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Clival paragangliomas: a report of two cases involving the midline skull base and review of the literature.

Mon, 04/16/2018 - 04:58
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Clival paragangliomas: a report of two cases involving the midline skull base and review of the literature.

J Neurooncol. 2017 May;132(3):473-478

Authors: Ruzevick J, Koh EK, Gonzalez-Cuyar LF, Cimino PJ, Moe K, Wright LA, Failor R, Ferreira M

Abstract
Head and neck paragangliomas are rare neuroendocrine tumors that arise from paraganglion cells of the parasympathetic nervous system. Paragangliomas arising from the midline skull base have only rarely been reported. Surgery is the mainstay of treatment and adjuvant radiation is often recommended. These tumors can rarely secrete metanephrines and normetanephrines which can complicate operative management. Here we present two cases of clival paragangliomas with unique clinical presentations and review the previous literature on skull base paragangliomas.

PMID: 28299533 [PubMed - indexed for MEDLINE]

[Blue rubber bleb nevus syndrome complicated by a ventricular septal defect: a case report].

Mon, 04/16/2018 - 04:58
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[Blue rubber bleb nevus syndrome complicated by a ventricular septal defect: a case report].

Nan Fang Yi Ke Da Xue Xue Bao. 2016 Dec 20;36(12):1599-1601

Authors: Chi XH, Wang QS, Xue YM, Liu F, Qi YS, Li GP

Abstract
OBJECTIVE: The co-occurrence of blue rubber bleb nevus syndrome (BRBNS) and ventricular septal defects is rare. Here we present a case of BRBNS in a 15-year-old boy who was born with multiple cavernous hemangiomas and a ventricular septal defect. Examinations revealed the presence of hemangioma lesions in the subcutaneous and mucosal tissues as well as in the cerebrum, nasopharynx, tongue, esophagus, gastric body, sigmoid colon and adrenal gland. Combined imaging modalities played an important role in the diagnosis of hemangioma lesions.

PMID: 27998851 [PubMed - indexed for MEDLINE]

An uncommon cause of acute pulmonary edema.

Mon, 04/16/2018 - 04:58
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An uncommon cause of acute pulmonary edema.

JAAPA. 2016 Sep;29(9):1-4

Authors: Nepal S, Giri S, Bhusal M, Siwakoti K, Pathak R

Abstract
Acute cardiogenic pulmonary edema secondary to catecholamine-induced cardiomyopathy is a very uncommon and fatal initial presentation of pheochromocytoma. However, with early clinical suspicion and aggressive management, the condition is reversible. This case report describes a patient who presented with hypertension, dyspnea, and cough with bloody streaks, and who recovered within 48 hours after appropriate treatment.

PMID: 27575897 [PubMed - indexed for MEDLINE]

Prevalence, clinical characteristics and long-term outcomes of classical 11 β-hydroxylase deficiency (11BOHD) in Turkish Population and novel mutations in CYP11B1 gene.

Mon, 04/09/2018 - 02:24
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Prevalence, clinical characteristics and long-term outcomes of classical 11 β-hydroxylase deficiency (11BOHD) in Turkish Population and novel mutations in CYP11B1 gene.

J Steroid Biochem Mol Biol. 2018 Apr 04;:

Authors: Baş F, Toksoy G, Ergun-Longmire B, Uyguner ZO, Abalı ZY, Poyrazoğlu Ş, Karaman V, Avcı Ş, Altunoğlu U, Bundak R, Karaman B, Başaran S, Darendeliler F

Abstract
Congenital adrenal hyperplasia (CAH) due to 11β-hydroxylase deficiency (11BOHD) is a rare autosomal recessive disorder and the second most common form of CAH.
AIM: To investigate genotype-phenotype correlation and to evaluate clinical characteristics and long-term outcomes of patients with 11BOHD.
METHODS: A total of 28 patients (n = 14, 46,XX; n = 14, 46,XY) with classical 11BOHD from 25 unrelated families were included in this study. Screening of CYP11B1 is performed by Sanger sequencing. Pathogenic features of novel variants are investigated by the use of multiple in silico prediction tools and with family based co-segregation studies. Protein simulations were investigated for two novel coding region alterations.
RESULTS: The age at diagnosis ranged from 6 days to 12.5 years. Male patients received diagnose at older ages than female patients. The rate of consanguinity was high (71.4%). Five out of nine 46,XX patients were diagnosed late (age 2-8.7 years) and were assigned as male due to severe masculinization. Twenty one patients have reached adult height and sixteen were ultimately short due to delayed diagnosis. Two male patients had testicular microlithiasis and 5 (35.7%) patients had testicular adrenal rest tumor during follow up. Four patients (28.6%) had gynecomastia. Mutation analyses in 25 index patients revealed thirteen different mutations in CYP11B1 gene, 4 of which were novel (c.393 + 3A>G, c.428G > C, c.1398 + 2T > A, c.1449_1451delGGT). The most frequent mutations were c.896T > C with 32%, c.954G > A with 16% and c.1179_1180dupGA with 12% in frequency. There was not a good correlation between genotype and phenotype; phenotypic variability was observed among the patients with same mutation.
CONCLUSION: This study presents the high allelic heterogeneity of CYP11B1 mutations in CAH patients from Turkey. Three dimensional protein simulations may provide additional support for the pathogenicity of the genetic alterations. Our results provide reliable information for genetic counseling, preventive and therapeutic strategies for the families.

PMID: 29626607 [PubMed - as supplied by publisher]

Adrenal hemorrhage: A single center experience and literature review.

Mon, 04/09/2018 - 02:24
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Adrenal hemorrhage: A single center experience and literature review.

Adv Clin Exp Med. 2018 Mar 27;:

Authors: Karwacka IM, Obołończyk Ł, Sworczak K

Abstract
BACKGROUND: Adrenal hemorrhage (AH) is a rare condition that can lead to acute adrenal insufficiency and may be fatal. The risk factors of AH include focal adrenal lesion, abdominal trauma and anticoagulation therapy. The clinical manifestation of AH varies widely; the symptoms may be related to adrenal insufficiency or may reflect multiple organ failure. However, in many cases, the course of AH is asymptomatic.
OBJECTIVES: The study is a retrospective analysis of 23 cases of AH, whose aim is to discuss the etiology and the management of selected patients, as well as a literature review.
MATERIAL AND METHODS: The paper presents a retrospective analysis of 23 patients with AH confirmed by radiological and/or pathological examination. Epidemiological data, the results of laboratory tests, and radiological and pathological examinations were included in the analysis.
RESULTS: The risk factors of AH were not established in 13 patients, 5 patients had experienced a trauma prior to AH diagnosis, 1 patient was diagnosed with sepsis, 2 patients had concomitant neoplastic disease, and in 2 patients, 2 risk factors were present. Among patients who required emergency admission, 5 patients were hospitalized due to acute abdominal pain, 1 patient due to sepsis and 1 patient due to symptoms of active endocrinopathy. In the remaining patients, diagnostic procedures were prompted by the detection of adrenal incidentaloma (AI). A total of 40% of patients underwent surgical treatment due to the magnitude of AH or clinical and laboratory evidence of overt endocrinopathy. In the remaining patients, conservative treatment and further observation was recommended. In 34.8% of these patients, follow-up examinations revealed a gradual regression.
CONCLUSIONS: It seems that there is a need to distinguish patients with AH who do not require surgical intervention. Follow-up radiological examination is necessary to reassess the lesion. The patients in whom shrinkage of the tumor can be observed are likely not to require surgical treatment.

PMID: 29616752 [PubMed - as supplied by publisher]

Pedigree analysis, diagnosis and treatment in Von Hippel-Lindau syndrome: A report of three cases.

Mon, 04/09/2018 - 02:24
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Pedigree analysis, diagnosis and treatment in Von Hippel-Lindau syndrome: A report of three cases.

Oncol Lett. 2018 Apr;15(4):4882-4890

Authors: Wang Y, Liang G, Tian J, Wang X, Chen A, Liang T, Du Y, Li H, Du J, Yu L, Chen Z

Abstract
The objective of the present study was to systematically investigate the clinical features, diagnosis and therapeutic treatment of Von Hippel-Lindau (VHL) syndrome in order to improve understanding of this disease. A total of 3 cases of VHL syndrome treated at the Affiliated Hospital of Zunyi Medical College (Zunyi, China) between September 2014 and October 2015 were retrospectively analyzed. The associated literature was reviewed, and the diagnostic and therapeutic features were discussed. Case 1 was diagnosed as VHL syndrome accompanied by a renal tumor on the right side, and radical tumor resection in the right kidney was performed. Postoperative pathological examination indicated clear cell carcinoma. Case 2 was diagnosed as VHL syndrome accompanied by bilateral adrenal pheochromocytoma. The left-side adrenal tumor was removed, and postoperative pathological analysis was suggestive of adrenal pheochromocytoma. Case 3 visited the hospital due to the presence of masses on the left and right sides of the kidney, but did not undergo surgery for personal reasons. Follow-ups were scheduled subsequent to surgery at another hospital. The diagnosis in all 3 cases was confirmed by genetic testing, where VHL mutations were detected in all patients. Following surgery, pedigree and genetic analysis was performed in all 3 pedigrees and VHL mutations were identified in 7 family members. The diagnosis of VHL syndrome should be based on the clinical manifestation of the patients and the results of genetic tests. DNA analysis of mutations is the main method for diagnosis. An appropriate surgical plan should be formulated based on the site, size and number of tumors, and the condition of the patient. Since VHL syndrome is an inheritable genetic disorder and relapse following surgery is common, pedigree analysis of the patient and lifelong follow-ups are essential. Additionally, physicians should pay attention to VHL syndrome in order to avoid missing diagnosis or misdiagnosis.

PMID: 29616089 [PubMed]

Adrenal gland tumors in dairy cattle from Northern Italy: morphological and phenotypical characterization in comparison with human pathology.

Mon, 04/09/2018 - 02:24
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Adrenal gland tumors in dairy cattle from Northern Italy: morphological and phenotypical characterization in comparison with human pathology.

Pol J Vet Sci. 2017 Dec;20(4):779-788

Authors: Biasibetti E, Giorcelli J, Deideri F, Bianco P, Capucchio MT, Volante M

Abstract
Bovine adrenal gland tumours are considered relatively common, although scarce data are available about their real incidence, pathological characterization, classification criteria and immunohistochemical profile. This study describes the morphological and immunophenotypical characteristics of 35 dairy cattle adrenal gland tumors from Northern Italy and compare them with human pathology. Macroscopical, histological, histochemical and immunohistochemical investigations were performed. Microscopically proliferative lesions were classified as focal hyperplasia (8/35), primary cortical tumors (15/35) , primary medullary tumors (12/35). The cortical tumors showed a highly heterogeneous spectrum of morphological aspects not matching the two major diagnostic categories of adenoma and carcinoma in either cattle or humans. The medullary tumors (7 neuroblastomas and 5 pheochromocytomas) showed morphological and immunophenotypical features largely overlapping with human counterparts. Although limited by the small number of neoplasms and the lack of evidence of metastases precluding a clear distinction between benign and malignant lesions, this study represents the first attempt to compare the bovine and the human pathology. The present data support the concept that adrenal tumors in cattle have distinctive features that deserve a species- specific classification.

PMID: 29611662 [PubMed - in process]

Significant prevalence of NR3C1 mutations in incidentally discovered bilateral adrenal hyperplasia: results of the French MUTA-GR Study.

Mon, 04/09/2018 - 02:24
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Significant prevalence of NR3C1 mutations in incidentally discovered bilateral adrenal hyperplasia: results of the French MUTA-GR Study.

Eur J Endocrinol. 2018 Apr;178(4):411-423

Authors: Vitellius G, Trabado S, Hoeffel C, Bouligand J, Bennet A, Castinetti F, Decoudier B, Guiochon-Mantel A, Lombes M, Delemer B, investigators of the MUTA-GR Study

Abstract
BACKGROUND: Recently discovered mutations of NR3C1 gene, encoding for the GR, in patients with glucocorticoid resistance and bilateral adrenal incidentalomas prompted us to investigate whether GR mutations might be associated with adrenal hyperplasia.
OBJECTIVE: The multicenter French Clinical Research Program (Muta-GR) was set up to determine the prevalence of GR mutations and polymorphisms in patients harboring bilateral adrenal incidentalomas associated with hypertension and/or biological hypercortisolism without clinical Cushing's signs.
RESULTS: One hundred patients were included in whom NR3C1 sequencing revealed five original heterozygous GR mutations that impaired GR signaling in vitro. Mutated patients presented with mild glucocorticoid resistance defined as elevated urinary free cortisol (1.7 ± 0.7 vs 0.9 ± 0.8 upper limit of normal range, P = 0.006), incomplete 1 mg dexamethasone suppression test without suppressed 8-AM adrenocorticotrophin levels (30.9 ± 31.2 vs 16.2 ± 17.5 pg/mL) compared to the non-mutated patients. Potassium and aldosterone levels were lower in mutated patients (3.6 ± 0.2 vs 4.1 ± 0.5 mmol/L, P = 0.01, and 17.3 ± 9.9 vs 98.6 ± 115.4 pg/mL, P = 0.0011, respectively) without elevated renin levels, consistent with pseudohypermineralocorticism. Ex vivo characterization of mutated patients' fibroblasts demonstrated GR haploinsufficiency as revealed by below-normal glucocorticoid induction of FKBP5 gene expression. There was no association between GR polymorphisms and adrenal hyperplasia in this cohort, except an over-representation of BclI polymorphism.
CONCLUSION: The 5% prevalence of heterozygous NR3C1 mutations discovered in our series is higher than initially thought and encourages GR mutation screening in patients with adrenal incidentalomas to unambiguously differentiate from Cushing's states and to optimize personalized follow-up.

PMID: 29444898 [PubMed - indexed for MEDLINE]

[Pathogenic and diagnostic roles of microRNAs in adrenocortical tumours].

Mon, 04/09/2018 - 02:24
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[Pathogenic and diagnostic roles of microRNAs in adrenocortical tumours].

Orv Hetil. 2018 Feb;159(7):245-251

Authors: Nagy Z, Decmann Á, Perge P, Igaz P

Abstract
Adrenocortical tumours are quite prevalent. Most of these tumours are benign, hormonally inactive adrenocortical adenomas. Rare hormone-secreting adrenocortical adenomas are associated with severe clinical consequences, whereas the prognosis of the rare adrenocortical cancer is rather poor in its advanced stages. The pathogenesis of these tumours is only partly elucidated. MicroRNAs are small, non-coding RNA molecules that are pivotal in the regulation of several basic cell biological processes via the posttranscriptional regulation of gene expression. Their altered expression has been described in many tumours. Several tissue microRNAs, such as miR-483-5p, miR-503, miR-210, miR-335 and miR-195 were found to be differentially expressed among benign and malignant adrenocortical tumours, and these could also have pathogenic relevance. Due to their tissue specific and stable expression, microRNAs can be exploited in diagnostics as well. As the histological diagnosis of adrenocortical malignancy is difficult, microRNAs might be of help in the establishment of malignancy. Novel data show that microRNAs are secreted in various body fluids, projecting their applicability as biomarkers as part of liquid biopsy. In this review, we attempt to present a synopsis on the pathogenic relevance of microRNAs in adrenocortical tumours and their potential diagnostic applicability. Orv Hetil. 2018; 159(7): 245-251.

PMID: 29429354 [PubMed - indexed for MEDLINE]

The comprehensive impact on human body induced by resolution of growth hormone excess.

Mon, 04/09/2018 - 02:24
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The comprehensive impact on human body induced by resolution of growth hormone excess.

Eur J Endocrinol. 2018 Apr;178(4):365-375

Authors: Zhang Z, Li Q, He W, Qiu H, Ye H, Wang Y, Shen M, He M, Yu Y, Shou X, Huang C, Yu H, Huang G, Tang W, Geng D, Fu C, Liu C, Ma Z, Ye Z, Zhang Q, Zhang Y, Shen Y, Yang Y, Wang M, Liu X, Lu Y, Hu R, Mao Y, Zhou L, Li Y, Li S, Tritos NA, Zhao Y

Abstract
CONTEXT: Chronic excess of growth hormone (GH) often leads to systemic complications. The reversibility of these complications after GH resolution is not fully understood.
OBJECTIVE: To investigate when and to what extent will the comorbidities be ameliorated.
DESIGN: We conducted a prospective study comprising 24 patients with acromegaly, who achieved remission after transsphenoidal surgery. The dynamic changes of endocrine, cardiovascular, respiratory, sleep, bone and morphology parameters were evaluated at enrollment and 1 week, 1 month, 3 months, 6 months and 12 months after surgery.
RESULTS: Random GH dropped by 98.4% at the first day postoperatively. IGF-I index dropped by 50% and 64% at 1 week and 1 month respectively and remained unchanged onwards. Glucose metabolism improved significantly at 1 week and stabilized at 1 month. Testosterone in male patients recovered to normal range since 1 month. Systolic blood pressures dropped markedly at 3 months while diastolic blood pressures fell mildly at later visits. Abnormal lung function showed no improvement. The decrease of bone formation and resorption markers occurred at 1 week and 3 months, respectively. At 1 month, the tongue area declined while the airway volume increased significantly, accompanied with improved obstructive sleep apnea syndrome. Extremities, lips and nasal ala became smaller since 1 week. Liver, kidney and spleen volumes declined by 6.4, 15.9, 9.2%, respectively at 1 month. The volumes of pancreas and adrenal showed no change.
CONCLUSIONS: The rapid resolution of excessive GH led to the reversible changes of systemic comorbidities in a time-dependent and organ-specific manner.

PMID: 29386229 [PubMed - indexed for MEDLINE]

High 18Fluor-DCFPyL Uptake in Adrenal Adenomas.

Mon, 04/09/2018 - 02:24
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High 18Fluor-DCFPyL Uptake in Adrenal Adenomas.

Clin Nucl Med. 2017 Nov;42(11):862-864

Authors: Peper JGK, Srbljin S, van der Zant FM, Knol RJJ, Wondergem M

Abstract
Radioisotope-labeled prostate-specific membrane antigen (PSMA) tracers have been proven accurate for detection of prostate cancer localizations. Uptake of those tracers in other malignant and benign lesions has been reported, including faint accumulation of Ga-PSMA-HBED-CC in adrenal adenoma. A 77-year-old man with prostate carcinoma was scanned with F-DCFPyL, a promising F-labeled PSMA ligand, for prostate-specific antigen progression while on luteinizing hormone-releasing hormone agonist therapy. The PET/CT shows F-DCFPyL uptake in bilateral enlarged adrenals. Non-contrast-enhanced CT scan indicated left adrenal adenoma. Regarding the high positive predictive value of multiphase contrast-enhanced CT (98%), presence of right adrenal adenoma is also likely.

PMID: 28825951 [PubMed - indexed for MEDLINE]

Protective Effect of Quercetin against Oxidative Stress-Induced Cytotoxicity in Rat Pheochromocytoma (PC-12) Cells.

Mon, 04/09/2018 - 02:24
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Protective Effect of Quercetin against Oxidative Stress-Induced Cytotoxicity in Rat Pheochromocytoma (PC-12) Cells.

Molecules. 2017 Jul 06;22(7):

Authors: Bao D, Wang J, Pang X, Liu H

Abstract
Oxidative stress has been implicated in the pathogenesis of many kinds of neurodegenerative disorders, particularly Parkinson's disease. Quercetin is a bioflavonoid found ubiquitously in fruits and vegetables, and has antioxidative activity. However, the underlying mechanism of the antioxidative effect of quercetin in neurodegenerative diseases has not been well explored. Here, we investigated the antioxidative effect and underlying molecular mechanisms of quercetin on PC-12 cells. We found that PC-12 cells pretreated with quercetin exhibited an increased cell viability and reduced lactate dehydrogenase (LDH) release when exposed to hydrogen peroxide (H₂O₂). The significantly-alleviated intracellular reactive oxygen species (ROS), malondialdehyde (MDA), and lipoperoxidation of the cell membrane of PC-12 cells induced by H₂O₂ were observed in the quercetin pretreated group. Furthermore, quercetin pretreatment markedly reduced the apoptosis of PC-12 cells and hippocampal neurons. The inductions of antioxidant enzyme catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) in PC-12 cells exposed to H₂O₂ were significantly reduced by preatment with quercetin. In addition, quercetin pretreatment significantly increased Bcl-2 expression, and reduced Bax, cleaved caspase-3 and p53 expressions. In conclusion, this study demonstrated that quercetin exhibited a protective effect against oxidative stress-induced apoptosis in PC-12 cells. Our findings suggested that quercetin may be developed as a novel therapeutic agent for neurodegenerative diseases induced by oxidative stress.

PMID: 28684704 [PubMed - indexed for MEDLINE]

Myxoid Adrenocortical Adenoma: A report of two cases and literature review.

Mon, 04/09/2018 - 02:24
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Myxoid Adrenocortical Adenoma: A report of two cases and literature review.

Pathol Res Pract. 2017 Jul;213(7):857-859

Authors: Wu H, Zhang F, Chen Y, Liu C, Yao S, Zhu X, Luo X, Zhuang H, Liu Y

Abstract
Myxoid adrenocortical adenomas are uncommon. There were only 61 cases reports documented, and the tumors are tended to be misdiagnosed in virtue of being rare and distinctive histological features. Recently we encountered two myxoid adrenocortical adenoma cases of a 31-year-old Chinese woman and a 45-year-old Chinese man. The patients did not receive further treatment after surgery and were still alive after following up for 20 months. Myxoid adrenocortical adenomas is extremely rare. Recognition of this entity would be beneficial for pathologists to avoid msidiagnosis, and unnecessary treatment.

PMID: 28559117 [PubMed - indexed for MEDLINE]

Analysis of histological and immunohistochemical patterns of benign and malignant adrenocortical tumors by computerized morphometry.

Mon, 04/09/2018 - 02:24
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Analysis of histological and immunohistochemical patterns of benign and malignant adrenocortical tumors by computerized morphometry.

Pathol Res Pract. 2017 Jul;213(7):815-823

Authors: Dalino Ciaramella P, Vertemati M, Petrella D, Bonacina E, Grossrubatscher E, Duregon E, Volante M, Papotti M, Loli P

Abstract
Diagnosis of benign and purely localized malignant adrenocortical lesions is still a complex issue. Moreover, histology-based diagnosis may suffer of a moment of subjectivity due to inter- and intra-individual variations. The aim of the present study was to assess, by computerized morphometry, the morphological features in benign and malignant adrenocortical neoplasms. Eleven adrenocortical adenomas (ACA) were compared with 18 adrenocortical cancers (ACC). All specimens were stained with H&E, cellular proliferation marker Ki-67 and reticulin. We generated a morphometric model based on the analysis of volume fractions occupied by Ki-67 positive and negative cells (nuclei and cytoplasm), vascular and inflammatory compartment; we also analyzed the surface fraction occupied by reticulin. We compared the quantitative data of Ki-67 obtained by morphometry with the quantification resulting from pathologist's visual reading. The volume fraction of Ki-67 positive cells in ACCs was higher than in ACAs. The volume fraction of nuclei in unit volume and the nuclear/cytoplasmic ratio in both Ki-67 negative cells and Ki-67 positive cells were prominent in ACCs. The surface fraction of reticulin was considerably lower in ACCs. Our computerized morphometric model is simple, reproducible and can be used by the pathologist in the histological workup of adrenocortical tumors to achieve precise and reader-independent quantification of several morphological characteristics of adrenocortical tumors.

PMID: 28554744 [PubMed - indexed for MEDLINE]

Adrenal surgery for oligometastatic tumors improves survival in selected cases.

Mon, 04/09/2018 - 02:24
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Adrenal surgery for oligometastatic tumors improves survival in selected cases.

J Visc Surg. 2017 Apr;154(2):87-91

Authors: Tomasini P, Garcia ME, Greillier L, Paladino C, Sebag F, Barlesi F

Abstract
INTRODUCTION: Oligometastatic cancer prognosis is distinct from polymetastatic cancer prognosis and surgery can improve survival. The objective of this study was to assess the role of adrenalectomy and to look for prognostic or predictive factors for the treatment of patients with oligometastatic solid tumors and adrenal metastasis.
MATERIAL AND METHODS: Patients with oligometastatic solid tumors undergoing adrenalectomy were selected. Clinical data were retrieved from electronic patients records. Progression-free survival (PFS), overall survival (OS) and clinical outcomes were assessed.
RESULTS: Forty patients were analyzed. Median PFS was 7.4 months and PFS was longer for metachronous versus synchronous adrenal metastasis (10.8 versus 4.5 months; P=0.008). Median OS was 22.8 months and OS was better with laparoscopic adrenalectomy versus open adrenalectomy (24.4 versus 11.2 months; P=0.05).
DISCUSSION: Adrenalectomy part of the treatment plan of oligometastatic solid tumors but patients have to be selected. Surgery might be indicated for metachronous metastasis when laparoscopic adrenalectomy is possible.

PMID: 27642061 [PubMed - indexed for MEDLINE]

Minimally invasive approaches to adrenal tumors: an up-to-date summary including patient position and port placement of laparoscopic, retroperitoneoscopic, robot-assisted, and single-site adrenalectomy.

Mon, 04/09/2018 - 02:24
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Minimally invasive approaches to adrenal tumors: an up-to-date summary including patient position and port placement of laparoscopic, retroperitoneoscopic, robot-assisted, and single-site adrenalectomy.

Curr Opin Urol. 2017 Jan;27(1):56-61

Authors: Hupe MC, Imkamp F, Merseburger AS

Abstract
PURPOSE OF REVIEW: There are multiple minimal invasive approaches to remove the adrenal gland. The purpose of this review is to summarize the most up-to-date findings about laparoscopic, retroperitoneoscopic, robot-assisted, and single-site adrenalectomy, and to define the most common approaches to the adrenal gland.
RECENT FINDINGS: Laparoscopic adrenalectomy is the gold standard to remove adrenal tumors. New approaches are being explored to outperform the advantages of laparoscopic adrenalectomy.
SUMMARY: Retroperitoneoscopic adrenalectomy, when performed by skilled surgeons, offers an alternative to the conventional laparoscopic approach, with better outcome. The robot-assisted and single-site approaches still need further studies to fully identify their roles in adrenalectomy.

PMID: 27533502 [PubMed - indexed for MEDLINE]

adrenal tumor; +30 new citations

Sun, 04/01/2018 - 23:54

30 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 2018/04/01

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adrenal tumor; +34 new citations

Sun, 03/25/2018 - 21:15

34 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 2018/03/25

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.

[Clinical characteristics of central diabetes insipidus: a retrospective analysis of 230 cases].

Sun, 03/11/2018 - 16:52
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[Clinical characteristics of central diabetes insipidus: a retrospective analysis of 230 cases].

Zhonghua Nei Ke Za Zhi. 2018 Mar 01;57(3):201-205

Authors: Zhang JP, Guo QH, Mu YM, Lyu ZH, Gu WJ, Yang GQ, Du J, Ba JM, Lu JM

Abstract
Objective: To evaluate the clinical characteristics and etiologies of central diabetes insipidus (CDI). Methods: The clinical data of 230 patients with CDI in the Department of Endocrinology of Chinese PLA General Hospital from 2008 June to 2014 December were collected and analyzed retrospectively. Results: The three most common causes of CDI were idiopathic CDI, lymphocytic hypophysitis and intracranial germ cell tumors. Among all the CDI, the idiopathic CDI accounted for 37.48%. There were significant differences in age onset and gender distribution among the different causes of CDI. The patients with intracranial germ cell tumors [age of onset(19.2±10.2) years] were younger than the other types of CDI. Germ cell tumors patients were more common in male, and lymphocytic hypophysitis patients were more common in female. The most frequent abnormality of anterior pituitary in patients with CDI was growth hormone deficiency, followed by hypogonadism, adrenal insufficiency and hypothyroidism. The dysfunction of thyroid axis and adrenal axis in patients with germ cell tumor was more common than those in patients with idiopathic and lymphocytic hypophysitis. Conclusions: The most common causes of central diabetes insipidus were idiopathic CDI, lymphocytic hypophysitis and intracranial germ cell tumors. There were differences in age of onset, gender distribution and abnormal production of anterior pituitary hormones among all causes of CDI patients.

PMID: 29518865 [PubMed - in process]

Surgery for pheochromocytoma: A 20-year experience of a single institution.

Sun, 03/11/2018 - 16:52
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Surgery for pheochromocytoma: A 20-year experience of a single institution.

Hormones (Athens). 2017 Oct;16(4):388-395

Authors: Aggeli C, Nixon AM, Parianos C, Vletsis G, Papanastasiou L, Kounadi T, Piaditis G, Zografos GN

Abstract
OBJECTIVE: Resection of pheochromocytomas is a challenging procedure due to hemodynamic lability. Our aim was to evaluate surgical outcomes in 67 patients with pheochromocytoma and to validate the role of laparoscopic surgery in the treatment of these tumors.
DESIGN: This study is a retrospective review. A total of 68 procedures for pheochromocytoma were performed between June 1997 and February 2017. All patients were investigated and operated on using an established departmental protocol. Relevant data were retrieved from the hospital records of 533 patients who underwent 541 adrenalectomies for benign and malignant adrenal tumors in the same period.
RESULTS: Sixty-nine tumors were removed from 67 patients. One patient with/MEN2A underwent bilateral resection of pheochromocytomas in two stages. Tumor size in laparoscopic procedures ranged from 1.2 cm to 11.0 cm (mean 5.87 cm). Thirty-seven patients had benign disease, 31 potentially malignant (based on PASS) and 1 malignant with metastasis. Eight were in the context of a familial syndrome. Forty-nine patients underwent laparoscopic adrenalectomy, 8 patients had open approach from the start for recurrent pheochromocytoma or large benign tumor, 1 patient had open approach due to inoperable malignant pheochromocytoma and 10 patients had conversions from laparoscopic to open procedure. Nine patients received sodium nitroprusside intraoperatively to treat hypertension. One patient developed pulmonary embolism and succumbed 1 month later. There were no recurrences of the benign or potentially malignant tumors during the follow-up period.
CONCLUSIONS: Laparoscopic resection of pheochromocytomas, despite its increased level of difficulty compared to that of other adrenal tumors, is a safe and effective procedure.

PMID: 29518759 [PubMed - in process]

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