The thoraco-abdominal scan demonstrated a mass in the left lung highly suggestive of malignancy and many enlarged mediastinal nodes, hepatic nodules, and hypertrophy of the left adrenal.
  • The diagnosis of sarcoidosis was incompatible with the deterioration of the patient's general status.
  • Subsequent radiographic explorations showed an increase in the size of the tumor mass and histological evaluation of a scan-guided trans-thoracic biopsy demonstrated small-cell carcinoma.
  • Small-cell lung carcinoma is the most common cancer with pituitary metastasis.
  • The proposed link between sarcoidosis and malignancy has remained controversial but has not been proven false.
  • [MeSH-major] Carcinoma, Small Cell / pathology. Hypopituitarism / etiology. Lung Neoplasms / pathology. Pituitary Neoplasms / secondary. Sarcoidosis / etiology
  • [MeSH-minor] Adrenal Gland Diseases / etiology. Bronchial Neoplasms / secondary. Bronchoscopy. Diabetes Complications / pathology. Diabetes Mellitus, Type 2 / pathology. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Smoking. Tomography, X-Ray Computed


66. Imataki O, Makimoto A, Kojima R, Sakiyama M, Hosono A, Takaue Y: Intensive multimodality therapy including paclitaxel and reduced-intensity allogeneic hematopoietic stem cell transplantation in the treatment of adrenal cancer with multiple metastases. Int J Clin Oncol; 2006 Apr;11(2):156-8
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  • [Title] Intensive multimodality therapy including paclitaxel and reduced-intensity allogeneic hematopoietic stem cell transplantation in the treatment of adrenal cancer with multiple metastases.
  • Adrenocortical carcinoma is a rare malignancy in adolescents and young adults.
  • The prognosis of unresectable/metastatic adrenocortical carcinoma remains very poor because the rarity of the tumor has made it difficult to establish treatment guidelines, and diagnosis and the resultant treatment can be greatly delayed.
  • We treated a 24-year-old woman who was diagnosed with adrenocortical carcinoma of the right adrenal gland which extended to the inferior vena cava.
  • Although she underwent surgical resection of the extensive tumor as the primary treatment, the disease recurred in the lung and liver as multiple metastases shortly after surgery.
  • Although this experience is limited, we suggest that TIP chemotherapy was effective for adrenocortical carcinoma, and a graft-versus-tumor effect after reduced-intensity stem cell transplantation may have contributed to the prolonged survival.
  • [MeSH-major] Adrenal Gland Neoplasms / therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hematopoietic Stem Cell Transplantation. Liver Neoplasms / therapy. Lung Neoplasms / therapy


67. Anouar Y, Yon L, Guillemot J, Thouennon E, Barbier L, Gimenez-Roqueplo AP, Bertherat J, Lefebvre H, Klein M, Muresan M, Grouzmann E, Plouin PF, Vaudry H, Elkahloun AG: Development of novel tools for the diagnosis and prognosis of pheochromocytoma using peptide marker immunoassay and gene expression profiling approaches. Ann N Y Acad Sci; 2006 Aug;1073:533-40
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  • [Title] Development of novel tools for the diagnosis and prognosis of pheochromocytoma using peptide marker immunoassay and gene expression profiling approaches.
  • Pheochromocytomas (PHEOs) are rare catecholamine-producing neoplasias that arise from chromaffin cells of the adrenal medulla or from extra-adrenal locations.
  • These neuroendocrine tumors are usually benign, but may also present as or develop into a malignancy.
  • There are currently no means to predict or to cure malignant tumors which have a poor prognosis.
  • We have recently validated several assays for the measurement of peptides derived from chromogranin A (CgA) and secretogranin II (SgII) in order to determine whether these secreted neuroendocrine products could provide useful, complementary markers for the diagnosis and prognosis of PHEOs.
  • Both the CgA-derived peptide WE14 and the SgII-derived peptide EM66 proved to be sensitive circulating markers for the diagnosis of PHEO.
  • In addition, much higher EM66 levels were measured in benign than in malignant tumoral tissues, suggesting that this peptide could represent a valuable tool for the prognosis of PHEO.
  • We have also initiated a comparative microarray study of benign and malignant PHEOs, which allowed the identification of a set of about 100 genes that were differentially expressed and best discriminated the two types of tumors.
  • A large majority of these genes were expressed at lower levels in the malignant disease and were associated with various characteristics of chromaffin cells, such as hormone secretion signaling and machinery, peptide maturation, and cellular morphology.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Gene Expression Profiling. Pheochromocytoma / genetics


68. Sfaxi M, Bouzouita A, Bouasker I, Kourda N, Ben Slama MR, Ben Jilani Baltaji S, Chebil M: [Primary bilateral adrenal T-cell lymphoma. A case report rarer than B-cell lymphoma]. Ann Endocrinol (Paris); 2008 Jun;69(3):249-53
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  • [Title] [Primary bilateral adrenal T-cell lymphoma. A case report rarer than B-cell lymphoma].
  • [Transliterated title] Lymphome surrénalien primitif bilatéral de phénotype T. Un cas clinique beaucoup plus rare que le lymphome B.
  • Primary adrenal lymphoma is a rare condition.
  • Adrenal lymphoma is often bilateral and in most of the cases of B-cell type.
  • The prognosis is bad and patient can die early because of acute adrenal insufficiency.
  • We report a case of a 70-year-old man who was admitted for acute adrenal insufficiency due to primary bilateral adrenal T-cell lymphoma.
  • Clinical features and imaging are not specific. (18)F-FDG PET Scan is an excellent mean to detect malignant tumor of adrenal gland.
  • [MeSH-major] Adrenal Gland Neoplasms / radionuclide imaging. Lymphoma, T-Cell / radionuclide imaging

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  • (PMID = 18455145.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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69. Kilickesmez O, Inci E, Atilla S, Tasdelen N, Yetimoğlu B, Yencilek F, Gurmen N: Diffusion-weighted imaging of the renal and adrenal lesions. J Comput Assist Tomogr; 2009 Nov-Dec;33(6):828-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diffusion-weighted imaging of the renal and adrenal lesions.
  • OBJECTIVES: The purpose of this study was to calculate the apparent diffusion coefficient (ADC) values of different renal and adrenal lesions to evaluate the ability of diffusion-weighted imaging in characterizing masses and determining malignancy.
  • METHODS: A total of 52 patients consisting of 67 renal lesions and 28 patients with 33 adrenal lesions in addition to 50 healthy controls with normal kidneys were enrolled in the study.
  • Diffusion-weighted imaging was performed with b factors of 0, 500, and 1000 s/mm2, and the ADCs of the normal kidney and renal and adrenal lesions were calculated.
  • RESULTS: The mean (SD) ADCs of the renal cortex and medulla of the control group were 2.08 (0.22) x 10(-3) and 1.94 (0.18) x 10(-3) mm2/s, respectively.
  • Focal renal lesions were as follows: simple cysts (2.94 [0.20] x 10(-3) mm2/s), hemorrhagic cysts (1.71 [0.38] x 10(-3) mm2/s), angiomyolipomas (1.40 [0.21] x 10(-3) mm2/s), renal cell carcinomas (1.06 [0.39] x 10(-3) mm2/s), metastases (1.50 [0.13] x 10(-3) mm2/s), and hydronephrosis (1.54 [0.25] x 10(-3) mm2/s).
  • Diffusion-weighted imaging was also able to differentiate angiomyolipomas and hemorrhagic cysts from renal cell carcinomas.
  • Adrenal lesions were subgrouped as adenomas (1.41 [0.27] x M10(-3) mm2/s), nonadenomatous solid masses (1.08 [0.28] x 10(-3) mm2/s), and cysts (2.82 [0.24] x 10(-3) mm2/s).
  • CONCLUSIONS: Our findings show that ADC measurement has a potential ability to differentiate benign and malignant focal renal and adrenal lesions with the guidance of conventional sequences.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Diffusion Magnetic Resonance Imaging / methods. Kidney Neoplasms / diagnosis
  • [MeSH-minor] Case-Control Studies. Contrast Media. Diagnosis, Differential. Female. Gadolinium DTPA. Humans. Image Interpretation, Computer-Assisted. Male. Middle Aged. Statistics, Nonparametric

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  • (PMID = 19940645.001).
  • [ISSN] 1532-3145
  • [Journal-full-title] Journal of computer assisted tomography
  • [ISO-abbreviation] J Comput Assist Tomogr
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media; K2I13DR72L / Gadolinium DTPA
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70. Vega Vega A, Canga Presa JM, Sanz de la Morena P, de la Cruz Vigo JL: [Laparoscopic adrenalectomy in adrenal carcinoma]. Actas Urol Esp; 2005 Mar;29(3):277-80
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  • [Title] [Laparoscopic adrenalectomy in adrenal carcinoma].
  • [Transliterated title] Adrenalectomía laparoscópica por patología maligna.
  • There is general agreement on the suitability of the laparoscopic approach for benign adrenal lesions against open procedures because of the efficacy and less morbidity.
  • For suspected adrenal malignancies laparoscopic use is controversial.
  • We report our experience in 6 cases of laparoscopic adrenalectomy in patients with the suspicion of adrenal malignancy confined in the gland.
  • We concluded that in a suspected adrenal malignancy organ confined laparoscopic adrenalectomy presents the advantage compared with open surgery of reduced morbidity and similar results in the follow up of the patient.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy

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  • (PMID = 15945253.001).
  • [ISSN] 0210-4806
  • [Journal-full-title] Actas urologicas espanolas
  • [ISO-abbreviation] Actas Urol Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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71. Liang YY, Dai YP, Cao MX, Zheng KL: [Diagnosis and therapy of metastatic tumors in the adrenal gland--a report of 21 cases]. Ai Zheng; 2006 Oct;25(10):1275-8
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  • [Title] [Diagnosis and therapy of metastatic tumors in the adrenal gland--a report of 21 cases].
  • BACKGROUND & OBJECTIVE: Recently, the occurrence of metastasis to the adrenal gland is increasing, while the early and differentiated diagnosis still remains difficult.
  • Whether metastasis to the adrenal gland needs to be resected and when and how the resection should be done are controversial.
  • This study was to explore the surgical indications of metastasis to the adrenal gland and the role of laparoscopic adrenalectomy in the treatment of this disease.
  • METHODS: Clinical data of 21 patients with metastatic tumors in the adrenal gland, treated in Cancer Center of Sun Yat-sen University from Mar.
  • Literature of the diagnosis and therapy was reviewed.
  • RESULTS: The diagnosis rates of ultrasonography and spiral or thin-cut computed tomography (CT) were 70.0% (7/10) and 84.6% (11/13).
  • CONCLUSIONS: Ultrasonography and CT are important diagnosis methods for metastatic adrenal cancer.
  • No evidence of tumor invasion revealed by preoperative imaging studies, no adjacent lymphadenopathy and no extraladrenal metastasis are indications of adrenalectomy.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenal Gland Neoplasms / ultrasonography. Adrenalectomy / methods. Laparoscopy

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  • (PMID = 17059775.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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72. Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R: Metastatic tumours to the oral cavity - pathogenesis and analysis of 673 cases. Oral Oncol; 2008 Aug;44(8):743-52
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  • The oral region is an uncommon site for metastatic tumour cell colonization and is usually evidence of a wide spread disease.
  • In 25% of cases, oral metastases were found to be the first sign of the metastatic spread and in 23% it was the first indication of an undiscovered malignancy at a distant site.
  • The primary site differs according to oral site colonization, in men the lung was the most common primary site affecting both the jawbones and oral mucosa (22% and 31.3%, respectively) followed by the prostate gland in the jawbones (11%) and kidney in the oral soft tissues (14%).
  • In women, the breast was the most common primary tumour affecting the jawbones and soft tissues (41% and 24.3%, respectively), followed by the adrenal and female genital organs (FGO) in the jawbones (7.7%) and FGO in the soft tissues (14.8%).
  • Because of its rarity, the diagnosis of a metastatic lesion in the oral region is challenging, both to the clinician and to the pathologist, in recognizing that a lesion is metastatic and in determining the site of origin.
  • The clinical presentation of a metastatic lesion in the oral cavity can be deceiving leading to a misdiagnosis of a benign process, therefore, in any case where the clinical presentation is unusual especially in patients with a known malignant disease a biopsy is mandatory.
  • [MeSH-major] Carcinoma / secondary. Jaw Neoplasms / secondary. Mouth Neoplasms / secondary
  • [MeSH-minor] Adult. Case-Control Studies. Combined Modality Therapy. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Sex Factors

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  • (PMID = 18061527.001).
  • [ISSN] 1368-8375
  • [Journal-full-title] Oral oncology
  • [ISO-abbreviation] Oral Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 150
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73. Cestari A, Naspro R, Rigatti P, Guazzoni G: Laparoscopic adrenalectomy and adrenal-preserving surgery. Curr Opin Urol; 2005 Mar;15(2):69-74
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  • [Title] Laparoscopic adrenalectomy and adrenal-preserving surgery.
  • PURPOSE OF REVIEW: The aim of this paper is to define the current role of laparoscopy in the management of surgical adrenal diseases evaluating the surgical aspects, the indications and contraindications of laparoscopic adrenalectomy, focusing also on the most innovative tendencies in the laparoscopic adrenal-preserving surgery.
  • The present review mainly focuses on defining the state of the art of current adrenal laparoscopic surgery.
  • SUMMARY: Laparoscopic adrenalectomy is becoming the 'platinum standard' for the treatment of the adrenal surgical diseases and it should be considered the treatment of choice for benign adrenal diseases.
  • In cases of malignancy and conservative surgery, adrenalectomy appears to be very promising, although a longer follow up and further studies are still needed to accurately assess the role played by these procedures.
  • Every patient who requires the ablation of the adrenal should receive laparoscopic opportunity.
  • Only those with advanced laparoscopic skills and a good knowledge of adrenal anatomy and pathophysiology will obtain the same excellent results currently reported in the literature.
  • [MeSH-major] Adrenal Gland Diseases / surgery. Adrenalectomy / methods. Laparoscopy / methods
  • [MeSH-minor] Adrenal Gland Neoplasms / surgery. Humans. Patient Selection

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  • (PMID = 15725927.001).
  • [ISSN] 0963-0643
  • [Journal-full-title] Current opinion in urology
  • [ISO-abbreviation] Curr Opin Urol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 37
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74. Wilhelm SM, Prinz RA, Barbu AM, Onders RP, Solorzano CC: Analysis of large versus small pheochromocytomas: operative approaches and patient outcomes. Surgery; 2006 Oct;140(4):553-9; discussion 559-60
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  • However, its application to pheochromocytomas larger than 6 cm is questioned due to concerns of malignancy and case complexity.
  • Our aim was to examine the impact of pheochromocytoma tumor size (>/=6 cm vs <6 cm) on operative approach and postoperative patient outcomes.
  • We examined patient and tumor demographics, pathologic diagnosis, operative approach (laparoscopic vs open), postoperative complications, and biochemical cure rates.
  • For the large tumors, 1 out of 25 (4%) was malignant, whereas no small tumors were malignant.
  • There was no statistically significant increased risk of malignancy in tumors >/=6 cm in size (P = .31).
  • Tumor recurrence was noted in 1 patient with a tumor <6 cm.
  • This study demonstrates that there is no significant difference in the rate of malignancy for pheochromocytomas >/=6 cm versus <6 cm.
  • There also were no significant differences identified in complication rates, postoperative biochemical cures, or tumor recurrence rates between these groups.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Pheochromocytoma / pathology. Pheochromocytoma / surgery

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  • (PMID = 17011902.001).
  • [ISSN] 0039-6060
  • [Journal-full-title] Surgery
  • [ISO-abbreviation] Surgery
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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75. Amar L, Baudin E, Burnichon N, Peyrard S, Silvera S, Bertherat J, Bertagna X, Schlumberger M, Jeunemaitre X, Gimenez-Roqueplo AP, Plouin PF: Succinate dehydrogenase B gene mutations predict survival in patients with malignant pheochromocytomas or paragangliomas. J Clin Endocrinol Metab; 2007 Oct;92(10):3822-8
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  • [Title] Succinate dehydrogenase B gene mutations predict survival in patients with malignant pheochromocytomas or paragangliomas.
  • CONTEXT: Pheochromocytomas and paragangliomas may be malignant either at presentation or during recurrence, but the clinical course of malignant tumors is unpredictable.
  • OBJECTIVE: The objective was to analyze survival according to clinical characteristics at diagnosis of malignancy and the presence or absence of SDHB mutations.
  • SETTING AND PARTICIPANTS: A total of 54 patients with malignant tumors were included.
  • Malignancy was scored according to the presence of metastases or histologically documented lymph node invasion.
  • MAIN OUTCOME MEASURES: The main outcome was the specific survival after the diagnosis of the first metastasis.
  • Patients were followed up from the diagnosis of primary tumor and from the diagnosis of the first metastasis to the present or to death with medians of 79 [interquartile range (IQR) 24; 190] and 39 [IQR 14; 94] months, respectively.
  • The 5-yr probability of survival after the diagnosis of the first metastasis was 0.55 (95% confidence interval 0.39-0.69).
  • Patients with SDHB mutations were younger, more frequently had extra-adrenal tumors, and had a shorter metanephrine excretion doubling time.
  • CONCLUSION: SDHB mutations, frequent in patients with malignant pheochromocytomas or paragangliomas, are associated with shorter survival.
  • Therefore, SDHB genetic testing may be of prognostic value for such patients, even those with an apparent sporadic and/or benign presentation at diagnosis.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Iron-Sulfur Proteins / genetics. Paraganglioma / genetics. Pheochromocytoma / genetics. Succinate Dehydrogenase / genetics

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  • (PMID = 17652212.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Iron-Sulfur Proteins; EC 1.3.5.1 / SDHB protein, human; EC 1.3.99.1 / Succinate Dehydrogenase
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76. Gervais DA, Kalva S, Thabet A: Percutaneous image-guided therapy of intra-abdominal malignancy: imaging evaluation of treatment response. Abdom Imaging; 2009 Sep-Oct;34(5):593-609
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  • [Title] Percutaneous image-guided therapy of intra-abdominal malignancy: imaging evaluation of treatment response.
  • The rising incidence of abdominal malignancies such as hepatocellular carcinoma (HCC) and renal cell carcinoma presents several challenges.
  • Imaging findings of treatment-induced tumor necrosis, viable tumor, complications, and, in particular, benign ancillary findings that may be confused with viable tumor are reviewed, as manifested on computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET).
  • [MeSH-major] Adrenal Gland Neoplasms / therapy. Carcinoma, Hepatocellular / therapy. Carcinoma, Renal Cell / therapy. Diagnostic Imaging. Kidney Neoplasms / therapy. Liver Neoplasms / therapy
  • [MeSH-minor] Catheter Ablation / methods. Contrast Media. Embolization, Therapeutic / methods. Humans. Lymphatic Metastasis. Postoperative Complications / diagnosis. Treatment Outcome


77. Advani A, Johnson SJ, Nicol MR, Papacleovoulou G, Evans DB, Vaikkakara S, Mason JI, Quinton R: Adult-onset hypogonadotropic hypogonadism caused by aberrant expression of aromatase in an adrenocortical adenocarcinoma. Endocr J; 2010;57(7):651-6
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  • Estrogen-secreting adrenal cancers are extremely rare, with feminizing symptoms attributed to aromatase expression in the adrenal tumor.
  • A right adrenal mass was identified on CT scanning and the patient underwent an open adrenalectomy.
  • Immunohistochemistry of the adrenal cancer confirmed aberrant expression of aromatase in most, although not all, carcinoma cells.
  • Transcripts associated with utilization of promoters II, I.1 and I.3 were prominently represented in the tumor aromatase mRNA.
  • This case highlights that clinical features of feminizing adrenocortical carcinomas can be secondary to estrogen production by aberrantly transcribed and translated aromatase within the tumor.
  • The diagnosis of adrenocortical adenocarcinoma should be considered in men presenting with low testosterone and gonadotropins, particularly in the presence of feminizing features.
  • [MeSH-major] Adenocarcinoma / genetics. Adrenal Cortex Neoplasms / genetics. Aromatase / genetics. Hypogonadism / genetics

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  • (PMID = 20467160.001).
  • [ISSN] 1348-4540
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] EC 1.14.14.1 / Aromatase
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78. McHugh K: Renal and adrenal tumours in children. Cancer Imaging; 2007;7:41-51
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  • [Title] Renal and adrenal tumours in children.
  • The differential diagnosis of renal and supra-renal masses firstly depends on the age of the child.
  • Neuroblastoma (NBL) may be seen antenatally or in the newborn period; this tumour has a good prognosis unlike NBL seen in older children (particularly NBL in those aged 2-4 years).
  • Benign renal masses predominate in early infancy but beyond the first year of life Wilms' tumour is the most common renal malignancy, until adolescence when renal cell carcinoma has similar or increased frequency as children get older.
  • Adrenal adenomas and carcinomas also occur in childhood; these tumours are indistinguishable on imaging but criteria for the diagnosis of adrenal carcinoma include size larger than 5 cm, a tendency to invade the inferior vena cava and to metastasise.
  • The most topical dilemmas in the radiological assessment of renal and adrenal tumours are presented.
  • Topics covered include a proposed revision to the staging of NBL, the problems inherent in distinguishing nephrogenic rests from Wilms' tumour and the current recently altered approach regarding small lung nodules in children with Wilms' tumour.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Diagnostic Imaging / methods. Kidney Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Age of Onset. Carcinoma, Renal Cell / diagnosis. Carcinoma, Renal Cell / epidemiology. Child. Child, Preschool. Diagnosis, Differential. Ganglioneuroblastoma / diagnosis. Ganglioneuroblastoma / epidemiology. Ganglioneuroblastoma / pathology. Humans. Infant. Infant, Newborn. Lung Neoplasms / radiography. Lung Neoplasms / secondary. Magnetic Resonance Imaging. Mass Screening. Neoplasm Staging. Neuroblastoma / diagnosis. Neuroblastoma / epidemiology. Neuroblastoma / pathology. Neuroblastoma / secondary. Neuroblastoma / therapy. Pheochromocytoma / diagnosis. Pheochromocytoma / epidemiology. Positron-Emission Tomography. Tomography, X-Ray Computed. Wilms Tumor / diagnosis. Wilms Tumor / epidemiology. Wilms Tumor / pathology. Wilms Tumor / therapy

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  • (PMID = 17339140.001).
  • [ISSN] 1470-7330
  • [Journal-full-title] Cancer imaging : the official publication of the International Cancer Imaging Society
  • [ISO-abbreviation] Cancer Imaging
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 19
  • [Other-IDs] NLM/ PMC1828369
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79. Kajor M, Ziaja J, Lange D, Król R, Ciupińska-Kajor M, Turska-d'Amico M, Maka B, Cierpka L: [Analysis of morphology of adrenal pheochromocytoma as regards their potential malignancy]. Endokrynol Pol; 2005 Nov-Dec;56(6):911-6
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  • [Title] [Analysis of morphology of adrenal pheochromocytoma as regards their potential malignancy].
  • BACKGROUND: Adrenal pheochromocytoma are diagnosed the most often in patients with arterial hypertension or with thyroid medullar cancer and suspicion of MEN II syndromes.
  • The aim of the study is to analyse the morphology of pheochromocytomas on the basis of Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) in order to estimate their potential malignancy.
  • The diagnosis of pheochromocytoma was establish before surgery in 87.5%.
  • 12.5% of patients were referred to surgery on the basis of tumour diameter (range 70 to 102 mm).
  • In 1 cases malignant form of pheochromocytoma was diagnosed on the basis of lymph nodes metastases.
  • Among 35 patients operated on more than 12 months ago 2 patients died: 1 patient with malignant pheochromocytoma (PASS=8 points) and 1 patient with MEN IIA syndrome (due to disseminated thyroid medullar cancer).
  • CONCLUSION: Analysis of pheochromocytoma in PASS is only of rough character and does not allow for clear-cut histological diagnosis of benign and malignant tumours.
  • The only unquestionable criterion of pheochromocytoma's malignancy remain metastases.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Pheochromocytoma / pathology. Pheochromocytoma / secondary
  • [MeSH-minor] Adult. Biomarkers, Tumor / analysis. Diagnosis, Differential. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Multiple Endocrine Neoplasia Type 2a / pathology. Neoplasm Staging. Thyroid Neoplasms / pathology

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  • (PMID = 16821210.001).
  • [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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80. Li FY, Ren XB, Xu EP, Huang Q, Sheng HQ, Lv BJ, Lai MD: RegIV expression showing specificity to gastrointestinal tract and its potential role in diagnosing digestive tract neuroendocrine tumor. J Zhejiang Univ Sci B; 2010 Apr;11(4):258-66
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  • [Title] RegIV expression showing specificity to gastrointestinal tract and its potential role in diagnosing digestive tract neuroendocrine tumor.
  • Regenerating gene IV (RegIV), a member of the regenerating gene family discovered in 2001, has been found to be involved in malignancy in several different organs including the stomach, colorectum, pancreas and prostate, but the overall expression profile of RegIV has not been reported.
  • To learn more about RegIV, we evaluated its distribution by immunohistochemistry (IHC) in a total of 360 samples including 24 types of normal tissue, 40 benign and malignant lesions, and 18 neuroendocrine tumors.
  • We found that in normal tissues, in addition to its relative specificity for the gastrointestinal tract, RegIV was detected in the adrenal gland and mammary gland.
  • Studies on additional sets of colorectal tumor samples showed that RegIV expression was predominant in colorectal adenoma (87.5%) and peritumoral tissue (100%) but not in cancer tissue (30.8%).
  • [MeSH-major] Adenocarcinoma / metabolism. Biomarkers, Tumor / metabolism. Gastrointestinal Tract / metabolism. Gene Expression Regulation, Enzymologic. Gene Expression Regulation, Neoplastic. Lectins, C-Type / biosynthesis. Neuroendocrine Tumors / metabolism

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  • (PMID = 20349522.001).
  • [ISSN] 1862-1783
  • [Journal-full-title] Journal of Zhejiang University. Science. B
  • [ISO-abbreviation] J Zhejiang Univ Sci B
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Lectins, C-Type; 0 / REG4 protein, human
  • [Other-IDs] NLM/ PMC2852542
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81. Lutgers HL, Vergragt J, Dong PV, de Vries J, Dullaart RP, van den Berg G, Ligtenberg JJ: Severe hypercortisolism: a medical emergency requiring urgent intervention. Crit Care Med; 2010 Jul;38(7):1598-601
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  • INTERVENTIONS: Etomidate was infused continuously to reduce endogenous adrenal cortisol secretion.
  • Plasma adrenocorticotropic hormone markedly decreased immediately after resection of the right adrenal gland.
  • Histopathological examination revealed a tumor of the right adrenal gland identified as a pheochromocytoma and hyperplasia of the left adrenal gland, but no signs of malignancy.
  • [MeSH-minor] Adrenal Gland Neoplasms / complications. Adrenalectomy. Adrenocorticotropic Hormone / blood. Colon, Sigmoid. Etomidate / therapeutic use. Female. Humans. Hydrocortisone / blood. Intensive Care Units. Intestinal Perforation / complications. Middle Aged. Multiple Organ Failure / etiology. Pheochromocytoma / complications. Sigmoid Diseases / complications

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  • (PMID = 20495451.001).
  • [ISSN] 1530-0293
  • [Journal-full-title] Critical care medicine
  • [ISO-abbreviation] Crit. Care Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone; Z22628B598 / Etomidate
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82. Boland GW, Blake MA, Holalkere NS, Hahn PF: PET/CT for the characterization of adrenal masses in patients with cancer: qualitative versus quantitative accuracy in 150 consecutive patients. AJR Am J Roentgenol; 2009 Apr;192(4):956-62
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  • [Title] PET/CT for the characterization of adrenal masses in patients with cancer: qualitative versus quantitative accuracy in 150 consecutive patients.
  • OBJECTIVE: The objective of our study was to evaluate a large cohort of patients with PET/CT to determine whether qualitative (visual) assessment, quantitative standardized uptake value (SUV), or standardized uptake ratio (SUR) techniques should be used when attempting to characterize adrenal masses in patients with cancer.
  • MATERIALS AND METHODS: The study group was composed of 150 consecutive patients (78 men, 72 women; mean age, 60 years; range, 24-88 years) with documented adrenal lesions.
  • All patients were known to have an underlying primary malignancy and were referred for PET/CT to evaluate the underlying primary and metastatic tumor burden.
  • Definitive lesion characterization was determined by evaluating all histologic adrenal specimens and all relevant prior and follow-up CT scans, including unenhanced, contrast-enhanced, and delayed contrast-enhanced washout studies.
  • All 26 malignant lesions were characterized by PET: All showed qualitative and quantitative signal intensity greater than the liver.
  • By combining unenhanced and qualitative CT data with the retrospective PET data, the analysis yielded a sensitivity of 100% for the detection of malignancy, a specificity of 99%, a positive predictive value (PPV) of 93%, a negative predictive value (NPV) of 100%, and an accuracy of 99% (Table 1).
  • CONCLUSION: PET/CT is a highly accurate method for differentiating benign from malignant adrenal masses particularly when using qualitative, rather than quantitative, PET data.
  • Occasional benign lesions do show mild to moderate increased FDG uptake compared with that of the liver and may mimic some malignant lesions.
  • Without evidence that these lesions are benign by unenhanced CT densitometry or adrenal mass stability or growth from previous CT scans, we recommend that these lesions be characterized using contrast-enhanced washout tests and that if those tests are inconclusive, using percutaneous biopsy if early lesion characterization is mandatory.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Adrenal Gland Neoplasms / radionuclide imaging. Positron-Emission Tomography / methods. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Contrast Media. Diagnosis, Differential. Female. Fluorodeoxyglucose F18. Humans. Image Interpretation, Computer-Assisted. Male. Middle Aged. Radiopharmaceuticals. Retrospective Studies. Sensitivity and Specificity

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  • (PMID = 19304700.001).
  • [ISSN] 1546-3141
  • [Journal-full-title] AJR. American journal of roentgenology
  • [ISO-abbreviation] AJR Am J Roentgenol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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83. Li YJ, Cai L, Sun HR, Gao S, Bai RJ: Increased FDG uptake in bilateral adrenal tuberculosis appearing like malignancy. Clin Nucl Med; 2008 Mar;33(3):191-2
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  • [Title] Increased FDG uptake in bilateral adrenal tuberculosis appearing like malignancy.
  • [MeSH-major] Adrenal Gland Diseases / radiography. Adrenal Gland Diseases / radionuclide imaging. Tuberculosis, Endocrine / radiography. Tuberculosis, Endocrine / radionuclide imaging
  • [MeSH-minor] Adrenal Gland Neoplasms / radiography. Adrenal Gland Neoplasms / radionuclide imaging. Diagnosis, Differential. Fluorodeoxyglucose F18 / pharmacokinetics. Humans. Male. Middle Aged. Radiopharmaceuticals / pharmacokinetics. Tomography, Emission-Computed. Tomography, X-Ray Computed

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  • (PMID = 18287843.001).
  • [ISSN] 0363-9762
  • [Journal-full-title] Clinical nuclear medicine
  • [ISO-abbreviation] Clin Nucl Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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84. Waldmann J, Slater EP, Langer P, Buchholz M, Ramaswamy A, Walz MK, Schmid KW, Feldmann G, Bartsch DK, Fendrich V: Expression of the transcription factor snail and its target gene twist are associated with malignancy in pheochromocytomas. Ann Surg Oncol; 2009 Jul;16(7):1997-2005
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  • [Title] Expression of the transcription factor snail and its target gene twist are associated with malignancy in pheochromocytomas.
  • Increasing evidence suggests that EMT plays a pivotal role in tumor progression and metastatic spread.
  • METHODS: Snail, Twist, and E-cadherin expression were assessed by immunohistochemistry and real-time quantitative reverse transcriptase-polymerase chain reaction in 12 malignant and 35 benign pheochromocytomas (PCC).
  • We observed Snail expression in 7 (58%) of 12 malignant PCC, whereas only 6 (17%) of 35 apparently benign PCC revealed Snail expression (P = 0.01).
  • Furthermore, 11 (92%) of 12 malignant PCC, but only 20 (57%) of 35 benign PCC, revealed Twist expression (P = 0.03).
  • In normal adrenal medulla, Snail, Twist, and E-cadherin expression could not be detected.
  • CONCLUSIONS: We describe for the first time that EMT markers Snail and Twist are expressed in PCC and that their expression is associated with malignancy.
  • Our study supports a role for EMT in the malignant transformation of PCC.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Biomarkers, Tumor / genetics. Nuclear Proteins / genetics. Pheochromocytoma / genetics. Transcription Factors / genetics. Twist Transcription Factor / genetics

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  • (PMID = 19412634.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cadherins; 0 / Nuclear Proteins; 0 / TWIST1 protein, human; 0 / Transcription Factors; 0 / Twist Transcription Factor; 0 / snail family transcription factors
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85. Chin EH, Baril DT, Weber KJ, Divino CM: Laparoscopic cortical-sparing adrenalectomy for bilateral pheochromocytoma. Surg Endosc; 2008 Sep;22(9):2075
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  • She underwent a CT scan of the chest which revealed an incidental finding of bilateral adrenal masses.
  • MIBG scan showed positive uptake in the left adrenal gland consistent with pheochromocytoma.
  • T2 weighted MRI showed bilateral adrenal masses, left greater than right.
  • The patient then underwent a right cortical-sparing adrenalectomy to avoid complete adrenal insufficiency and Addisonian crisis.
  • At surgery, a small, well-circumscribed mass of the inferior right adrenal gland was found, and excised in its entirety.
  • Risks for both recurrence and malignancy require lifelong follow-up in these patients.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy / methods. Neoplasms, Multiple Primary / surgery. Pheochromocytoma / surgery
  • [MeSH-minor] Adrenal Insufficiency / prevention & control. Adult. Female. Humans. Incidental Findings. Postoperative Complications / prevention & control. Postoperative Hemorrhage / prevention & control


86. Shyla A, Hölzlwimmer G, Calzada-Wack J, Bink K, Tischenko O, Guilly MN, Chevillard S, Samson E, Graw J, Atkinson MJ, Pellegata NS: Allelic loss of chromosomes 8 and 19 in MENX-associated rat pheochromocytoma. Int J Cancer; 2010 May 15;126(10):2362-72
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  • Pheochromocytomas are neoplasias of neural crest origin that arise from the chromaffin cells of the adrenal medulla.
  • We also analyzed additional candidate genes, that is, rat homologues of genes predisposing to human pheochromocytoma and known tumor-suppressor genes, but we found no AI.
  • The relative small number of allelic changes we found in rat pheochromocytoma might be related to their nonmalignant status and losses at chromosomes 8 and 19 are events that precede malignancy.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Chromosomes, Human, Pair 19. Chromosomes, Human, Pair 8. Cyclin-Dependent Kinase Inhibitor p27 / genetics. Frameshift Mutation. Loss of Heterozygosity. Pheochromocytoma / genetics


87. Gaillard S, Meyer P: [The adrenal incidentaloma: disease of modern era]. Rev Med Suisse; 2009 Apr 8;5(198):774-8
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  • [Title] [The adrenal incidentaloma: disease of modern era].
  • The adrenal incidentaloma is a mass of the adrenal gland discovered incidentally during a radiologic exam.
  • Adrenal mass are nowadays a common medical problem due to the increasing frequency of radiological exams of the abdomen and the increased resolution and quality of these exams.
  • The physician needs however to assess the functionality of the mass by evaluating hormone hypersecretion and whether the mass is benign or malignant.
  • Radiologic criteria can help to distinguish between malignant or benign tumor.
  • Surgery is indicated in the presence of a functional tumor or if there is a suspicion of malignancy.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Incidental Findings

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  • (PMID = 19418979.001).
  • [ISSN] 1660-9379
  • [Journal-full-title] Revue médicale suisse
  • [ISO-abbreviation] Rev Med Suisse
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Switzerland
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88. Kramer H, Sanders J, Post WJ, Groen HJ, Suurmeijer AJ: Analysis of cytological specimens from mediastinal lesions obtained by endoscopic ultrasound-guided fine-needle aspiration. Cancer; 2006 Aug 25;108(4):206-11
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  • BACKGROUND: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) seems to be a powerful tool to obtain cytologic specimens from mediastinal and celiac lymph nodes, enlarged left adrenal glands, and intrapulmonary tumors with mediastinal extension.
  • METHODS: Cytologic assessment of EUS-FNA specimens was performed and specimens were classified as positive, negative, suspicious for malignancy, or unsatisfactory for diagnosis.
  • RESULTS: Cytologic specimens were collected from 155 lymph nodes, 10 left adrenal glands, and 9 intrapulmonary tumor masses.
  • With EUS imaging only, lymph node diameter and a round or irregular shape were significant predictors of malignancy at multiple logistic regression analysis, but their clinical usefulness is very limited (PPV = 0.78 and NPV = 0.45).
  • For left adrenal gland specimens, sensitivity and specificity were 0.89 and 1.00, respectively.
  • Specimens from left adrenal glands and intrapulmonary tumor masses showed promising results.
  • [MeSH-major] Biopsy, Fine-Needle. Carcinoma, Non-Small-Cell Lung / diagnosis. Endosonography. Lung Neoplasms / diagnosis. Lymph Nodes / pathology. Mediastinum / pathology
  • [MeSH-minor] Adrenal Glands / pathology. Celiac Artery / pathology. Cytodiagnosis. Humans. Predictive Value of Tests. Sensitivity and Specificity

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  • [Copyright] Copyright 2006 American Cancer Society.
  • (PMID = 16752408.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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89. Groth SS, Andrade RS: Endobronchial and endoscopic ultrasound-guided fine-needle aspiration: a must for thoracic surgeons. Ann Thorac Surg; 2010 Jun;89(6):S2079-83
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  • A thoracic surgeon facile in endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA) and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) can accurately sample mediastinal lymph nodes (MLNs) for histologic assessment of mediastinal adenopathy and for thoracic malignancy staging.
  • Although mediastinoscopy is the gold standard for histologic MLN assessment, EBUS-FNA and EUS-FNA have emerged as useful, less-invasive sampling techniques that offer access to a wider range of MLN stations than mediastinoscopy and can be used to biopsy suspicious lesions within (ie, peribronchial masses) and outside the mediastinum (ie, left adrenal gland masses, liver lesions, and enlarged celiac lymph nodes).
  • The negative predictive value of EBUS-TBNA and EUS-FNA in patients with malignancy is somewhat lower than the negative predictive value of mediastinoscopy.
  • Therefore, we recommend that nonmalignant EBUS or EUS cytologic findings should be confirmed with a surgical MLN biopsy (ie, mediastinoscopy or thoracoscopy) if the pretest probability of malignancy is high.
  • [MeSH-major] Biopsy, Fine-Needle / methods. Thoracic Neoplasms / pathology. Thoracic Neoplasms / ultrasonography. Thoracic Surgical Procedures / methods

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  • [Copyright] 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
  • [CommentIn] Ann Thorac Surg. 2011 Mar;91(3):989-90; author reply 990-1 [21353054.001]
  • (PMID = 20493985.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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90. Strong VE, Kennedy T, Al-Ahmadie H, Tang L, Coleman J, Fong Y, Brennan M, Ghossein RA: Prognostic indicators of malignancy in adrenal pheochromocytomas: clinical, histopathologic, and cell cycle/apoptosis gene expression analysis. Surgery; 2008 Jun;143(6):759-68
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  • [Title] Prognostic indicators of malignancy in adrenal pheochromocytomas: clinical, histopathologic, and cell cycle/apoptosis gene expression analysis.
  • BACKGROUND: Pheochromocytomas are malignant in approximately 10% of patients.
  • The histologic differentiation between benign and malignant tumors is difficult, the latter diagnosed by the presence of metastatic disease or recurrence.
  • AIM: To determine if postoperative histologic evaluation using the previously proposed Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) and cell cycle/apoptosis markers can predict patients at risk for recurrence.
  • METHODS: Using the Memorial Sloan-Kettering Cancer Center adrenal database, we identified 48 patients with 51 resected pheochromocytomas (1987-2006).
  • This pheochromocytoma scoring system is based on the presence of 12 different histologic parameters, including tumor necrosis, mitotic rate, tumor cell spindling, and the presence of large cell nests.
  • In addition, we constructed a tissue microarray of all 5 malignant tumors and 41 of the benign tumors.
  • RESULTS: Forty-three patients had a benign clinical course while 5 patients harbored a clinically malignant pheochromocytoma.
  • Tumor necrosis (focal or confluent) was a particularly powerful indicator of malignancy present in 4 of 5 patients (80%) with malignant tumors, but only in 3 of 42 cases (7%) with benign neoplasms (P = .0009).
  • The presence of a high mitotic rate (>3/10 high power fields) and tumor cell spindling significantly correlated with malignancy (P = .026 and .041, respectively).
  • High cellularity was more often present in the malignant lesions (P = .050).
  • There was a highly significant difference in PASS scores between benign and malignant cases (P = .0003).
  • All malignant pheochromocytomas had a PASS score >/=6, well above the previously proposed >/=4 cutoff value.
  • Two of the 4 patients testing positive for Ki-67 (>2% nuclear staining) had a clinically malignant course while only 3 (7%) of the 41 cases with lower Ki-67 positivity rate behaved in a malignant fashion (P = .055).
  • Ki-67-positive tumor had a significantly higher chance of harboring tumor necrosis than Ki-67-negative neoplasms (P < .01).
  • There was no difference in staining between benign and malignant pheochromocytomas using p53, Bcl-2, mdm-2, cyclin D1, p21, and p27. CONCLUSIONS:.
  • (1) A PASS score of <4 predicted benign pheochromocytomas. (2) All malignant pheochromocytomas had a PASS score >/=6, which was significantly higher compared with the benign lesions.
  • Ki-67 may help identify those neoplasms at risk for recurrence by prompting the pathologist to look aggressively for adverse histologic features.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / pathology. Apoptosis. Cell Cycle. Gene Expression Regulation, Neoplastic. Neoplasm Recurrence, Local / genetics. Pheochromocytoma / diagnosis. Pheochromocytoma / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Biomarkers, Tumor / metabolism. Diagnosis, Differential. Female. Humans. Ki-67 Antigen / genetics. Ki-67 Antigen / metabolism. Male. Middle Aged. Necrosis / diagnosis. Necrosis / genetics. Necrosis / pathology. Predictive Value of Tests. Prognosis. Prospective Studies. Risk Factors. Severity of Illness Index. Single-Blind Method


91. Zhou GW, Wei Y, Chen X, Jiang XH, Li XY, Ning G, Li HW: Diagnosis and surgical treatment of multiple endocrine neoplasia. Chin Med J (Engl); 2009 Jul 5;122(13):1495-500
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  • [Title] Diagnosis and surgical treatment of multiple endocrine neoplasia.
  • BACKGROUND: Multiple endocrine neoplasia (MEN) is relatively rare.
  • We discuss the diagnosis and surgical treatment of MEN.
  • There were 22 cases of primary hyperparathyroidism (PHPT), 10 cases of enteropanceatic tumor including 9 cases of insulinoma, 15 cases of pituitary adenoma, 9 cases of adrenal adenoma, 2 cases of thymic carcinoid.
  • Two patients had 4 glands involved, 3 patients had 3 glands involved, 16 patients had 2 glands involved, and 6 patients had only one gland involved.
  • 27 patients had pheochromocytoma including 12 cases of multiple foci and 5 malignancy.
  • Two patients underwent thymus tumor extirpation.
  • Twenty two MEN2a patients underwent pheochromocytoma enucleation including bilateral adrenal resection in 10 cases.
  • Among them, 3 cases underwent bilateral adrenal operations.
  • Germline mutation test is helpful in establishing a diagnosis.
  • [MeSH-major] Multiple Endocrine Neoplasia / surgery

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  • (PMID = 19719936.001).
  • [ISSN] 0366-6999
  • [Journal-full-title] Chinese medical journal
  • [ISO-abbreviation] Chin. Med. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Codon; 0 / MEN1 protein, human; 0 / Proto-Oncogene Proteins; EC 2.7.10.1 / Proto-Oncogene Proteins c-ret; EC 2.7.10.1 / RET protein, human
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92. Lin LF, Huang PT, Tsai MH, Chen TM, Ho KS: Role of endoscopic ultrasound-guided fine-needle aspiration in lung and mediastinal lesions. J Chin Med Assoc; 2010 Oct;73(10):523-9
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  • It can provide tissue diagnosis of lung cancer where bronchoscopy is non-diagnostic.
  • It is a minimally invasive method for lymph node (N) and metastasis (M) staging of non-small cell lung cancer, and is helpful for tissue proof of mediastinal mass with unknown origin.
  • METHODS: This was a retrospective analysis of prospectively collected data of 20 cases, with 21 EUS-FNAs of lung and mediastinal lesions (1 EUS-FNA performed on left adrenal gland) for tissue diagnosis and staging.
  • Malignancy was proven by FNA biopsy results, mediastinoscopy when performed, or by clinical course and follow-up.
  • Median tumor size was 2.6 cm (range, 1.8-5.0 cm), and median number of punctures was 3 (range, 2-7).
  • The size of the left adrenal metastasis for extramediastinal EUS-FNA was 1.2 cm.
  • Of the 16 EUS-FNA-positive cases, 12 were for tissue diagnosis, 3 were for both tissue diagnosis and staging (N2 and M1 staging), and 1 was for N2 staging.
  • EUS-FNA provided a tissue diagnosis in 14 cases where bronchoscopy was negative.
  • CONCLUSION: EUS-FNA can diagnose lung cancer by confirmation of mediastinal lymph node metastasis, by direct puncture of lung tumor close to the esophagus.
  • It is useful for lymph node (N) stations 5, 7, 8 and metastasis (M) staging in non-small cell lung cancer, and for the diagnosis of mediastinal mass of unknown etiology.
  • [MeSH-major] Biopsy, Fine-Needle / methods. Carcinoma, Non-Small-Cell Lung / diagnosis. Endosonography / methods. Lung Neoplasms / diagnosis. Mediastinal Neoplasms / diagnosis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Lymphatic Metastasis. Male. Mediastinoscopy. Mediastinum / pathology. Middle Aged. Neoplasm Staging. Retrospective Studies

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  • [Copyright] Copyright © 2010 Elsevier. Published by Elsevier B.V. All rights reserved.
  • (PMID = 21051029.001).
  • [ISSN] 1728-7731
  • [Journal-full-title] Journal of the Chinese Medical Association : JCMA
  • [ISO-abbreviation] J Chin Med Assoc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China (Republic : 1949- )
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93. Bodtger U, Vilmann P, Clementsen P, Galvis E, Bach K, Skov BG: Clinical impact of endoscopic ultrasound-fine needle aspiration of left adrenal masses in established or suspected lung cancer. J Thorac Oncol; 2009 Dec;4(12):1485-9
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  • [Title] Clinical impact of endoscopic ultrasound-fine needle aspiration of left adrenal masses in established or suspected lung cancer.
  • INTRODUCTION: Correct lung cancer staging is pivotal for optimal allocation to surgical and nonsurgical treatment.
  • A left adrenal gland (LAG) mass is found in 5 to 16%, and malignancy preclude surgery.
  • Endoscopic ultrasound (EUS) is superior to other imaging procedures in visualizing LAG, but the impact of EUS-fine needle aspiration (FNA) on tumor, node, metastasis (TNM)-staging, treatment, and survival is unknown.
  • METHODS: The impact of EUS-FNA of the LAG on TNM staging, treatment, and survival was evaluated retrospectively in all patients (n = 40) referred to EUS during 2000-2006 for known or suspected lung cancer and where EUS disclosed an enlarged LAG.
  • RESULTS: EUS-FNA of an enlarged LAG altered the TNM staging in 70% (downstaged: 26 of 28 patients) and treatment in 48% (gained surgery 25%, avoided surgery 5%, surgically verified benign disease 5%, no cancer and no further workup 5%, and no cancer, control computed tomography, and then no further workup 8%).
  • A malignant LAG lesion was found in 28% and was significantly associated with shorter survival.
  • CONCLUSION: EUS-FNA of an enlarged LAG in patients with known or suspected lung cancer had a significant impact on TNM staging, treatment, and survival.
  • The impact of routine visualization of the LAG in lung cancer workup needs to be prospectively validated.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Biopsy, Fine-Needle / methods. Endoscopy. Lung Neoplasms / pathology. Lung Neoplasms / ultrasonography. Mediastinal Neoplasms / pathology
  • [MeSH-minor] Adenocarcinoma / pathology. Adenocarcinoma / surgery. Adenocarcinoma / ultrasonography. Adult. Aged. Carcinoma, Large Cell / pathology. Carcinoma, Large Cell / surgery. Carcinoma, Large Cell / ultrasonography. Carcinoma, Non-Small-Cell Lung / pathology. Carcinoma, Non-Small-Cell Lung / surgery. Carcinoma, Non-Small-Cell Lung / ultrasonography. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / surgery. Carcinoma, Squamous Cell / ultrasonography. Endosonography. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Preoperative Care. Prognosis. Retrospective Studies. Small Cell Lung Carcinoma / pathology. Small Cell Lung Carcinoma / surgery. Small Cell Lung Carcinoma / ultrasonography. Treatment Outcome


94. Wu D, Tischler AS, Lloyd RV, DeLellis RA, de Krijger R, van Nederveen F, Nosé V: Observer variation in the application of the Pheochromocytoma of the Adrenal Gland Scaled Score. Am J Surg Pathol; 2009 Apr;33(4):599-608
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  • [Title] Observer variation in the application of the Pheochromocytoma of the Adrenal Gland Scaled Score.
  • Morphologic determination of the malignant potential of adrenal pheochromocytoma is a challenging problem in surgical pathology.
  • A multiparameter Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) was recently developed based on a comprehensive study of a single institutional cohort of 100 cases.
  • Assignment of a PASS was proposed to be useful for identifying pheochromocytomas with potential to metastasize, which defines malignancy according to the current World Health Organization terminology.
  • We further examined the utility of PASS by reviewing an independent single institutional cohort of adrenal pheochromocytomas as evaluated by 5 multi-institutional pathologists with at least 10 years experience in endocrine pathology.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Pheochromocytoma / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Child, Preschool. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Observer Variation. Predictive Value of Tests. Prognosis. Severity of Illness Index. Young Adult


95. Cavallaro G, Basile U, Polistena A, Giustini S, Arena R, Scorsi A, Zinnamosca L, Letizia C, Calvieri S, De Toma G: Surgical management of abdominal manifestations of type 1 neurofibromatosis: experience of a single center. Am Surg; 2010 Apr;76(4):389-96
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  • [Title] Surgical management of abdominal manifestations of type 1 neurofibromatosis: experience of a single center.
  • Abdominal manifestations of NF1 include five kinds of tumors: neurogenic tumors (neurofibromas, malignant peripheral nerve sheath tumors [MPNSTs], and ganglioneuromas); neuroendocrine tumors (pheochromocytomas and carcinoids); nonneurogenic gastrointestinal stromal tumors (GISTs); embryonal tumors; and miscellaneous.
  • The present experience depends on the participation in the National Project for Diagnosis and Treatment of Rare Diseases.
  • In the group of patients with a diagnosis of von Recklinghausen disease, 10 patients underwent surgical treatment for gastrointestinal and retroperitoneal tumors associated with NF1.
  • Early diagnosis of these abdominal manifestations is very important because of the risk of malignancy, organic complications (such as pheochromocytoma), or hemorrhagic-obstructive complications such as in case of tumors of the gastrointestinal tract (GISTs and neurofibromas).
  • The importance of an annual clinical evaluation on the part of a multidisciplinary pool of clinicians in highly specialized centers allows early detection of complications and of neoplastic transformation.
  • Genetic screening allows preclinical diagnosis with a sensibility of 95 per cent.
  • Further studies are necessary to detect predictive factors of malignant tumor development of severe clinical conditions.
  • [MeSH-major] Abdominal Neoplasms / surgery. Neurofibromatosis 1 / surgery
  • [MeSH-minor] Adolescent. Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery. Adult. Female. Gastrointestinal Neoplasms / diagnosis. Gastrointestinal Neoplasms / surgery. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Peripheral Nervous System Neoplasms / diagnosis. Peripheral Nervous System Neoplasms / surgery. Pheochromocytoma / diagnosis. Pheochromocytoma / surgery. Retroperitoneal Neoplasms / diagnosis. Retroperitoneal Neoplasms / surgery. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 20420249.001).
  • [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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96. Frysák Z: [Adrenal cancer]. Vnitr Lek; 2009 Jan;55(1):6
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  • [Title] [Adrenal cancer].
  • [Transliterated title] Karcinom kůry nadledvin.
  • [MeSH-major] Adrenal Cortex Neoplasms

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  • [CommentOn] Vnitr Lek. 2009 Jan;55(1):54-61 [19227956.001]
  • (PMID = 19227948.001).
  • [ISSN] 0042-773X
  • [Journal-full-title] Vnitr̆ní lékar̆ství
  • [ISO-abbreviation] Vnitr Lek
  • [Language] cze
  • [Publication-type] Comment; Editorial
  • [Publication-country] Czech Republic
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97. Stehr C, Velasco S, Velasco A, López M JM: [Is adrenal tumor size related to evolution time or does it represent a biological difference?]. Rev Med Chil; 2007 Dec;135(12):1526-9
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  • [Title] [Is adrenal tumor size related to evolution time or does it represent a biological difference?].
  • [Transliterated title] El tamaño de los tumores suprarrenales ¿está en relación al tiempo de evolución o expresa una diferencia biológica?
  • BACKGROUND: Adrenal tumor (AT) malignancy has been related to tumor size.
  • Since laparoscopic surgery is being used, smaller adrenal tumors are being excised.
  • AIM: To evaluate eventual clinical and histological differences between adrenal tumors smaller than 4 cm. and those larger than 6 cm.
  • PATIENTS AND METHODS: Retrospective review of pathological reports and clinical records of patients operated for adrenal tumors, dividing them in two groups.
  • Nineteen tumors of group 2 were malignant, compared with one of group 1 (p <0.001).
  • CONCLUSIONS: The tumor size of adrenal cortical tumors may represent biological differences, suggesting two different tumor populations.
  • At time of diagnosis adrenal carcinomas are almost always larger than 6 cm.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Glands / pathology. Carcinoma / pathology
  • [MeSH-minor] Biomarkers, Tumor. Female. Humans. Hyperplasia. Incidental Findings. Male. Middle Aged. Neoplasm Invasiveness. Retrospective Studies. Time Factors

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  • (PMID = 18357352.001).
  • [ISSN] 0034-9887
  • [Journal-full-title] Revista médica de Chile
  • [ISO-abbreviation] Rev Med Chil
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Chile
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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98. Montoya M, Brown JW, Fishman LM: Comparative effects of chemotherapeutic agents on the growth and survival of human adrenal carcinoma cells in culture. Horm Metab Res; 2008 May;40(5):302-5
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  • [Title] Comparative effects of chemotherapeutic agents on the growth and survival of human adrenal carcinoma cells in culture.
  • Adrenocortical carcinoma is an uncommon malignancy that is usually fatal within a short time after diagnosis.
  • We have investigated the effects on the growth and survival of SW-13 human adrenal carcinoma cells in culture of some currently used and some potentially new agents in the treatment of adrenal cancer.
  • All the other agents tested required much higher doses for effect, including mitotane, the current most commonly used chemotherapy for adrenal cancer, with an EC (50) of 3.3x10 (-4) M.
  • These data suggest that paclitaxel, 2-methoxyestradiol, and cytosine arabinofuranoside should be further evaluated for their potential in the chemotherapy of adrenal carcinoma.
  • [MeSH-major] Adrenal Gland Neoplasms / drug therapy. Antineoplastic Agents / pharmacology
  • [MeSH-minor] Cell Line, Tumor. Cell Survival / drug effects. Dose-Response Relationship, Drug. Drug Screening Assays, Antitumor / methods. Humans

  • MedlinePlus Health Information. consumer health - Adrenal Gland Cancer.
  • ClinicalTrials.gov. clinical trials - ClinicalTrials.gov .
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  • (PMID = 18491247.001).
  • [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] Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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99. Cyriac J, Weizman D, Urbach DR: Laparoscopic adrenalectomy for the management of benign and malignant adrenal tumors. Expert Rev Med Devices; 2006 Nov;3(6):777-86
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic adrenalectomy for the management of benign and malignant adrenal tumors.
  • Laparoscopic adrenalectomy has become the preferred approach for removal of the adrenal gland.
  • Adrenalectomy is usually required for the removal of adrenal tumors causing excess hormone production or because a malignant adrenal tumor cannot be excluded.
  • Current controversies include the appropriateness of laparoscopic adrenalectomy for large or malignant tumors, the role of partial adrenalectomy and the management of some conditions with uncertain natural history (such as subclinical hypercortisolism).
  • With the increased use of sensitive cross-sectional imaging, the detection of clinically inapparent adrenal masses is likely to continue to increase.
  • Due to the fact that malignancy cannot be excluded with certainty in some patients with cortical adenomas, it is expected that the rate of laparoscopic adrenalectomy will continue to increase.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy / methods

  • MedlinePlus Health Information. consumer health - Adrenal Gland Cancer.
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  • (PMID = 17280543.001).
  • [ISSN] 1743-4440
  • [Journal-full-title] Expert review of medical devices
  • [ISO-abbreviation] Expert Rev Med Devices
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 63
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100. Libè R, Fratticci A, Bertherat J: Adrenocortical cancer: pathophysiology and clinical management. Endocr Relat Cancer; 2007 Mar;14(1):13-28
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adrenocortical cancer: pathophysiology and clinical management.
  • Adrenocortical cancer (ACC) is a rare tumor with a poor prognosis.
  • By contrast, benign adrenocortical tumors are frequent, underlying the importance of a correct diagnosis of malignancy of such tumors.
  • ACC can be diagnosed by the investigation of endocrine signs of steroid excess, symptoms due to tumor growth or an adrenal incidentaloma.
  • Imaging by CT-scan or MRI shows a large heterogeneous tumor with a low fat content.
  • Careful pathological investigation with the assessment of the Weiss score is important for the diagnosis of malignancy.
  • Tumors localized to the adrenal gland (McFarlane stages 1 and 2) have a better outcome than invasive and metastatic tumors (stages 3 and 4).
  • Tumor removal by a specialized team is crucial for treatment and should always aim at complete removal.
  • [MeSH-major] Adrenal Cortex Neoplasms / genetics. Adrenal Cortex Neoplasms / therapy
  • [MeSH-minor] Genes, Tumor Suppressor. Humans. Oncogenes / genetics






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