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1. Cadden IS, Atkinson AB, Johnston BT, Pogue K, Connolly R, McCance D, Ardill JE, Russell CF, McGinty A: Cyclooxygenase-2 expression correlates with phaeochromocytoma malignancy: evidence for a Bcl-2-dependent mechanism. Histopathology; 2007 Dec;51(6):743-51
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  • AIMS: Phaeochromocytomas are rare but potentially life-threatening neuroendocrine tumours of the adrenal medulla or sympathetic nervous system ganglia.
  • There are no histological features which reliably differentiate benign from malignant phaeochromocytomas.
  • METHODS AND RESULTS: COX-2 and Bcl-2 expression were examined immunohistochemically in tissue from 41 sporadic phaeochromocytoma patients followed up for a minimum of 5 years after diagnosis.
  • [MeSH-major] Adrenal Gland Neoplasms / metabolism. Biomarkers, Tumor / analysis. Cyclooxygenase 2 / biosynthesis. Pheochromocytoma / metabolism. Proto-Oncogene Proteins c-bcl-2 / biosynthesis

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  • (PMID = 17916073.001).
  • [ISSN] 0309-0167
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Proto-Oncogene Proteins c-bcl-2; EC 1.14.99.1 / Cyclooxygenase 2
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2. Vilar L, Freitas Mda C, Canadas V, Albuquerque JL, Botelho CA, Egito CS, Arruda MJ, Moura e Silva L, Coelho CE, Casulari LA, Naves LA: Adrenal incidentalomas: diagnostic evaluation and long-term follow-up. Endocr Pract; 2008 Apr;14(3):269-78
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  • [Title] Adrenal incidentalomas: diagnostic evaluation and long-term follow-up.
  • OBJECTIVE: To evaluate the cause and the clinical and laboratory features of adrenal incidentalomas (AI) in 52 patients and to assess the evolution of nonsurgically treated lesions during long-term follow-up.
  • Carcinomas were the largest adrenal masses (mean diameter, 11.7 +/- 1.3 cm).
  • With the exception of 1 pheochromocytoma, 1 cyst, and 1 myelolipoma, all AI larger than 6 cm were carcinomas.
  • After 12 months of follow-up, however, a 45-year-old woman had adrenal mass enlargement from 3.2 cm to 4.4 cm; the excised lesion proved to be an adenoma.
  • Moreover, evidence of cortisol hypersecretion developed after 24 months of follow-up in a 30-year-old man with a 3.5-cm adenoma in the left adrenal gland.
  • CONCLUSION: Our findings demonstrate that most AI are nonfunctioning benign lesions and emphasize the need for long-term follow-up of patients with conservatively managed lesions, in light of the potential for evolution to hormonal hypersecretion or tumor growth.
  • [MeSH-major] Adenoma / diagnosis. Adrenal Gland Neoplasms / diagnosis. Incidental Findings
  • [MeSH-minor] Adrenal Cortex Neoplasms / blood. Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / surgery. Adrenocortical Adenoma / blood. Adrenocortical Adenoma / diagnosis. Adrenocortical Adenoma / surgery. Adult. Brazil. Female. Follow-Up Studies. Humans. Hydrocortisone / blood. Longitudinal Studies. Male. Middle Aged. Prognosis. Retrospective Studies

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  • [CommentIn] Endocr Pract. 2008 Apr;14(3):267-8 [18463031.001]
  • (PMID = 18463032.001).
  • [ISSN] 1934-2403
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone
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3. Will OC, Hansmann A, Phillips RK, Palazzo FF, Meeran K, Marshall M, Clark SK: Adrenal incidentaloma in familial adenomatous polyposis: a long-term follow-up study and schema for management. Dis Colon Rectum; 2009 Sep;52(9):1637-44
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  • [Title] Adrenal incidentaloma in familial adenomatous polyposis: a long-term follow-up study and schema for management.
  • PURPOSE: Adrenal incidentaloma is often diagnosed in patients with familial adenomatous polyposis, because they frequently undergo abdominal imaging and have a raised incidence of adrenal incidentaloma.
  • This study investigates the natural history of adrenal incidentaloma in familial adenomatous polyposis, and suggests a schema for management.
  • METHODS: An original cohort of 14 familial adenomatous polyposis patients with adrenal incidentaloma, identified prospectively 12 years ago, was followed up clinically and radiologically.
  • For both cohorts, characteristics of patients (genotype, age at diagnosis, concomitant diagnoses) and incidentaloma (size, laterality, rate of growth, outcome) are described.
  • RESULTS: Overall, 3 of 30 patients underwent adrenalectomy; one patient had pheochromocytoma and another had an adenoma of borderline malignancy.
  • A further three lesions were radiologically suspicious for malignancy at the time of diagnosis; one was in a patient who was unfit for surgery but died of nonadrenal causes after nine years.
  • None of the lesions radiologically benign at diagnosis showed an aggressive course, but one patient required referral for surgery after 12 years because of a slow increase in size of the lesion.
  • CONCLUSIONS: Familial adenomatous polyposis-associated adrenal incidentaloma may warrant long-term follow-up.
  • [MeSH-major] Adenoma / diagnosis. Adenoma / therapy. Adenomatous Polyposis Coli / pathology. Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / therapy. Incidental Findings


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4. Waldmann J, Langer P, Habbe N, Fendrich V, Ramaswamy A, Rothmund M, Bartsch DK, Slater EP: Mutations and polymorphisms in the SDHB, SDHD, VHL, and RET genes in sporadic and familial pheochromocytomas. Endocrine; 2009 Jun;35(3):347-55
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  • Malignant PC revealed multiple (>2) genetic alterations more frequently than benign PC (4/7 vs. 4/29, P = 0.03).
  • Interestingly intronic variants of the SDHB gene occur more frequently in malignant than in benign PC (3/7 vs. 2/29, P = 0.04).
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Pheochromocytoma / genetics. Proto-Oncogene Proteins c-ret / genetics. Succinate Dehydrogenase / genetics. Von Hippel-Lindau Tumor Suppressor Protein / genetics

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  • (PMID = 19399650.001).
  • [ISSN] 1355-008X
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / SDHD protein, human; EC 1.3.5.1 / SDHB protein, human; EC 1.3.99.1 / Succinate Dehydrogenase; EC 2.3.2.27 / Von Hippel-Lindau Tumor Suppressor Protein; EC 2.7.10.1 / Proto-Oncogene Proteins c-ret; EC 2.7.10.1 / RET protein, human; EC 6.3.2.- / VHL protein, human
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5. Havekes B, Romijn JA, Eisenhofer G, Adams K, Pacak K: Update on pediatric pheochromocytoma. Pediatr Nephrol; 2009 May;24(5):943-50
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  • [Title] Update on pediatric pheochromocytoma.
  • Pheochromocytomas are rare tumors in children arising from chromaffin cells of adrenal medullary or extra-adrenal paraganglionic tissue.
  • The formerly used guidelines for pheochromocytoma have been changed by recent discoveries, implementation of new approaches, and understanding of biochemistry, genetics, imaging, pathophysiology, and nomenclature of these tumors.
  • In children, pheochromocytomas are more frequently familial, extra-adrenal, bilateral, and multifocal than in adults.
  • Because of a highly variable clinical presentation, pheochromocytoma is often referred to as the great mimic.
  • Measurements of plasma or urinary fractionated metanephrines are recommended as first-line biochemical tests for diagnosis, with optimum diagnostic sensitivity to be preferred over specificity.
  • This article reviews recent advances in biochemistry, genetics, and imaging and outlines recommendations for improved evaluation and treatment of children with benign or malignant pheochromocytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Pheochromocytoma / pathology

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  • (PMID = 18566838.001).
  • [ISSN] 1432-198X
  • [Journal-full-title] Pediatric nephrology (Berlin, Germany)
  • [ISO-abbreviation] Pediatr. Nephrol.
  • [Language] eng
  • [Grant] United States / Intramural NIH HHS / /
  • [Publication-type] Journal Article; Research Support, N.I.H., Intramural; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 5001-33-2 / Metanephrine
  • [Number-of-references] 66
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6. Guillemot J, Compagnon P, Cartier D, Thouennon E, Bastard C, Lihrmann I, Pichon P, Thuillez C, Plouin PF, Bertherat J, Anouar Y, Kuhn JM, Yon L, Lefebvre H: Metoclopramide stimulates catecholamine- and granin-derived peptide secretion from pheochromocytoma cells through activation of serotonin type 4 (5-HT4) receptors. Endocr Relat Cancer; 2009 Mar;16(1):281-90
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  • [Title] Metoclopramide stimulates catecholamine- and granin-derived peptide secretion from pheochromocytoma cells through activation of serotonin type 4 (5-HT4) receptors.
  • The aim of the study was to investigate the mechanism of action of metoclopramide and expression of serotonin type 4 (5-HT(4)) receptors in pheochromocytoma tissues.
  • Tissue explants, obtained from 18 pheochromocytomas including the tumor removed from a 46-year-old female patient who experienced life-threatening hypertension crisis after metoclopramide administration and 17 additional pheochromocytomas (9 benign and 8 malignant) were studied.
  • Cultured pheochromocytoma cells derived from the patient who previously received metoclopramide were incubated with metoclopramide and various 5-HT(4) receptor ligands.
  • Catecholamine- and granin-derived peptide concentrations were measured in pheochromocytoma cell incubation medium by HPLC and radioimmunological assays.
  • All 5-HT(4) receptor agonists must therefore be contraindicated in patients with proven or suspected pheochromocytoma.
  • [MeSH-major] Adrenal Gland Neoplasms / drug therapy. Dopamine Antagonists / pharmacology. Metoclopramide / pharmacology. Pheochromocytoma / drug therapy. Receptors, Serotonin, 5-HT4 / genetics
  • [MeSH-minor] Adrenal Medulla / cytology. Adrenal Medulla / drug effects. Catecholamines / secretion. Chromogranins / secretion. Cisapride / pharmacology. Domperidone / pharmacology. Female. Humans. Middle Aged. RNA, Messenger / metabolism. Retrospective Studies. Reverse Transcriptase Polymerase Chain Reaction. Serotonin Receptor Agonists / pharmacology. Tumor Cells, Cultured

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  • (PMID = 18948374.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Catecholamines; 0 / Chromogranins; 0 / Dopamine Antagonists; 0 / RNA, Messenger; 0 / Serotonin Receptor Agonists; 158165-40-3 / Receptors, Serotonin, 5-HT4; 5587267Z69 / Domperidone; L4YEB44I46 / Metoclopramide; UVL329170W / Cisapride
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7. St Julien J, Ball D, Schulick R: Robot-assisted cortical-sparing adrenalectomy in a patient with Von Hippel-Lindau disease and bilateral pheochromocytomas separated by 9 years. J Laparoendosc Adv Surg Tech A; 2006 Oct;16(5):473-7
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  • Von Hippel-Lindau disease is a heritable syndrome that confers an increased risk of developing various benign and malignant tumors to those with a germline mutation of the tumor suppressor gene.
  • He was found to have a left pheochromocytoma which was successfully managed with open total adrenalectomy.
  • He presented again at age 18 with a second pheochromocytoma in the right adrenal gland.
  • [MeSH-major] Adrenal Gland Neoplasms / etiology. Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Neoplasms, Second Primary / etiology. Neoplasms, Second Primary / surgery. Pheochromocytoma / etiology. Pheochromocytoma / surgery. Robotics. von Hippel-Lindau Disease / complications
  • [MeSH-minor] Adolescent. Adrenal Cortex. Child. Humans. Male. Time Factors

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  • (PMID = 17004871.001).
  • [ISSN] 1557-9034
  • [Journal-full-title] Journal of laparoendoscopic & advanced surgical techniques. Part A
  • [ISO-abbreviation] J Laparoendosc Adv Surg Tech A
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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8. Imanaka M, Iida K, Takahashi K, Tsuji K, Nishizawa H, Fukuoka H, Takeno R, Takahashi Y, Okimura Y, Kaji H, Chihara K: The N131S mutation in the von Hippel-Lindau gene in a Japanese family with pheochromocytoma and hemangioblastomas. Endocr J; 2006 Dec;53(6):819-27
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  • [Title] The N131S mutation in the von Hippel-Lindau gene in a Japanese family with pheochromocytoma and hemangioblastomas.
  • von Hippel-Lindau (VHL) disease (VHLD) is a hereditary autosomal dominant syndrome that causes various benign and malignant tumors.
  • Here, we report a mutation in the VHL gene in a Japanese family with VHLD type 2A, characterized by pheochromocytoma (PHE), and hemangioblastomas (HAB) in both the retina and thoracic spinal cord but without renal cell carcinoma (RCC).
  • We also identified somatic loss of heterozygosity (LOH) at chromosome 3p25-26 in the adrenal tumor of the patient.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Cerebellar Neoplasms / genetics. Hemangioblastoma / genetics. Mutation. Pheochromocytoma / genetics. Von Hippel-Lindau Tumor Suppressor Protein / genetics

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  • (PMID = 17001110.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] EC 6.3.2.19 / Von Hippel-Lindau Tumor Suppressor Protein
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9. Altinova AE, Toruner F, Cimen AR, Karakoc A, Atasever T, Yetkin I, Ayvaz G, Cakir N, Arslan M: The association of neurofibromatosis, bilateral pheochromocytoma and primary hyperparathyroidism. Exp Clin Endocrinol Diabetes; 2007 Jul;115(7):468-70
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  • [Title] The association of neurofibromatosis, bilateral pheochromocytoma and primary hyperparathyroidism.
  • Neurofibromatosis (NF) is a hereditary disease and carries increased risk of both benign and malignant tumor development.
  • Pheochromocytoma or hyperparathyroidism have been reported to be associated with NF type 1 (NF1).
  • However, the coexistance of pheochromocytoma and parathyroid adenoma in a patient with NF1 is very rare.
  • We report a case of a 37-year-old male with NF1, bilateral pheochromocytoma and parathyroid adenoma.
  • [MeSH-major] Adrenal Gland Neoplasms / complications. Hyperparathyroidism, Primary / complications. Neurofibromatoses / complications. Pheochromocytoma / complications


10. Waldmann J, Fendrich V, Holler J, Buchholz M, Heinmöller E, Langer P, Ramaswamy A, Samans B, Walz MK, Rothmund M, Bartsch DK, Slater EP: Microarray analysis reveals differential expression of benign and malignant pheochromocytoma. Endocr Relat Cancer; 2010 Sep;17(3):743-56
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  • [Title] Microarray analysis reveals differential expression of benign and malignant pheochromocytoma.
  • The diagnosis of a malignant pheochromocytoma (PC) can only be established by the presence of distant metastases, but a subset of apparently benign PCs develop metastases.
  • We have employed a microarray analysis to identify a typical gene expression profile which distinguishes malignant from benign PC.
  • Total RNA was isolated from fresh-frozen tissue of five benign and five malignant PCs.
  • The reference consisted of laser microdissected tissue from normal adrenal medulla.
  • The analysis revealed a more than twofold difference in expression between benign and malignant PCs in 132 genes: 19 were up-regulated and 113 were down-regulated.
  • Comparative analysis by microarray of all ten PCs (benign/malignant) versus normal adrenal medulla revealed a more than twofold expression difference in 455/539 and 491/671 genes respectively.
  • Several of these genes are known to participate on adrenal tumorigenesis, potential tumor suppressor genes, and oncogenes.
  • Comprehensive gene expression analysis of malignant and benign PCs revealed different gene profiles, which could be used to discriminate between malignant and benign PCs.
  • [MeSH-major] Adrenal Gland Neoplasms / metabolism. Adrenal Medulla / metabolism. Biomarkers, Tumor / metabolism. Gene Expression Profiling. Pheochromocytoma / metabolism


11. Chen G, Yao J, Mou L, Fang X, Huang H, Liang J, Li L, Ye L, Lin L, Wen J: Clinical analysis of 249 cases of adrenal tumors in a Chinese hospital. Urol Int; 2010;85(3):270-5
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  • [Title] Clinical analysis of 249 cases of adrenal tumors in a Chinese hospital.
  • OBJECTIVE: This study was designed to evaluate the clinical and pathological characteristics of adrenal masses.
  • METHODS: The clinical data of 249 cases of adrenal masses which were confirmed at operation and by pathology were analyzed.
  • Overall, females were more commonly represented than males, especially with Cushing's syndrome and typical pheochromocytoma (female:male ratio 3.3:1.9), however the prevalence of adrenal incidentalomas (AIs) in males and females was similar.
  • Of 109 adrenocortical adenomas, 47 were primary aldosteronism, 31 were Cushing's syndrome, 30 were AIs, and 1 was adrenal virilization.
  • Of 72 benign pheochromocytomas, 51 were typical pheochromocytomas and 21 were AIs.
  • Of 14 adrenal nodular hyperplasias, 6 were Cushing's syndrome and 8 were primary aldosteronism.
  • Of the remaining 30 benign tumors, all presented as AIs.
  • The diameter of malignant tumors (10.9 ± 5.6 cm) was significantly larger than that of benign tumors (4.5 ± 3.7 cm) (p < 0.001).
  • CONCLUSION: This study shows a high rate of AIs in patients with adrenal masses selected for surgery.
  • Hormone levels should be determined in symptomatic or incidental patients with adrenal masses.
  • Imaging examination (CT and MRI) is the first method used to detect and localize adrenal masses.
  • Tumor size is an important parameter of diagnosis and management of patients with adrenal masses, especially AIs.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. China. Cushing Syndrome / diagnosis. Female. Hospitals. Humans. Magnetic Resonance Imaging / methods. Male. Middle Aged. Pheochromocytoma / diagnosis. Retrospective Studies. Tomography, X-Ray Computed / methods

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  • [Copyright] Copyright © 2010 S. Karger AG, Basel.
  • (PMID = 20606391.001).
  • [ISSN] 1423-0399
  • [Journal-full-title] Urologia internationalis
  • [ISO-abbreviation] Urol. Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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12. Luo Z, Li J, Qin Y, Ma Y, Liang X, Xian J, Lu D, Wei M, Yang JY, Yang MQ, He Z: Differential expression of human telomerase catalytic subunit mRNA by in situ hybridization in pheochromocytomas. Endocr Pathol; 2006;17(4):387-98
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  • We investigated the expression of human telomerase catalytic component (hTERT) mRNA, hTERT protein, Ki-67 antigen, and p27kip1 in pheochromocytomas (27 benign, 7 suspected malignant, and 7 malignant), and evaluated the possibility of expressions of these proteins, and hTERT mRNA serve as diagnostic markers for predicting the biological behavior of these tumors.
  • By in situ hybridization, hTERT mRNA was expressed in 5/7 malignant tumors (defined as the presence of metastasis and/or extensive local invasion) as compared with 3/27 benign tumors.
  • All benign tumors exhibited no immunopositivity or <1% of cells stained for Ki-67 antigen.
  • While no statistical difference in p27kip1 expressions was observed among benign, malignant, and suspected malignant tumors, there was a statistical difference between the normal adrenal medulla samples and tumors (p < 0.001).
  • Thus, hTERT mRNA detection by in situ hybridization, hTERT expression, and Ki-67 antigen expression are all useful tools for differentiating malignant from benign pheochromocytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Pheochromocytoma / genetics. RNA, Messenger / metabolism. Telomerase / genetics
  • [MeSH-minor] Adolescent. Adrenal Medulla / metabolism. Adrenal Medulla / pathology. Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / genetics. Biomarkers, Tumor / metabolism. Cyclin-Dependent Kinase Inhibitor p27 / metabolism. Female. Follow-Up Studies. Humans. In Situ Hybridization. Ki-67 Antigen / metabolism. Male. Middle Aged. Neoplasm Proteins / genetics. Neoplasm Proteins / metabolism

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  • (PMID = 17525487.001).
  • [ISSN] 1046-3976
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Ki-67 Antigen; 0 / Neoplasm Proteins; 0 / RNA, Messenger; 147604-94-2 / Cyclin-Dependent Kinase Inhibitor p27; EC 2.7.7.49 / Telomerase
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13. Fassnacht M, Weismann D, Ebert S, Adam P, Zink M, Beuschlein F, Hahner S, Allolio B: AKT is highly phosphorylated in pheochromocytomas but not in benign adrenocortical tumors. J Clin Endocrinol Metab; 2005 Jul;90(7):4366-70
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  • [Title] AKT is highly phosphorylated in pheochromocytomas but not in benign adrenocortical tumors.
  • Immunohistochemistry for total AKT and pAKT was performed in pheochromocytomas (n = 8), ACC (n = 4), and normal adrenal glands (n = 2).
  • MAIN OUTCOME MEASURES: Determination of pAKT/total AKT ratio in adrenal tissues was the main outcome.
  • [MeSH-major] Adrenal Cortex Neoplasms / metabolism. Adrenal Gland Neoplasms / metabolism. Pheochromocytoma / metabolism. Protein-Serine-Threonine Kinases / metabolism. Proto-Oncogene Proteins / metabolism

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  • (PMID = 15855265.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Proto-Oncogene Proteins; 0 / Tumor Suppressor Proteins; EC 2.7.1.- / Phosphatidylinositol 3-Kinases; EC 2.7.11.1 / AKT1 protein, human; EC 2.7.11.1 / Protein-Serine-Threonine Kinases; EC 2.7.11.1 / Proto-Oncogene Proteins c-akt; EC 3.1.3.- / Phosphoric Monoester Hydrolases; EC 3.1.3.48 / PTEN protein, human; EC 3.1.3.67 / PTEN Phosphohydrolase
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14. Zarnegar R, Kebebew E, Duh QY, Clark OH: Malignant pheochromocytoma. Surg Oncol Clin N Am; 2006 Jul;15(3):555-71
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  • [Title] Malignant pheochromocytoma.
  • Malignant pheochromocytoma is a rare disease with a high mortality.
  • However, differentiating between benign and malignant pheochromocytoma is impossible in the absence of locoregional invasion or distant metastasis.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Pheochromocytoma / surgery

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  • (PMID = 16882497.001).
  • [ISSN] 1055-3207
  • [Journal-full-title] Surgical oncology clinics of North America
  • [ISO-abbreviation] Surg. Oncol. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 35MRW7B4AD / 3-Iodobenzylguanidine
  • [Number-of-references] 79
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15. Lifante JC, Cenedese A, Fernandez Vila JM, Peix JL: [Impact of laparoscopy on the management of adrenal diseases. A retrospective study of 220 patients]. Ann Chir; 2005 Oct;130(9):547-52
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  • [Title] [Impact of laparoscopy on the management of adrenal diseases. A retrospective study of 220 patients].
  • OBJECTIVE: Soon after its introduction in 1992, laparoscopic adrenalectomy became the gold standard in the surgical management of most adrenal tumors.
  • RESULTS: The indications of adrenalectomy were: Cushing syndrome 18%, pheochromocytoma 31%, Conn syndrome 16%, incidentaloma 21%, and malignant tumours 13%.
  • CONCLUSIONS: This study is consistent with the findings of the literature supporting that there are no indications for the open procedure in case of small benign lesions.
  • The video-asisted adrenalectomy had not changed the management of the adrenal incidentaloma.
  • [MeSH-major] Adrenal Gland Diseases / surgery. Adrenalectomy / methods. Laparoscopy. Video-Assisted Surgery / methods

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  • (PMID = 15993374.001).
  • [ISSN] 0003-3944
  • [Journal-full-title] Annales de chirurgie
  • [ISO-abbreviation] Ann Chir
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
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16. Shen SJ, Cheng HM, Chiu AW, Chou CW, Chen JY: Perioperative hypertensive crisis in clinically silent pheochromocytomas: report of four cases. Chang Gung Med J; 2005 Jan;28(1):44-50
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  • Improvements in imaging have resulted in an increase in incidentally discovered adrenal tumors.
  • The adrenal incidentalomas have been identified in at least 2%-3% of patients receiving abdominal computed tomography (CT), and pheochromocytomas are reported to occur in about 5.1%-23.0% of those patients.
  • Herein we present 4 cases of pheochromocytomas as unforeseen adrenal masses on abdominal images.
  • The characteristics of these tumors were that they (1) were noted to have no particular symptoms, (2) were confirmed biochemically and pathologically with immunophenotypic staining, (3) were benign in nature, and (4) produced apparent blood-pressure fluctuations during the operation.
  • [MeSH-major] Adrenal Gland Neoplasms / complications. Hypertension / etiology. Pheochromocytoma / complications


17. Iihara M, Obara T: [Diagnosis and surgical treatment of adrenal tumors]. Nihon Geka Gakkai Zasshi; 2005 Aug;106(8):479-83
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  • [Title] [Diagnosis and surgical treatment of adrenal tumors].
  • Adrenal surgery is necessary for the management of functioning adrenal tumors, such as aldosterone-producing adenoma, cortisol-producing adenoma, and pheochromocytoma.
  • The role of adrenal imaging in primary hyperaldosteronism is to separate the surgically resectable unilateral aldosteronoma from bilateral hyperplasia.
  • Once the clinical diagnosis of primary hyperaldosteronism is confirmed, adrenal computed tomography (CT) with 3-mm sections should be the first imaging study.
  • If the results of CT and NP-59 scintigraphy are equivocal, adrenal venous sampling is necessary.
  • Cortisol-producing adrenocortical adenomas are seen as adrenal masses 2.5 cm or larger in diameter in CT scanning.
  • When an adrenal mass measures more than 5 cm in diameter, a functioning adrenal carcinoma should be considered.
  • In the past decade, laparoscopic adrenalectomy has replaced open adrenalectomy as a standard operative procedure for benign adrenal tumors.
  • Adrenal-sparing laparoscopic surgery has recently become a feasible option in patients with hereditary bilateral pheochromocytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery
  • [MeSH-minor] Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / surgery. Adrenal Medulla. Humans

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  • (PMID = 16119111.001).
  • [ISSN] 0301-4894
  • [Journal-full-title] Nihon Geka Gakkai zasshi
  • [ISO-abbreviation] Nihon Geka Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 17
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18. Wängberg B, Muth A, Khorram-Manesh A, Jansson S, Nilsson O, Forssell-Aronsson E, Tisell L, Ahlman H: Malignant pheochromocytoma in a population-based study: survival and clinical results. Ann N Y Acad Sci; 2006 Aug;1073:512-6
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  • [Title] Malignant pheochromocytoma in a population-based study: survival and clinical results.
  • One hundred fifty-four consecutive patients with pheochromocytoma (PC, n=137) or paraganglioma (PG, n=17) were treated at our unit.
  • Within 4 years two patients died of tumor progression. (2) Locally advanced disease (n=4), all resected for cure. (3) Malignancy disclosed during follow-up after adrenalectomy with "benign" histopathology (n=4).
  • Active surgical treatment and phenoxybenzamine resulted in low tumor-related mortality in groups 2 and 3; five patients died 8-30 years after diagnosis, four of PC/PG (three from group 2 and one from group 3) and one of other causes.
  • To diagnose PC/PG early, screening of adrenal incidentalomas has been suggested.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Pheochromocytoma / pathology


19. Pugliese R, Boniardi M, Sansonna F, Maggioni D, De Carli S, Costanzi A, Scandroglio I, Ferrari GC, Di Lernia S, Magistro C, Loli P, Grossrubatscher E: Outcomes of laparoscopic adrenalectomy. Clinical experience with 68 patients. Surg Oncol; 2008 Jul;17(1):49-57
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  • Adrenal masses averaged 5.4cm in size (range 1.2-13cm) and 56.7g in weight (range 10-265) including 71 benign and 8 malignant lesions.
  • A total of 79 adrenal glands were resected, 44 right sided and 35 left sided.
  • Three left adrenalectomies for pheochromocytoma were robot-assisted.
  • Patients affected by hormone secreting or bilateral lesions, by unilateral or bilateral pheochromocytoma and by bilateral Cushing's disease were transferred to the endocrinological ward so that their overall hospital stay was prolonged to 9+/-2.8 days on average (range 7-17).
  • While long-term results after LA for cortical carcinomas were poor and LA is not recommended in such cases, long-term results after LA for adrenal metastases were encouraging.
  • [MeSH-major] Adrenal Gland Diseases / surgery. Adrenalectomy / methods. Laparoscopy / methods

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  • (PMID = 17949973.001).
  • [ISSN] 0960-7404
  • [Journal-full-title] Surgical oncology
  • [ISO-abbreviation] Surg Oncol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Netherlands
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20. Wang H, Zhou FJ, Qin ZK, Han H, Liu ZW: [Laparoscopic surgery for benign adrenal tumor: a report of 10 cases]. Ai Zheng; 2005 Jan;24(1):76-8
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  • [Title] [Laparoscopic surgery for benign adrenal tumor: a report of 10 cases].
  • BACKGROUND & OBJECTIVE: Adrenalectomy is a standard treatment for benign adrenal tumors.
  • Conventional open operation usually results in bigger incisions, more blood loss, and long hospital stay to patients; while laparoscopic approaches could make up above shortcomings, which is used to resect benign adrenal tumors gradually.
  • METHODS: Clinical data of 10 patients with benign adrenal tumors undergone laparoscopic adrenalectomy were retrospectively analyzed to summarize the experiences and techniques in laparoscopic surgery.
  • CONCLUSION: Laparoscopic surgery for treatment of benign adrenal tumors has the advantages of minimal invasion, safety, and efficiency, and may be a primary therapeutic option for benign adrenal tumors.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy. Pheochromocytoma / surgery

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  • (PMID = 15642205.001).
  • [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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21. Blanes A, Sanchez-Carrillo JJ, Diaz-Cano SJ: Topographic molecular profile of pheochromocytomas: role of somatic down-regulation of mismatch repair. J Clin Endocrinol Metab; 2006 Mar;91(3):1150-8
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  • CONTEXT AND OBJECTIVE: Despite extensive molecular investigation of adrenal pheochromocytomas, no information is available on their molecular and mismatch repair (MMR) profiles by topographic compartments.
  • PATIENTS, OUTCOME MEASURES, AND INTERVENTIONS: Pheochromocytomas were classified as malignant (16 sporadic tumors with distant metastases), locally invasive (30 sporadic tumors showing retroperitoneal infiltration only), and benign (all remaining tumors).
  • More genetic abnormalities involving the peripheral compartment were revealed in 34 pheochromocytomas (23.8%): 12 of 16 malignant, 10 of 30 locally invasive, and 12 of 97 benign.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Adrenal Gland Neoplasms / pathology. Base Pair Mismatch / genetics. DNA Repair / genetics. Gene Expression Regulation, Neoplastic. Pheochromocytoma / genetics. Pheochromocytoma / pathology
  • [MeSH-minor] Adrenal Medulla / pathology. Base Sequence. DNA Primers. DNA, Neoplasm / genetics. DNA, Satellite / genetics. Genes, p53. Humans. Loss of Heterozygosity. Multiple Endocrine Neoplasia Type 2a / genetics. Polymorphism, Single Nucleotide. Retinoblastoma Protein / genetics


22. Willenberg HS, Schott M, Saeger W, Tries A, Scherbaum WA, Bornstein SR: Expression of connexins in chromaffin cells of normal human adrenals and in benign and malignant pheochromocytomas. Ann N Y Acad Sci; 2006 Aug;1073:578-83
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  • [Title] Expression of connexins in chromaffin cells of normal human adrenals and in benign and malignant pheochromocytomas.
  • We studied the expression of Cx26, Cx32, Cx43, and Cx50 in chromaffin cells of 10 normal human adrenal glands, 10 benign, and 13 malignant pheochromocytomas.
  • Immunohistochemistry showed that Cx50 expression seemed to be the predominant form of Cx expressed in human chromaffin cells, whereas Cx43 immunoreactivity was the most prominent form found in the adrenal cortex.
  • Immunohistological testing for Cx expression does not however allow differentiation of benign from malignant pheochromocytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / metabolism. Adrenal Glands / metabolism. Chromaffin Cells / metabolism. Connexins / metabolism. Pheochromocytoma / metabolism

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  • (PMID = 17102126.001).
  • [ISSN] 0077-8923
  • [Journal-full-title] Annals of the New York Academy of Sciences
  • [ISO-abbreviation] Ann. N. Y. Acad. Sci.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Connexins
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23. 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.
  • 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.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / therapy. Paraganglioma / diagnosis. Paraganglioma / therapy. Pheochromocytoma / diagnosis. Pheochromocytoma / therapy

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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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24. De Toma G, Letizia C, Cavallaro G, Polistena A, Cotesta D, Petramala L, Porciello R, Giustini S, Calvieri S: Adrenal pheochromocytoma and jejunal neurofibroma in type 1 neurofibromatosis: report of a case. G Chir; 2007 May;28(5):199-202
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  • [Title] Adrenal pheochromocytoma and jejunal neurofibroma in type 1 neurofibromatosis: report of a case.
  • Diagnosis, despite extreme clinical variability, is defined by established diagnostic criteria.
  • CASE REPORT: A case of a patient affected by NF1, with hypertension due to adrenal pheochromocytoma and with jejunal neurofibroma, is reported.
  • DISCUSSION AND CONCLUSIONS: Variability in clinical presentation of NF1 with possible manifestation of severe systemic benign and malignant diseases requires strict follow-up and specific screening of extra-cutaneous lesions.
  • [MeSH-major] Adrenal Gland Neoplasms. Jejunal Neoplasms. Neoplasms, Multiple Primary. Neurofibromatosis 1. Pheochromocytoma


25. Li Q, Fan Q, Li D, Zhang H: Nonfunctioning benign cardiac pheochromocytoma. J Cancer Res Clin Oncol; 2009 Jan;135(1):103-5
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  • [Title] Nonfunctioning benign cardiac pheochromocytoma.
  • PURPOSE: Nonfunctioning benign cardiac pheochromocytoma is one of the rarest tumors and only a few cases have been described before.
  • We present a rare case of nonfunctioning benign cardiac pheochromocytoma and a review of the literature with special emphasis on diagnosis and treatment.
  • METHODS: Different from the other cardiac pheochromocytomas, its symptoms and signs are so nonspecific that it is easy to make a misdiagnosis or missed diagnosis.
  • One patient with nonfunctioning benign cardiac pheochromocytoma was treated surgically and relevant cases data were collected.
  • Clinical features, diagnosis and treatment of pheochromocytoma were discussed.
  • The prognosis for patients of benign cardiac pheochromocytomas was excellent, but for those of malignant ones was very poor.
  • CONCLUSION: Reviewing the few reported cases, most nonfunctioning benign cardiac pheochromocytomas can be cured completely by operation with good prognosis.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Heart Neoplasms / diagnosis. Pheochromocytoma / diagnosis
  • [MeSH-minor] Adult. Diagnosis, Differential. Echocardiography. Humans. Male. Radiography, Thoracic

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  • (PMID = 18563442.001).
  • [ISSN] 0171-5216
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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26. Gimm O, Krause U, Brauckhoff M, Hoang-Vu C, Dralle H: Distinct expression of galectin-3 in pheochromocytomas. Ann N Y Acad Sci; 2006 Aug;1073:571-7
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  • Unless distant metastases or local invasion are present, the diagnosis of malignant pheochromocytoma is challenging.
  • Four malignant and 24 benign (10 sporadic, 14 hereditary) pheochromocytomas were analyzed for the expression of galectin-3.
  • One malignant pheochromocytoma with distant metastases showed strong and one malignant undifferentiated pheochromocytoma with local invasion showed partly strong cytoplasmic staining.
  • Nine of 10 sporadic and all hereditary benign pheochromocytomas had absent/weak staining.
  • One benign sporadic pheochromocytoma had moderate cytoplasmic staining.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Galectin 3 / genetics. Pheochromocytoma / genetics

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  • (PMID = 17102125.001).
  • [ISSN] 0077-8923
  • [Journal-full-title] Annals of the New York Academy of Sciences
  • [ISO-abbreviation] Ann. N. Y. Acad. Sci.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Galectin 3
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27. Amar L, Peyrard S, Rossignol P, Zinzindohoue F, Gimenez-Roqueplo AP, Plouin PF: Changes in urinary total metanephrine excretion in recurrent and malignant pheochromocytomas and secreting paragangliomas. Ann N Y Acad Sci; 2006 Aug;1073:383-91
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  • We quantified urinary excretion of total metanephrines (metanephrine plus normetanephrine) (UETM) in 261 patients with pheochromocytoma (PH) or secreting paraganglioma, before primary tumor resection.
  • The tumor was considered benign in 242 patients and malignant in 19 patients.
  • Patients with malignant tumors had higher UETM and tumor diameters, lower plasma epinephrine concentrations, and were more likely to have secreting paragangliomas than patients with benign tumors.
  • In the 215 patients with a single-benign primary tumor, preoperative UETM and tumor diameter were significantly correlated.
  • Urinary metanephrine excretion is a marker of tumor activity and a surrogate of tumor burden in patients with pheochromocytoma or secreting paraganglioma.
  • [MeSH-major] Adrenal Gland Neoplasms / urine. Metanephrine / urine. Paraganglioma / urine. Pheochromocytoma / urine

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  • (PMID = 17102107.001).
  • [ISSN] 0077-8923
  • [Journal-full-title] Annals of the New York Academy of Sciences
  • [ISO-abbreviation] Ann. N. Y. Acad. Sci.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 5001-33-2 / Metanephrine
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28. Sanz C, Vezzosi D, Pigny P, Bennet A, Caron P: Multiple endocrine neoplasia type 2a and germ line C634G RET mutation diagnosed in an 80-year-old patient. Ann Endocrinol (Paris); 2009 Apr;70(2):141-4
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  • Concomitantly, a chest-abdominal computed tomography was performed and revealed a 22 mm right adrenal incidentaloma.
  • After right adrenalectomy which confirmed the diagnosis of pheochromocytoma, the patient underwent total thyroidectomy with dissection of the central lymph node compartment and right parathyroidectomy.
  • On histopathologic examination, both thyroid lobes presented 13 foci of MTC without lymph node metastasis and the parathyroid gland presented a benign adenoma without hyperplasia.
  • The diagnosis of Men2a at the age of 80 years and the absence of lymph node metastasis of the multiple MTC in a carrier of C634G mutation were unusual and argued for the possible role of genetic modifier(s) in this MEN 2a patient.
  • [MeSH-minor] Adenoma / radionuclide imaging. Adrenalectomy. Aged, 80 and over. Calcitonin / blood. Catecholamines / urine. Goiter, Nodular / ultrasonography. Humans. Male. Parathyroid Neoplasms / radionuclide imaging. Parathyroidectomy. Radiopharmaceuticals. Technetium Tc 99m Sestamibi. Thyroid Gland / radionuclide imaging. Thyrotropin / blood

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  • (PMID = 19201392.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Catecholamines; 0 / Radiopharmaceuticals; 9002-71-5 / Thyrotropin; 9007-12-9 / Calcitonin; 971Z4W1S09 / Technetium Tc 99m Sestamibi; EC 2.7.10.1 / Proto-Oncogene Proteins c-ret
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29. Reisch N, Peczkowska M, Januszewicz A, Neumann HP: Pheochromocytoma: presentation, diagnosis and treatment. J Hypertens; 2006 Dec;24(12):2331-9
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  • [Title] Pheochromocytoma: presentation, diagnosis and treatment.
  • Pheochromocytomas are rare, mostly benign catecholamine-producing tumors of chromaffin cells of the adrenal medulla or of a paraganglion.
  • The diagnosis of pheochromocytomas depends mainly upon the demonstration of catecholamine excess by 24-h urinary catecholamines and metanephrines or plasma metanephrines.
  • They are localized by a computed tomography scan and magnetic resonance imaging of the adrenal glands and abdomen; complementary 123I-metaiodobenzylguanidine scintigraphy and 18F-dihydroxyphenylalanine-positron emission tomography are available.
  • Laparoscopic and adrenal sparing surgical intervention following preoperative alpha-blockade is the treatment of choice and usually curative.
  • This review provides an update on identification and management of pheochromocytomas, emphasizing current developments in diagnosis, including genetic testing, pathophysiology and treatment of pheochromocytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / therapy. Pheochromocytoma / diagnosis. Pheochromocytoma / therapy


30. Vezzosi D, Bouisson M, Escourrou G, Laurell H, Selves J, Seguin P, Pradayrol L, Caron P, Buscail L: Clinical utility of telomerase for the diagnosis of malignant well-differentiated endocrine tumours. Clin Endocrinol (Oxf); 2006 Jan;64(1):63-7
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  • [Title] Clinical utility of telomerase for the diagnosis of malignant well-differentiated endocrine tumours.
  • OBJECTIVE: The distinction between benign and malignant well-differentiated endocrine tumours is hard to achieve.
  • The aim of the present study was to determine whether detection of telomerase or quantification of human telomerase reverse transcriptase protein subunit (hTERT) differ between benign and malignant endocrine tumours.
  • Based on clinical and histopathological criteria, tumours were categorized with the most recent WHO classification as 'benign' (n = 14), 'uncertain' (n = 5) or 'malignant' (n = 12) with (n = 7) or without (n = 5) metastasis after a mean follow-up of 40.4 +/- 25.8 months (4-122 months).
  • RESULTS: Telomerase activity was detected in 7 malignant and metastatic tumours, in 1 malignant tumour without metastases, in 1 uncertain tumour and in 1 benign tumour. hTERT mRNA levels were significantly higher in malignant endocrine tumours with or without metastases (P = 0.001) when compared to benign tumours.
  • The negative predictive value of hTERT mRNA quantification for the diagnosis of malignancy was 88.9%, whereas the positive predictive value was 68.7%.
  • [MeSH-major] Biomarkers, Tumor / analysis. Clinical Enzyme Tests. DNA-Binding Proteins / analysis. Endocrine Gland Neoplasms / diagnosis. Telomerase / analysis
  • [MeSH-minor] Adrenal Gland Neoplasms / diagnosis. Adult. Aged. Carcinoid Tumor / diagnosis. Female. Gastrinoma / diagnosis. Glucagonoma / diagnosis. Humans. Insulinoma / diagnosis. Intestinal Neoplasms / diagnosis. Lung Neoplasms / diagnosis. Male. Middle Aged. Pancreatic Neoplasms / diagnosis. Pheochromocytoma / diagnosis. Predictive Value of Tests. Retrospective Studies. Reverse Transcriptase Polymerase Chain Reaction. Tumor Suppressor Protein p53 / analysis

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  • (PMID = 16402930.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / DNA-Binding Proteins; 0 / Tumor Suppressor Protein p53; EC 2.7.7.49 / Telomerase
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31. Tabarin A, Bardet S, Bertherat J, Dupas B, Chabre O, Hamoir E, Laurent F, Tenenbaum F, Cazalda M, Lefebvre H, Valli N, Rohmer V, French Society of Endocrinology Consensus: Exploration and management of adrenal incidentalomas. French Society of Endocrinology Consensus. Ann Endocrinol (Paris); 2008 Dec;69(6):487-500
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  • [Title] Exploration and management of adrenal incidentalomas. French Society of Endocrinology Consensus.
  • The French Society of Endocrinology convened a multidisciplinary panel of endocrinologists, radiologists, nuclear physicians and surgeons to address the appropriate evaluation and treatment of adrenal incidentalomas.
  • The crucial points of the French consensus are: the usefulness of CT-scanning evaluation of adrenal incidentalomas, the systematic screening for pheochromocytoma, the usefulness of the 1mg overnight dexamethasone test to screen for latent hypercortisolism, the difficulty to interpret mild biological abnormalities of the HPA axis, the consensus to remove surgically most of tumours greater than 4cm, the necessity to follow clinically glucorticoid tissular targets in the follow-up of non operated benign adrenocortical incidentalomas.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / surgery. Adrenal Gland Neoplasms / therapy
  • [MeSH-minor] Adrenal Cortex Neoplasms / pathology. Adrenal Cortex Neoplasms / therapy. Adrenal Glands / pathology. Animals. Biopsy. Humans. Positron-Emission Tomography

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  • (PMID = 19022420.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] eng
  • [Publication-type] Guideline; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 117
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32. Timmers HJ, Gimenez-Roqueplo AP, Mannelli M, Pacak K: Clinical aspects of SDHx-related pheochromocytoma and paraganglioma. Endocr Relat Cancer; 2009 Jun;16(2):391-400
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  • [Title] Clinical aspects of SDHx-related pheochromocytoma and paraganglioma.
  • Paragangliomas (PGLs) derive from either sympathetic chromaffin tissue in adrenal and extra-adrenal abdominal or thoracic locations, or from parasympathetic tissue of the head and neck.
  • SDHB mutations mainly predispose to extra-adrenal, and to a lesser extent, adrenal PGLs, with a high malignant potential, but also head and neck paragangliomas (HNPGL).
  • SDHD mutations are typically associated with multifocal HNPGL and usually benign adrenal and extra-adrenal PGLs.
  • The identification of SDHx mutations in patients with PGL is warranted for a tailor-made approach to the biochemical diagnosis, imaging, treatment, follow-up, and family screening.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Paraganglioma / genetics. Pheochromocytoma / genetics. Succinate Dehydrogenase / genetics

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  • (PMID = 19190077.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Grant] United States / Intramural NIH HHS / / Z01 HD008735-08
  • [Publication-type] Journal Article; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] EC 1.3.99.1 / Succinate Dehydrogenase
  • [Number-of-references] 54
  • [Other-IDs] NLM/ NIHMS750209; NLM/ PMC4711350
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33. Suh I, Shibru D, Eisenhofer G, Pacak K, Duh QY, Clark OH, Kebebew E: Candidate genes associated with malignant pheochromocytomas by genome-wide expression profiling. Ann Surg; 2009 Dec;250(6):983-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: To improve our understanding of the molecular mechanisms involved in malignant pheochromocytoma by examining differences in the gene expression profile between benign and malignant tumors.
  • BACKGROUND: The molecular events involved in the malignant transformation of pheochromocytoma are poorly understood.
  • There are also no reliable and uniformly accepted histopathologic criteria to distinguish benign from malignant pheochromocytoma.
  • METHODS: We performed genome-wide expression profiling of 58 pheochromocytomas (29 benign and sporadic, 16 benign and hereditary, 13 malignant) with technical and biologic replication.
  • Supervised cluster analysis showed almost completely separate clustering between benign and malignant tumors.
  • Ten differentially expressed genes had high diagnostic accuracy, and 5 of these genes (CFC1, FAM62B, HOMER1, LRRN3, TBX3, ADAMTS) in combination had an area under the receiver operating characteristic (ROC) curve of 0.96 for distinguishing benign versus malignant tumors.
  • CONCLUSIONS: Differentially expressed genes between benign and malignant pheochromocytomas distinguish between these tumors with high diagnostic accuracy.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Gene Expression Regulation, Neoplastic. Genes, Neoplasm / genetics. Genetic Association Studies / methods. Pheochromocytoma / genetics. RNA, Neoplasm / genetics

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  • (PMID = 19661783.001).
  • [ISSN] 1528-1140
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / RNA, Neoplasm
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34. 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).
  • A stable hypotensive result after adrenalectomy was observed in 97.1, 66.8% patients with pheochromocytoma and mineralocorticism, respectively.
  • 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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35. Zografos GN, Vasiliadis G, Farfaras AN, Aggeli C, Digalakis M: Laparoscopic surgery for malignant adrenal tumors. JSLS; 2009 Apr-Jun;13(2):196-202
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  • [Title] Laparoscopic surgery for malignant adrenal tumors.
  • Advances in imaging have improved early detection of primary and metastatic adrenal tumors.
  • The laparoscopic approach, the gold standard for benign adrenal diseases, is controversial for malignant adrenal tumors.
  • A prospective randomized study of the role of laparoscopic surgery in adrenal cancer is not feasible because of the rarity of the disease.
  • A review of the literature demonstrates the safety and efficacy of laparoscopic adrenalectomy for solitary adrenal tumors.
  • In primary adrenal malignancies, the laparoscopic approach should be considered cautiously, only when it can achieve complete tumor resection with an intact adrenal capsule.

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  • (PMID = 19660215.001).
  • [ISSN] 1086-8089
  • [Journal-full-title] JSLS : Journal of the Society of Laparoendoscopic Surgeons
  • [ISO-abbreviation] JSLS
  • [Language] ENG
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 63
  • [Other-IDs] NLM/ PMC3015945
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36. Tiberio GA, Piardi T, Cerea K, Ronconi M, Bertoloni G, Frassi E, Portolani N, Giulini SM: [Laparoscopic adrenalectomy: an initial experience]. Chir Ital; 2005 May-Jun;57(3):273-81
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  • Our aim was to evaluate the short-term results of a series of 65 consecutive laparoscopic adrenalectomies performed on 63 patients with benign or metastatic tumours measuring < or = 7 cm.
  • The surgical indication was primary hyperaldosteronism in 32 cases, pheochromocytoma in 7, Cushing syndrome and disease in 5 and 2 cases, respectively, incidentaloma in 11 and metastasis in 8 cases.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy. Laparoscopy
  • [MeSH-minor] Adult. Aged. Cushing Syndrome / surgery. Female. Humans. Hyperaldosteronism / surgery. Male. Middle Aged. Pheochromocytoma / surgery. Retrospective Studies. Treatment Outcome

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  • (PMID = 16231814.001).
  • [ISSN] 0009-4773
  • [Journal-full-title] Chirurgia italiana
  • [ISO-abbreviation] Chir Ital
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
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37. Wagnerova H, Dudasova D, Lazurova I: Hormonal and metabolic evaluation of adrenal incidentalomas. Neoplasma; 2009;56(6):521-5
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  • [Title] Hormonal and metabolic evaluation of adrenal incidentalomas.
  • The biochemical and hormonal data in patients with adrenal incidentalomas were evaluated to compare the differences between adrenal adenomas and other benign lesions and to find the relationship between metabolic parameters and adrenal hormones.
  • Ninety two patients (29men, age 20-90 years) with incidentally discovered unilateral or bilateral adrenal masses detected on CT were included in this study for the reasons others than adrenal pathology.
  • In the group of patients with adrenal masses the prevalence of arterial hypertension was three fold higher, the prevalence of DM was approximately five fold higher and the prevalence of the overweight and obesity two fold higher than is reported in the general population.
  • The most frequent adrenal masses were nonfunctional masses, the occurence of functional lesions was as follows: steroid enzymopathies (an exaggerated response of 17-OHP indicating a possible 21-hydroxylase deficiency), subclinical Cushing syndrome, primary aldosteronism and pheochromocytoma (5%, 2%, 2% and 1% respectively).
  • In this study we confirmed a higher prevalence of symptoms characteristic for different metabolic syndromes in these patients with adrenal incidentalomas, which indicate systematic screening for the metabolic syndrome including evaluation of the insuline resistance in this patients.
  • [MeSH-major] Adenoma / metabolism. Adrenal Gland Neoplasms / metabolism. Hormones / analysis. Metabolic Syndrome X / metabolism

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  • [CommentIn] J Urol. 2010 Nov;184(5):1925 [22519994.001]
  • (PMID = 19728761.001).
  • [ISSN] 0028-2685
  • [Journal-full-title] Neoplasma
  • [ISO-abbreviation] Neoplasma
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Slovakia
  • [Chemical-registry-number] 0 / Catecholamines; 0 / Hormones; 0 / Triglycerides; 5001-33-2 / Metanephrine; 97C5T2UQ7J / Cholesterol; EC 1.14.99.10 / Steroid 21-Hydroxylase; EC 3.4.23.15 / Renin
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38. Ctvrtlík F, Herman M, Student V, Tichá V, Minarík J: Differential diagnosis of incidentally detected adrenal masses revealed on routine abdominal CT. Eur J Radiol; 2009 Feb;69(2):243-52
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  • [Title] Differential diagnosis of incidentally detected adrenal masses revealed on routine abdominal CT.
  • PURPOSE: The aim of this study was to compare CT findings of adrenal incidentalomas with a definitive histological diagnosis in order to establish CT features characteristic for individual types of lesions.
  • PATIENTS AND METHODS: The retrospective study comprised of patients with adrenal lesions detected on abdominal CT.
  • The study consisted of 62 adrenal expansions found in 55 patients (in seven patients bilateral lesions were found).
  • According to the definitive histological diagnosis after adrenalectomy, the lesions were divided into the following six groups: primary adrenocortical carcinoma (n=4), metastasis (n=7), adrenocortical adenoma (n=37), pheochromocytoma (n=9), myelolipoma (n=2), and others (n=3).
  • CONCLUSION: Standard CT of the abdomen (not specifically aimed at adrenal glands) is a suitable method for distinguishing adrenal lesions which need to be operated on from those which are probably benign but need to be monitored.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Radiographic Image Interpretation, Computer-Assisted / methods. Radiography, Abdominal / methods. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adult. Aged. Diagnosis, Differential. Female. Humans. Incidental Findings. Male. Middle Aged. Radiographic Image Enhancement / methods. Reproducibility of Results. Sensitivity and Specificity. Young Adult

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  • (PMID = 18226485.001).
  • [ISSN] 1872-7727
  • [Journal-full-title] European journal of radiology
  • [ISO-abbreviation] Eur J Radiol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
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39. Scholz T, Schulz C, Klose S, Lehnert H: Diagnostic management of benign and malignant pheochromocytoma. Exp Clin Endocrinol Diabetes; 2007 Mar;115(3):155-9
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  • [Title] Diagnostic management of benign and malignant pheochromocytoma.
  • Measurement of free plasma metanephrines, genetic testing and specific imaging procedures--such as MIBG and octreotide scintigraphy or fluorodopamine PET--represent a considerable progress, and the management of benign pheochromocytomas has become very effective.
  • Here, telomerase catalytic subunit (hTERT) activity and heat shock protein 90 expression could serve both as molecular markers allowing an earlier diagnosis of malignancy and as therapeutic targets.
  • Familial syndromes should be considered both in benign and malignant pheochromocytoma, and should be tested for prior to surgery in selected patient groups.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Pheochromocytoma / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Genetic Techniques. Humans. Sensitivity and Specificity

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  • (PMID = 17427102.001).
  • [ISSN] 0947-7349
  • [Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • [ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 48
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40. Bollo J, López-Boado MA, Fernández-Cruz L: [Pheochromocytoma and benign mediastinal cyst]. Cir Esp; 2007 Jan;81(1):52
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  • [Title] [Pheochromocytoma and benign mediastinal cyst].
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Mediastinal Cyst / diagnosis. Pheochromocytoma / diagnosis


41. Meyer-Rochow GY, Jackson NE, Conaglen JV, Whittle DE, Kunnimalaiyaan M, Chen H, Westin G, Sandgren J, Stålberg P, Khanafshar E, Shibru D, Duh QY, Clark OH, Kebebew E, Gill AJ, Clifton-Bligh R, Robinson BG, Benn DE, Sidhu SB: MicroRNA profiling of benign and malignant pheochromocytomas identifies novel diagnostic and therapeutic targets. Endocr Relat Cancer; 2010 Sep;17(3):835-46
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  • [Title] MicroRNA profiling of benign and malignant pheochromocytomas identifies novel diagnostic and therapeutic targets.
  • There is increasing evidence to suggest that miRNAs could be useful in cancer diagnosis, prognosis, and therapy.
  • We performed miRNA microarray expression profiling on a cohort of 12 benign and 12 malignant pheochromocytomas and identified a number of differentially expressed miRNAs.
  • These results were validated in a separate cohort of ten benign and ten malignant samples using real-time quantitative RT-PCR; benign samples had a minimum follow-up of at least 2 years.
  • It was found that IGF2 as well as its intronic miR-483-5p was over-expressed, while miR-15a and miR-16 were under-expressed in malignant tumours compared with benign tumours.
  • These miRNAs were found to be diagnostic and prognostic markers for malignant pheochromocytoma.
  • The functional role of miR-15a and miR-16 was investigated in vitro in the rat PC12 pheochromocytoma cell line, and these miRNAs were found to regulate cell proliferation via their effect on cyclin D1 and apoptosis.
  • These data indicate that miRNAs play a pivotal role in the biology of malignant pheochromocytoma, and represent an important class of diagnostic and prognostic biomarkers and therapeutic targets warranting further investigation.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Biomarkers, Tumor / genetics. Gene Expression Profiling. Gene Expression Regulation, Neoplastic. MicroRNAs / physiology. Pheochromocytoma / genetics
  • [MeSH-minor] Adrenal Glands / metabolism. Adrenal Glands / pathology. Animals. Apoptosis. Blotting, Western. Cell Cycle. Cohort Studies. Follow-Up Studies. Humans. Oligonucleotide Array Sequence Analysis. Prognosis. RNA, Messenger / genetics. Rats. Reverse Transcriptase Polymerase Chain Reaction. Survival Rate. Tumor Cells, Cultured


42. Fariña LA, Antón I, Fernández GC: [Large adrenal pseudocyst mimicking cystic pheochromocytoma: excision minimising laparoscopic access]. Actas Urol Esp; 2009 Sep;33(8):913-6
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  • [Title] [Large adrenal pseudocyst mimicking cystic pheochromocytoma: excision minimising laparoscopic access].
  • [Transliterated title] Seudoquiste adrenal grande que simula feocromocitoma quístico: exéresis minimizando el acceso laparoscópico.
  • INTRODUCTION: Adrenal cysts and pseudocysts are rare and usually benign and asymptomatic; they are discovered either accidentally or during examination for non-specific abdominal discomfort.
  • The differential diagnosis for adrenal cysts must consider cystic adrenal carcinoma and cystic pheochromocytoma, which are both extremely rare, but more severe and difficult to treat.
  • PATIENTS AND RESULTS: A 55 year-old woman reported right-side flank pain; imaging studies discovered a 10 cm cystic adrenal tumour, with radiological indications of cystic pheochromocytoma.
  • Pathological study showed benign pseudocyst.
  • CONCLUSIONS: As less invasive laparoscopic procedures become widespread, an increasing number of case reports and series of cases regarding adrenal cyst operations have recently been reported.
  • A review of the literature shows that the cysts are generally benign, but it is not always possible to identify cystic adrenal carcinoma or cystic pheochromocytoma from the radiology image.
  • [MeSH-major] Adrenal Gland Diseases / diagnosis. Adrenal Gland Diseases / surgery. Adrenal Gland Neoplasms / diagnosis. Cysts / diagnosis. Cysts / surgery. Laparoscopy. Pheochromocytoma / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Female. Humans. Middle Aged


43. Singh PK, Buch HN: Adrenal incidentaloma: evaluation and management. J Clin Pathol; 2008 Nov;61(11):1168-73
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  • [Title] Adrenal incidentaloma: evaluation and management.
  • Adrenal incidentalomas are adrenal masses discovered incidental to imaging studies performed for reasons unrelated to adrenal pathology.
  • Although most adrenal incidentalomas are non-functioning benign adenomas, their increasing prevalence presents diagnostic and therapeutic challenges.
  • The assessment of adrenal incidentalomas is aimed at deciding whether or not the tumour should be surgically removed.
  • Biochemical screening for tumour hypersecretion is mandatory in all adrenal incidentalomas, since hormone secreting tumours may be clinically silent.
  • The diagnosis of phaeochromocytoma is of paramount importance because of its life-threatening complications.
  • Non-functioning adrenal incidentalomas need assessment for risk of malignancy, and this is based on the size of the tumour and its imaging characteristics.
  • The duration and frequency of reassessment remains unclear, as the natural history of adrenal incidentalomas has yet to be clearly defined, and there is a lack of controlled studies comparing surgical intervention with observation.
  • However, the possibility of acquiring autonomous hypersecretion or conversion to malignancy in an incidentaloma diagnosed to be a benign non-functioning lesion is very low, and most patients may be safely discharged after an initial follow-up period of 2 years.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis
  • [MeSH-minor] Adenoma / diagnosis. Diagnosis, Differential. Humans. Incidental Findings. Long-Term Care / methods. Pheochromocytoma / diagnosis. Tomography, X-Ray Computed

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  • (PMID = 18955573.001).
  • [ISSN] 1472-4146
  • [Journal-full-title] Journal of clinical pathology
  • [ISO-abbreviation] J. Clin. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 117
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44. Korpershoek E, Loonen AJ, Corvers S, van Nederveen FH, Jonkers J, Ma X, Ziel-van der Made A, Korsten H, Trapman J, Dinjens WN, de Krijger RR: Conditional Pten knock-out mice: a model for metastatic phaeochromocytoma. J Pathol; 2009 Mar;217(4):597-604
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  • Phaeochromocytomas (PCCs) are neuro-endocrine tumours of the adrenal medulla that are usually benign, but approximately 10% of patients develop metastases.
  • Here we describe adrenal tumours generated in a Pten conditional knock-out (KO) mouse model.
  • Thirty-two of 41 (78%) male Psa-Cre;Pten-loxP/loxP mice presented adrenal tumours that were shown to be PCC by histology and by immunohistochemical staining for enzymes in the catecholamine biosynthetic pathway.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Disease Models, Animal. Lung Neoplasms / secondary. Neoplasm Proteins / genetics. PTEN Phosphohydrolase / genetics. Pheochromocytoma / secondary


45. Bissada NK, Safwat AS, Seyam RM, Al Sobhi S, Hanash KA, Jackson RJ, Sakati N, Bissada MA: Pheochromocytoma in children and adolescents: a clinical spectrum. J Pediatr Surg; 2008 Mar;43(3):540-3
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  • [Title] Pheochromocytoma in children and adolescents: a clinical spectrum.
  • PURPOSE: The purpose of the study was to identify the spectrum of disease characteristics of pheochromocytoma in children.
  • METHODS: Records of 21 consecutive children diagnosed with pheochromocytoma were reviewed.
  • Patients included 17 with adrenal and 4 with extra-adrenal tumors including 1 in the urinary bladder.
  • Seventeen had sporadic and 4 had familial pheochromocytoma.
  • Associated manifestations were the predominant features in 1 of the 4 patients with familial pheochromocytoma.
  • The patient with bladder pheochromocytoma presented with gross hematuria.
  • Two patients (1 sporadic and 1 familial) had malignant pheochromocytoma.
  • One patient with benign pheochromocytoma had multiple recurrences in chromaffin-containing sites.
  • One patient with malignant pheochromocytoma died of the disease, and 1 with recurrent pheochromocytoma had neurologic consequences.
  • CONCLUSIONS: Pheochromocytoma in children has unique characteristics.
  • To our knowledge, this series is one of the largest reports of adrenal pheochromocytoma in children.
  • It also reflects the spectrum of pheochromocytoma in this age group.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery. Pheochromocytoma / diagnosis. Pheochromocytoma / surgery


46. 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.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Biopsy, Fine-Needle / methods. Endoscopy. Ultrasonography


47. Ahlman H: Malignant pheochromocytoma: state of the field with future projections. Ann N Y Acad Sci; 2006 Aug;1073:449-64
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  • [Title] Malignant pheochromocytoma: state of the field with future projections.
  • The prevalence of malignant pheochromocytoma is about 10%, and is somewhat higher for paraganglioma.
  • A problem for clinical follow-up is that patients with "benign" histopathologic findings may develop metastatic disease.
  • At the first international symposium on pheochromocytoma in Bethesda (2005) experts from different disciplines and patients shared their experiences, and the present knowledge of this rare disease was updated.
  • The discussion related to future strategies for better clinical/histopathologic diagnosis and understanding of different geno- and phenotypes.
  • [MeSH-major] Adrenal Gland Neoplasms / epidemiology. Pheochromocytoma / epidemiology


48. Gao B, Meng F, Bian W, Chen J, Zhao H, Ma G, Shi B, Zhang J, Liu Y, Xu Z: Development and validation of pheochromocytoma of the adrenal gland scaled score for predicting malignant pheochromocytomas. Urology; 2006 Aug;68(2):282-6
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  • [Title] Development and validation of pheochromocytoma of the adrenal gland scaled score for predicting malignant pheochromocytomas.
  • OBJECTIVES: To evaluate the diagnostic performances of the pheochromocytoma of the adrenal gland scaled score (PASS) proposed in a previous report and that of a logistic model developed in this investigation.
  • METHODS: In all 130 patients with malignant or assumed benign pheochromocytomas, 15 predictive variables were observed.
  • CONCLUSIONS: ROC analysis indicated that the PASS could be used for the diagnosis of malignant pheochromocytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Pheochromocytoma / pathology


49. Juan-Sallés C, Ramos-Vara JA, Garner MM: Pheochromocytoma in six New World primates. Vet Pathol; 2009 Jul;46(4):662-6
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  • [Title] Pheochromocytoma in six New World primates.
  • Six New World primates, including 2 golden lion tamarins (Leontopithecus rosalia), 2 cotton-top tamarins (Saguinus o. oedipus), 1 black howler monkey (Alouatta caraya), and 1 black-handed spider monkey (Ateles g. geoffroyi), were diagnosed with unilateral (4/6) or bilateral (1/6) adrenal or extra-adrenal (1/6) pheochromocytoma by light microscopy and immunohistochemical staining for chromogranin A.
  • Overt invasive behavior or metastases were not observed in any primate, and thus these neoplasms were considered benign.
  • [MeSH-major] Adrenal Gland Neoplasms / veterinary. Animals, Zoo. Monkey Diseases / pathology. Pheochromocytoma / veterinary. Platyrrhini

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  • (PMID = 19276065.001).
  • [ISSN] 1544-2217
  • [Journal-full-title] Veterinary pathology
  • [ISO-abbreviation] Vet. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chromogranin A
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50. Kobayashi H, Kaneko G, Nishimoto K, Uchida A: [A case of pheochromocytoma associated with neurofibromatosis type 1]. Hinyokika Kiyo; 2009 Dec;55(12):749-52
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  • [Title] [A case of pheochromocytoma associated with neurofibromatosis type 1].
  • Pheochromocytoma occurs in 0.1 to 5.7% of patients with type 1 neurofibromatosis (NF1).
  • Radiological findings of pheochromocytoma are often similar to those of neurofibroma; therefore, any pheochromocytoma should be excised in hypertensive patients with NF1.
  • A 60-year-old male patient with NF1 was referred to this hospital for an incidentally discovered right adrenal mass, 7 x 6 mm in diameter.
  • The patient had multiple benign tumors and suffered from hypertension for 4 years.
  • A histopathological diagnosis of pheochromocytoma was made.
  • Screening of the adrenal tumor is strongly recommended for NF1 patients with hypertension, since any unfavorable events due to catecholamine such as cardiomyopathy and fatal arrhythmia can be avoided by adequate surgical intervention.
  • [MeSH-major] Adrenal Gland Neoplasms / complications. Neurofibromatosis 1 / complications. Pheochromocytoma / complications


51. 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.
  • 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.
  • [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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52. Yao L, Schiavi F, Cascon A, Qin Y, Inglada-Pérez L, King EE, Toledo RA, Ercolino T, Rapizzi E, Ricketts CJ, Mori L, Giacchè M, Mendola A, Taschin E, Boaretto F, Loli P, Iacobone M, Rossi GP, Biondi B, Lima-Junior JV, Kater CE, Bex M, Vikkula M, Grossman AB, Gruber SB, Barontini M, Persu A, Castellano M, Toledo SP, Maher ER, Mannelli M, Opocher G, Robledo M, Dahia PL: Spectrum and prevalence of FP/TMEM127 gene mutations in pheochromocytomas and paragangliomas. JAMA; 2010 Dec 15;304(23):2611-9
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  • All mutation carriers had adrenal tumors, including 7 bilateral (P = 2.7 × 10(-4)) and/or with familial disease (5 of 20 samples; P = .005).
  • The most common presentation was that of a single benign adrenal tumor in patients older than 40 years.
  • CONCLUSIONS: Germline mutations of FP/TMEM127 were associated with pheochromocytoma but not paraganglioma and occurred in an age group frequently excluded from genetic screening algorithms.

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  • (PMID = 21156949.001).
  • [ISSN] 1538-3598
  • [Journal-full-title] JAMA
  • [ISO-abbreviation] JAMA
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / 5 P30 CA465920; United States / NIA NIH HHS / AG / P01AG19316; United States / NIA NIH HHS / AG / P30 AG013319; United States / NCI NIH HHS / CA / P30 CA54174; United Kingdom / Cancer Research UK / /
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Membrane Proteins; 0 / TMEM127 protein, human
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53. Guillemot J, Barbier L, Thouennon E, Vallet-Erdtmann V, Montero-Hadjadje M, Lefebvre H, Klein M, Muresan M, Plouin PF, Seidah N, Vaudry H, Anouar Y, Yon L: Expression and processing of the neuroendocrine protein secretogranin II in benign and malignant pheochromocytomas. Ann N Y Acad Sci; 2006 Aug;1073:527-32
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  • [Title] Expression and processing of the neuroendocrine protein secretogranin II in benign and malignant pheochromocytomas.
  • The aim of the present study was to compare the expression levels of secretogranin II (SgII), prohormone convertases (PC)1 and PC2, and the proteolytic processing of SgII in benign versus malignant pheochromocytomas.
  • Quantitative (Q)-PCR experiments indicated that SgII, PC1, and PC2 mRNAs were overexpressed in pheochromocytoma compared to non-tumoral chromaffin cells (P<0.001) and in benign compared to malignant tumors (P<0.01).
  • Western blot analysis using a human SgII antiserum revealed the occurrence of a 97-kDa band corresponding to the expected size of SgII, with significantly higher quantities in benign than in malignant tumors (P<0.05).
  • Using antisera directed against sequential regions of SgII (N-terminal, secretoneurin [SN], EM66, internal, and C-terminal sequences), we observed distinct processing profiles between benign and malignant pheochromocytomas.
  • RIA measurement showed that EM66 median values between benign and malignant chromaffin cell tumors were significantly different (128.5 vs. 6.3 ng/mg protein, respectively; P<0.001).
  • Taken together, these results indicate that, in pheochromocytoma, malignancy is associated with reduced PC1, PC2, and SgII mRNA expression and decreased levels of processing products of SgII, in line with the low concentrations of EM66 that occur in malignant tumors.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Gene Expression Profiling. Pheochromocytoma / diagnosis

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  • (PMID = 17102121.001).
  • [ISSN] 0077-8923
  • [Journal-full-title] Annals of the New York Academy of Sciences
  • [ISO-abbreviation] Ann. N. Y. Acad. Sci.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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54. Neri V, Ambrosi A, Fersini A, Valentino TP: Laparoscopic adrenalectomy: transperitoneal lateral approach. Cases study. Ann Ital Chir; 2005 Mar-Apr;76(2):123-6
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  • MATERIAL AND METHOD: In the period 1997-September 2004 we treated 17 patients with adrenal pathology: eight patients underwent to an open anterior transperitoneal adrenalectomy and nine patients underwent a laparoscopic adrenalectomy with lateral transperitoneal approach.
  • DISCUSSION: Both procedures allow to achieve the complete resolution of the adrenal pathology if it is confined within the gland and no more than 8 cm. in size.
  • Therefore, the AA can believe that the laparoscopic approach is at present the gold standard in the treatment of all benign adrenal pathologies with a no more than 8 cm. size.
  • [MeSH-minor] Adenoma / surgery. Adrenal Cortex Neoplasms / surgery. Adrenal Gland Neoplasms / surgery. Adrenocortical Adenoma / surgery. Female. Humans. Laparotomy. Male. Middle Aged. Pheochromocytoma / surgery. Safety. Time Factors. Treatment Outcome

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  • (PMID = 16302650.001).
  • [ISSN] 0003-469X
  • [Journal-full-title] Annali italiani di chirurgia
  • [ISO-abbreviation] Ann Ital Chir
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Italy
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55. Geli J, Kiss N, Karimi M, Lee JJ, Bäckdahl M, Ekström TJ, Larsson C: Global and regional CpG methylation in pheochromocytomas and abdominal paragangliomas: association to malignant behavior. Clin Cancer Res; 2008 May 1;14(9):2551-9
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  • EXPERIMENTAL DESIGN: A panel of 53 primary tumors (42 benign, 11 malignant) was analyzed by quantitative bisulfite pyrosequencing.
  • Global hypomethylation of LINE-1 elements was observed in tumors compared with normal adrenal samples (P < 0.02).
  • [MeSH-major] Abdominal Neoplasms / genetics. Adrenal Gland Neoplasms / genetics. CpG Islands / genetics. DNA Methylation. Paraganglioma / genetics. Pheochromocytoma / genetics. Promoter Regions, Genetic


56. Johnson PT, Horton KM, Fishman EK: Adrenal mass imaging with multidetector CT: pathologic conditions, pearls, and pitfalls. Radiographics; 2009 Sep-Oct;29(5):1333-51
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  • [Title] Adrenal mass imaging with multidetector CT: pathologic conditions, pearls, and pitfalls.
  • The adrenal gland is involved by a range of neoplasms, including primary and metastatic malignant tumors; however, the most common tumor detected is the incidental benign adenoma.
  • Although computed tomographic (CT) findings will not always yield a definitive diagnosis, attention to these findings provides a road map to guide image interpretation.
  • Adrenocortical carcinoma typically has an RPW of less than 40%; however, large size and heterogeneity are more reliable indicators of the diagnosis than are washout values.
  • Washout characteristics of pheochromocytoma are variable; in conjunction with high levels of dynamic enhancement, pheochromocytomas may mimic adenoma (ie, APW > 60%, RPW > 40%).
  • After contrast material administration, metastases usually demonstrate slower washout on delayed images (APW < 60%, RPW < 40%) than do adenomas, although hypervascular metastases may enhance similarly to pheochromocytoma.
  • Finally, a number of nonadrenal pathologic conditions have been reported to mimic adrenal masses at CT.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Adrenal Glands / radiography. Diagnostic Errors / prevention & control. Image Enhancement / methods. Tomography, X-Ray Computed / methods

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  • [Copyright] (c) RSNA, 2009.
  • (PMID = 19755599.001).
  • [ISSN] 1527-1323
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 56
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57. Bembo SA, Elimian A, Waltzer W, Carlson HE: Pheochromocytoma in a pregnant woman with a history of intracerebral aneurysms. Am J Med Sci; 2005 Jun;329(6):317-9
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  • [Title] Pheochromocytoma in a pregnant woman with a history of intracerebral aneurysms.
  • Pheochromocytoma in pregnancy is rare; if unrecognized, potentially fatal hypertensive crises may occur.
  • Laboratory data revealed elevated 24-hour urinary catecholamine and metanephrine levels, and abdominal sonography showed a 10-cm right adrenal mass.
  • Postpartum abdominal computed tomography scanning confirmed a 10-cm right adrenal mass.
  • A benign pheochromocytoma was removed without incident.
  • This case illustrates the importance of early diagnosis and management of pheochromocytoma in pregnancy and is also an example of the rare association of pheochromocytoma with intracerebral aneurysms.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Pheochromocytoma / diagnosis. Pregnancy Complications, Neoplastic / diagnosis


58. Rescorla FJ: Malignant adrenal tumors. Semin Pediatr Surg; 2006 Feb;15(1):48-56
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  • [Title] Malignant adrenal tumors.
  • Adrenal tumors, apart from neuroblastoma, are relatively rare in infancy and childhood.
  • Most adrenal lesions are benign, and both benign and malignant tumors may be hormonally active thus, making accurate preoperative diagnosis difficult.
  • The two main malignant tumors are adrenocortical carcinoma and pheochromocytoma.
  • In both tumors, it may be difficult to determine benign from malignant and the biologic behavior and degree of invasion may portend a more malignant course.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / therapy. Adrenocortical Carcinoma / diagnosis. Adrenocortical Carcinoma / therapy. Pheochromocytoma / diagnosis. Pheochromocytoma / therapy

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  • (PMID = 16458846.001).
  • [ISSN] 1055-8586
  • [Journal-full-title] Seminars in pediatric surgery
  • [ISO-abbreviation] Semin. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 98
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59. Tica I, Tica VI, Mihailov C: Rare association of adrenal tumors. Rom J Intern Med; 2007;45(1):107-11
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  • [Title] Rare association of adrenal tumors.
  • Adrenal incidentalomas represent a true problem both in the clinical diagnosis and in their treatment.
  • A great variety of pathologies may be found under the umbrella of this concept: benign adenomas - functioning or not, myelolipomas, hamartomas, or granulomatous infiltrations of the adrenal.
  • The possibility of malignancy should be considered in each case, especially in patients with a known extra-adrenal primary.
  • We present an interesting case because of the surprising association of two adrenal tumors, with a long time lapse between them, with ascites and pleurisy and because of the difficulty of treatment in a patient refusing surgery.
  • Miss MR, 61 years old, was treated surgically for pheochromocytoma 28 years ago (left adrenalectomy).
  • A right adrenal incidentaloma of 21/15 mm - in association with ascites and pleurisy - was found at CT scan.
  • [MeSH-major] Adrenal Gland Neoplasms / complications. Adrenal Gland Neoplasms / diagnosis. Ascites / complications. Pheochromocytoma / complications. Pleurisy / complications

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  • (PMID = 17966451.001).
  • [ISSN] 1220-4749
  • [Journal-full-title] Romanian journal of internal medicine = Revue roumaine de médecine interne
  • [ISO-abbreviation] Rom J Intern Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Romania
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60. Fariña Pérez LA: [Laparoscopic adrenalectomy]. Actas Urol Esp; 2006 May;30(5):510-2
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  • Laparoscopic extirpation of the suprarenal gland is considered the 'gold standard' of surgery for benign conditions, but its indication in suprarenal cancer is still controversial.
  • In this article, we review the pros and cons of the laparoscopic approach in the different disorders that affect the adrenal gland, pheochromocytoma, cancer, partial and bilateral adrenalectomy, etc.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy

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  • (PMID = 16884103.001).
  • [ISSN] 0210-4806
  • [Journal-full-title] Actas urologicas españolas
  • [ISO-abbreviation] Actas Urol Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 15
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61. Chervin RA, Danilowicz K, Pitoia F, Gómez RM, Bruno OD: [A study of 34 cases of adrenal incidentaloma]. Medicina (B Aires); 2007;67(4):341-50
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  • [Title] [A study of 34 cases of adrenal incidentaloma].
  • Adrenal incidentaloma, a tumor discovered unexpectedly during imaging performed for non-adrenal related causes, has become a frequent clinical concern.
  • Although in most cases they are benign and hormonally nonfunctioning, it is important to appropriately identify those few cases of malignant or hyperfunctioning lesions of surgical resolution.
  • In the present retrospective study we analyzed 34 patients with adrenal incidentaloma.
  • Of these, 32% of the patients displayed hyperfunctioning pathologies that included subclinical Cushing's syndrome in four patients, probable primary hyperaldosteronism in two, late onset congenital adrenal hyperplasia in one, adrerocortical carcinoma in one and pheochromocytoma in three.
  • CT and/or MRI permitted the identification of adenomas and were crucial to decide on surgery in two patients with nonfunctioning pheochromocytomas and in a patient carrying a primitive adrenocortical carcinoma, a diagnosis also suggested by a mixed pattern of hypersecretion of androgens and cortisol.
  • Nonfunctioning tumors were mainly adenomas (87%) with individual cases of histoplasmosis, pseudocyst, idiopathic adrenal hyperplasia and mielolipoma.
  • [MeSH-major] Adenoma / diagnosis. Adrenal Gland Neoplasms / diagnosis. Cushing Syndrome / diagnosis. Pheochromocytoma / diagnosis
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Aged. Androgens / secretion. Child. Diagnosis, Differential. Female. Humans. Incidental Findings. Male. Middle Aged. Retrospective Studies. Treatment Outcome

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  • (PMID = 17891929.001).
  • [ISSN] 0025-7680
  • [Journal-full-title] Medicina
  • [ISO-abbreviation] Medicina (B Aires)
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Argentina
  • [Chemical-registry-number] 0 / Androgens
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62. Korpershoek E, Stobbe CK, van Nederveen FH, de Krijger RR, Dinjens WN: Intra-tumoral molecular heterogeneity in benign and malignant pheochromocytomas and extra-adrenal sympathetic paragangliomas. Endocr Relat Cancer; 2010 Sep;17(3):653-62
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  • [Title] Intra-tumoral molecular heterogeneity in benign and malignant pheochromocytomas and extra-adrenal sympathetic paragangliomas.
  • Pheochromocytomas (PCCs) and extra-adrenal sympathetic paragangliomas (sPGLs) are catecholamine-producing tumors occurring in the context of hereditary tumor syndromes, with known germline mutations, and as sporadic tumors.
  • Since knowledge on intra-tumoral heterogeneity is important for understanding the pathogenesis of these tumors, we investigated 12 benign and 8 malignant PCCs and sPGLs for loss of heterozygosity (LOH) on DNA extracted from different regions of each tumor and from metastases.
  • Benign tumors were found to have less intra-tumoral heterogeneity (overall 8%) than malignant tumors (overall 23%), with the highest frequencies for chromosome 1p36 in the benign tumors (17%) and 1p13 and 3q24 in malignant tumors (both 38%).
  • We demonstrate that malignant PCC and sPGL have more intra-tumoral molecular heterogeneity than benign tumors, which suggests that benign and malignant PCC and sPGL have a different pathogenesis.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Chromosomes, Human. Loss of Heterozygosity. Paraganglioma / genetics. Pheochromocytoma / genetics

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  • (PMID = 20488782.001).
  • [ISSN] 1479-6821
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA, Neoplasm
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63. Carlsen E, Abdullah Z, Kazmi SM, Kousparos G: Pheochromocytomas, PASS, and immunohistochemistry. Horm Metab Res; 2009 Sep;41(9):715-9
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  • Differentiation between malignant and benign pheochromocytomas of the adrenal gland traditionally relies on the presence of clinically detectable metastases.
  • The PASS system for differentiating between benign and malignant pheochromocytomas is based on defined morphological criteria, of which some are related to tumour cell proliferation and survival.
  • [MeSH-major] Adrenal Gland Neoplasms / metabolism. Adrenal Gland Neoplasms / pathology. Pheochromocytoma / metabolism. Pheochromocytoma / pathology


64. Meyer-Rochow GY, Soon PS, Delbridge LW, Sywak MS, Bambach CP, Clifton-Bligh RJ, Robinson BG, Sidhu SB: Outcomes of minimally invasive surgery for phaeochromocytoma. ANZ J Surg; 2009 May;79(5):367-70
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  • Laparoscopic adrenalectomy is now accepted as the procedure of choice for the resection of benign adrenocortical tumours, but few studies have assessed whether the outcomes of laparoscopic adrenalectomy for adrenal phaeochromocytoma are similar to that of other adrenal tumour types.
  • Clinical and operative data were obtained from an adrenal tumour database and hospital records.
  • Despite the greater size of the phaeochromocytomas compared to the remaining adrenal tumour types (44 mm vs 30 mm, P < 0.01), however, rate of conversion and morbidity were no different.
  • Laparoscopic adrenalectomy for phaeochromocytoma is a safe procedure with similar outcomes to laparoscopic adrenalectomy for other adrenal tumour types.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy / methods. Pheochromocytoma / surgery

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  • (PMID = 19566519.001).
  • [ISSN] 1445-2197
  • [Journal-full-title] ANZ journal of surgery
  • [ISO-abbreviation] ANZ J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Australia
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65. Ohta S, Lai EW, Pang AL, Brouwers FM, Chan WY, Eisenhofer G, de Krijger R, Ksinantova L, Breza J, Blazicek P, Kvetnansky R, Wesley RA, Pacak K: Downregulation of metastasis suppressor genes in malignant pheochromocytoma. Int J Cancer; 2005 Mar 10;114(1):139-43
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  • [Title] Downregulation of metastasis suppressor genes in malignant pheochromocytoma.
  • There is no reliable method currently available to predict malignant potential of pheochromocytoma based on conventional histology or genetic, molecular or immunohistochemical markers.
  • Metastasis suppressor genes affect the spread of several cancers and, therefore, may provide promise as prognostic markers or therapeutic targets for malignant pheochromocytoma.
  • We hypothesized that the downregulation of metastasis suppressor genes in malignant pheochromocytoma may play a role in malignant behavior.
  • The study included 15 benign and 10 malignant pheochromocytomas.
  • Six metastasis suppressor genes (nm23-H1, TIMP-4, BRMS-1, TXNIP, CRSP-3 and E-Cad) were downregulated significantly in malignant compared to benign pheochromocytoma (p < 0.05, Mann-Whitney U-test).
  • We applied a non-linear rule using median malignant value (MMV) as a threshold to use metastasis suppressor genes to distinguish malignant from benign samples.
  • After cross-validation, the non-linear rule produced no errors in 10 malignant samples and 3 errors in the 15 benign samples, with an overall error rate of 12%.
  • These results suggest that downregulation of metastasis suppressor genes reflect malignant pheochromocytoma with a high degree of sensitivity.
  • Thus, we conclude that altered function of these metastasis suppressor gene pathways may play an important role in the malignant behavior of pheochromocytoma.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Genes, Tumor Suppressor. Pheochromocytoma / metabolism
  • [MeSH-minor] Adrenal Gland Neoplasms / metabolism. Adult. Aged. Cadherins / metabolism. Down-Regulation. Female. Humans. Male. Mediator Complex. Middle Aged. NM23 Nucleoside Diphosphate Kinases. Nucleoside-Diphosphate Kinase / metabolism. Polymerase Chain Reaction. Prognosis. Tissue Inhibitor of Metalloproteinases / metabolism. Trans-Activators / metabolism

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  • (PMID = 15523699.001).
  • [ISSN] 0020-7136
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cadherins; 0 / MED23 protein, human; 0 / Mediator Complex; 0 / NM23 Nucleoside Diphosphate Kinases; 0 / Tissue Inhibitor of Metalloproteinases; 0 / Trans-Activators; 0 / tissue inhibitor of metalloproteinase-4; EC 2.7.4.6 / NME1 protein, human; EC 2.7.4.6 / Nucleoside-Diphosphate Kinase
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66. Mazzaglia PJ, Monchik JM: Limited value of adrenal biopsy in the evaluation of adrenal neoplasm: a decade of experience. Arch Surg; 2009 May;144(5):465-70
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  • [Title] Limited value of adrenal biopsy in the evaluation of adrenal neoplasm: a decade of experience.
  • OBJECTIVE: To determine the value of percutaneous adrenal biopsy in the evaluation of adrenal neoplasm.
  • PATIENTS: All adult patients undergoing image-guided adrenal biopsy from 1997 to 2007.
  • Eighty-eight biopsies (53.4%) were performed in patients with a prior diagnosis of cancer.
  • Forty-five (26.4%) were performed when imaging study results suggested previously undiagnosed cancer with a simultaneous adrenal metastasis.
  • Thirty (20.2%) were performed for isolated adrenal incidentalomas.
  • Prebiopsy evaluation for pheochromocytoma was performed in less than 5% of patients with established or suspected nonadrenal malignancies and 32% of patients with incidentalomas.
  • In patients with isolated adrenal incidentaloma, a radiology report recommended biopsy 33% of the time for characteristics inconsistent with benign adenoma.
  • Benign incidentalomas measured mean (SD) 4.2 (2.1) cm (range, 1.4-10.7 cm), and malignancies measured mean (SD) 9.3 (3.3) cm (range, 5.3-14 cm) (P < .05).
  • All incidentalomas 5 cm or less (n = 18) were benign.
  • There were 4 false-negative biopsy results: 3 adrenocortical carcinomas and 1 pheochromocytoma.
  • CONCLUSIONS: Biopsy is unhelpful in patients with isolated adrenal incidentaloma.
  • Despite atypical radiographic findings, all nonfunctioning nodules 5 cm or less were benign.
  • The value of biopsy remains the diagnosis of metastatic carcinoma in patients with a nonadrenal primary malignancy, proven by the more than 70% positive rate in this group.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Biopsy / methods. Pheochromocytoma / pathology

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  • (PMID = 19451490.001).
  • [ISSN] 1538-3644
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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67. Yuan W, Wang W, Cui B, Su T, Ge Y, Jiang L, Zhou W, Ning G: Overexpression of ERBB-2 was more frequently detected in malignant than benign pheochromocytomas by multiplex ligation-dependent probe amplification and immunohistochemistry. Endocr Relat Cancer; 2008 Mar;15(1):343-50
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  • [Title] Overexpression of ERBB-2 was more frequently detected in malignant than benign pheochromocytomas by multiplex ligation-dependent probe amplification and immunohistochemistry.
  • To analyze the genetic alterations of pheochromocytomas and evaluate the difference among malignant, extra-adrenal, and benign pheochromocytomas.
  • All 43 patients (24 women and 19 men; mean age 44.6+/-13.6 years; range 18-75 years; 9 with malignant, 7 extra-adrenal, and 27 benign) showed multiple copy number losses or gains.
  • The average copy number change was 13.10 in malignant, 13.93 in benign, and 13.47 in paraganglioma patients.
  • However, we discovered that in the malignant pheochromocytomas, 6 of the 9 patients (67%) showed erythroblastic leukemia viral oncogene homolog 2 (ERBB-2) oncogene gain, whereas only 12 of the 34 (35%) identified change in the benign and extra-adrenal pheochromocytomas.
  • Further, IHC confirmed that ERBB-2-positive staining was more frequent and stronger in malignant pheochromocytomas than in benign and extra-adrenal pheochromocytomas.
  • Our study illustrates the chromosomal changes of the whole genome of Chinese pheochromocytoma patients.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Gene Amplification. Genes, erbB-2 / genetics. Paraganglioma / genetics. Pheochromocytoma / classification. Pheochromocytoma / genetics

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  • (PMID = 18310300.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2254511
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68. Geli J, Nord B, Frisk T, Edström Elder E, Ekström TJ, Carling T, Bäckdahl M, Larsson C: Deletions and altered expression of the RIZ1 tumour suppressor gene in 1p36 in pheochromocytomas and abdominal paragangliomas. Int J Oncol; 2005 May;26(5):1385-91
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  • A panel of 18 pheochromocytomas (14 benign, and 4 malignant) and 11 abdominal paragangliomas (4 benign, and 7 malignant) were characterised for somatic deletions and mRNA expression status of RIZ1 using loss of heterozygosity (LOH) analysis and real-time quantitative PCR, respectively.
  • RIZ1 mRNA appeared to be significantly under-expressed in the tumour samples compared to normal adrenal controls (mean 0.6 vs. 1.0, p<0.001).
  • [MeSH-major] Abdominal Neoplasms / genetics. Adrenal Gland Neoplasms / genetics. Chromosomes, Human, Pair 1. DNA-Binding Proteins / biosynthesis. DNA-Binding Proteins / genetics. Gene Deletion. Gene Expression Profiling. Nuclear Proteins / biosynthesis. Nuclear Proteins / genetics. Paraganglioma / genetics. Pheochromocytoma / genetics. Transcription Factors / biosynthesis. Transcription Factors / genetics

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  • (PMID = 15809732.001).
  • [ISSN] 1019-6439
  • [Journal-full-title] International journal of oncology
  • [ISO-abbreviation] Int. J. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / DNA-Binding Proteins; 0 / Nuclear Proteins; 0 / RNA, Messenger; 0 / Retinoblastoma Protein; 0 / Transcription Factors; EC 2.1.1.43 / Histone-Lysine N-Methyltransferase; EC 2.1.1.43 / PRDM2 protein, human
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69. Frazzetta M, Tornambè A, Barrera T, Sciortino A, Lucania M, Frazzetta F, Sammartano A, Bonventre S, Vetri R: [Adrenal incidentaloma: case report and synthesis of indication and thresholds of surgery therapy]. G Chir; 2010 Nov-Dec;31(11-12):534-6
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  • [Title] [Adrenal incidentaloma: case report and synthesis of indication and thresholds of surgery therapy].
  • In 1982, the term "incidentaloma" was introduced to indicate lesions detected on adrenal regions, found unexpectedly.
  • Incidentalomas with diameters under 1 cm seem to not have a pathologic significance, and are considered like manifestation of the gland involution in advanced-age subjects, and can remain unseen for a long time.
  • The mass dimensions are a fundamental parameter used to distinguish benign lesions from malign ones (2, 3).
  • Most Authors suspect malignity in masses above 5-6 cm, while considering those with a diameter under 3 cm to be benign.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy. Diabetes Mellitus, Type 2 / complications. Incidental Findings. Pheochromocytoma / surgery


70. Legmann P: [Adrenal incidentaloma: management approaches: CT - MRI]. J Radiol; 2009 Mar;90(3 Pt 2):426-43
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  • [Title] [Adrenal incidentaloma: management approaches: CT - MRI].
  • The adrenal gland may be affected by several pathologies, and the detection of an adrenal nodule may occur during the work-up of a biological abnormality, oncologic work-up, or be incidental.
  • Cross-sectional imaging has had a great impact on the diagnostic work-up of adrenal nodules.
  • CT, without and with intravenous contrast, is the first line imaging study for evaluation of adrenal nodules.
  • A spontaneous density below 10 HU confirms the benign nature of a nodule.
  • When lesions cannot be characterized, postcontrast CT or MR imaging, including in and out of phase imaging, may allow diagnosis.
  • [MeSH-major] Adenoma / diagnosis. Adenoma / radiography. Adrenal Gland Diseases / diagnosis. Adrenal Gland Diseases / radiography. Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / radiography. Cushing Syndrome / diagnosis. Cushing Syndrome / radiography. Incidental Findings. Magnetic Resonance Imaging / methods. Sarcoma, Ewing / diagnosis. Sarcoma, Ewing / radiography. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / radiography. Adrenal Glands / pathology. Adult. Algorithms. Biopsy. Cysts / diagnosis. Cysts / radiography. Diagnosis, Differential. Female. Hemangioma / diagnosis. Hemangioma / radiography. Hematoma / diagnosis. Hematoma / radiography. Humans. Lymphoma / diagnosis. Lymphoma / radiography. Pheochromocytoma / diagnosis. Pheochromocytoma / radiography. Sarcoma / diagnosis. Sarcoma / radiography


71. Gumbs AA, Gagner M: Laparoscopic adrenalectomy. Best Pract Res Clin Endocrinol Metab; 2006 Sep;20(3):483-99
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  • Laparoscopic adrenalectomy (LA) was first described in the literature in 1992, and has become the preferred method for the removal of benign functioning and non-functioning tumors of the adrenal gland <12 cm.
  • The objectives of the present study are to review the experience of LA gained since it was first done in 1992 and to critically evaluate its effectiveness for the surgical management of endocrine hypertension; specifically pheochromocytoma, aldosteronoma and Cushing's syndrome and disease, as opposed to open adrenalectomy.
  • The benefits of minimally invasive techniques for the removal of the adrenal gland include decreased requirements for analgesics, improved patient satisfaction, shorter hospital stay and recovery time when compared to open surgery.
  • [MeSH-minor] Adenoma / secretion. Adenoma / surgery. Adrenal Gland Neoplasms / secretion. Adrenal Gland Neoplasms / surgery. Aldosterone / secretion. Convalescence. Cushing Syndrome / surgery. Humans. Length of Stay. Patient Satisfaction. Pheochromocytoma / surgery

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  • (PMID = 16980207.001).
  • [ISSN] 1521-690X
  • [Journal-full-title] Best practice & research. Clinical endocrinology & metabolism
  • [ISO-abbreviation] Best Pract. Res. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 4964P6T9RB / Aldosterone
  • [Number-of-references] 112
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72. van Nederveen FH, Perren A, Dannenberg H, Petri BJ, Dinjens WN, Komminoth P, de Krijger RR: PTEN gene loss, but not mutation, in benign and malignant phaeochromocytomas. J Pathol; 2006 Jun;209(2):274-80
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  • [Title] PTEN gene loss, but not mutation, in benign and malignant phaeochromocytomas.
  • Furthermore, benign and malignant PCCs are found in several PTEN knockout mouse models.
  • Tumour and germline DNA was analysed from 31 patients with apparently sporadic PCC, including 14 clinically benign and 17 malignant tumours, for loss of the PTEN gene locus, mutations in the PTEN gene, and for PTEN protein expression by immunohistochemistry.
  • Loss of heterozygosity (LOH) analysis showed loss of PTEN in four malignant tumours (40%) and in one benign tumour (14%).
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Genes, Tumor Suppressor / physiology. Neoplasm Proteins / genetics. PTEN Phosphohydrolase / genetics. Pheochromocytoma / genetics

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  • [Copyright] Copyright (c) 2006 Pathological Society of Great Britain and Ireland.
  • (PMID = 16538614.001).
  • [ISSN] 0022-3417
  • [Journal-full-title] The Journal of pathology
  • [ISO-abbreviation] J. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA, Neoplasm; 0 / Neoplasm Proteins; EC 3.1.3.48 / PTEN protein, human; EC 3.1.3.67 / PTEN Phosphohydrolase
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73. Faria JF, Goldman SM, Szejnfeld J, Melo H, Kater C, Kenney P, Huayllas MP, Demarchi G, Francisco VV, Andreoni C, Srougi M, Ortiz V, Abdalla N: Adrenal masses: characterization with in vivo proton MR spectroscopy--initial experience. Radiology; 2007 Dec;245(3):788-97
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  • [Title] Adrenal masses: characterization with in vivo proton MR spectroscopy--initial experience.
  • PURPOSE: To prospectively determine the accuracy of in vivo proton ((1)H) magnetic resonance (MR) spectroscopy in distinguishing adrenal adenomas, pheochromocytomas, adrenocortical carcinomas, and metastases, with histologic or computed tomographic findings and follow-up data as the reference standards.
  • Sixty consecutive patients (24 male and 36 female patients; mean age, 53 years) harboring adrenal tumors larger than 2 cm in diameter (mean diameter, 4.6 cm +/- 3.4 [standard deviation]) entered the study and were examined with a 1.5-T MR imaging system and point-resolved multivoxel (1)H MR spectroscopy.
  • Metabolite ratios (choline-creatine, choline-lipid, lipid-creatine, and 4.0-4.3 ppm/creatine) and cutoff values (obtained by using receiver operating characteristic analyses) were obtained and compared for each type of adrenal mass, which was identified previously on the basis of clinical, hormonal, and pathologic evidence.
  • CONCLUSION: (1)H MR spectroscopy can be used to characterize adrenal masses on the basis of spectral findings for benign adenomas, carcinomas, pheochromocytomas, and metastases.
  • [MeSH-major] Adenoma / diagnosis. Adrenal Gland Neoplasms / diagnosis. Adrenocortical Carcinoma / diagnosis. Magnetic Resonance Spectroscopy. Pheochromocytoma / diagnosis
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Prospective Studies. Reproducibility of Results

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  • [Copyright] (c) RSNA, 2007.
  • [CommentIn] Radiology. 2009 Mar;250(3):955-6; author reply 955-6; discussion 956 [19244058.001]
  • (PMID = 18024453.001).
  • [ISSN] 1527-1315
  • [Journal-full-title] Radiology
  • [ISO-abbreviation] Radiology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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74. Yu R, Nissen NN, Dhall D, Wei M: Pheochromocytoma in patients suspected of harboring adrenal metastasis: management and clinical predictors. Endocr Pract; 2008 Nov;14(8):967-72
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  • [Title] Pheochromocytoma in patients suspected of harboring adrenal metastasis: management and clinical predictors.
  • OBJECTIVE: To study clinical management of patients with suspected adrenal metastasis and to assess whether there are clinical predictors of pheochromocytoma in this patient population.
  • METHODS: In this retrospective cross-sectional study, we reviewed medical records of patients who had adrenalectomy for adrenal lesions or had adrenal biopsy performed between January 1997 and July 2007 in a large academic hospital.
  • Patients who harbored adrenal masses that were suspected of being metastases were identified on clinical findings.
  • Pathologic diagnosis, demographic data, clinical history, imaging studies, and laboratory test results were reviewed and compared among patients whose adrenal mass was determined to be metastasis, adenoma, or pheochromocytoma.
  • RESULTS: One-hundred sixty-three patients had adrenalectomy or had adrenal biopsy during the study period.
  • Thirty patients (18%) had adrenal masses that were suspected of being metastases.
  • Of the adrenal masses, 18 (60%) were metastases, 8 (27%) were benign adenomas, and 4 (13%) were pheochromocytomas.
  • Eleven patients (37%) had biochemical testing for pheochromocytoma.
  • Adrenal biopsy was performed without biochemical testing for pheochromocytoma in 9 patients (30%), including 2 subsequently found to have this tumor.
  • Adrenalectomy was performed in 10 patients (33%) without biochemical testing for pheochromocytoma.
  • Clinical parameters were similar among patients with metastasis, adenoma, or pheochromocytoma.
  • There were no clinical predictors to suggest pheochromocytoma.
  • CONCLUSIONS: Pheochromocytoma occurs frequently in patients suspected of harboring adrenal metastasis, but this tumor is often not considered in clinical practice.
  • The size and imaging characteristics of the adrenal mass and history of known metastasis may help clinicians in decision-making.
  • Biochemical testing for pheochromocytoma should ideally be performed in all patients suspected of having adrenal metastasis.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Pheochromocytoma / pathology

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  • (PMID = 19095594.001).
  • [ISSN] 1934-2403
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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75. International Pediatric Endosurgery Group: IPEG guidelines for the surgical treatment of adrenal masses in children. J Laparoendosc Adv Surg Tech A; 2010 Mar;20(2):vii-ix
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  • [Title] IPEG guidelines for the surgical treatment of adrenal masses in children.
  • Laparoscopic adrenalectomy and adrenal biopsy are technically feasible in children.
  • There are no absolute contraindications to the laparoscopic approach, but for neuroblastomas and other adrenal neoplasms, care must be taken to maintain the principles of cancer surgery.
  • As opposed to adults, there are fewer benign indications for adrenalectomy, but in selected cases, laparoscopic resection of the adrenal is feasible.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy / methods
  • [MeSH-minor] Biopsy / methods. Child. Evidence-Based Medicine. Humans. Neuroblastoma / diagnosis. Neuroblastoma / surgery. Pheochromocytoma / diagnosis. Pheochromocytoma / surgery

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  • (PMID = 20230240.001).
  • [ISSN] 1557-9034
  • [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; Practice Guideline
  • [Publication-country] United States
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76. Safwat AS, Bissada NK, Seyam RM, Al Sobhi S, Hanash KA: The clinical spectrum of phaeochromocytoma: analysis of 115 patients. BJU Int; 2008 Jun;101(12):1561-4
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  • RESULTS: Of the 115 patients, 90 had adrenal tumours, 18 extra-adrenal and seven combined adrenal and extra-adrenal tumours.
  • Ten patients had malignant and 105 had benign phaeochromocytoma.
  • The diagnosis of phaeochromocytoma is confirmed by chemical methods, and located using imaging techniques, with computed tomography, magnetic resonance imaging and (131)I-meta-iodobenzyl guanidine radioisotope scanning being the most common.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Hypertension / etiology. Pheochromocytoma / pathology


77. Ruiz-Tovar J, Pérez de Oteyza J, Alonso Hernández N, Díez Tabernilla M, Rojo Blanco R, Collado Guirao MV, García Villanueva A: [Laparoscopic adrenalectomy]. Cir Esp; 2007 Sep;82(3):161-5
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  • INTRODUCTION: In the last few years, laparoscopic adrenalectomy has become widely used in the management of adrenal disease.
  • RESULTS: Surgery was indicated for Cushing's syndrome in 46% of the patients, aldosteronoma in 25%, incidentaloma in 21% and pheochromocytoma in 8%.
  • The mean size of the gland was 4 cm.
  • CONCLUSIONS: Laparoscopic adrenalectomy should be considered the procedure of choice for the surgical management of benign adrenal disease.
  • [MeSH-minor] Female. Humans. Hyperaldosteronism / surgery. Male. Middle Aged. Pheochromocytoma / surgery. Pituitary ACTH Hypersecretion / surgery

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  • (PMID = 17916287.001).
  • [ISSN] 0009-739X
  • [Journal-full-title] Cirugía española
  • [ISO-abbreviation] Cir Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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78. Dietrich CF, Ignee A, Barreiros AP, Schreiber-Dietrich D, Sienz M, Bojunga J, Braden B: Contrast-enhanced ultrasound for imaging of adrenal masses. Ultraschall Med; 2010 Apr;31(2):163-8
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  • [Title] Contrast-enhanced ultrasound for imaging of adrenal masses.
  • PURPOSE: The number of incidentally discovered adrenal masses is growing due to the increased use of modern high-resolution imaging techniques.
  • However, the characterization and differentiation of benign and malignant adrenal lesions is challenging.
  • This study aimed to evaluate contrast-enhanced ultrasound for the characterization of adrenal masses.
  • MATERIALS AND METHODS: We studied 58 patients with adrenal masses detected with computed tomography, magnetic resonance imaging, or ultrasound.
  • 7 patients had bilateral adrenal lesions.
  • The contrast enhancement pattern of all adrenal lesions was documented.
  • RESULTS: The 18 malignant adrenal tumors were significantly larger at the time of diagnosis compared to the 40 benign lesions (p < 0.03).
  • The majority of benign adrenal lesions (37 / 40) had a nonspecific type of contrast enhancement (24 / 40) or a peripheral to central contrast filling (13 / 40) described as the iris phenomenon.
  • Similar findings were observed in malignant adrenal tumors: most malignant lesions also showed nonspecific (6 / 18) or peripheral to central contrast filling (9 / 18).
  • CONCLUSION: Contrast-enhanced ultrasound facilitates the visualization of vascularization even in small adrenal masses, but it does not help to distinguish malignant and benign lesions.
  • [MeSH-major] Adrenal Gland Neoplasms / ultrasonography. Contrast Media / administration & dosage. Image Enhancement. Phospholipids. Sulfur Hexafluoride
  • [MeSH-minor] Adrenal Gland Diseases / ultrasonography. Adult. Aged. Cushing Syndrome / ultrasonography. Diagnosis, Differential. Female. Humans. Incidental Findings. Lipoma / blood supply. Lipoma / ultrasonography. Magnetic Resonance Imaging. Male. Middle Aged. Multiple Endocrine Neoplasia Type 2a / blood supply. Multiple Endocrine Neoplasia Type 2a / ultrasonography. Neoplasms, Multiple Primary / blood supply. Neoplasms, Multiple Primary / ultrasonography. Neovascularization, Pathologic / ultrasonography. Pheochromocytoma / blood supply. Pheochromocytoma / ultrasonography. Sensitivity and Specificity. Tomography, X-Ray Computed. Young Adult

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  • [Copyright] Georg Thieme Verlag KG Stuttgart . New York.
  • (PMID = 19401979.001).
  • [ISSN] 1438-8782
  • [Journal-full-title] Ultraschall in der Medizin (Stuttgart, Germany : 1980)
  • [ISO-abbreviation] Ultraschall Med
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Contrast Media; 0 / Phospholipids; 0 / contrast agent BR1; WS7LR3I1D6 / Sulfur Hexafluoride
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79. Hara I, Kawabata G, Hara S, Yamada Y, Tanaka K, Fujisawa M: Clinical outcomes of laparoscopic adrenalectomy according to tumor size. Int J Urol; 2005 Dec;12(12):1022-7
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  • OBJECTIVES: In order to evaluate the indication and usefulness of laparoscopic adrenalectomy, clinical outcomes of laparoscopic adrenalectomy for patients with adrenal tumors were examined.
  • PATIENTS AND METHODS: A total of 63 patients with adrenal tumor underwent laparoscopic adrenalectomy in our institute between 1999 and 2003.
  • Underlying pathologies comprised Cushing syndrome (n = 12), pheochromocytoma (n = 13), primary aldosteronism (n = 21), non-functioning adenoma (n = 12) and others (n = 5).
  • Long-term clinical outcome was better for patients with pheochromocytoma or primary aldosteronism than for patients with Cushing syndrome.
  • CONCLUSIONS: Laparoscopic adrenalectomy for benign tumor offers excellent surgical outcomes and convalescence.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy

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  • (PMID = 16409603.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
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80. Berker D, Isik S, Erden G, Tutuncu YA, Ozcan HN, Caner S, Tekelek B, Aydin Y, Guler S: Serum matrix metalloproteinase-9 levels in the diagnosis of functioning adrenal tumors. Endocr Pract; 2010 May-Jun;16(3):419-27
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  • [Title] Serum matrix metalloproteinase-9 levels in the diagnosis of functioning adrenal tumors.
  • OBJECTIVE: To investigate whether serum matrix metalloproteinase-9 (MMP-9) levels can be used as a diagnostic tool in determining the functioning status of benign adrenal tumors.
  • METHODS: In this case-control study, medical records of patients with adrenal tumors who consecutively presented to an endocrinology clinic between August 2005 and October 2008 were evaluated.
  • Findings were compared among patients with functioning adrenal tumors, patients with nonfunctioning adrenal tumors, and control participants.
  • RESULTS: Of 370 patients with adrenal tumors, 50 with adrenal incidentaloma met the inclusion criteria.
  • Group 1 included 20 patients with functioning adrenal tumors (14 with Cushing syndrome and 6 with pheochromocytoma), and Group 2 included 30 patients with nonfunctioning adrenal tumors.
  • MMP-9 levels were higher in patients with nonfunctioning adrenal tumors and functioning adrenal tumors than in control participants (P<.001).
  • MMP-9 levels in patients with functioning adrenal tumors were significantly higher than those in patients with nonfunctioning adrenal tumors (P = .002).
  • After operation, MMP-9 levels decreased significantly in patients with Cushing syndrome and in those with pheochromocytoma; however, patients with Cushing syndrome and pheochromocytoma had similar MMP-9 levels preoperatively and postoperatively.
  • CONCLUSION: Our data suggest that serum MMP-9 levels may be useful in differentiating benign subclinical functioning adrenal tumors from benign nonfunctioning adrenal tumors.
  • [MeSH-major] Adrenal Gland Neoplasms / blood. Adrenal Gland Neoplasms / diagnosis. Matrix Metalloproteinase 9 / blood

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  • (PMID = 20061295.001).
  • [ISSN] 1934-2403
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] EC 3.4.24.35 / Matrix Metalloproteinase 9
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81. Zhu Y, He HC, Yuan F, Zhang J, Rui WB, Zhao JP, Shen ZJ, Ning G: Heparanase-1 and Cyclooxygenase-2: prognostic indicators of malignancy in pheochromocytomas. Endocrine; 2010 Aug;38(1):93-9
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  • The objective of this article is to evaluate Heparanase-1 and Cyclooxygenase-2 as tissue-based markers of pheochromocytoma prognosis.
  • Ninety-two sporadic pheochromocytoma patients with a minimum of 8-year follow-up post-diagnosis were enrolled.
  • Slides of normal adrenal glands in nephrectomy specimens from 20 patients with benign renal tumors were as control.
  • Positive staining for Heparanase-1 was observed in 23.68% of the benign and 77.78% of the malignant cases, whereas none of the normal adrenal controls showed positive staining.
  • Similarly, Cyclooxygenase-2 staining was seen in 23.68% of the benign versus 83.33% of the malignant cases, and none of the normal controls appeared positive for Cyclooxygenase-2.
  • Malignant cases showed higher microvessel density compared to benign tumors and normal controls (36.41, 21.43, and 13.36%, respectively).
  • Heparanase-1 and Cyclooxygenase-2 combined is better than their own to be used as a marker to distinguish malignant from benign pheochromocytoma.
  • [MeSH-major] Adrenal Gland Neoplasms / metabolism. Cyclooxygenase 2 / metabolism. Eukaryotic Initiation Factor-3 / metabolism. Glucuronidase / metabolism. Pheochromocytoma / metabolism

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  • (PMID = 20960108.001).
  • [ISSN] 1559-0100
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / EIF3A protein, human; 0 / Eukaryotic Initiation Factor-3; EC 1.14.99.1 / Cyclooxygenase 2; EC 3.2.1.- / heparanase; EC 3.2.1.31 / Glucuronidase
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82. González JI, Angoso M, García JA, Clemen JJ, Prado A, Angoso F: [Extra-adrenal pheochromocytoma: update of the most controversial features. Apropos of two cases]. Cir Esp; 2005 Mar;77(3):166-9
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  • [Title] [Extra-adrenal pheochromocytoma: update of the most controversial features. Apropos of two cases].
  • They are usually symptomatic and sporadic and are generally located in the adrenal medulla.
  • We present two cases of extra-adrenal nonfunctional pheochromocytomas located in the retroperitoneum.
  • The tumors were apparently benign and sporadic and were not associated with other neoplasms or hereditary diseases.
  • Several immunohistochemical techniques were performed to reach the definitive diagnosis.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / radiography. Pheochromocytoma / pathology. Pheochromocytoma / radiography

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  • (PMID = 16420910.001).
  • [ISSN] 0009-739X
  • [Journal-full-title] Cirugía española
  • [ISO-abbreviation] Cir Esp
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 16
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83. Nap RR, Meinardi JR, van den Berg G, Dullaart RP, de Vries J, Wolffenbuttel BH: [Long-term follow-up is indicated after surgery for a phaeochromocytoma]. Ned Tijdschr Geneeskd; 2006 May 13;150(19):1045-9
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  • Studies report recurrence ofphaeochromocytoma in 8-20% of cases, and such a recurrence may be either benign or malignant.
  • Factors predictive for recurrence are older age, a malignant primary tumour, tumour weight above 60 g, extra-adrenal origin of the tumour and peroperative tumour spill.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Pheochromocytoma / surgery

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  • (PMID = 16733977.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Netherlands
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84. Terzolo M, Bovio S, Pia A, Reimondo G, Angeli A: Management of adrenal incidentaloma. Best Pract Res Clin Endocrinol Metab; 2009 Apr;23(2):233-43
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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 incidentaloma.
  • Clinically inapparent adrenal masses, or adrenal incidentalomas, are discovered inadvertently in the course of work-up or treatment of unrelated disorders.
  • Two critical questions should be answered before trying to outline the management of adrenal incidentaloma:.
  • (1) identify either primary (adrenocortical cancer) or secondary (adrenal metastasis) malignancy;.
  • Radiological evaluation is the key to the differential diagnosis of benign and malignant tumours.
  • Endocrine testing is necessary to exclude phaeochromocytoma in all patients with an adrenal incidentaloma because this tumour may remain undiagnosed after imaging studies.
  • The management of clinically inapparent adrenal adenomas may vary depending whether or not they are functioning.
  • [MeSH-major] Adrenal Gland Neoplasms / therapy
  • [MeSH-minor] Adenoma / diagnosis. Adenoma / drug therapy. Adenoma / therapy. Animals. Humans. Pheochromocytoma / diagnosis. Pheochromocytoma / therapy

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  • (PMID = 19500766.001).
  • [ISSN] 1878-1594
  • [Journal-full-title] Best practice & research. Clinical endocrinology & metabolism
  • [ISO-abbreviation] Best Pract. Res. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 46
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85. Liu XK, Liu XJ, Dong X, Kong CZ: [Clinical research about treatment for adrenal incidentalomas]. Zhonghua Wai Ke Za Zhi; 2008 Jun 1;46(11):832-4
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  • [Title] [Clinical research about treatment for adrenal incidentalomas].
  • OBJECTIVE: To explore the therapeutic methods of adrenal incidentalomas.
  • Pathological results indicated that 34 cases were pheochromocytoma, 83 adrenal cortical adenoma, 5 adrenal cortical carcinoma, 3 metastases carcinoma, and 26 other benign tumors.
  • CONCLUSIONS: Surgical operations should be performed in malignant tumors, hypersecretion tumors, deuto-clinical adrenal cortical tumors, pheochromocytoma and those whose diameters of tumors are over 3 cm.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery

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  • (PMID = 19035218.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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86. Kalinin AP, Bogatyrev OP, Poliakova GA, Beloshitskiĭ ME, Britvin TA: [Adrenal gland surgery]. Vestn Ross Akad Med Nauk; 2005;(11):43-9
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  • [Title] [Adrenal gland surgery].
  • The authors of the article analyze more than 30-year experience of surgical treatment of adrenal gland diseases, offering a detailed description of clinical and morphological features of the main nosological forms such as Itsenko-Cushing disease and syndrome, primary hyperaldosteronism, pheochromocytoma, incidentaloma, and malignant adrenal tumors.
  • The paper contains basic diagnostic criteria, indications to operative treatment, and extents of surgery for each of the diseases considered, as well as comparative analysis of peculiarities of conventional ("open"), and endoscopic adrenal gland surgeries.
  • The article demonstrates significance of various immunohistochemical markers in differentiation between malignant and benign adrenal tumors.

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  • (PMID = 16408654.001).
  • [ISSN] 0869-6047
  • [Journal-full-title] Vestnik Rossiiskoi akademii meditsinskikh nauk
  • [ISO-abbreviation] Vestn. Akad. Med. Nauk SSSR
  • [Language] RUS
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Russia (Federation)
  • [Number-of-references] 16
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87. Bahrami A, Truong LD, Shen SS, Krishnan B: Synchronous renal and adrenal masses: an analysis of 80 cases. Ann Diagn Pathol; 2009 Feb;13(1):9-15
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  • [Title] Synchronous renal and adrenal masses: an analysis of 80 cases.
  • Synchronous renal and adrenal masses are uncommon.
  • Although adrenal masses in the context of renal cell carcinoma (RCC) are often suspected as metastasis, other adrenal lesions with different therapeutic and prognostic implications may coexist with RCC.
  • In a retrospective review of 550 radical nephrectomies with ipsilateral adrenalectomy, 80 cases of coexisting renal and adrenal masses were identified.
  • The renal masses included 76 RCCs, 3 oncocytomas, and 1 malignant pheochromocytoma of adrenal gland involving the kidney.
  • Although the gross pathologic impression of adrenal masses in the presence of RCC was metastasis, on histologic examination, 56% of them were found to be benign lesions (mostly adrenal adenoma/hyperplasia), whereas malignant involvement from RCC was seen in 43%.
  • The benign and malignant nature of the adrenal lesions in the context of RCC could not be discriminated based on the size of adrenal mass.
  • Because of the prognostic implication of direct or metastatic involvement of adrenal gland in the setting of RCC and the possibility of finding small metastatic foci, a meticulous gross and microscopic examination of adrenal glands is emphasized.
  • Rare unusual combinations of renal and adrenal lesions such as RCC and adrenal histoplasmosis, RCC and adrenal myelolipoma, renal oncocytoma, and adrenal pheochromocytoma are also described.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Glands / pathology. Carcinoma, Renal Cell / pathology. Kidney / pathology. Kidney Neoplasms / pathology
  • [MeSH-minor] Adenoma, Oxyphilic / pathology. Adenoma, Oxyphilic / surgery. Adrenalectomy. Adult. Aged. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Neoplasm Staging. Nephrectomy. Pheochromocytoma / pathology. Pheochromocytoma / surgery. Retrospective Studies

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  • (PMID = 19118776.001).
  • [ISSN] 1532-8198
  • [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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88. Rohana AG, Norazmi MK, Norlaila M: A rare case of Von Hippel Lindau disease. Med J Malaysia; 2006 Jun;61(2):254-7
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  • Pheochromocytoma is a rare catecholamine-secreting tumour typically arising within the adrenal medulla.
  • VHL is associated with multi-organ involvement of benign and malignant tumours characterized by the presence of retinal angiomas, hemangioblastomas of the cerebellum and spinal cord, renal cell carcinomas, pheochromocytomas and other cystic lesions in the kidneys, pancreas, and epididymis.
  • This case report describes a 37 years old Chinese gentleman who presented to our institution for further management of bilateral pheochromocytoma and retinal angioblastoma with problems of duodenal ulcer and anaemia.
  • With these features the criteria for the diagnosis of von Hippel Lindau disease was established.
  • [MeSH-major] von Hippel-Lindau Disease / diagnosis
  • [MeSH-minor] Adrenal Gland Neoplasms / diagnosis. Adrenalectomy. Adult. Diagnosis, Differential. Humans. Male. Pheochromocytoma / diagnosis. Tomography, X-Ray Computed

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  • (PMID = 16898326.001).
  • [ISSN] 0300-5283
  • [Journal-full-title] The Medical journal of Malaysia
  • [ISO-abbreviation] Med. J. Malaysia
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Malaysia
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89. Tonks ID, Mould AW, Schroder WA, Cotterill A, Hayward NK, Walker GJ, Kay GF: Dual loss of rb1 and Trp53 in the adrenal medulla leads to spontaneous pheochromocytoma. Neoplasia; 2010 Mar;12(3):235-43
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  • [Title] Dual loss of rb1 and Trp53 in the adrenal medulla leads to spontaneous pheochromocytoma.
  • Using a Cre/loxP system, we have determined the phenotypic consequences attributable to in vivo deletion of both Rb1 and Trp53 in the mouse adrenal medulla.
  • The coablation of these two tumor suppressor genes during embryogenesis did not disrupt adrenal gland development but resulted in the neoplastic transformation of the neural crest-derived adrenal medulla, yielding pheochromocytomas (PCCs) that developed with complete penetrance and were inevitably bilateral.
  • Despite their typically benign status, these PCCs had profound ramifications on mouse vitality, with effected mice having a median survival of only 121 days.
  • The structural remodeling of the heart in mice harboring Rb1(-/-):Trp53(-/-) PCCs suggests that the mortality of these mice may be attributable to the inappropriate release of catecholamines from the mutated adrenal chromaffin cells.
  • On the basis of the collective data from Rb1 and Trp53 knockout mouse models, it seems that the conversion of Rb1 loss-driven adrenal medulla hyperplasia to PCC can be greatly enhanced by the compound loss of Trp53, whereas the loss of Trp53 alone is generally ineffectual on adrenal chromaffin cell homeostasis.
  • Consequently, the Trp53 tumor suppressor gene is an efficient genetic modifier of Rb1 loss in the development of PCC, and their compound loss in the adrenal medulla has a profound impact on both cellular homeostasis and animal vitality.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Genes, p53 / physiology. Pheochromocytoma / pathology. Retinoblastoma Protein / physiology


90. Lai EW, Perera SM, Havekes B, Timmers HJ, Brouwers FM, McElroy B, Adams KT, Ohta S, Wesley RA, Eisenhofer G, Pacak K: Gender-related differences in the clinical presentation of malignant and benign pheochromocytoma. Endocrine; 2008 Aug-Dec;34(1-3):96-100
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  • [Title] Gender-related differences in the clinical presentation of malignant and benign pheochromocytoma.
  • In this study, we evaluated 23 male and 35 female pheochromocytoma patients for symptoms and signs of pheochromocytoma with special regard to gender-related differences in presentation.
  • Subgroup analyses and multiple regression analysis revealed gender differences to be irrespective of benign or malignant disease, use of adrenoceptor-blockade, age and biochemical phenotype.
  • We conclude female patients have significantly more self-reported pheochromocytoma signs and symptoms than male patients irrespective of biochemical phenotype and tumor presentation which may be related to distinct catecholamine receptor sensitivity.
  • Clinicians should be aware of these complaints in female pheochromocytoma patients and offer adequate treatment if indicated.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Pheochromocytoma / diagnosis. Sex Characteristics

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  • (PMID = 18982461.001).
  • [ISSN] 1355-008X
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Grant] United States / Intramural NIH HHS / /
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Intramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers
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91. Joynt KE, Moslehi JJ, Baughman KL: Paragangliomas: etiology, presentation, and management. Cardiol Rev; 2009 Jul-Aug;17(4):159-64
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  • Paragangliomas are catecholamine-secreting tumors arising from the chromaffin cells of the sympathetic ganglia, and are known as extra-adrenal pheochromocytomas.
  • These tumors commonly present with episodic hypertension, tachycardia, headache, and diaphoresis, and can be either benign or malignant.
  • Diagnosis is made by serum and urine analysis for catecholamines and metanephrines, and confirmed with imaging studies including computed tomography scanning, magnetic resonance imaging, or 123-I metaiodobenzylguanidine imaging.
  • The majority of these tumors are benign, but for patients with malignant disease, chemotherapy, and radiation therapy may provide modest benefit.
  • Long-term follow-up is essential, as paragangliomas can recur many years after initial diagnosis.
  • [MeSH-major] Adrenal Gland Neoplasms / therapy. Paraganglioma, Extra-Adrenal / therapy. Pheochromocytoma / therapy

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  • (PMID = 19525677.001).
  • [ISSN] 1538-4683
  • [Journal-full-title] Cardiology in review
  • [ISO-abbreviation] Cardiol Rev
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 45
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92. Kino M, Suzuki H, Naya Y, Komiya A, Imamoto T, Ichikawa T, Tatsuno I, Ishida H, Shindo T, Seki N: Comparative genomic hybridization reveals frequent losses of 1p and 3q in benign pheochromocytomas of Japanese patients. Cancer Genet Cytogenet; 2007 Jun;175(2):169-72
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  • [Title] Comparative genomic hybridization reveals frequent losses of 1p and 3q in benign pheochromocytomas of Japanese patients.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Chromosome Deletion. Chromosomes, Human, Pair 1 / genetics. Chromosomes, Human, Pair 3 / genetics. Pheochromocytoma / genetics

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  • (PMID = 17556075.001).
  • [ISSN] 0165-4608
  • [Journal-full-title] Cancer genetics and cytogenetics
  • [ISO-abbreviation] Cancer Genet. Cytogenet.
  • [Language] eng
  • [Publication-type] Comparative Study; Letter
  • [Publication-country] United States
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93. Marazuela M, Domínguez-Gadea L, Larrañaga E, Rodríguez-Ramos R, López-Gallardo G, Rodríguez-Eyre JL, Gómez-Pan A: [The use of suprarenal scintigraphy in the differential diagnosis of suprarenal incidentaloma]. Rev Clin Esp; 2005 Jul;205(7):316-21
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  • [Title] [The use of suprarenal scintigraphy in the differential diagnosis of suprarenal incidentaloma].
  • OBJECTIVES: To assess the usefulness of adrenal scintigraphy for clinical evaluation of adrenal incidentalomas, and its relation with pathological diagnosis and follow-up.
  • PATIENTS AND METHODS: We have studied 46 patients with unilateral adrenal incidentaloma of size between 10 and 100 mm (average 30.5 +/- 19 mm).
  • The lesions were discovered with abdominal computerized tomography in the study of a primary tumor (22%) or in the evaluation of benign pathology (78%).
  • Adrenal scintigraphy assessed uptake in adrenal incidentaloma.
  • Hormonal study included urinary catecholamines, plasma cortisol after dexamethasone, adrenal androgens, and renin and aldosterone in hypertensive patients.
  • Adrenal incidentaloma was considered nonfunctional if the lesion did not modified its size nor showed analytical alterations along a follow-up higher than 8 months.
  • RESULTS: Of 46 adrenal lesions, seven didn't show uptake (three metastases, one cyst, one adrenal carcinoma, one pheochromocytoma, and one angiomyolipoma), 34 showed excessive uptake (29 nonfunctional adrenal nodules and 5 hyperfunctional adrenal nodules), and five had normal uptake (nonfunctional adrenal nodules).
  • Adrenal scintigraphy was compatible in all cases with cytological study or the response to chemotherapy.
  • CONCLUSIONS: Detection of a lesion with no uptake in adrenal scintigraphy forces to carry out complementary explorations in order to rule out malignant pathology.
  • A lesion with excessive uptake is indicative of a benign process and should be assessed with hormonal determinations.
  • [MeSH-major] Adrenal Gland Neoplasms / radionuclide imaging

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  • (PMID = 16029757.001).
  • [ISSN] 0014-2565
  • [Journal-full-title] Revista clínica española
  • [ISO-abbreviation] Rev Clin Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone
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94. 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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  • OBJECTIVE: The objective was to analyze survival according to clinical characteristics at diagnosis of malignancy and the presence or absence of SDHB mutations.
  • 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.
  • 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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95. Martiniova L, Lai EW, Elkahloun AG, Abu-Asab M, Wickremasinghe A, Solis DC, Perera SM, Huynh TT, Lubensky IA, Tischler AS, Kvetnansky R, Alesci S, Morris JC, Pacak K: Characterization of an animal model of aggressive metastatic pheochromocytoma linked to a specific gene signature. Clin Exp Metastasis; 2009;26(3):239-50
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  • [Title] Characterization of an animal model of aggressive metastatic pheochromocytoma linked to a specific gene signature.
  • There is presently no cure for metastatic pheochromocytoma and no reliable way to distinguish malignant from benign tumors before the development of metastases.
  • In order to successfully manage pheochromocytoma, it is necessary to better understand the biological determinants of tumor behavior.
  • For this purpose, we have recently established a mouse model of metastatic pheochromocytoma using tail vein injection of mouse pheochromocytoma (MPC) cells.
  • Serial harvest, culture and re-selection of metastatic liver lesions produced even more aggressive pheochromocytoma cells that retained their biochemical phenotype.

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  • (PMID = 19169894.001).
  • [ISSN] 1573-7276
  • [Journal-full-title] Clinical & experimental metastasis
  • [ISO-abbreviation] Clin. Exp. Metastasis
  • [Language] ENG
  • [Grant] United States / Intramural NIH HHS / / ZIC HG200365-03; United States / Intramural NIH HHS / / ZIC HG200365-01; United States / NINDS NIH HHS / NS / R01 NS037685; United States / NINDS NIH HHS / NS / NS 37685; United States / Intramural NIH HHS / / ZIC HG200365-02
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Other-IDs] NLM/ NIHMS420223; NLM/ PMC3505859
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96. Hsiao CC, Huang CC, Sheen JM, Tai MH, Chen CM, Huang LL, Chuang JH: Differential expression of delta-like gene and protein in neuroblastoma, ganglioneuroblastoma and ganglioneuroma. Mod Pathol; 2005 May;18(5):656-62
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  • Three adrenal tissues from children died of diseases other than adrenal tumors and one from an adult with pheochromocytoma were severed as normal and disease controls.
  • The stronger expression of dlk in gangliocytes in ganglioneuroma, in contrast to weaker or no expression in gangliocytes in ganglioneuroblastoma and neuroblasts in neuroblastoma, suggests upregulation of dlk during differentiation of neuroblastoma into more benign form.
  • Furthermore, higher dlk protein expression in the tumor endothelium than in the endothelium of normal adrenal gland implies that dlk may regulate the endothelial function in neuroblastic tumors.

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  • (PMID = 15605081.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Glycoproteins; 0 / RNA, Messenger; 62229-50-9 / Epidermal Growth Factor
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97. Pohl PP, Meyer A, Lammers BJ, Goretzki PE: [Abdominal preoperation. No contraindication for laparoscopic transabdominal adrenalectomy]. Chirurg; 2008 Jun;79(6):571-5
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  • Benign adrenal gland tumors smaller than 6 cm are nowadays the indication for minimally invasive surgery.
  • [MeSH-major] Abdomen / surgery. Adrenal Gland Neoplasms / surgery. Adrenalectomy / contraindications. Adrenocortical Adenoma / surgery. Carcinoma / surgery. Cushing Syndrome / surgery. Laparoscopy / contraindications. Pheochromocytoma / surgery

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  • (PMID = 17879074.001).
  • [ISSN] 0009-4722
  • [Journal-full-title] Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen
  • [ISO-abbreviation] Chirurg
  • [Language] ger
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Germany
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98. Reisch N, Walz MK, Erlic Z, Neumann HP: [Pheochromocytoma - still a challenge]. Internist (Berl); 2009 Jan;50(1):27-35
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  • [Title] [Pheochromocytoma - still a challenge].
  • Pheochromocytomas are rare, mostly benign catecholamine-producing tumors arising from the chromaffin cells of the adrenal medulla or in the paraganglia.
  • Computed tomography scan and magnetic resonance imaging of the adrenal glands and abdomen as well as functional imaging with (123)Iod-MIBG scintigraphy and (18)F-dopa positron emission tomography are used for tumor localization.
  • The therapy of choice is the endoscopic adrenal sparing surgery following preoperative alpha-blockade.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / therapy. Hypertension / diagnosis. Hypertension / prevention & control. Pheochromocytoma / diagnosis. Pheochromocytoma / therapy


99. Anagnostis P, Karagiannis A, Tziomalos K, Kakafika AI, Athyros VG, Mikhailidis DP: Adrenal incidentaloma: a diagnostic challenge. Hormones (Athens); 2009 Jul-Sep;8(3):163-84
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  • [Title] Adrenal incidentaloma: a diagnostic challenge.
  • The widespread application of abdominal imaging procedures has resulted in an increased frequency of clinically silent adrenal masses.
  • Adrenal incidentaloma (AI) is a term applied to an accidentally discovered adrenal mass on imaging performed for the investigation of an unrelated complaint.
  • Adrenal incidentalomas (AIs) are a cluster of different pathologies, the majority of which are benign and non-functioning adrenal adenomas.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Incidental Findings
  • [MeSH-minor] Adrenocortical Adenoma / diagnosis. Algorithms. Biopsy, Fine-Needle. Cushing Syndrome / diagnosis. Humans. Magnetic Resonance Imaging. Pheochromocytoma / diagnosis. Tomography, X-Ray Computed

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  • (PMID = 19671516.001).
  • [ISSN] 1109-3099
  • [Journal-full-title] Hormones (Athens, Greece)
  • [ISO-abbreviation] Hormones (Athens)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Greece
  • [Number-of-references] 181
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100. Petri BJ, Speel EJ, Korpershoek E, Claessen SM, van Nederveen FH, Giesen V, Dannenberg H, van der Harst E, Dinjens WN, de Krijger RR: Frequent loss of 17p, but no p53 mutations or protein overexpression in benign and malignant pheochromocytomas. Mod Pathol; 2008 Apr;21(4):407-13
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  • [Title] Frequent loss of 17p, but no p53 mutations or protein overexpression in benign and malignant pheochromocytomas.
  • Genetic changes in the tumorigenesis of sporadic pheochromocytomas are poorly understood, and there are no good markers to discriminate benign from malignant pheochromocytomas. p53 is a tumor suppressor gene and aberrations in this gene are frequently found in many tumor types.
  • The role of p53 in pheochromocytoma tumorigenesis is unclear, with some studies suggesting that p53 mutations can be used to discriminate benign from malignant pheochromocytomas while other studies do not find such an association.
  • Comparative genomic hybridization analysis of 31 benign and 20 malignant tumors showed loss of the p53 locus at chromosome 17p13.1 in 23/51 (45%) cases, and most of these results were confirmed by fluorescence in situ hybridization.
  • Furthermore, p53 immunohistochemistry on 35 cases revealed strong nuclear p53 expression in only two pheochromocytoma metastases, all other tumors being negative.
  • We conclude that, although there is frequent loss of the p53 locus on 17p, the p53 gene does not appear to play a major role in pheochromocytoma tumorigenesis.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Biomarkers, Tumor / genetics. Chromosomes, Human, Pair 17 / genetics. Pheochromocytoma / genetics. Tumor Suppressor Protein p53 / genetics. Tumor Suppressor Protein p53 / metabolism

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  • (PMID = 18223555.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Tumor Suppressor Protein p53
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