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1. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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2. Babinska A, Sworczak K, Wisniewski P, Nałecz A, Jaskiewicz K: The role of immunohistochemistry in histopathological diagnostics of clinically "silent" incidentally detected adrenal masses. Exp Clin Endocrinol Diabetes; 2008 Apr;116(4):246-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of immunohistochemistry in histopathological diagnostics of clinically "silent" incidentally detected adrenal masses.
  • BACKGROUND: The detectability of adrenal incidentalomas (incidentally found adrenal tumours) in the whole population is estimated at 0.1%; 0.42% in non-endocrine patients and at 4.3% in oncologically diagnosed ones.
  • Even up to 16% of incidentalomas of adrenal glands can be malignant lesions.
  • The issue of crucial importance is the histopathological differentiation between benign lesions and malignant tumours of the adrenal cortex and medulla.
  • OBJECTIVES: To evaluate whether the immunohistochemical analysis of the expression of p53, p21, PCNA and Ki67 in the tumour's tissue can be useful in the histopathological diagnostics of adrenal incidentalomas and whether it is important for prognosis.
  • RESULTS: We found a statistically significant correlation between the expression of p53, p21, Ki67 and the differential diagnosis of adrenal cortical adenoma and adrenocortical carcinoma (for proteins: p53 p=0.010, for p21 p=0.010, for Ki67 p<0.001).
  • The statistical significant correlation between PCNA protein and diagnosis of adrenal cortical adenoma and adrenocortical carcinoma was not found.
  • The statistically significant correlation between p21, PCNA proteins and the diagnosis of benign and malignant PHEOs was not estimated.
  • There was no expression of Ki67 or p53 protein above the assumed level in benign and malignant pheochromocytomas.
  • [MeSH-major] Adenoma / pathology. Adrenal Gland Neoplasms / pathology. Pheochromocytoma / pathology

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  • (PMID = 18393131.001).
  • [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
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 0 / Proliferating Cell Nuclear Antigen; 0 / Proto-Oncogene Proteins c-bcl-2; 0 / Tumor Suppressor Protein p53; EC 2.7.11.1 / p21-Activated Kinases
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3. Brauckhoff M, Dralle H: [Recurrent operations on the adrenal glands]. Chirurg; 2005 Mar;76(3):227-37
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  • [Title] [Recurrent operations on the adrenal glands].
  • Repeat adrenalectomy may be required due to ipsilateral recurrence of benign or malignant adrenal tumors after previous total or subtotal adrenalectomy.
  • Following subtotal adrenalectomy, the risk of ipsilateral recurrence correlates with disease, follow-up, localization, size of the adrenal remnant, and, in case of familial pheochromocytoma, probably with genotype.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Adrenocortical Carcinoma / surgery. Neoplasm Recurrence, Local / surgery. Pheochromocytoma / surgery
  • [MeSH-minor] 3-Iodobenzylguanidine / therapeutic use. Adult. Antineoplastic Agents, Hormonal / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Lymph Node Excision. Male. Middle Aged. Mitotane / therapeutic use. Octreotide / therapeutic use. Palliative Care. Paraneoplastic Endocrine Syndromes / diagnosis. Paraneoplastic Endocrine Syndromes / mortality. Paraneoplastic Endocrine Syndromes / surgery. Radiotherapy, Adjuvant. Reoperation

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  • (PMID = 15739057.001).
  • [ISSN] 0009-4722
  • [Journal-full-title] Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen
  • [ISO-abbreviation] Chirurg
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 35MRW7B4AD / 3-Iodobenzylguanidine; 78E4J5IB5J / Mitotane; RWM8CCW8GP / Octreotide
  • [Number-of-references] 45
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4. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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5. Elder EE, Elder G, Larsson C: Pheochromocytoma and functional paraganglioma syndrome: no longer the 10% tumor. J Surg Oncol; 2005 Mar 1;89(3):193-201
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  • [Title] Pheochromocytoma and functional paraganglioma syndrome: no longer the 10% tumor.
  • Recent developments in clinical and molecular research on these tumor forms have significantly clarified their genetic backgrounds and challenged the view of "pheochromocytoma as the 10% rule tumor."
  • Firstly, a larger proportion of these tumors are today discovered in normotensive patients during imaging carried out for other reasons than suspicion of pheochromocytoma.
  • Secondly, although the differential diagnosis between malignant and benign tumors remains a challenge, the risk of malignancy well exceeds the classical 10% in patients with extra-adrenal disease, and/or carriers of germ-line SDHB mutations.
  • Finally, up to a third of patients carry a germ-line mutation in a gene predisposing to pheochromocytoma and/or paraganglioma.
  • Genetic testing in apparently sporadic cases is therefore regarded as beneficial, especially in patients diagnosed before 50 years of age, and in patients with bilateral, multifocal, malignant and/or extra-adrenal disease.
  • [MeSH-major] Abdominal Neoplasms / genetics. Adrenal Gland Neoplasms / genetics. Genetic Testing. Germ-Line Mutation. Paraganglioma, Extra-Adrenal / genetics. Pheochromocytoma / genetics
  • [MeSH-minor] Diagnosis, Differential. Genetic Predisposition to Disease / genetics. Head and Neck Neoplasms / genetics. Humans. Membrane Proteins / genetics. Neurofibromatosis 1 / genetics. Succinate Dehydrogenase. Tumor Suppressor Proteins / genetics. Ubiquitin-Protein Ligases / genetics. Von Hippel-Lindau Tumor Suppressor Protein. von Hippel-Lindau Disease / genetics

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  • [Copyright] (c) 2005 Wiley-Liss, Inc.
  • (PMID = 15719371.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Membrane Proteins; 0 / SDHD protein, human; 0 / Tumor Suppressor Proteins; EC 1.3.99.1 / Succinate Dehydrogenase; EC 6.3.2.19 / Ubiquitin-Protein Ligases; EC 6.3.2.19 / VHL protein, human; EC 6.3.2.19 / Von Hippel-Lindau Tumor Suppressor Protein
  • [Number-of-references] 59
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6. 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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7. Pradeep PV, Mishra AK, Aggarwal V, Bhargav PR, Gupta SK, Agarwal A: Adrenal cysts: an institutional experience. World J Surg; 2006 Oct;30(10):1817-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adrenal cysts: an institutional experience.
  • INTRODUCTION: Adrenal cysts are rare clinical entities.
  • We report our institutional experience with adrenal cysts and also assess various management options.
  • MATERIAL AND METHODS: Over the past 15 years the Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, has had seven cases of adrenal cysts, of which two were functional: one patient had Cushing's syndrome and the other patient had pheochromocytoma.
  • It is generally agreed that a hormonal work-up is necessary in all cases of adrenal cysts to rule out a sub-clinical disease.
  • Adrenal neoplasms, including adrenocortical carcinomas, can be associated with cysts that are benign in appearance.
  • However, surgical excision provides a definite histopathological diagnosis and also removes the fear of future complications such as hemorrhage into the cyst and local pressure effects due to the tumor.
  • CONCLUSIONS: Given that the adrenals are a vascular gland and taking into consideration the possibilities of bleeding and complications in the cyst, our treatment of choice is the elective excision of adrenal cysts.
  • [MeSH-major] Academies and Institutes / statistics & numerical data. Adrenal Gland Diseases / diagnosis. Adrenal Gland Diseases / surgery. Adrenalectomy / methods. Cysts / diagnosis. Cysts / surgery
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Follow-Up Studies. Humans. India. Laparoscopy. Middle Aged. Retrospective Studies. Tomography, X-Ray Computed

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  • (PMID = 16983481.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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8. Igaz P, Wiener Z, Szabó P, Falus A, Gaillard RC, Horányi J, Rácz K, Tulassay Z: Functional genomics approaches for the study of sporadic adrenal tumor pathogenesis: clinical implications. J Steroid Biochem Mol Biol; 2006 Oct;101(2-3):87-96
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Functional genomics approaches for the study of sporadic adrenal tumor pathogenesis: clinical implications.
  • Although sporadic adrenal tumors are frequently encountered in the general population their pathogenesis is not well elucidated.
  • Some studies have already been published describing gene expression profiles of benign and malignant adrenocortical tumors and phaeochromocytomas.
  • Some alterations in gene expression appear so specific for certain tumor types that their application in diagnosis, determination of prognosis and the choice of therapy can be envisaged.
  • In this short review, the authors will present a synopsis of these recent findings that seem to open new perspectives in adrenal tumor pathogenesis, with emphasis on changes in steroidogenic enzyme expression profiles and highlighting possible clinical implications.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Biomarkers, Tumor / analysis. Chromosome Aberrations. Genomics / methods
  • [MeSH-minor] Gene Expression Profiling. Gene Expression Regulation, Neoplastic. Humans. Models, Biological. Molecular Biology / methods. Pheochromocytoma / genetics

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  • (PMID = 16891114.001).
  • [ISSN] 0960-0760
  • [Journal-full-title] The Journal of steroid biochemistry and molecular biology
  • [ISO-abbreviation] J. Steroid Biochem. Mol. Biol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 89
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9. 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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10. 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


11. 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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12. Kuruba R, Gallagher SF: Current management of adrenal tumors. Curr Opin Oncol; 2008 Jan;20(1):34-46
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  • [Title] Current management of adrenal tumors.
  • PURPOSE OF REVIEW: Adrenal tumors evoke considerable interest and diagnostic challenges.
  • RECENT FINDINGS: Significant advances have been made in diagnostic imaging modalities for identifying malignancy risk in adrenal incidentalomas.
  • SUMMARY: Laparoscopic adrenalectomy has emerged as standard of care in the treatment of functional benign adenomas and nonfunctional tumors larger than 4 cm when adrenocortical carcinoma is not suspected.
  • International consensus conferences have attempted to standardize diagnostic and treatment approaches in the management of adrenal tumors; further research is necessary.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / drug therapy
  • [MeSH-minor] Adrenal Glands / pathology. Adrenal Glands / radiography. Adrenocortical Carcinoma / diagnosis. Adrenocortical Carcinoma / drug therapy. Adrenocortical Carcinoma / genetics. Chemotherapy, Adjuvant. Humans. Pheochromocytoma / diagnosis. Pheochromocytoma / drug therapy. Prognosis. Tomography, X-Ray Computed

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  • (PMID = 18043254.001).
  • [ISSN] 1040-8746
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 68
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13. 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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14. Mischke K, Graf J, Rulands D, Koch KC, Hanrath P, Janssens U: [Cardiogenic shock in a 61 year old female with recurrent panic attacks]. Internist (Berl); 2005 May;46(5):580-5
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  • Conducting an abdominal ultrasound we detected a mass at the right adrenal gland.
  • The suspected diagnosis of pheochromocytoma was confirmed by elevated catecholamine levels in the urine and a CT scan.
  • After recompensation and subsequent administration of phenoxybenzamine a benign pheochromocytoma was resected.
  • A massive catecholamine secretion due to a pheochromocytoma can lead to a cardiogenic shock and multiple organ failure.
  • In patients with recurrent panic attacks and hypertension a pheochromocytoma should be included in the differential diagnosis.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery. Panic Disorder / diagnosis. Panic Disorder / prevention & control. Pheochromocytoma / diagnosis. Secondary Prevention. Shock, Cardiogenic / diagnosis. Shock, Cardiogenic / prevention & control
  • [MeSH-minor] Cardiomyopathies / diagnosis. Cardiomyopathies / etiology. Diagnosis, Differential. Female. Humans. Middle Aged

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  • [ISSN] 0020-9554
  • [Journal-full-title] Der Internist
  • [ISO-abbreviation] Internist (Berl)
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
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15. Lehrfeld T, Natale R, Sharma S, Mendoza PJ, Schwab Ii CW, Lee DI: Robot-assisted excision of a retroperitoneal mass between the left renal artery and vein. JSLS; 2010 Jul-Sep;14(3):447-9
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  • BACKGROUND: Extra-adrenal pheochromocytomas are rare.
  • The pathology demonstrated a benign pheochromocytoma.
  • To our knowledge, this is the first report of a peri-hilar excision of a pheochromocytoma using this approach.
  • CONCLUSION: Extra-adrenal pheochromocytomas are rare and can present in difficult locations.

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  • (PMID = 21333207.001).
  • [ISSN] 1086-8089
  • [Journal-full-title] JSLS : Journal of the Society of Laparoendoscopic Surgeons
  • [ISO-abbreviation] JSLS
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC3041050
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16. 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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17. 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


18. Adler JT, Meyer-Rochow GY, Chen H, Benn DE, Robinson BG, Sippel RS, Sidhu SB: Pheochromocytoma: current approaches and future directions. Oncologist; 2008 Jul;13(7):779-93
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  • [Title] Pheochromocytoma: current approaches and future directions.
  • Pheochromocytomas are rare catecholamine-secreting tumors that arise from chromaffin tissue within the adrenal medulla and extra-adrenal sites.
  • While medical management plays a significant role in the treatment of pheochromocytoma patients, surgical excision remains the only cure.
  • Improved medical management and surgical techniques and an increased understanding of hereditary disease have improved the outcome of pheochromocytoma patients with benign disease; however, the outcome of patients with malignant disease remains poor.
  • In this review, we discuss the presentation, diagnosis, management, and future directions in the management of this disease.
  • [MeSH-major] Adrenal Gland Neoplasms. Pheochromocytoma
  • [MeSH-minor] Adrenal Glands / surgery. Chemotherapy, Adjuvant. Genetic Predisposition to Disease. Humans. Neoplasm Metastasis / prevention & control. Radiotherapy, Adjuvant


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

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  • (PMID = 17679462.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; 30461-91-7 / 19-Iodocholesterol; 4964P6T9RB / Aldosterone; 6B3QJ94C7P / 6-iodomethylcholesterol; EC 3.4.23.15 / Renin; WI4X0X7BPJ / Hydrocortisone; X4W3ENH1CV / Norepinephrine; YKH834O4BH / Epinephrine
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20. Waldmann J, Bartsch DK, Kann PH, Fendrich V, Rothmund M, Langer P: Adrenal involvement in multiple endocrine neoplasia type 1: results of 7 years prospective screening. Langenbecks Arch Surg; 2007 Jul;392(4):437-43
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  • [Title] Adrenal involvement in multiple endocrine neoplasia type 1: results of 7 years prospective screening.
  • BACKGROUND: Adrenal tumors are a common manifestation of the multiple endocrine neoplasia type 1 (MEN-1) syndrome.
  • Adrenal glands have been screened by biochemical analysis and either by endoscopic ultrasound (EUS) or computed tomography (CT) or both.
  • Age at diagnosis of MEN-1, type of adrenal tumor, genotype, therapy, and clinical characteristics have been analyzed.
  • RESULTS: In 21 (55%) patients, adrenal involvement of the disease was detected.
  • Adrenal lesions were detected in average 6.9 years after the initial diagnosis of MEN-1.
  • Twelve patients had unilateral while nine had bilateral adrenal lesions.
  • EUS detected all adrenal tumors, whereas CT failed in seven cases.
  • In three patients, functioning tumors (one pheochromocytoma, one bilateral Cushing adenoma, and one adrenocortical carcinoma) and one nonfunctioning adenoma were diagnosed by histology and biochemical assessment.
  • Nonfunctioning adrenal lesions, not characterized by histology yet, were found in 18 patients.
  • There was no statistical difference with regard to adrenal involvement between patients with germline mutations in exons 2 and 10 (12/21) and those with mutations in exons 3-9 (6/11).
  • CONCLUSION: MEN-1-associated adrenal tumors are mostly small, benign, and nonfunctioning and much more common than previously reported.
  • [MeSH-major] Adrenal Gland Neoplasms. Multiple Endocrine Neoplasia Type 1

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  • (PMID = 17235589.001).
  • [ISSN] 1435-2443
  • [Journal-full-title] Langenbeck's archives of surgery
  • [ISO-abbreviation] Langenbecks Arch Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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21. Hofland J, van Nederveen FH, Timmerman MA, Korpershoek E, de Herder WW, Lenders JW, Verhofstad AA, de Krijger RR, de Jong FH: Expression of activin and inhibin subunits, receptors and binding proteins in human pheochromocytomas: a study based on mRNA analysis and immunohistochemistry. Clin Endocrinol (Oxf); 2007 Mar;66(3):335-40
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  • OBJECTIVE: Pheochromocytomas are uncommon tumours arising from chromaffin cells of the adrenal medulla and related paraganglia.
  • So far, one of the few reported markers to discriminate malignant from benign tumours is the betaB-subunit of inhibin and activin, members of the transforming growth factor (TGF)-beta superfamily of growth and differentiation factors.
  • RESULTS: The immunohistochemical investigations revealed that staining of the inhibin betaB-subunit was positive in 12 of 36 (33%) benign and 5 of 34 (15%) malignant pheochromocytomas (P > 0.05).
  • Therefore, it was not possible to discriminate between benign and malignant tumours solely on the basis of inhibin betaB-subunit immunohistochemistry.
  • Quantitative real-time RT-PCR in nine benign and four malignant tumours showed expression of inhibin alpha-, betaA- and betaB-subunits, the activin receptors Alk-4, ActRIIA, and ActRIIB, and the inhibin- and activin-binding proteins betaglycan and follistatin in all samples.
  • Only inhibin betaA-subunit expression was different in malignant compared to benign pheochromocytomas (P = 0.020).
  • CONCLUSIONS: No clear role for activin and inhibin was found in discriminating between benign and malignant pheochromocytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / chemistry. Biomarkers, Tumor / analysis. Inhibin-beta Subunits / analysis. Pheochromocytoma / chemistry
  • [MeSH-minor] Activin Receptors, Type I / analysis. Activin Receptors, Type I / genetics. Activin Receptors, Type II / analysis. Activin Receptors, Type II / genetics. Adult. Blotting, Northern / methods. Chi-Square Distribution. Diagnosis, Differential. Female. Follistatin / analysis. Follistatin / genetics. Gene Expression. Humans. Immunohistochemistry. Inhibins / analysis. Inhibins / genetics. Male. Middle Aged. Proteoglycans / analysis. Proteoglycans / genetics. RNA, Messenger / analysis. Receptors, Transforming Growth Factor beta / analysis. Receptors, Transforming Growth Factor beta / genetics. Reverse Transcriptase Polymerase Chain Reaction. Statistics, Nonparametric

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  • (PMID = 17302865.001).
  • [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 / Follistatin; 0 / Proteoglycans; 0 / RNA, Messenger; 0 / Receptors, Transforming Growth Factor beta; 0 / inhibin beta A subunit; 0 / inhibin-alpha subunit; 145170-29-2 / betaglycan; 57285-09-3 / Inhibins; 93443-12-0 / Inhibin-beta Subunits; EC 2.7.11.30 / ACVR1B protein, human; EC 2.7.11.30 / Activin Receptors, Type I; EC 2.7.11.30 / Activin Receptors, Type II; EC 2.7.11.30 / activin receptor type II-A; EC 2.7.11.30 / activin receptor type II-B
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22. 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


23. Kim HY, Kim SG, Lee KW, Seo JA, Kim NH, Choi KM, Baik SH, Choi DS: Clinical study of adrenal incidentaloma in Korea. Korean J Intern Med; 2005 Dec;20(4):303-9
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  • [Title] Clinical study of adrenal incidentaloma in Korea.
  • BACKGROUND: This study was designed to evaluate the clinical, endocrinological and histological characteristics of adrenal incidentalomas.
  • METHODS: Eighty patients (41, males; 38, females; age range 17-80 years) who were diagnosed with adrenal incidentaloma at Korea University Hospital from 1992 to 2003 were studied retrospectively.
  • The diameter of the carcinomas (mean: 10.8 cm, range: 5-19 cm) were significantly larger than the diameter of benign adenomas (mean: 2.84 cm, range: 1-6 cm) (p=0.002).
  • Changes in mass size and function were observed only between 10 and 26 months after the initial diagnosis.
  • CONCLUSIONS: These data show that an endocrine evaluation should be performed in all adrenal incidentalomas, and an adrenalectomy is recommended for tumors 5 cm or greater or tumors with adrenocortical hyperfunction.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Incidental Findings
  • [MeSH-minor] Adolescent. Adrenocortical Adenoma / diagnosis. Adult. Aged. Aged, 80 and over. Carcinoma / diagnosis. Female. Humans. Korea. Male. Middle Aged. Pheochromocytoma / diagnosis. Retrospective Studies

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  • (PMID = 16491828.001).
  • [ISSN] 1226-3303
  • [Journal-full-title] The Korean journal of internal medicine
  • [ISO-abbreviation] Korean J. Intern. Med.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC3891076
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24. Guillemot J, Anouar Y, Montero-Hadjadje M, Grouzmann E, Grumolato L, Roshmaninho-Salgado J, Turquier V, Duparc C, Lefebvre H, Plouin PF, Klein M, Muresan M, Chow BK, Vaudry H, Yon L: Circulating EM66 is a highly sensitive marker for the diagnosis and follow-up of pheochromocytoma. Int J Cancer; 2006 Apr 15;118(8):2003-12
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  • [Title] Circulating EM66 is a highly sensitive marker for the diagnosis and follow-up of pheochromocytoma.
  • We have previously demonstrated that measurement of tissue concentration of the novel secretogranin II-derived peptide EM66 may help to discriminate between benign and malignant pheochromocytomas.
  • The aim of the present study was to characterize EM66 in plasma and urine of healthy volunteers and pheochromocytoma patients, in order to further evaluate the usefulness of this peptide as a circulating marker for the management of the tumors.
  • In patients with pheochromocytoma, plasma EM66 levels were 10-fold higher than those of healthy volunteers (26.9 (7.3-44) ng/ml), and returned to normal values after removal of the tumor.
  • These data indicate that EM66 is secreted in the general circulation and that elevated plasma EM66 levels are correlated with the occurrence of pheochromocytoma.
  • Thus, EM66 is a sensitive plasma marker that should be considered as a complementary tool in the management of pheochromocytoma.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / pathology. Biomarkers, Tumor / blood. Chromogranins / blood. Chromogranins / urine. Peptide Fragments / blood. Pheochromocytoma / diagnosis. Pheochromocytoma / pathology. Secretogranin II / blood
  • [MeSH-minor] Adult. Aged. Case-Control Studies. Chromatography, High Pressure Liquid. Diagnosis, Differential. Female. Humans. Immunoassay. Male. Metanephrine. Middle Aged. Sensitivity and Specificity

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  • [Copyright] Copyright (c) 2005 Wiley-Liss, Inc.
  • (PMID = 16287097.001).
  • [ISSN] 0020-7136
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chromogranins; 0 / EM66 peptide; 0 / Peptide Fragments; 0 / Secretogranin II; 5001-33-2 / Metanephrine
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25. De Krijger RR, Petri BJ, Van Nederveen FH, Korpershoek E, De Herder WW, De Muinck Keizer-Schrama SM, Dinjens WN: Frequent genetic changes in childhood pheochromocytomas. Ann N Y Acad Sci; 2006 Aug;1073:166-76
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  • Pheochromocytomas (PCCs) are rare catecholamine-producing tumors of the adrenal gland which may also occur elsewhere in the abdomen and are then called paragangliomas.
  • A proportion of PCCs occurs in hereditary cancer syndromes, including multiple endocrine neoplasia Type 2 (MEN2), caused by mutations in the RET proto-oncogene, von Hippel-Lindau (VHL) disease, caused by VHL gene abnormalities, and the pheochromocytoma-paraganglioma (PCC-PGL) syndrome, caused by mutations in SDHB and SDHD.
  • From our single-institution collection of PCCs, we have selected 10 cases that occurred in individuals up to 18 years of age at diagnosis.
  • All tumors were benign (average follow-up: 12 years) and were located in the adrenal.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Pheochromocytoma / genetics

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  • [ErratumIn] Ann N Y Acad Sci. 2006;1086:241. Petri, Bart-Jeroen [added]
  • (PMID = 17102083.001).
  • [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 / DNA Primers; EC 1.3.99.1 / Succinate Dehydrogenase; EC 2.7.10.1 / Proto-Oncogene Proteins c-ret; EC 2.7.10.1 / RET protein, human; EC 6.3.2.19 / VHL protein, human; EC 6.3.2.19 / Von Hippel-Lindau Tumor Suppressor Protein
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26. Erem C, Hacihasanoglu A, Cinel A, Isik AC, Reis A, Sari A, Ersoz HO, Ukinç K: Carotid body tumors and adrenal pheochromocytomas in siblings of a Turkish family. Med Princ Pract; 2006;15(5):396-400
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  • [Title] Carotid body tumors and adrenal pheochromocytomas in siblings of a Turkish family.
  • OBJECTIVE: This is a report of 2 hypertensive siblings with a history of carotid body tumors and subsequent benign adrenal pheochromocytomas (pheos) in a family where the mother had died of possible adrenal carcinoma.
  • CLINICAL PRESENTATION AND INTERVENTION: The first case was a 35-year-old woman with paroxysmal hypertensive attacks and a right adrenal mass.
  • Abdominal MRI and (131)I-MIBG scintigraphy revealed a right adrenal tumor.
  • The second case, the 45-year-old brother of the first case, was found to have a left adrenal mass on abdominal MRI.
  • Such tumors may be extra-adrenal or multifocal.
  • [MeSH-major] Adrenal Gland Neoplasms / genetics. Carotid Body Tumor / genetics. Pheochromocytoma / genetics
  • [MeSH-minor] Adrenalectomy. Adult. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Pedigree. Turkey

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  • (PMID = 16888401.001).
  • [ISSN] 1011-7571
  • [Journal-full-title] Medical principles and practice : international journal of the Kuwait University, Health Science Centre
  • [ISO-abbreviation] Med Princ Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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27. 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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28. 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


29. Björklund P, Cupisti K, Fryknäs M, Isaksson A, Willenberg HS, Akerström G, Hellman P, Westin G: Stathmin as a marker for malignancy in pheochromocytomas. Exp Clin Endocrinol Diabetes; 2010 Jan;118(1):27-30
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  • Pheochromocytomas of the adrenal medulla may be life-threatening catecholamine-producing tumors which are malignant in about 10% of cases.
  • Differential diagnosis between malignant and benign tumors is dependent on the development of metastasis or extensive local invasion.
  • We applied an expression microarray containing 7770 cDNA clones and analysed the expression profiles in eleven tumors compared to normal adrenal medulla.
  • RT-PCR analysis further confirmed mRNA overexpression, 6 to 8-fold for benign and malignant tumors, and 16-fold for metastases.
  • Stathmin protein overexpression was observed by immunohistochemistry, and distinct differential protein expression between benign and malignant/metastasis specimens was confirmed by Western blot analysis.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Biomarkers, Tumor / metabolism. Pheochromocytoma / diagnosis. Stathmin / metabolism
  • [MeSH-minor] Adrenal Medulla / metabolism. Adrenal Medulla / pathology. Adult. Aged. Blotting, Western. Diagnosis, Differential. Female. Gene Expression Profiling. Humans. Immunohistochemistry. Male. Middle Aged. Oligonucleotide Array Sequence Analysis. RNA, Messenger / metabolism. Reverse Transcriptase Polymerase Chain Reaction. Young Adult

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  • [Copyright] J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart, New York.
  • (PMID = 19449284.001).
  • [ISSN] 1439-3646
  • [Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • [ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / RNA, Messenger; 0 / STMN1 protein, human; 0 / Stathmin
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30. Stelow EB, Debol SM, Stanley MW, Mallery S, Lai R, Bardales RH: Sampling of the adrenal glands by endoscopic ultrasound-guided fine-needle aspiration. Diagn Cytopathol; 2005 Jul;33(1):26-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Sampling of the adrenal glands by endoscopic ultrasound-guided fine-needle aspiration.
  • Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) has proven to be a valuable modality for the primary diagnosis and staging of gastrointestinal, and perigastrointestinal malignancy.
  • Aside from assessing thoracic and abdominal lymph nodes and the liver for metastases, EUS can assess and sample the adrenal glands, which are frequently involved by metastatic disease, but can also harbor benign primary neoplasms.
  • The cytology files at our institution were reviewed for all cases of EUS-guided FNA of the adrenal glands.
  • Results were compared with overall EUS-guided FNA performance and the performance of non-EUS-guided FNA of the adrenal.
  • Between 1/1/00 and 5/15/04 there were 24 cases of EUS-guided FNA of the adrenal gland from 22 different patients (13 men; 9 women) at our institution.
  • This represented 1.4% of overall EUS-guided FNA and 77% of adrenal gland FNA.
  • Almost all FNAs were of the left adrenal gland (23 of 24).
  • Final diagnoses were as follows: cortical tissue consistent with cortical adenoma (19), metastatic adenocarcinoma (3), pheochromocytoma (1), and adrenal cortical carcinoma (1).
  • EUS-guided FNA of the adrenal gland is primarily used in the staging of other malignancies when lesions of the left adrenal are recognized sonographically.
  • Diagnostic tissue is easily obtained, including material for cell block IHC, which allows definitive diagnosis in cases that present difficult differential diagnoses.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Glands / pathology. Biopsy, Fine-Needle / methods. Endosonography / methods
  • [MeSH-minor] Adenocarcinoma / diagnosis. Adenoma / diagnosis. Adrenocortical Carcinoma / diagnosis. Adult. Aged. Aged, 80 and over. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Pheochromocytoma / diagnosis. Sensitivity and Specificity

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  • [Copyright] 2005 Wiley-Liss, Inc
  • (PMID = 15945088.001).
  • [ISSN] 8755-1039
  • [Journal-full-title] Diagnostic cytopathology
  • [ISO-abbreviation] Diagn. Cytopathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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31. Pacak K, Eisenhofer G, Ahlman H, Bornstein SR, Gimenez-Roqueplo AP, Grossman AB, Kimura N, Mannelli M, McNicol AM, Tischler AS, International Symposium on Pheochromocytoma: Pheochromocytoma: recommendations for clinical practice from the First International Symposium. October 2005. Nat Clin Pract Endocrinol Metab; 2007 Feb;3(2):92-102
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  • [Title] Pheochromocytoma: recommendations for clinical practice from the First International Symposium. October 2005.
  • The First International Symposium on Pheochromocytoma, held in October 2005, included discussions about developments concerning these rare catecholamine-producing tumors.
  • Recommendations were made during the symposium for biochemical diagnosis, localization, genetics, and treatment.
  • Measurement of plasma or urinary fractionated metanephrines, the most accurate screening approach, was recommended as the first-line test for diagnosis; reference intervals should favor sensitivity over specificity.
  • Inadequate methods to distinguish malignant from benign tumors and a lack of effective treatments for malignancy are important problems requiring further resolution.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Paraganglioma / diagnosis. Pheochromocytoma / diagnosis. Pheochromocytoma / therapy

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  • (PMID = 17237836.001).
  • [ISSN] 1745-8366
  • [Journal-full-title] Nature clinical practice. Endocrinology & metabolism
  • [ISO-abbreviation] Nat Clin Pract Endocrinol Metab
  • [Language] eng
  • [Publication-type] Consensus Development Conference; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0J45DE6B88 / Normetanephrine; 5001-33-2 / Metanephrine; EC 2.7.10.1 / Proto-Oncogene Proteins c-ret
  • [Number-of-references] 83
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32. Widimský J Jr: Recent advances in the diagnosis and treatment of pheochromocytoma. Kidney Blood Press Res; 2006;29(5):321-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Recent advances in the diagnosis and treatment of pheochromocytoma.
  • Pheochromocytoma (PHEO) is considered to be a rare cause of hypertension.
  • The diagnosis of PHEO is therefore extremely important.
  • Plasma-free metanephrines or urinary fractionated metanephrines seem to have higher diagnostic values compared to plasma or urinary catecholamines for the biochemical diagnosis of PHEO.
  • Imaging with (123)I-metaiodobenzylguanidine or (18)F-fluorodopamine PET, if available, are in addition to CT/MRI useful for the detection of multifocal/extra-adrenal forms.
  • Appropriate pharmacologic treatment with subsequent laparoscopic extirpation of PHEO is usually successful in benign forms.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Pheochromocytoma / diagnosis

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  • (PMID = 17119341.001).
  • [ISSN] 1420-4096
  • [Journal-full-title] Kidney & blood pressure research
  • [ISO-abbreviation] Kidney Blood Press. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 26
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33. Blake MA, Cronin CG, Boland GW: Adrenal imaging. AJR Am J Roentgenol; 2010 Jun;194(6):1450-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adrenal imaging.
  • OBJECTIVE: Adrenal nodules are frequently encountered on current high-resolution imaging, and accurate characterization of such lesions is critical for appropriate patient care.
  • Our article highlights how imaging techniques such as CT densitometry, CT washout characteristics, chemical shift MRI, PET, and PET/CT help characterize most adrenal lesions.
  • We focus on these techniques as well as specifically, because of space constraints, the varied imaging appearances of adrenocortical carcinoma, pheochromocytoma, and lymphoma on these techniques.
  • CONCLUSION: The imaging characterization of adrenal lesions has continued to advance over the past decade as new technologies have evolved.
  • CT, MRI, PET, and PET/CT are now established clinical techniques capable of differentiating benign from malignant adrenal lesions.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenocortical Carcinoma / diagnosis. Diagnostic Imaging. Lymphoma / diagnosis. Pheochromocytoma / diagnosis
  • [MeSH-minor] Contrast Media. Diagnosis, Differential. Humans. Magnetic Resonance Imaging / methods. Radiopharmaceuticals. Tomography, Emission-Computed / methods. Tomography, X-Ray Computed / methods


34. Han XN, Chen B, Ye XD, Wang J, Liu GH: [Clinical manifestation and multiphasic spiral CT scanning features of abdominal pheochromocytoma: report of 70 cases]. Zhonghua Zhong Liu Za Zhi; 2009 Feb;31(2):139-42
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  • [Title] [Clinical manifestation and multiphasic spiral CT scanning features of abdominal pheochromocytoma: report of 70 cases].
  • OBJECTIVE: The purpose of this study was to assess the imaging characteristics of abdominal pheochromocytoma in multiphasic spiral CT scanning, and to determine whether these image characteristics can aid in differentiating pheochromocytoma from other types of tumors or not.
  • RESULTS: Among the 70 patients, there were 41 patients with endocrine symptoms related to pheochromocytoma, 15 had a latent pheochromocytoma and the remaining 14 cases presented with a non-functioning pheochromocytoma.
  • Sixty cases had a tumor located in the adrenal gland, while 8 in retroperitoneal space, and 2 cases had both intraadrenal and ectopic lesions simultaneously.
  • Sixty patients had a benign pheochromocytoma, the other 10 had a malignant one or relapse after operation.
  • However, when a small tumor has moderate blood supply, it should be differentiated with an adrenal adenoma; when a big one has moderate blood supply, it should be differentiated with other malignant tumors.
  • Furthermore, a part of malignant pheochromocytomas is really difficult to be differentiated from some benign lesions by spiral CT images alone.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Pheochromocytoma / radiography. Retroperitoneal Neoplasms / radiography. Tomography, Spiral Computed / methods
  • [MeSH-minor] Adenoma / blood supply. Adenoma / radiography. Adenoma / surgery. Adolescent. Adult. Aged. Aged, 80 and over. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Radiographic Image Enhancement. Retrospective Studies. Young Adult

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  • (PMID = 19538893.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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35. Feng C, Li HZ, Yan WG, Gao JG, Xu WF, Luo YF, Cao JL: [The significance of Ki-67 antigen expression in the distinction between benign and malignant pheochromocytomas]. Zhonghua Wai Ke Za Zhi; 2007 Dec 15;45(24):1697-700
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [The significance of Ki-67 antigen expression in the distinction between benign and malignant pheochromocytomas].
  • OBJECTIVES: To investigate the expression of Ki-67 antigen in benign and malignant pheochromocytomas, and to evaluate whether the expression of Ki-67 antigen could serve as a diagnostic marker for predicting the biological behaviour of these tumors.
  • METHODS: Ki-67 antigen were detected by immunohistochemical technique and image analysis in 57 cases of clinically documented benign and malignant pheochromocytomas were analyzed.
  • RESULTS: Ki-67 index was low in benign pheochromocytomas (average 0.98%), and high in malignant pheochromocytomas (average 3.78%).
  • There was statistically significant difference in expressions of Ki-67 antigen between benign and malignant pheochromocytomas.
  • The Ki-67 index of 2 cases in benign pheochromocytomas (5.1%, 2/39) and 10 cases in malignant pheochromocytomas (55.6%, 10/18) was higher than 3%.
  • The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Ki-67 index higher than 3% to diagnosis malignant pheochromocytomas was 82.5%, 55.6%, 94.9%, 83.3% and 82.2%.
  • Immunohistochemical assessment of Ki-67 antigen can be useful in the differential diagnosis of malignant from benign pheochromocytomas.
  • Ki-67 index (> 3%) is a useful marker for distinguishing benign from malignant tumors or for predicting the malignant potential of pheochromocytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Biomarkers, Tumor / analysis. Ki-67 Antigen / analysis. Pheochromocytoma / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. Diagnosis, Differential. Female. Follow-Up Studies. Humans. Immunohistochemistry. Male. Middle Aged. Sensitivity and Specificity

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  • (PMID = 18476530.001).
  • [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
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Ki-67 Antigen
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36. Alberti C: [Adrenal incidentalomas: etiologic diagnostics and basic therapeutic management. A mini-review]. G Chir; 2009 May;30(5):243-50
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  • [Title] [Adrenal incidentalomas: etiologic diagnostics and basic therapeutic management. A mini-review].
  • Since the late 1970s, the number of serendipitously discovered adrenal masses has progressively increased through the widespread use of great sensitivity/high resolution diagnostic imaging while abdomen scanning for extra-adrenal lesions.
  • The majority of these masses are benign and without evidence of endocrine activity.
  • Most adrenal incidentalomas are cortical adenomas whereas the prevalence of adrenocortical carcinomas and other adrenal masses (lipomas, myelolipomas, angio-myelo-lipomas, sarcomas, hamartomas, lymphomas) is relatively low.
  • An accurate management of adrenal incidentalomas requires an agreement among radiologist, endocrinologist, oncologist and surgeon.
  • Arguments for benign incidentalomas are mainly small size (< 4 cm), low CT attenuation coefficients and/or typical features on RM imaging.
  • Surgery is mandatory for secretory tumours (functioning cortical adenomas, pheochromocytoma) and for adrenal malignancies.
  • Even modest hormonal activities, as sometimes exhibited from asymptomatic pheochromocytoma or in subclinical primary hypercortisolism/hyperaldosteronism, may be associated with morbidity of some importance.
  • In accordance with international literature, the size of adrenal incidentalomas may be a discriminant criterion for their management: surgery is recommended for masses of large (> 6 cm) diameter or increasing at CT/RM follow-up reevaluation whereas the masses between 4/6 cm form an indeterminate group where the management varies from institution to institution.
  • Laparoscopic transperitoneal as well as retro-peritoneoscopic procedures are gaining more and more attention for less invasive treatment of adrenal incidentalomas.
  • According to 2002 USA-National Institutes of Health guidelines, further studies are necessary to better define natural history, CT and RM malignant features, functional aptitudes of adrenal incidentalomas in order to propose optimal modalities of follow-up and proper surgical strategies.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery
  • [MeSH-minor] Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / surgery. Adrenocortical Adenoma / diagnosis. Adrenocortical Adenoma / surgery. Diagnosis, Differential. Humans. Incidental Findings. Magnetic Resonance Imaging. Practice Guidelines as Topic. Prevalence. Prognosis. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 19505420.001).
  • [ISSN] 0391-9005
  • [Journal-full-title] Il Giornale di chirurgia
  • [ISO-abbreviation] G Chir
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 72
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37. 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


38. Musholt TJ: [Diagnosis of and surgical therapy for pheochromocytoma and paraganglioma]. Zentralbl Chir; 2010 Jun;135(3):226-32
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  • [Title] [Diagnosis of and surgical therapy for pheochromocytoma and paraganglioma].
  • However, in the absence of metastasis, reliable differentiation between -benign and malignant growth is preoperatively and even histopathologically rarely possible.
  • Minimally invasive techniques using a transabdominal or retroperitoneal approach have become the gold standard for the resection of unifocal benign pheochromocytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Paraganglioma / surgery. Pheochromocytoma / surgery
  • [MeSH-minor] Adrenal Glands / pathology. Adrenalectomy / methods. Diagnosis, Differential. Humans. Minimally Invasive Surgical Procedures. Multiple Endocrine Neoplasia / diagnosis. Multiple Endocrine Neoplasia / pathology. Multiple Endocrine Neoplasia / surgery

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  • [Copyright] Georg Thieme Verlag Stuttgart, New York.
  • (PMID = 20549585.001).
  • [ISSN] 1438-9592
  • [Journal-full-title] Zentralblatt für Chirurgie
  • [ISO-abbreviation] Zentralbl Chir
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
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39. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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40. Micali S, Peluso G, De Stefani S, Celia A, Sighinolfi MC, Grande M, Bianchi G: Laparoscopic adrenal surgery: new frontiers. J Endourol; 2005 Apr;19(3):272-8
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  • [Title] Laparoscopic adrenal surgery: new frontiers.
  • After about 10 years of experience, laparoscopic adrenalectomy has become the gold standard for the treatment of adrenal lesions.
  • Here, we describe the presenting features, imaging methods, and current surgical approaches to diseases of the adrenal gland.
  • There is general agreement on the suitability of the laparoscopic approach for benign adrenal lesions, but controversy exists about using laparoscopy for suspected adrenal malignancy, metastasis, and partial adrenalectomy.
  • In particular, we focus our attention on the new surgical approaches to the gland.

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  • (PMID = 15865511.001).
  • [ISSN] 0892-7790
  • [Journal-full-title] Journal of endourology
  • [ISO-abbreviation] J. Endourol.
  • [Language] ENG
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 67
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41. Gao B, Kong F, Xu Z: Development of differential diagnosis for benign and malignant pheochromocytomas. Int J Urol; 2008 Sep;15(9):771-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Development of differential diagnosis for benign and malignant pheochromocytomas.
  • A review on the development of differentiating diagnosis between malignant and benign pheochromocytomas in imaging studies, biological fluid examinations, pathological examinations, molecular markers and genome studies, was updated in the hopes of guiding the next studies of pheochromcytomas.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Pheochromocytoma / pathology
  • [MeSH-minor] Diagnosis, Differential. Genome, Human. Humans

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  • (PMID = 18651863.001).
  • [ISSN] 1442-2042
  • [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; Review
  • [Publication-country] Australia
  • [Number-of-references] 58
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42. O'Malley R, Chughtai B, Sukkarieh T, Kirschenbaum A, Naik R, Sawas A, Khan SA, Rehman J: Case and management of incidentalomas in patients with Von Hippel-Lindau disease. Urol Int; 2005;75(2):189-91
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  • Adrenal incidentalomas, those adrenal masses discovered on imaging studies undertaken for other indications, represent an evaluation and management conundrum.
  • Evaluating every incidentaloma for functional status and/or resecting all incidentalomas would not be cost-effective because the vast majority of incidentalomas are benign, non-functioning adenomas.
  • In this article we report a case of a pheochromocytoma presenting as a small incidentaloma in a patient with Von Hippel-Lindau disease.
  • We review the current literature describing the appropriate evaluation and management of adrenal incidentalomas and investigate the nuances of evaluation of these masses in patients with Von Hippel-Lindau disease.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Pheochromocytoma / surgery. Precancerous Conditions / pathology. von Hippel-Lindau Disease / diagnosis
  • [MeSH-minor] Adult. Diagnosis, Differential. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Neoplasm Staging. Risk Assessment. Treatment Outcome


43. 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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44. Gazymov MM, Filipov DS: [Adrenal tumors: topical diagnosis and surgical outcomes]. Urologiia; 2005 Sep-Oct;(5):9-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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45. El-Daly H, Rao P, Palazzo F, Gudi M: A rare entity of an unusual site: adenomatoid tumour of the adrenal gland: a case report and review of the literature. Patholog Res Int; 2010;2010:702472
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  • [Title] A rare entity of an unusual site: adenomatoid tumour of the adrenal gland: a case report and review of the literature.
  • This is a case report of a 51 year old male who was found to have an incidental left sided non-functioning adrenal mass on routine medical examination and which was confirmed by CT and MRI scans.
  • There was focal extension to capsule and peri-adrenal fat.
  • A diagnosis of an adenomatoid tumour as made.
  • Adenomatoid tumours are rare benign tumours of mesothelial derivation.
  • The adrenal gland is devoid of a mesothelial lining and the most accepted hypothesis for an adenomatoid tumour originating in the adrenal gland is derivation from mesothelial rests.
  • As the adrenal gland is an extremely rare site of occurrence for an adenomatoid tumour, it is frequently mistaken for adrenocortical tumours or a pheochromocytoma clinically and radiologically.

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  • (PMID = 21151721.001).
  • [ISSN] 2042-003X
  • [Journal-full-title] Pathology research international
  • [ISO-abbreviation] Patholog Res Int
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2990199
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46. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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47. 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
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48. de Krijger RR, van Nederveen FH, Korpershoek E, Dinjens WN: New developments in the detection of the clinical behavior of pheochromocytomas and paragangliomas. Endocr Pathol; 2006;17(2):137-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Pheochromocytomas (PCC) are catecholamine-producing tumors that are, by definition, located in the adrenal medulla.
  • Extra-adrenal catecholamine-producing tumors are called paragangliomas (PGL), which should be distinguished from head and neck paragangliomas, which are of parasympathetic origin.
  • As is true for many (neuro)endocrine tumors, but unlike most other epithelial tumors, histopathological analysis does not allow a distinction to be made between PCC and PGL that will follow a benign course and those that have metastasized or will do so, a condition associated with poor prognosis.
  • In this article, recent attempts at marker detection, such as those mentioned above, as well as emerging knowledge on the molecular abnormalities in benign and malignant PCC and PGL will be presented.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Paraganglioma / diagnosis. Pheochromocytoma / diagnosis
  • [MeSH-minor] Biomarkers, Tumor / analysis. Diagnosis, Differential. Gene Expression Profiling. Humans. Nucleic Acid Hybridization. Prognosis

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  • (PMID = 17159246.001).
  • [ISSN] 1046-3976
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 18
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49. Guérin M, Guillemot J, Thouënnon E, Pierre A, El-Yamani FZ, Montero-Hadjadje M, Dubessy C, Magoul R, Lihrmann I, Anouar Y, Yon L: Granins and their derived peptides in normal and tumoral chromaffin tissue: Implications for the diagnosis and prognosis of pheochromocytoma. Regul Pept; 2010 Nov 30;165(1):21-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Granins and their derived peptides in normal and tumoral chromaffin tissue: Implications for the diagnosis and prognosis of pheochromocytoma.
  • Pheochromocytomas are rare catecholamine-secreting tumors that arise from chromaffin tissue within the adrenal medulla and extra-adrenal sites.
  • The diagnosis of pheochromocytomas depends mainly upon the demonstration of catecholamine excess by 24-h urinary catecholamines and metanephrines or plasma metanephrines.
  • In this context, we will focus here on reviewing the distribution and characterization of granins and their processing products in normal and tumoral chromaffin cells, and their clinical usefulness for the diagnosis and prognosis of pheochromocytomas.
  • In most cases, elevated levels of these entities were found, in correlation with tumor occurrence, while rarely discriminating between benign and malignant neoplasms.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / pathology. Chromaffin Cells / metabolism. Chromaffin Cells / pathology. Chromogranins / metabolism. Pheochromocytoma / diagnosis. Pheochromocytoma / pathology


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

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  • [Copyright] Copyright © 2010 Elsevier Inc. All rights reserved.
  • (PMID = 21167383.001).
  • [ISSN] 1532-8708
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones
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51. Pacak K, Ilias I, Adams KT, Eisenhofer G: Biochemical diagnosis, localization and management of pheochromocytoma: focus on multiple endocrine neoplasia type 2 in relation to other hereditary syndromes and sporadic forms of the tumour. J Intern Med; 2005 Jan;257(1):60-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Biochemical diagnosis, localization and management of pheochromocytoma: focus on multiple endocrine neoplasia type 2 in relation to other hereditary syndromes and sporadic forms of the tumour.
  • Approximately 50% of patients with multiple endocrine neoplasia (MEN) 2A or 2B develop pheochromocytoma.
  • These tumours are almost exclusively benign and localized in the adrenal glands.
  • About one-third are bilateral at initial diagnosis.
  • Amongst patients with pheochromocytoma, those with MEN 2A have subtler symptoms compared to those with sporadic disease.
  • Since pheochromocytomas in patients with MEN 2 often secrete catecholamines episodically (but metabolize them continuously to metanephrines), the first choice for biochemical diagnosis is the measurement of free metanephrines in plasma, with urinary fractionated metanephrines being the second choice.
  • In patients with biochemically proven MEN 2-related pheochromocytoma, anatomical imaging of the adrenals (with either computerized tomography or magnetic resonance) should be obtained next.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Multiple Endocrine Neoplasia / complications. Pheochromocytoma / diagnosis


52. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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53. Nawar R, Aron D: Adrenal incidentalomas -- a continuing management dilemma. Endocr Relat Cancer; 2005 Sep;12(3):585-98
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adrenal incidentalomas -- a continuing management dilemma.
  • Adrenal incidentalomas (AI), adrenal tumors detected through an imaging procedure done for reasons unrelated to adrenal dysfunction, is becoming a common clinical problem with the more frequent utilization of different imaging techniques.
  • Most such tumors are benign and hormonally inactive.
  • The benefit of making a diagnosis of a clinically significant AI must be considered in the context of the patient's overall condition and preferences.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / physiopathology. Incidental Findings
  • [MeSH-minor] Adrenal Gland Diseases / diagnosis. Adrenal Gland Diseases / etiology. Humans. National Institutes of Health (U.S.). Pheochromocytoma / diagnosis. United States

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  • (PMID = 16172193.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 99
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54. Koroscil TM, McDonald S, Stutes S, Vila RJ: Use of fluorine-18-labelled deoxyglucose positron emission tomography with computed tomography to localize a paraganglioma in pregnancy. South Med J; 2010 Dec;103(12):1238-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Phenoxybenzamine and labetalol were initiated for presumed pheochromocytoma.
  • At thirteen weeks of pregnancy, a noncontrast magnetic resonance imaging (MRI) of the abdomen failed to identify an adrenal or extra-adrenal mass.
  • At 21-weeks gestation, an abdominal [18-F]-fluorodeoxyglucose positron emission tomography with computed tomography demonstrated an extra-adrenal lesion.
  • The patient underwent a laparotomy during the second trimester with successful removal of a benign paraganglioma.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Paraganglioma / radiography. Pheochromocytoma / radiography. Pregnancy Complications, Neoplastic / radiography
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Fluorodeoxyglucose F18. Humans. Magnetic Resonance Imaging. Positron-Emission Tomography. Pregnancy. Tomography, X-Ray Computed


55. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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  • [Publication-country] Germany
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56. Welsh SJ, Khan S: Radiological localizing techniques in adrenal tumors. Minerva Endocrinol; 2009 Jun;34(2):161-9
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  • [Title] Radiological localizing techniques in adrenal tumors.
  • The characterisation of adrenal lesions is a common radiological dilemma.
  • Incidental adrenal lesions are commonly detected with computed tomography (CT), and lesion characterisation is critical.
  • The prevalence of incidental adrenal lesions has been reported to be 2.3% at autopsy and 0.5-2% with abdominal CT.
  • Although the majority of adrenal lesions are benign, in patients with an extra-adrenal primary cancer the probability of an adrenal mass being a metastasis is 52%.
  • Unfortunately, there may be significant overlap between the imaging appearances of benign lesions such as lipid-poor adenomas and malignant lesions, particularly metastases and small adrenal carcinomas.
  • This review highlights recent advances in radiological imaging of adrenal lesions and we discuss the relative merits of CT and magnetic resonance imaging to aid the identification of benign and malignant adrenal lesions and their roles, in combination with biochemical and clinical data, in recognizing common pathologies such as adrenal adenoma, phaeochromocytoma, carcinoma and metastases.
  • We also discuss the radiological characteristics of rarer adrenal lesions including lymphoma, neuroblastic tumours (neuroblastoma, ganglioneuroblastoma, and ganglioneuroma), lipomatous tumours (myelolipoma, angiolipoma, teratoma, lipoma and liposarcoma), in addition to hemangioma, hemangiosarcoma and leiomyosarcoma.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Incidental Findings. Tomography, X-Ray Computed
  • [MeSH-minor] Adrenal Cortex Neoplasms / radiography. Adrenocortical Adenoma / radiography. Adrenocortical Carcinoma / radiography. Diagnosis, Differential. Ganglioneuroblastoma / radiography. Ganglioneuroma / radiography. Humans. Lymphoma / radiography. Magnetic Resonance Imaging. Neoplasm Metastasis. Neoplasms, Adipose Tissue / radiography. Neoplasms, Vascular Tissue / radiography. Neuroblastoma / radiography. Pheochromocytoma / radiography. Predictive Value of Tests. Sensitivity and Specificity. Teratoma / radiography

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  • (PMID = 19471240.001).
  • [ISSN] 0391-1977
  • [Journal-full-title] Minerva endocrinologica
  • [ISO-abbreviation] Minerva Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 42
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57. 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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58. Cotesta D, Petramala L, Serra V, Pergolini M, Crescenzi E, Zinnamosca L, De Toma G, Ciardi A, Carbone I, Massa R, Filetti S, Letizia C: Clinical experience with pheochromocytoma in a single centre over 16 years. High Blood Press Cardiovasc Prev; 2009 Dec;16(4):183-93
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  • [Title] Clinical experience with pheochromocytoma in a single centre over 16 years.
  • BACKGROUND: Pheochromocytoma and paraganglioma are rare tumours of neuroectodermal origin.
  • Pheochromocytoma occurs in 0.1-2% of people with hypertension, while the incidence rises to 4-5% in patients with incidental adrenal mass.
  • AIM: To analyse the presentation, diagnosis and localization, pathology, molecular genetic aspects, surgical management and long-term outcome of a large series of patients with pheochromocytoma referred to a single centre.
  • METHODS: From 1992 to 2008, we observed 91 patients with pheochromocytoma, 70 (77%) with the sporadic form and 21 (23%) with the hereditary form.
  • In the group with the hereditary form, the mean age at diagnosis was significantly lower than the mean age of the group with the sporadic form (38 vs 48 years; p < 0.001).
  • RESULTS: Eighty (88%) patients with pheochromocytoma were symptomatic and the classical triad of palpitations, headache and diaphoresis was present in 30% of patients.
  • In 12% of patients, the pheochromocytoma was discovered during radiological images (adrenal incidentaloma).
  • The unilateral adrenal localization was observed in 78% of patients, bilateral in 15% and extra-adrenal in 7% of patients.
  • All pheochromocytoma patients underwent surgical procedure and the laparotomic approach was used in 49 (53%) patients, while the laparoscopic approach was performed in 42 (47%) patients.
  • Pheochromocytoma was benign in 86 patients (93%) [mean size was 4.3 cm] and the malignant form was found in five patients (7%) [mean size was 10 cm].
  • CONCLUSIONS: These data from a large cohort of patients are consistent with those reported in the literature and show that pheochromocytoma is an in important challenge for clinicians.

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  • (PMID = 23334910.001).
  • [ISSN] 1120-9879
  • [Journal-full-title] High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension
  • [ISO-abbreviation] High Blood Press Cardiovasc Prev
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] New Zealand
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59. 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


60. Grossrubatscher E, Dalino P, Vignati F, Gambacorta M, Pugliese R, Boniardi M, Rossetti O, Marocchi A, Bertuzzi M, Loli P: The role of chromogranin A in the management of patients with phaeochromocytoma. Clin Endocrinol (Oxf); 2006 Sep;65(3):287-93
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  • Combining the results of CgA and urinary catecholamines (epinephrine and norepinephrine), the sensitivity for diagnosis of phaeochromocytoma was 100%.
  • Urinary catecholamines, metabolites (metanephrine and normetanephrine) and CgA levels in patients with malignant phaeochromocytoma did not differ significantly from those of patients with benign lesions.
  • [MeSH-major] Adrenal Gland Neoplasms / blood. Biomarkers, Tumor / blood. Chromogranin A / blood. Pheochromocytoma / blood

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  • (PMID = 16918946.001).
  • [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 / Catecholamines; 0 / Chromogranin A; 0J45DE6B88 / Normetanephrine; 5001-33-2 / Metanephrine
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61. Vassilatou E, Vryonidou A, Michalopoulou S, Manolis J, Caratzas J, Phenekos C, Tzavara I: Hormonal activity of adrenal incidentalomas: results from a long-term follow-up study. Clin Endocrinol (Oxf); 2009 May;70(5):674-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Hormonal activity of adrenal incidentalomas: results from a long-term follow-up study.
  • OBJECTIVE: To investigate the natural course of apparently benign adrenal incidentalomas with no overt hyperfunction at diagnosis, as their clinical significance and appropriate management are still controversial.
  • DESIGN: Prospective long-term follow-up study of patients with adrenal incidentalomas with periodic hormonal and morphological evaluation.
  • PATIENTS AND METHODS: A total of 77 patients with incidental adrenal masses, diameter 1.0-6.0 cm (median 2.5 cm), were submitted to a hormonal assessment of adrenal function at diagnosis.
  • This was repeated, together with an adrenal CT scan, 12 months later and then every 12-24 months, for a period of 12-154 months (mean 62.7 +/- 31.9, median 60.0).
  • RESULTS: At diagnosis, 57 patients had normal adrenal function and 20 had subclinical Cushing's syndrome.
  • During follow-up, adrenal function remained normal in 49 patients, subclinical Cushing's syndrome was confirmed in 12, whilst intermittent subclinical autonomous cortisol hypersecretion was found in 12 patients.
  • CONCLUSIONS: Subclinical autonomous cortisol hypersecretion is the most frequent hormonal abnormality in patients with adrenal incidentalomas, and may be intermittent in a significant percentage of cases.
  • A growth tendency is observed in some adrenal incidentalomas without evidence of malignant transformation and occasionally can be related to development of overt hyperfunction.
  • [MeSH-major] Adrenal Cortex Hormones / secretion. Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / secretion
  • [MeSH-minor] Adult. Aged. Cushing Syndrome / diagnosis. Cushing Syndrome / physiopathology. Female. Follow-Up Studies. Humans. Hydrocortisone / secretion. Incidental Findings. Male. Middle Aged. Pheochromocytoma / diagnosis. Pheochromocytoma / secretion. Prospective Studies. Tomography, X-Ray Computed


62. Iacconi P, Donatini G, Iacconi C, De Bartolomeis C, Cucinotta M, Puccini M, Miccoli P: Unexpected histological findings of lesions diagnosed in the adrenal region in a series of 420 patients submitted to adrenal surgery. Review of our experience. J Endocrinol Invest; 2008 Oct;31(10):873-6
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  • [Title] Unexpected histological findings of lesions diagnosed in the adrenal region in a series of 420 patients submitted to adrenal surgery. Review of our experience.
  • INTRODUCTION: The incidence of adrenal incidentalomas is reported to be up to 30% in the current literature; nevertheless, in some patients undergoing surgery, a final diagnosis of non-adrenal origin of the mass is performed.
  • In this paper we present our experience of 13 patients with unexpected histological findings of lesions diagnosed in the adrenal region.
  • Pre-operative diagnosis was: incidentaloma (34.0% of patients), Conn's adenoma (29.0%), Cushing's adenoma (13.9%), pheochromocytoma (8.8%), suspicious metastasis (7.3%), Cushing's disease (6.0%), other (1.0%).
  • RESULTS: Final histology revealed an unexpected diagnosis of non-adrenal origin of the mass in 13 patients (3.1%).
  • Histology demonstrated a benign neurogenic tumor in 10 patients.
  • In the other 3 patients diagnosis was respectively of lymphnode, hemangioma and a gastric metastasis of melanoma.
  • Mean operative time in this group was higher compared to laparoscopic resection for adrenal lesion (95.3 min vs 73.2 min).
  • CONCLUSION: A small percentage of our patients (3.1%) demonstrated unexpected findings of the lesion pre-operatively misinterpreted as an adrenal mass.
  • Despite a complete pre-operative assessment, adrenal lesions might reveal a different origin, increasing the surgical challenge as well as the morbidity for the patient.
  • [MeSH-major] Adrenal Gland Diseases / diagnosis. Adrenal Gland Neoplasms / diagnosis. Adrenalectomy / methods
  • [MeSH-minor] Adrenal Glands / pathology. Adrenal Glands / surgery. Adult. Diagnostic Errors. Female. Humans. Incidental Findings. Laparoscopy. Male. Pregnancy. Tomography, X-Ray Computed

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  • (PMID = 19092291.001).
  • [ISSN] 1720-8386
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
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63. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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64. 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


65. 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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66. 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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67. 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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68. 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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69. 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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70. 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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71. Bjornsson B, Birgisson G, Oddsdottir M: Laparoscopic adrenalectomies: A nationwide single-surgeon experience. Surg Endosc; 2008 Mar;22(3):622-6
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  • Since then, all procedures for presumed benign lesions of the adrenals have been performed laparoscopically in a single center.
  • The preoperative diagnosis was documented, as well as the pathologic diagnosis, operative details, complications, and length of hospital stay.
  • RESULTS: In 49 operations, 53 adrenal glands were removed from 48 patients (37 women and 11 men).
  • The left adrenal was removed from 29 patients, the right adrenal from 14 patients, and both adrenals from 5 patients.
  • The most common indications and diagnoses included 17 nonsecreting tumors (12 adenomas, 3 hyperplasias, 1 complex adrenal cyst, and 1 hemangioma), 12 aldosteronomas (10 aldosteronomas and 2 nodular hyperplasias), and 10 pheochromocytomas (9 confirmed, 1 adrenal hyperplasia).
  • CONCLUSION: The results of laparoscopic adrenalectomies in Iceland for benign lesions of the adrenals are comparable with published results from large referral centers.
  • [MeSH-major] Adrenal Gland Neoplasms / surgery. Adrenalectomy / methods. Laparoscopy / methods. Laparoscopy / statistics & numerical data. Pheochromocytoma / surgery

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  • (PMID = 18163169.001).
  • [ISSN] 1432-2218
  • [Journal-full-title] Surgical endoscopy
  • [ISO-abbreviation] Surg Endosc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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72. 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


73. Ridho FE, Adam FM, Adam JM: Adrenal incidentaloma. Acta Med Indones; 2009 Apr;41(2):87-93
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  • [Title] Adrenal incidentaloma.
  • Adrenal Incidentaloma is an adrenal tumor, which is unidentified before the imaging procedures conducted for an abnormality which is initially unforeseen as an adrenal disease.
  • Symptoms and/or clinical signs of adrenal tumor do not have to be present prior to a diagnosis.
  • Adrenal Incidentaloma can be divided into non-hypersecreting adrenal adenoma, hypersecreting tumor, primary adrenal carcinoma, other adrenal mass, and metastases.
  • The majority of adrenal tumor is non-hypersecreting adrenal adenoma, but it is always considered as hypersecreting tumor until proven otherwise.
  • Some conditions that can be found due to hormonal activity of adrenal incidentaloma is subclinical Cushing's syndrome, pheochromocytoma, aldosteronoma (Conn's disease), and several tumors which secrete androgen and sex hormone.
  • Diagnostic approach of adrenal incidentaloma is focused on two main problems, which are, whether the lesion is hormonally active even though lacking characteristic clinical signs, and whether the lesion is benign or malignant; thus it needs hormonal and radiologic evaluation, even a fine needle biopsy.
  • The management for adrenal incidentaloma includes surgical removal for hormonally active adrenal tumors, or inactive tumors with size less than 4 cm.
  • [MeSH-major] Adrenal Gland Neoplasms. Aldosterone / blood. Catecholamines / urine. Incidental Findings. Renin / blood
  • [MeSH-minor] Biopsy, Fine-Needle. Diagnosis, Differential. Humans. Indonesia / epidemiology. Morbidity / trends

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  • (PMID = 19390128.001).
  • [ISSN] 0125-9326
  • [Journal-full-title] Acta medica Indonesiana
  • [ISO-abbreviation] Acta Med Indones
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Indonesia
  • [Chemical-registry-number] 0 / Catecholamines; 4964P6T9RB / Aldosterone; EC 3.4.23.15 / Renin
  • [Number-of-references] 38
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74. 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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  • [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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75. Feng C, Li HZ, Yan WG, Luo YF, Cao JL: [The expression and significance of chromogranin A and synaptophysin in adrenal gland tumors]. Zhonghua Zhong Liu Za Zhi; 2005 Aug;27(8):486-8
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  • [Title] [The expression and significance of chromogranin A and synaptophysin in adrenal gland tumors].
  • OBJECTIVE: To investigate the expression of chromogranin A (CgA) and synaptophysin (Syn) for differential diagnosis of different kinds of adrenal gland tumors.
  • METHODS: The samples of 69 adrenal gland tumors and 4 normal adrenal glands were immunohistochemically analyzed for the expression of chromogranin A and synaptophysin.
  • RESULTS: In the normal adrenal gland, CgA and Syn was exclusively detected in the medulla.
  • Syn was detected in adrenocortical adenomas 27/28 (96.4%), adrenocortical carcinoma 7/8 (87.5%), pheochromocytoma 24/25 (96.0%) and adrenal metastatic carcinoma 6/8 (75.0%), respectively.
  • CONCLUSION: There is statistically significant difference of CgA expression between adrenalcortical and adrenal medullary tumors, and also between benign and malignant pheochromocytomas.
  • CgA and Syn are immunohistochemically reliable markers in the differential diagnosis of various kinds of adrenal gland tumors.
  • [MeSH-major] Adrenal Gland Neoplasms / metabolism. Chromogranin A / biosynthesis. Pheochromocytoma / metabolism. Synaptophysin / biosynthesis
  • [MeSH-minor] Adrenocortical Adenoma / diagnosis. Adrenocortical Adenoma / metabolism. Adrenocortical Carcinoma / diagnosis. Adrenocortical Carcinoma / metabolism. Diagnosis, Differential. Female. Humans. Male

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  • (PMID = 16188147.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Chromogranin A; 0 / Synaptophysin
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76. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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


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

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  • [Copyright] Copyright (c) 2007 S. Karger AG, Basel.
  • (PMID = 18174744.001).
  • [ISSN] 1423-0046
  • [Journal-full-title] Hormone research
  • [ISO-abbreviation] Horm. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 42
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78. Nieman LK: Approach to the patient with an adrenal incidentaloma. J Clin Endocrinol Metab; 2010 Sep;95(9):4106-13
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  • [Title] Approach to the patient with an adrenal incidentaloma.
  • Unsuspected adrenal masses, or incidentalomas, are increasingly found with the widespread use of thoracic and abdominal imaging.
  • These masses may be hormonally active or nonfunctional and malignant or benign.
  • All patients should undergo biochemical testing for pheochromocytoma, either with plasma or urinary catecholamine measurements.
  • This is particularly important before surgical resection, which is routinely recommended for masses larger than 4 cm in diameter without a clear-cut diagnosis and for others with hormonal secretion or ominous imaging characteristics.
  • For masses that appear to be benign (<10 HU; washout, >50%), small (<3 cm), and completely nonfunctioning, imaging and biochemical reevaluation (pheochromocytoma and hypercortisolism only) at 1-2 yr (or more) is appropriate.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / therapy. Algorithms. Carcinoma / diagnosis. Carcinoma / therapy. Incidental Findings
  • [MeSH-minor] Biopsy, Fine-Needle. Cushing Syndrome / complications. Cushing Syndrome / diagnosis. Diagnosis, Differential. Female. Humans. Middle Aged. Practice Guidelines as Topic

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  • (PMID = 20823463.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 50
  • [Other-IDs] NLM/ PMC2936073
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79. 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


80. 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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81. 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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82. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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


83. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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84. Nürnberg D: [Ultrasound of adrenal gland tumours and indications for fine needle biopsy (uFNB)]. Ultraschall Med; 2005 Dec;26(6):458-69
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  • [Title] [Ultrasound of adrenal gland tumours and indications for fine needle biopsy (uFNB)].
  • The normal adrenal glands can be detected by high-resolution-sonography in a high percentage of cases.
  • Sonography is also highly sensitive in the diagnosis of tumours of the adrenal glands.
  • Amongst the benign tumours, adenomas are the most frequent (up to 8%).
  • The adrenal glands are the fourth most common location of metastases.
  • Much less frequent are infiltrates of lymphomas in adrenal glands tumours (3.4%).
  • Incidentalomas are accidentally detected tumours of the adrenal glands without clinical symptoms.
  • The uFNB of the adrenal glands has a high sensitivity (90-95%).
  • Recommendations for this procedure in accidentally detected tumours of the adrenal glands: < 3 cm and hormonally inactive --> US-follow up, > 5 cm + suspected tumour --> surgery, 3-5 cm uFNB after laboratory diagnostics.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / ultrasonography. Biopsy, Fine-Needle
  • [MeSH-minor] Adrenal Glands / cytology. Adrenal Glands / pathology. Adrenal Glands / ultrastructure. Humans. Lymphoma / pathology. Lymphoma / ultrasonography. Pheochromocytoma / pathology. Pheochromocytoma / ultrasonography

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  • (PMID = 16453217.001).
  • [ISSN] 0172-4614
  • [Journal-full-title] Ultraschall in der Medizin (Stuttgart, Germany : 1980)
  • [ISO-abbreviation] Ultraschall Med
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 116
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85. 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


86. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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87. Halefoglu AM, Bas N, Yasar A, Basak M: Differentiation of adrenal adenomas from nonadenomas using CT histogram analysis method: a prospective study. Eur J Radiol; 2010 Mar;73(3):643-51
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  • [Title] Differentiation of adrenal adenomas from nonadenomas using CT histogram analysis method: a prospective study.
  • OBJECTIVE: The objective of our study was to prospectively evaluate the effectiveness of computed tomography (CT) histogram analysis method in the differentiation of benign and malignant adrenal masses.
  • MATERIALS AND METHODS: Between March 2007 and June 2008, 94 patients (46 males, 48 females, age range: 30-79 years, mean age: 57.7 years) with 113 adrenal masses (mean diameter: 3.03 cm, range: 1.07-8.02 cm) were prospectively evaluated.
  • Histogram analysis method was performed using a circular region of interest (ROI) and mean attenuation, total number of pixels, number of negative pixels and subsequent percentage of negative pixels were detected on both unenhanced and delayed contrast-enhanced CT images for each adrenal mass.
  • Final diagnoses were based on imaging follow-up of minimum 6 months, biopsy, surgery and adrenal washout study.
  • Both methods gave a 100% specificity for the diagnosis of adenoma.
  • CONCLUSION: The CT histogram analysis is a simple and easily applicable method which provides higher sensitivity than the commonly used 10HU threshold mean attenuation method of unenhanced CT and can replace it for the diagnosis of an adenoma.
  • But with contrast-enhanced CT, although 100% specificity is being maintained, the sensitivities obtained are very poor for each method and is therefore likely to limit CT histogram analysis to be used as a clinically useful adjunct in the diagnosis of adenoma.
  • [MeSH-major] Adrenal Gland Neoplasms / radiography. Adrenocortical Adenoma / radiography. Pheochromocytoma / radiography. Tomography, Spiral Computed / methods
  • [MeSH-minor] Adult. Aged. Contrast Media. Diagnosis, Differential. Female. Humans. Iohexol / analogs & derivatives. Male. Middle Aged. Prospective Studies. Sensitivity and Specificity

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  • [Copyright] Copyright 2008 Elsevier Ireland Ltd. All rights reserved.
  • (PMID = 19167179.001).
  • [ISSN] 1872-7727
  • [Journal-full-title] European journal of radiology
  • [ISO-abbreviation] Eur J Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Contrast Media; 4419T9MX03 / Iohexol; 712BAC33MZ / iopromide
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88. Gonsior A, Pfeiffer H, Führer D, Liatsikos E, Schwalenberg T, Stolzenburg JU: [Adrenal tumors. Principles of diagnostics and operative treatment]. Urologe A; 2010 May;49(5):659-68; quiz 669-70
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  • [Title] [Adrenal tumors. Principles of diagnostics and operative treatment].
  • Adrenal masses are very heterogeneous and comprise benign or malignant tumors, unilateral or bilateral masses and variable endocrine activity.
  • Because of these attributes adrenal gland masses are a clinical challenge.
  • This article gives a summary of diagnostic steps and indications for adrenal surgery including perioperative management.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery
  • [MeSH-minor] Adrenal Gland Diseases / diagnosis. Adrenal Gland Diseases / surgery. Adrenal Hyperplasia, Congenital / diagnosis. Adrenal Hyperplasia, Congenital / surgery. Adrenalectomy / instrumentation. Adrenalectomy / methods. Adrenogenital Syndrome / diagnosis. Adrenogenital Syndrome / surgery. Chemotherapy, Adjuvant. Combined Modality Therapy. Cushing Syndrome / diagnosis. Cushing Syndrome / surgery. Diagnosis, Differential. Diagnostic Imaging. Humans. Hyperaldosteronism / diagnosis. Hyperaldosteronism / surgery. Laparoscopes. Neoplasms, Multiple Primary / diagnosis. Neoplasms, Multiple Primary / drug therapy. Neoplasms, Multiple Primary / radiotherapy. Neoplasms, Multiple Primary / surgery. Pheochromocytoma / diagnosis. Pheochromocytoma / surgery. Radiotherapy, Adjuvant. Sensitivity and Specificity

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  • (PMID = 20449781.001).
  • [ISSN] 1433-0563
  • [Journal-full-title] Der Urologe. Ausg. A
  • [ISO-abbreviation] Urologe A
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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89. Lombardi CP, Raffaelli M, De Crea C, Traini E, D'Amore AM, Bellantone R: [Pheochromocytoma: role of preoperative diagnosis in the assessment of malignancy risk and in the choice of surgical approach]. Suppl Tumori; 2005 May-Jun;4(3):S211
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  • [Title] [Pheochromocytoma: role of preoperative diagnosis in the assessment of malignancy risk and in the choice of surgical approach].
  • Differential diagnosis with benign lesions can be difficult even on a pathological basis.
  • Despite safe laparoscopic adrenalectomy (LA) has been reported for lesions up to 10 cm, it is considered hazardous for pheochromocytoma larger than 6 cm, because of the risk of malignancy and iatrogenic pheochromocytomatosis.
  • The medical records of all the patients who underwent adrenalectomy for pheochromocytoma were reviewed.
  • All the preoperatively available data (demographic, clinical, biochemical and radiological) were recorded as well as final pathological diagnosis.
  • Comparative analysis of patients with benign and malignant pheochromocytomas was performed.
  • Sixty-three adrenalectomies for pheochromocytoma were performed in 60 patients.
  • Fifty-seven benign and 6 malignant pheochromocytomas were identified.
  • No significant difference was found between patients with malignant and benign lesions concerning age, gender, family history, symptoms, laboratory and radiological findings.
  • In particular, no significant difference was found for lesion size between the benign (63.3 +/- 30.6 mm, range, 20-150) and the malignant group (48.6 +/- 16.5 mm; range, 30-70).
  • No preoperatively available data can reliably differentiate between benign and malignant pheochromocytomas.
  • Thus, pheochromocytoma size does not seem a reliable predictor of malignancy.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / surgery. Pheochromocytoma / diagnosis. Pheochromocytoma / surgery

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  • (PMID = 16437995.001).
  • [ISSN] 2283-5423
  • [Journal-full-title] I supplementi di Tumori : official journal of Società italiana di cancerologia ... [et al.]
  • [ISO-abbreviation] Suppl Tumori
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
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90. Strong VE, Kennedy T, Al-Ahmadie H, Tang L, Coleman J, Fong Y, Brennan M, Ghossein RA: Prognostic indicators of malignancy in adrenal pheochromocytomas: clinical, histopathologic, and cell cycle/apoptosis gene expression analysis. Surgery; 2008 Jun;143(6):759-68
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  • [Title] Prognostic indicators of malignancy in adrenal pheochromocytomas: clinical, histopathologic, and cell cycle/apoptosis gene expression analysis.
  • The histologic differentiation between benign and malignant tumors is difficult, the latter diagnosed by the presence of metastatic disease or recurrence.
  • AIM: To determine if postoperative histologic evaluation using the previously proposed Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) and cell cycle/apoptosis markers can predict patients at risk for recurrence.
  • METHODS: Using the Memorial Sloan-Kettering Cancer Center adrenal database, we identified 48 patients with 51 resected pheochromocytomas (1987-2006).
  • This pheochromocytoma scoring system is based on the presence of 12 different histologic parameters, including tumor necrosis, mitotic rate, tumor cell spindling, and the presence of large cell nests.
  • In addition, we constructed a tissue microarray of all 5 malignant tumors and 41 of the benign tumors.
  • RESULTS: Forty-three patients had a benign clinical course while 5 patients harbored a clinically malignant pheochromocytoma.
  • Tumor necrosis (focal or confluent) was a particularly powerful indicator of malignancy present in 4 of 5 patients (80%) with malignant tumors, but only in 3 of 42 cases (7%) with benign neoplasms (P = .0009).
  • There was a highly significant difference in PASS scores between benign and malignant cases (P = .0003).
  • There was no difference in staining between benign and malignant pheochromocytomas using p53, Bcl-2, mdm-2, cyclin D1, p21, and p27. CONCLUSIONS:.
  • (1) A PASS score of <4 predicted benign pheochromocytomas. (2) All malignant pheochromocytomas had a PASS score >/=6, which was significantly higher compared with the benign lesions.
  • [MeSH-major] Adrenal Gland Neoplasms / diagnosis. Adrenal Gland Neoplasms / pathology. Apoptosis. Cell Cycle. Gene Expression Regulation, Neoplastic. Neoplasm Recurrence, Local / genetics. Pheochromocytoma / diagnosis. Pheochromocytoma / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Biomarkers, Tumor / metabolism. Diagnosis, Differential. Female. Humans. Ki-67 Antigen / genetics. Ki-67 Antigen / metabolism. Male. Middle Aged. Necrosis / diagnosis. Necrosis / genetics. Necrosis / pathology. Predictive Value of Tests. Prognosis. Prospective Studies. Risk Factors. Severity of Illness Index. Single-Blind Method


91. 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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92. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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93. 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


94. 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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95. 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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96. 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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97. Anagnostis P, Efstathiadou Z, Polyzos SA, Tsolakidou K, Litsas ID, Panagiotou A, Kita M: Long term follow-up of patients with adrenal incidentalomas--a single center experience and review of the literature. Exp Clin Endocrinol Diabetes; 2010 Oct;118(9):610-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long term follow-up of patients with adrenal incidentalomas--a single center experience and review of the literature.
  • INTRODUCTION: Adrenal incidentalomas (AIs) constitute an emerging clinical entity due to the increased use of abdominal imaging for diagnostic purposes.
  • Most often it consists of benign-nonfunctioning lesions and an increase in size during follow-up is reported in about 9% (0-26%), whereas their functional evolution is rare.
  • The patients underwent basal and dynamic evaluation of the hypothalamic-pituitary-adrenal axis, renin-angiotensin-aldosterone system and adrenomedullary function.
  • Mass enlargement and adrenal hyperfunction were estimated at yearly intervals.
  • RESULTS: Adrenalectomy was performed in 5 patients (4 benign cortical adenomas and 1 pheochromocytoma).
  • Abnormal manifestation, based on clinical, laboratory and histological evaluation, was observed in 4 patients [1 (1.56%) with SCS, 2 (3.12%) with pheochromocytoma and 1 (1.56%) with aldosteronoma], 3 of which were diagnosed at their initial evaluation and 1 at the 3 (rd) year of follow-up.
  • CONCLUSIONS: AIs present usually as benign, non-secretory lesions.
  • [MeSH-major] Adenoma / therapy. Adrenal Gland Neoplasms / therapy. Incidental Findings
  • [MeSH-minor] Adrenalectomy / statistics & numerical data. Disease Progression. Female. Follow-Up Studies. Humans. Male. Middle Aged. Pheochromocytoma / diagnosis. Pheochromocytoma / epidemiology. Pheochromocytoma / pathology. Pheochromocytoma / therapy. Prevalence. Retrospective Studies. Tumor Burden

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  • [Copyright] © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.
  • (PMID = 19856259.001).
  • [ISSN] 1439-3646
  • [Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • [ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
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98. de Bruijne EL, Burgmans JP, Krestin GP, Pols HA, van den Meiracker AH, de Herder WW: [Adrenal incidentaloma: a clinical problem related to imaging]. Ned Tijdschr Geneeskd; 2005 Aug 13;149(33):1821-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Adrenal incidentaloma: a clinical problem related to imaging].
  • During the diagnostic work-up, an unsuspected adrenal mass was found in both patients.
  • Hormonal evaluation and imaging showed a benign non-hyperactive functioning adenoma in one patient and a pheochromocytoma in the other.
  • Wider application and improvement of abdominal imaging procedures have caused an increase of incidentally detected adrenal masses, posing a common clinical problem.
  • Typically, a diagnosis can be made on the basis of the characteristic radiological image.
  • An algorithm is presented for the management of adrenal incidentalomas.
  • [MeSH-major] Adenoma / diagnosis. Adrenal Gland Neoplasms / diagnosis. Incidental Findings. Pheochromocytoma / diagnosis

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  • (PMID = 16128177.001).
  • [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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99. Huang KH, Chung SD, Chen SC, Chueh SC, Pu YS, Lai MK, Lin WC: Clinical and pathological data of 10 malignant pheochromocytomas: long-term follow up in a single institute. Int J Urol; 2007 Mar;14(3):181-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We report the clinical and histological data of long-term follow up in 10 patients with malignant pheochromocytoma.
  • METHODS: The clinical charts of 10 patients with malignant pheochromocytoma from a single institute were reviewed.
  • The diagnosis of pheochromocytoma was confirmed at surgery.
  • Extra-adrenal tumors occurred in four patients including paraganglioma tumors in three cases and bladder tumor in one case.
  • Histological characteristics were not helpful for diagnosis of malignancy and for prediction of prognosis.
  • All patients achieved long-term survival except for two who died of metastasis 1.5 years and 2 years after diagnosis.
  • Close long-term follow up for more than 10 years after surgery is necessary in patients with pheochromocytoma.
  • The possibility of malignancy should be kept in mind even though the initial pathology is benign.
  • [MeSH-major] Adrenal Gland Neoplasms / pathology. Adrenal Gland Neoplasms / therapy. Adrenalectomy. Antineoplastic Agents / therapeutic use. Pheochromocytoma
  • [MeSH-minor] Adolescent. Adult. Aged. Bone Neoplasms / diagnosis. Bone Neoplasms / secondary. Female. Follow-Up Studies. Humans. Liver Neoplasms / diagnosis. Liver Neoplasms / secondary. Lung Neoplasms / diagnosis. Lung Neoplasms / secondary. Lymphatic Metastasis. Male. Middle Aged. Positron-Emission Tomography. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate. Time Factors. Tomography, X-Ray Computed. Urinary Bladder Neoplasms / diagnosis. Urinary Bladder Neoplasms / secondary

  • MedlinePlus Health Information. consumer health - Adrenal Gland Cancer.
  • MedlinePlus Health Information. consumer health - Cancer Chemotherapy.
  • MedlinePlus Health Information. consumer health - Pheochromocytoma.
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  • (PMID = 17430251.001).
  • [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
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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100. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • 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






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