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NCBI: db=pubmed; Term=adrenal tumor
Updated: 6 days 6 hours ago

adrenal tumor; +32 new citations

Sat, 01/11/2020 - 08:14

32 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

adrenal tumor

These pubmed results were generated on 2020/01/11

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

Adrenal cortical carcinoma: pathology, genomics, prognosis, imaging features, and mimics with impact on management.

Sat, 01/04/2020 - 06:58
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Adrenal cortical carcinoma: pathology, genomics, prognosis, imaging features, and mimics with impact on management.

Abdom Radiol (NY). 2020 Jan 01;:

Authors: Ahmed AA, Thomas AJ, Ganeshan DM, Blair KJ, Lall C, Lee JT, Morshid AI, Habra MA, Elsayes KM

Abstract
Adrenocortical carcinoma (ACC) is a rare tumor with a poor prognosis. Most tumors are either metastatic or locally invasive at the time of diagnosis. Differentiation between ACC and other adrenal masses depends on clinical, biochemical, and imaging factors. This review will discuss the genetics, pathological, and imaging feature of ACC.

PMID: 31894378 [PubMed - as supplied by publisher]

Inhibitory Interplay of SULT2B1b Sulfotransferase with AKR1C3 Aldo-keto Reductase in Prostate Cancer.

Sat, 01/04/2020 - 06:58
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Inhibitory Interplay of SULT2B1b Sulfotransferase with AKR1C3 Aldo-keto Reductase in Prostate Cancer.

Endocrinology. 2020 Jan 02;:

Authors: Park S, Song CS, Lin CL, Jiang S, Osmulski PA, Wang CM, Marck BT, Matsumoto AM, Morrissey C, Gaczynska ME, Chen Y, Mostaghel EA, Chatterjee B

Abstract
SULT2B1b (SULT2B) is a prostate-expressed hydroxysteroid sulfotransferase, which may regulate intracrine androgen homeostasis by mediating 3β-sulfation of DHEA, the precursor for DHT biosynthesis. The aldo-keto reductase AKR1C3 regulates androgen receptor (AR) activity in castration-resistant prostate cancer (CRPC) by promoting tumor-tissue androgen biosynthesis from adrenal DHEA and also by functioning as an AR-selective coactivator. Herein we report that SULT2B-depleted CRPC cells, arising from stable RNA interference or gene knockout, are markedly upregulated for AKR1C3, activated for ERK1/2 survival signal, and induced for epithelial-to-mesenchymal(EMT)-like changes. EMT was evident from increased mesenchymal proteins and elevated EMT-inducing transcription factors SNAI1 and TWIST1 in immunoblot and single-cell mass cytometry analyses. SULT2B-knockout cells showed greater motility and invasion in vitro; growth escalation in xenograft study; and enhanced metastatic potential predicted on the basis of decreased cell stiffness and adhesion revealed from atomic force microscopy analysis. While AR and androgen levels were unchanged, AR activity was elevated, since PSA and FKBP5 mRNA induction by DHT-activated AR was several-fold higher in SULT2B-silenced cells. AKR1C3 silencing prevented ERK1/2 activation and SNAI1 induction in SULT2B-depleted cells. SULT2B was undetectable in nearly all CRPC metastases from fifty autopsy cases. Primary tumors showed variable and Gleason score independent SULT2B levels. CRPC metastases lacking SULT2B expressed AKR1C3. Since AKR1C3 is frequently elevated in advanced prostate cancer, the inhibitory influence of SULT2B on AKR1C3 upregulation, ERK1/2 activation, EMT-like induction and on cell motility and invasiveness may be clinically significant. Pathways regulating the inhibitory SULT2B-AKR1C3 axis may inform new avenue(s) for targeting SULT2B-deficient prostate cancer.

PMID: 31894239 [PubMed - as supplied by publisher]

Computed tomography-guided cryoablation for functional adrenal aldosteronoma.

Sat, 01/04/2020 - 06:58
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Computed tomography-guided cryoablation for functional adrenal aldosteronoma.

Minim Invasive Ther Allied Technol. 2019 Dec 31;:1-5

Authors: Fu YF, Cao C, Shi YB, Zhang W, Huang YY

Abstract
Purpose: To assess the safety and clinical effectiveness of computed tomography (CT)-guided cryoablation for functional adrenal aldosteronoma.Material and methods: From June 2012 to December 2018, 11 patients with functional adrenal aldosteronoma underwent CT-guided cryoablation in our center. Data comprising complete ablation rate, clinical success rate, procedure-related complications and long-term outcome were collected and analyzed.Results: A total of 11 aldosteronoma in 11 patients were treated. Complete ablation was achieved in all patients after a single ablation session. No procedure-related complications occurred. Clinical success rate was 100%. Mean aldosterone levels, and systolic and diastolic pressure decreased from 858.6 ± 93.2 pmol/L, 156.4 ± 7.8 mmHg and 90.0 ± 10.5 mmHg prior to treatment, respectively, to 321.8 ± 41.2 pmol/L (p < .001), 129.1 ± 9.4 mmHg (p < .001) and 76.4 ± 5.5 mmHg (p = .005) after treatment, respectively. Mean renin and potassium improved from 0.2 ± 0.1 μg/L/h and 2.9 ± 0.2 mmol/L before treatment, respectively to 4.6 ± 0.4 μg/L/h (p < .001) and 4.2 ± 0.2 mmol/L (p < .001) following treatment, respectively. No tumor or clinical symptom recurrence occurred during the follow-up.Conclusions: CT-guided cryoablation is a safe and effective method for the treatment of functional adrenal aldosteronoma.

PMID: 31889464 [PubMed - as supplied by publisher]

Comparison of Robotic Posterior Retroperitoneal Adrenalectomy over Laparoscopic Posterior Retroperitoneal Adrenalectomy: A Single Tertiary Center Experience.

Sat, 01/04/2020 - 06:58
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Comparison of Robotic Posterior Retroperitoneal Adrenalectomy over Laparoscopic Posterior Retroperitoneal Adrenalectomy: A Single Tertiary Center Experience.

Int J Endocrinol. 2019;2019:9012910

Authors: Kim WW, Lee YM, Chung KW, Hong SJ, Sung TY

Abstract
Background: The aim of this study is to compare the clinical outcomes of laparoscopic posterior retroperitoneal adrenalectomy (LPRA) and robotic posterior retroperitoneal adrenalectomy (RPRA) and determine the differences that could affect the outcomes.
Methods: We retrospectively analyzed 230 adrenalectomy cases from 2014 to 2017. There were 169 LPRA and 61 RPRA cases, and their clinicopathological features and surgical outcomes were compared.
Results: In LPRA, there was a positive relationship between operation time and male gender, early period of experience, adrenal tumor size, and pheochromocytoma. In RPRA, adrenal tumor size and pheochromocytoma were the factors affecting the operation time. When the adrenal tumor size was ≤5.5 cm, the operation time of LPRA was shorter than that of RPRA (p=0.001). When the tumor size was >5.5 cm, there was no significant difference in the operation times of LPRA and RPRA (p=0.102).
Conclusions: RPRA is a feasible and technically safe approach for benign adrenal diseases. The use of RPRA could benefit patients and provide comfort by overcoming the factors contributing to a longer operation time in the laparoscopic technique, such as male gender and high BMI.

PMID: 31885564 [PubMed]

Molecular Mechanisms of Primary Aldosteronism.

Sat, 01/04/2020 - 06:58
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Molecular Mechanisms of Primary Aldosteronism.

Endocrinol Metab (Seoul). 2019 Dec;34(4):355-366

Authors: Tevosian SG, Fox SC, Ghayee HK

Abstract
Primary aldosteronism (PA) results from excess production of mineralocorticoid hormone aldosterone by the adrenal cortex. It is normally caused either by unilateral aldosterone-producing adenoma (APA) or by bilateral aldosterone excess as a result of bilateral adrenal hyperplasia. PA is the most common cause of secondary hypertension and associated morbidity and mortality. While most cases of PA are sporadic, an important insight into this debilitating disease has been derived through investigating the familial forms of the disease that affect only a minor fraction of PA patients. The advent of gene expression profiling has shed light on the genes and intracellular signaling pathways that may play a role in the pathogenesis of these tumors. The genetic basis for several forms of familial PA has been uncovered in recent years although the list is likely to expand. Recently, the work from several laboratories provided evidence for the involvement of mammalian target of rapamycin pathway and inflammatory cytokines in APAs; however, their mechanism of action in tumor development and pathophysiology remains to be understood.

PMID: 31884735 [PubMed - in process]

Toxic effects of triptolide on adrenal steroidogenesis in H295R cells and female rats.

Sat, 01/04/2020 - 06:58
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Toxic effects of triptolide on adrenal steroidogenesis in H295R cells and female rats.

J Biochem Mol Toxicol. 2019 Nov;33(11):e22394

Authors: Xu LY, Wu W, Cheng R, Sun LX, Jiang ZZ, Zhang LY, Zhang ZJ, Su YW, Huang X

Abstract
Triptolide (TP), a major active ingredient of Tripterygium wilfordii, exerts potent immunosuppressive effects in the treatment of rheumatoid arthritis but is not widely used in clinical practice due to its multiorgan toxicity, particularly hepatotoxicity, nephrotoxicity, and reproductive toxicity. An LC-MS/MS approach was employed to explore the endocrine-disrupting effects of TP. The endocrine-disrupting effects of various concentrations (0-100 nM) of TP for 48 hour were firstly investigated using an in vitro model (H295R cell line). It was found that TP did not decrease cell viability. The transcriptional levels of steroidogenic enzymes in H295R cells were assessed by quantificational real-time polymerase chain reaction. The possible adrenal and endocrine effects of oral administration of TP (0, 50, and 500 μg/kg) for 28 days on both normal and collagen-induced arthritis (CIA) rats were also explored. The serum and adrenal tissue hormone levels (corticosterone and progesterone) and adrenal histopathology were analyzed, with the results that TP significantly decreased the level of cortisol in H295R cells and the level of plasma corticosterone in both normal and CIA rats. Histological alterations in adrenal cortex were observed at the dose of 500 μg/kg. Exposure to TP for 48 hour had an obvious inhibitory effect on the messenger RNA transcript levels of HSD3B2, CYP21A2, CYP17A1, and CYP11B1, which is essential for the synthesis of corticosteroids. In a word, TP leads to the disorder of corticosteroid synthesis and secretion, and corticosteroid may be a potential biomarker for the treatment of multiorgan toxicity of TP.

PMID: 31557376 [PubMed - indexed for MEDLINE]

Gastric diffuse large B-cell lymphoma with bilateral adrenal metastasis.

Sat, 01/04/2020 - 06:58
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Gastric diffuse large B-cell lymphoma with bilateral adrenal metastasis.

BMJ Case Rep. 2019 Jul 03;12(7):

Authors: Hassan M, Mandal AK, Sidhu JS, Cardenas LM

Abstract
Extranodal adrenal involvement in non-Hodgkin's lymphoma is very rare, estimated to be around less than 0.2%. Most common sites involved are stomach, intestine and testis. It is very rare for adrenal tumours to present as primary adrenal insufficiency, with an incidence of around 1.2% in patients diagnosed with adrenal masses. Diffuse large B cell lymphoma (DLBL) originating from the stomach and metastasizing to bilateral adrenal glands is an extremely uncommon occurrence with only three cases found on review of the literature. We present a case of a 62-year-old African-American man who presented with nausea, vomiting, abdominal pain and hypotension, later being diagnosed as DLBL of the gastric antrum metastasized to bilateral adrenal glands. Initial laboratory workup revealed including hormonal analysis and cosyntropin test revealed adrenal insufficiency. The patient later died during the hospitalisation after developing respiratory failure, severe hypotension refractory to vasopressors and severe metabolic acidosis.

PMID: 31272994 [PubMed - indexed for MEDLINE]

Health Care Resource Utilization and Costs Associated with Corticosteroid Use in Patients with Castration-Resistant Prostate Cancer: An Administrative Claims Analysis.

Sat, 01/04/2020 - 06:58
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Health Care Resource Utilization and Costs Associated with Corticosteroid Use in Patients with Castration-Resistant Prostate Cancer: An Administrative Claims Analysis.

J Manag Care Spec Pharm. 2019 Aug;25(8):889-897

Authors: Schultz NM, Penson DF, Wilson SD, Song Y, Yang H, Ramaswamy K, Lowentritt B

Abstract
BACKGROUND: Corticosteroids are used in the management of castration-resistant prostate cancer (CRPC) to reduce tumor-related symptoms because of CRPC therapies. Since corticosteroids have been associated with a range of toxicities, their use may increase the economic burden sustained by patients with CRPC. However, the economic impact of using corticosteroids in patients with CRPC has not been well characterized.
OBJECTIVE: To assess the effect of previous corticosteroid use on health care resource utilization (HRU) and health care costs among men with CRPC.
METHODS: Using administrative claims data (2007-2016), adult chemotherapy-naive patients who initiated CRPC treatment following surgical or medical castration were identified. Based on the cumulative corticosteroid dose during the 12 months before CRPC treatment initiation, patients were grouped into 4 cohorts: no corticosteroid (0 gm), low corticosteroid (< 0.5 gm), medium corticosteroid (0.5-2.0 gm), and high corticosteroid (> 2.0 gm). All-cause HRU and costs (2017 U.S. dollars) were compared between cohorts during the 1-year study period following CRPC treatment initiation using the no corticosteroid cohort as reference. Multivariable regression models were used to adjust for baseline covariates, including age, region, index year, Charlson Comorbidity Index score, presence of bone metastases, baseline all-cause HRU, and corticosteroid-related clinical events during baseline.
RESULTS: 9,425 patients were included (no corticosteroid = 6,765, low corticosteroid = 1,660, medium corticosteroid = 655, and high corticosteroid = 345). On average, patients in the no corticosteroid cohort were older and had a lower baseline HRU and comorbidity burden than patients in the other 3 cohorts. During the study period, patients with corticosteroid exposure (across all corticosteroid cohorts) had significantly more inpatient admissions (high corticosteroid vs. no corticosteroid adjusted incidence rate ratio [IRR] = 1.56; P < 0.001), emergency department visits (high corticosteroid vs. no corticosteroid adjusted IRR = 1.30; P = 0.001), and outpatient visits (high corticosteroid vs. no corticosteroid adjusted IRR = 1.11; P < 0.001). In addition, compared with the no corticosteroid cohort, patients with corticosteroid exposure had significantly higher monthly total costs (high corticosteroid vs. no corticosteroid adjusted difference = $2,600; P < 0.001), including medical service costs (high corticosteroid vs. no corticosteroid adjusted difference = $1,564; P < 0.001) and pharmacy costs (high corticosteroid vs. no corticosteroid adjusted difference = $825; P < 0.001).
CONCLUSIONS: Cumulative corticosteroid exposure before CRPC treatment initiation was associated with significantly higher HRU and costs. This increase in economic burden was more prominent among patients with annual cumulative corticosteroid doses of more than 2.0 gm. These results suggest that previous corticosteroid use may result in a higher economic burden among patients with CRPC.
DISCLOSURES: This study was funded by Astellas Pharma (Northbrook, IL) and Medivation, a Pfizer Company (San Francisco, CA), the codevelopers of enzalutamide. The study sponsor was involved in the study design, data interpretation, and review. All authors contributed to the development of the manuscript and maintained control over the final content. Schultz and Wilson are employed by Astellas Pharma. Schultz owns stock in Gilead Sciences and Shire. Song and Yang are employed by Analysis Group, which received consultancy fees from Astellas Pharma. Ramaswamy is employed by Pfizer, and Lowentritt is employed by Chesapeake Urology and has served as a speaker and consultant for Astellas Pharma, Pfizer, Bayer, Dendreon, and Janssen. A synopsis of the current research was presented in poster format at the AMCP Managed Care & Specialty Pharmacy Annual Meeting 2019, which took place in San Diego, CA, on March 25-28, 2019.

PMID: 31172866 [PubMed - indexed for MEDLINE]

Adrenal Myelolipoma with Adrenocortical Adenoma Presenting with Hypertension Only.

Sat, 01/04/2020 - 06:58
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Adrenal Myelolipoma with Adrenocortical Adenoma Presenting with Hypertension Only.

J Coll Physicians Surg Pak. 2019 Jun;29(6):S65-S67

Authors: Yang F, Sun C, Pang S, Cai J, Lin H, Tan W

Abstract
Here, we present a case of a 25-year Chinese female who was diagnosed with non-functional adrenocortical adenoma containing myelolipoma with hypertension as the only symptom. Serum levels of cortisol, aldosterone, angiotensin I/II and renin activity were normal. Myelolipoma is a benign, non-functioning retroperitoneal tumour occurring predominantly in the adrenal gland and relatively uncommon. With the advancement of radiological studies, the incidental detection of myelolipoma has been noted. However, the coexistence of adrenal myelolipoma and adrenal adenoma still remains extremely rare. Though usually benign, the later may present with endocrine dysfunction, such as Cushing's syndrome, and requires proper management. Surgical resection is reserved for symptomatic tumours or large myelolipoma (>7 cm in size). The final diagnosis mainly relies on pathological examination. The left adrenal mass was completely removed via retroperitoneal laparoscopic approach. Postoperative recovery was uneventful and her blood pressure (BP) readings were normal. At 15 months follow-up, the patient was normotensive and there was no recurrence of tumour.

PMID: 31142427 [PubMed - indexed for MEDLINE]

A rare initial clinical presentation of pheochromocytoma.

Sat, 01/04/2020 - 06:58
Related Articles

A rare initial clinical presentation of pheochromocytoma.

BMJ Case Rep. 2019 May 24;12(5):

Authors: Burgan H, Celi J

PMID: 31129631 [PubMed - indexed for MEDLINE]

Reply to "Proper tumor classification and growth rate are key elements when considering indications and results of radiotherapy for head and neck paragangliomas".

Sat, 01/04/2020 - 06:58
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Reply to "Proper tumor classification and growth rate are key elements when considering indications and results of radiotherapy for head and neck paragangliomas".

Head Neck. 2019 08;41(8):2837-2838

Authors: Lassen-Ramshad Y, Ozyar E, Alanyali S, Poortmans P, Van Houtte P, Sohawon S, Esassolak M, Krengli M, Villa S, Miller RC, Demiroz C, Akyurek S, Aggerholm-Pedersen N, Thariat J

PMID: 31058391 [PubMed - indexed for MEDLINE]

Proper tumor classification and growth rate are key elements when considering indications and results of radiotherapy for head and neck paragangliomas.

Sat, 01/04/2020 - 06:58
Related Articles

Proper tumor classification and growth rate are key elements when considering indications and results of radiotherapy for head and neck paragangliomas.

Head Neck. 2019 08;41(8):2835-2836

Authors: Albertini R, Mariani-Costantini R, Sanna M

PMID: 31034657 [PubMed - indexed for MEDLINE]

A Previously Unrecognized Monocytic Component of Pheochromocytoma and Paraganglioma.

Sat, 01/04/2020 - 06:58
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A Previously Unrecognized Monocytic Component of Pheochromocytoma and Paraganglioma.

Endocr Pathol. 2019 Jun;30(2):90-95

Authors: Farhat NA, Powers JF, Shepard-Barry A, Dahia P, Pacak K, Tischler AS

Abstract
We describe a consistently present, previously unrecognized, population of monocytes in pheochromocytomas and paragangliomas. Although sustentacular cells are generally recognized as a common component of these tumors, differential immunohistochemical staining for CD163 and S100 shows that monocytes can in fact be more numerous. These cells frequently resemble sustentacular cells topographically and cytologically, possibly explaining why they have not been previously noticed. They contribute to the tumor proteome and may have implications for tumor biology. No correlations were identifiable between the presence of these cells and any clinical characteristics of the tumors in the present study. A possible association with genotype is suggested by immunoblot showing high expression of CD163 protein in tumors with succinate dehydrogenase mutations.

PMID: 31001800 [PubMed - indexed for MEDLINE]

Killer-cell immunoglobulin-like receptor ligand mismatch cord blood transplantation in high-risk neuroblastoma.

Sat, 01/04/2020 - 06:58
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Killer-cell immunoglobulin-like receptor ligand mismatch cord blood transplantation in high-risk neuroblastoma.

Pediatr Int. 2019 Jun;61(6):566-571

Authors: Matsuno R, Toyama D, Akiyama K, Isoyama K, Shiozawa E, Yamamoto S

Abstract
BACKGROUND: The prognosis of high-risk neuroblastoma stage 4 with bone marrow metastasis, MYCN amplified, or refractory neuroblastoma is poor. To date, no standard treatment has been established. In four selected cases, we challenged the killer-cell immunoglobulin-like receptor ligand mismatch cord blood transplantation in graft-versus-host disease (GVHD) with reduced-intensity conditioning.
METHODS: Prior to this study, conventional chemotherapy, autologous peripheral blood stem cell transplantation with high-dose chemotherapy (busulfan and melphalan), surgery and radiation therapy were completed in every case. The status before cord blood transplantation in two cases was not complete remission (CR) and in the others it was CR. The primary site was the mediastinum, two adrenal glands and a retroperitoneum, respectively. Three patients had bone and bone marrow metastasis and one had MYCN amplification. In all cases, international neuroblastoma pathology classification was unfavorable histology. All patients were >2 years of age.
RESULTS: Relapse occurred only in one patient 17 months after the last transplantation, and the other three patients maintained disease-free survival for 74, 36, and 24 months, respectively. In one case of relapse the disease could be controlled by conventional chemotherapy. Except one, all patients had no severe complications, such as acute or chronic GVHD. One patient had gastric antral vascular ectasia and hemorrhagic cystitis.
CONCLUSION: This strategy might be feasible and should be investigated for efficacy in the future. No definite conclusion can be made, however, due to the very small number of patients. Further prospective studies are required to determine its efficacy.

PMID: 30974480 [PubMed - indexed for MEDLINE]

Laparoscopic adrenalectomy for metastatic disease: Retrospective cohort with long-term, comprehensive follow-up.

Sat, 01/04/2020 - 06:58
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Laparoscopic adrenalectomy for metastatic disease: Retrospective cohort with long-term, comprehensive follow-up.

Surgery. 2019 05;165(5):958-964

Authors: Drake FT, Beninato T, Xiong MX, Shah NV, Kluijfhout WP, Feeney T, Suh I, Gosnell JE, Shen WT, Duh QY

Abstract
BACKGROUND: Several malignancies metastasize to the adrenal gland, especially non-small cell lung cancer, renal cell carcinoma, and melanoma. Adrenalectomy is associated with prolonged survival, but laparoscopic adrenalectomy for this indication is controversial. Our objective was to characterize and quantify outcomes after laparoscopic adrenalectomy for metastases to the adrenal gland.
METHODS: A prospectively maintained surgical database and institutional cancer registry were queried for patients who underwent adrenalectomy for metastases. From 1995 to 2016, a total of 62 patients underwent adrenalectomy for metastases, with 59 (95.%) having been performed laparoscopically. Primary end points were cumulative probability of 5-year survival and median survival. Patients in the institutional series were compared with Surveillance, Epidemiology, and End Results patients with metastatic non-small cell lung cancer, renal cell carcinoma, and melanoma.
RESULTS: There were no deaths within a 30-day period, 6 complications, and 2 conversions to open adrenalectomy. Non-small cell lung cancer (N = 20), renal cell carcinoma (N = 14), and melanoma (N = 8) were the 3 most common adrenal metastases. Overall, cumulative probability of 5-year survival was 37% and median survival was 34 months (95% CI 26-53 months). Median survival for non-small cell lung cancer was 26 months, for renal cell carcinoma was 67 months, and for melanoma was 30 months (P = NS). There was no demonstrable survival benefit for metachronous versus synchronous presentations, no association with size or disease-free interval, nor the presence/history of other metastases.
CONCLUSION: Laparoscopic adrenalectomy for metastases is safe when performed by experienced surgeons. Outcomes are similar or improved compared with series with predominantly open adrenalectomies. Patients selected for laparoscopic adrenalectomy to treat metastatic disease also have prolonged survival compared with Surveillance, Epidemiology, and End Results patients with metastatic non-small cell lung cancer, renal cell carcinoma, or melanoma who do not undergo resection of metastatic disease.

PMID: 30591377 [PubMed - indexed for MEDLINE]

The who, when, and why of primary adrenal malignancies: Insights into the epidemiology of a rare clinical entity.

Sat, 01/04/2020 - 06:58
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The who, when, and why of primary adrenal malignancies: Insights into the epidemiology of a rare clinical entity.

Cancer. 2019 04 01;125(7):1050-1059

Authors: Chandrasekar T, Goldberg H, Klaassen Z, Wallis CJD, Woon DTS, Herrera-Caceres JO, Kulkarni GS, Fleshner NE

Abstract
BACKGROUND: Primary malignancies of the adrenal glands are rare. Epidemiologic assessment of primary adrenal malignancies is lacking and has been limited to case reports and series. Population-level data can provide a better understanding of the incidence, distribution, and prognostic factors associated with these rare malignancies.
METHODS: The Surveillance, Epidemiology, and End Results database (1973-2013) was queried for all patients who were diagnosed with primary adrenal malignancies, categorized in 5 histologic groups: adrenocortical carcinoma (ACC), pheochromocytoma and paraganglioma (PH), neuroblastoma (NE), non-Hodgkin lymphoma (NHL), and sarcoma (SA). Age-adjusted incidence, distribution trends, and cancer-specific survival (CSS) for each group were analyzed.
RESULTS: In total, 4695 patients with primary adrenal malignancies were identified, including 2057 with ACC, 512 with PH, 1863 with NE, 202 with NHL, and 61 with SA. The age-adjusted incidence of all 5 histologic subtypes was rising. Age at presentation differed substantially by histologic group: NE was the most prevalent during the first decade of life, whereas ACC predominated after age 30 years, and NHL outnumbered PH after age 70 years. Patient-specific factors were not associated with advanced disease at the time of presentation. The 5-year CSS rate for each histologic subtype was 38% for ACC, 69% for PH, 64% for NE, 38% for NHL, and 42% for SA. Survival outcomes for patients with ACC, NHL, PH and SA remained unchanged over the 40-year study period. Multimodal therapy was associated with higher CSS in patients with NE.
CONCLUSIONS: This first population-level analysis of all primary adrenal malignancies provides important initial data regarding presentation and clinical outcomes. Notably, except for patients with NE, the survival of patients with these rare cancers has not improved over the past 40 years.

PMID: 30561782 [PubMed - indexed for MEDLINE]

Factors associated with long-term retention of treatment with golimumab in a real-world setting: an analysis of the Spanish BIOBADASER registry.

Sat, 01/04/2020 - 06:58
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Factors associated with long-term retention of treatment with golimumab in a real-world setting: an analysis of the Spanish BIOBADASER registry.

Rheumatol Int. 2019 03;39(3):509-515

Authors: Hernandez MV, Sanchez-Piedra C, Garcia-Magallon B, Cuende E, Manero J, Campos-Fernandez C, Martin-Domenech R, Del Pino-Montes J, Manrique S, Castro-Villegas MC, Ruiz-Montesinos D, Sanchez-Alonso F, Diaz-Gonzalez F, Cea-Calvo L, Gómez-Reino JJ, BIOBADASER Study Group

Abstract
The retention rate of a biological drug (percentage of patients remaining on treatment over time) provides an index of a drug's overall effectiveness. The golimumab retention rate as first-line biological therapy was high in clinical trial extensions lasting 5 years. Real-world studies also indicate good retention rates but have been of shorter duration. The probability of retention with golimumab treatment was assessed, as any line of anti-tumor necrosis factor-alpha therapy, for up to 5 years in patients with rheumatoid arthritis (RA), axial spondyloarthritis (SpA) or psoriatic arthritis (PsA), associated factors were analyzed. A retrospective database analysis of the Spanish registry of patients with rheumatic disorders receiving biological drugs (BIOBADASER) was performed. Among 353 patients, 29.8% had RA, 41.6% SpA and 28.6% PsA. Golimumab was the first biological drug in 40.1% of patients, second in 30.1% and third/later in 29.8%. The overall probability of retention of golimumab at years 1, 2, 3, 4 and 5 was 85.9% (95% confidence interval 81.4-89.5%), 73.7% (67.1-79.1%), 68.5% (60.5-75.1%), 60.6% (50.2-69.5%) and 57.1% (44.9-67.5%), respectively. Retention was similar across indications (p = 0.070) but was greater when golimumab was used as the first biological agent compared with later therapy lines (p < 0.001). Factors associated with higher retention of golimumab treatment (Cox regression) were use as a first-line biological and concomitant methotrexate treatment; corticosteroid need was associated with lower retention. The long-term probability of golimumab retention was high in this real-world study of patients with rheumatic diseases, especially when used as the first biological drug.

PMID: 30353269 [PubMed - indexed for MEDLINE]

Adrenomedullary function, obesity and permissive influences of catecholamines on body mass in patients with chromaffin cell tumours.

Sat, 01/04/2020 - 06:58
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Adrenomedullary function, obesity and permissive influences of catecholamines on body mass in patients with chromaffin cell tumours.

Int J Obes (Lond). 2019 02;43(2):263-275

Authors: An Y, Reimann M, Masjkur J, Langton K, Peitzsch M, Deutschbein T, Fassnacht M, Rogowski-Lehmann N, Beuschlein F, Fliedner S, Stell A, Prejbisz A, Januszewicz A, Lenders J, Bornstein SR, Eisenhofer G

Abstract
BACKGROUND: Obesity-associated activation of sympathetic nervous outflow is well documented, whereas involvement of dysregulated adrenomedullary hormonal function in obesity is less clear. This study assessed relationships of sympathoadrenal function with indices of obesity and influences of circulating catecholamines on body mass.
METHODS: Anthropometric and clinical data along with plasma and 24-h urine samples were collected from 590 volunteers and 1368 patients tested for phaeochromocytoma and paraganglioma (PPGL), among whom tumours were diagnosed in 210 individuals.
RESULTS: Among patients tested for PPGL, those with tumours less often had a body mass index (BMI) above 30 kg/m2 (12 vs. 31%) and more often a BMI under 25 kg/m2 (56 vs. 32%) than those without tumours (P < 0.0001). Urinary outputs of catecholamines in patients with PPGL were negatively related to BMI (r = -0.175, P = 0.0133). Post-operative weight gain (P < 0.0001) after resection of PPGL was positively related to presurgical tumoural catecholamine output (r = 0.257, P = 0.0101). Higher BMI in men and women and percent body fat in women of the volunteer group were associated with lower plasma concentrations and urinary outputs of adrenaline and metanephrine, the former indicating obesity-related reduced adrenaline secretion and the latter obesity-related reduced adrenomedullary adrenaline stores. Daytime activity was associated with substantial increases in urinary adrenaline and noradrenaline excretion, with blunted responses in obese subjects.
CONCLUSIONS: The findings in patients with PPGL support an influence of high circulating catecholamines on body weight. Additional associations of adrenomedullary dysfunction with obesity raise the possibility of a permissive influence of the adrenal medulla on the regulation of body weight.

PMID: 29717268 [PubMed - indexed for MEDLINE]

adrenal tumor; +27 new citations

Sat, 12/28/2019 - 06:04

27 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

adrenal tumor

These pubmed results were generated on 2019/12/28

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