Error message

Deprecated function: The each() function is deprecated. This message will be suppressed on further calls in menu_set_active_trail() (line 2405 of /mnt/stor5-wc1-dfw1/644438/www.adrenaltumors.org/web/content/includes/menu.inc).

News & Updates

Subscribe to News & Updates feed News & Updates
NCBI: db=pubmed; Term=adrenal tumor
Updated: 1 day 10 hours ago

A Multimodality Review of Adrenal Tumors.

Wed, 11/28/2018 - 02:39
Related Articles

A Multimodality Review of Adrenal Tumors.

Curr Probl Diagn Radiol. 2018 Oct 25;:

Authors: Bhargava P, Sangster G, Haque K, Garrett J, Donato M, D'Agostino H

Abstract
Adrenal tumors are very commonly encountered in the practice of radiology. They may arise from the adrenal gland itself, either the cortex or the medulla, or they could be secondary lesions. They may be benign or malignant. The functioning adrenal tumors lead to hypersecretion of adrenal hormones leading to clinical syndromes. Computed tomography is the most common imaging modality used for the initial evaluation of adrenal tumors. Magnetic resonance imaging and functional scintigraphic techniques are frequently used for atypical presentations or further evaluation. We present a multimodality review of common and uncommon adrenal tumors. We highlight their characteristic and specific imaging features which help us in making a diagnosis and suggesting an appropriate follow up for further management. The spectrum of adrenal tumors is wide with varying appearances on different imaging modalities. Imaging techniques used for adrenal tumor imaging have their own strengths and weaknesses as it relates to the final diagnosis. It is important to be familiar with imaging characteristics of adrenal tumors for appropriate diagnosis and management. Differentiation of benign (leave alone) tumors from malignant (surgical) ones along with appropriate disposition of incidentalomas are some of the challenges facing the radiologist.

PMID: 30472137 [PubMed - as supplied by publisher]

Incidence and predictive factors of hypoglycemia after pheochromocytoma resection.

Wed, 11/28/2018 - 02:39
Related Articles

Incidence and predictive factors of hypoglycemia after pheochromocytoma resection.

Int J Urol. 2018 Nov 22;:

Authors: Araki S, Kijima T, Waseda Y, Komai Y, Nakanishi Y, Uehara S, Yasuda Y, Yoshida S, Yokoyama M, Ishioka J, Matsuoka Y, Saito K, Kihara K, Nakano Y, Yoshimoto T, Uchida T, Fujii Y

Abstract
OBJECTIVES: To determine the incidence and preoperative risk factors of post-excisional hypoglycemia in patients undergoing pheochromocytoma resection.
METHODS: Patients who underwent surgical resection of pheochromocytoma at a single institution were retrospectively enrolled in the present study. The primary end-point was the development of post-excisional hypoglycemia; that is, a serum glucose level <70 mg/dL. The serum levels of immunoreactive insulin and glucose levels during the preoperative oral glucose-tolerance test and surgery were analyzed to elucidate the mechanism of hypoglycemia.
RESULTS: A total of 49 patients underwent surgical resection of pheochromocytoma, of which 21 patients (43%) developed post-excisional hypoglycemia. The incidence of hypoglycemia was not statistically different between patients with adrenal tumors and those with extra-adrenal tumors (18/41 [44%] vs 3/8 [38%], respectively, P = 0.73). There was no difference in the immunoreactive insulin/glucose ratio during the preoperative oral glucose-tolerance test between patients with and those without post-excisional hypoglycemia. The intraoperative immunoreactive insulin/glucose ratio was significantly higher in patients with hypoglycemia than in those without hypoglycemia. A higher 24-h urinary epinephrine level, but not norepinephrine level, was a predictive factor for post-excisional hypoglycemia.
CONCLUSIONS: Post-excisional hypoglycemia is a frequent complication of pheochromocytoma resection, irrespective of the tumor location, and might be common in patients with epinephrine-predominant tumors. All patients undergoing resection of adrenal and extra-adrenal pheochromocytoma require intensive monitoring of serum glucose levels during and after surgery.

PMID: 30467902 [PubMed - as supplied by publisher]

Influence of slice thickness on result of CT histogram analysis in indetermined adrenal masses.

Wed, 11/28/2018 - 02:39
Related Articles

Influence of slice thickness on result of CT histogram analysis in indetermined adrenal masses.

Abdom Radiol (NY). 2018 Nov 20;:

Authors: Tüdös Z, Kučera P, Szász P, Hartmann I, Langová K, Škarda J, Čtvrtlík F

Abstract
PURPOSE: The aim was to determine the optimal slice thickness of CT images and the optimal threshold of negative voxels for CT histogram analysis to distinguish adrenal adenomas from non-adenomas with a mean attenuation more than 10 Hounsfield units (HU).
METHODS: Volume CT histogram analysis of 83 lipid-poor adenomas and 80 non-adenomas was performed retrospectively. The volume of interest was extracted from each adrenal lesion, and the mean attenuation, standard deviation (SD), and percentage of voxels with a negative CT value were recorded using reconstructions with different slice thicknesses (5 mm, 2.5 mm, 1.25 mm). The percentage of negative voxels was correlated with SD as a measure of image noise and with the reference splenic tissue values. The sensitivity, specificity, and positive predictive value (PPV) for the identification of adenomas were calculated using reconstructions with different slice thicknesses and three different thresholds of negative voxels (1%, 5%, 10%).
RESULTS: The percentage of negative voxels increased with a thinner slice thickness and correlated with increasing CT image noise in adenomas, non-adenomas, and spleen. Using a threshold of 10% negative voxels and a slice thickness of 5 mm, we reached a sensitivity of 53.0%, specificity of 98.8% and the highest PPV, and thus we propose this combination for clinical use. Other combinations achieved a clearly lower specificity and PPV as a result of the increasing noise in CT images.
CONCLUSION: The CT slice thickness significantly affects the result and diagnostic value of histogram analysis. Thin CT slice reconstructions are inappropriate for histogram analysis.

PMID: 30460531 [PubMed - as supplied by publisher]

Adrenal cavernous hemangioma: a case report.

Wed, 11/28/2018 - 02:39
Related Articles

Adrenal cavernous hemangioma: a case report.

BMC Surg. 2018 Nov 20;18(1):103

Authors: Feo CV, De Troia A, Pedriali M, Sala S, Zatelli MC, Carcoforo P, Feo CF

Abstract
BACKGROUND: Adrenal cavernous hemangiomas are very rare benign tumors that usually present as incidental findings on abdominal imaging. Preoperative differential diagnosis from other benign or malignant adrenal neoplasms may be challenging.
CASE PRESENTATION: A 70-year old man was referred for an 8-cm abdominal mass incidentally discovered on a contrast-enhanced computed tomography (CT) performed to investigate a pulmonary nodule. Biochemical tests ruled out any endocrine dysfunction and iodine 123 metaiodobenzylguanidine whole body scintiscan single-photon emission CT excluded a pheocromocitoma. Findings on magnetic resonance imaging were non-specific and the patient was elected for a left adrenalectomy. Histopathological diagnosis revealed a cavernous hemangioma. A portion of the resected tissue was tested for drug sensitivity to mitotane, doxorubicin, and sunitinib.
CONCLUSIONS: Adrenal hemangioma is a rare disease but should be included in the differential diagnosis of adrenal tumors. The surgical resection is generally required to exclude malignant disease, resolve pressure-related symptoms, and prevent retroperitoneal hemorrhage. Although specific features in diagnostic imaging are often lacking, if the diagnosis is established preoperatively a laparoscopic adrenalectomy can be performed due to the benign nature of the lesion. Doxorubicin and sunitinib were both capable of reducing primary culture cell viability, this suggest that similar drugs may be useful in the medical treatment of adrenal hemangiomas.

PMID: 30458815 [PubMed - in process]

Malignant phyllodes tumor with metastases to lung, adrenal and brain: A rare case report.

Wed, 11/28/2018 - 02:39
Related Articles

Malignant phyllodes tumor with metastases to lung, adrenal and brain: A rare case report.

Ann Med Surg (Lond). 2018 Dec;36:113-117

Authors: Khanal S, Singh YP, Bhandari A, Sharma R

Abstract
Background: Phyllodes tumors are spectrum of tumors ranging from benign to malignant. Malignant spectrum pose a management challenge for clinicians due to high risks of recurrence and metastasis. Malignant phyllodes tumor with brain, lung and adrenal metastases at the same time is rare.
Case presentation: A 37 years-old unmarried female presented with an ulcerated huge lump in left breast with severe bleeding. Trucut biopsy showed necrosis with spindle cell proliferation with atypia for which she underwent modified radical mastectomy with final diagnosis of malignant phyllodes tumor. Three months after surgery, patient presented with headache, which on further evaluation showed masses in lung, right adrenal and brain.
Conclusion: We presented a rare case of malignant phyllodes tumor with clinical, imaging and histological findings with metastases to multiple sites early in course and poor outcome of the patient despite margin negative resection.

PMID: 30455875 [PubMed]

Genetics of adrenal tumors.

Wed, 11/28/2018 - 02:39
Related Articles

Genetics of adrenal tumors.

Presse Med. 2018 Jul - Aug;47(7-8 Pt 2):e107-e108

Authors: Bertherat J

PMID: 30172347 [PubMed - indexed for MEDLINE]

Florid hyperandrogenism due to a benign adrenocortical adenoma.

Wed, 11/28/2018 - 02:39
Related Articles

Florid hyperandrogenism due to a benign adrenocortical adenoma.

BMJ Case Rep. 2018 Jul 30;2018:

Authors: LaVoie M, Constantinides V, Robin N, Kyriacou A

Abstract
A 26-year-old woman with a history of polycystic ovarian syndrome presented with secondary amenorrhea, worsening hirsutism, acne, deepening of voice and unexplained 10-20 kg weight gain. Her Ferriman-Gallway hirsutism score was 12 with cystic facial acne and increased masculine phenotype. Urine Beta-Human Chorionic Gonadotropins (bHCG) was negative. She had elevated serum testosterone of 551 ng/dL, androstenedione at 7.46 ng/mL and dehydroepiandrosterone sulfate (DHEAS) at 4243 µg/L. Overnight dexamethasone suppression test showed mildly unsuppressed cortisol (2.89 µg/dL). Urinary free cortisol along with paired serum cortisol and adrenocorticotrophic hormone (ACTH) tests were normal (55.4 µg/24 hours, 13.44 mcg/dL, 30.4 pg/mL respectively). Her leutinizing hormone (LH) was low(<0.1 mIU/mL), follicle stimulating hormone (FSH) low/normal (1.41 mIU/mL) with sex hormone binding globulin (SHBG) level 45nmol/L and the rest of the pituitary and adrenal workup was unremarkable. Thyroid stimulating hormone (TSH) was 2.15mU/mL. MRI revealed a 3.1 cm, indeterminate but well-defined left adrenal lesion and polycystic ovaries without abdominal lymphadenopathy. Given radiological appearances and despite biochemical concerns for adrenocortical malignancy, a multidisciplinary team meeting decision was made to proceed with laparoscopic adrenalectomy. Histology was consistent with a benign adenoma. Postoperatively, there was clinical and biochemical resolution of the disease.

PMID: 30061126 [PubMed - indexed for MEDLINE]

LC-MS/MS based profiling and dynamic modelling of the steroidogenesis pathway in adrenocarcinoma H295R cells.

Wed, 11/28/2018 - 02:39
Related Articles

LC-MS/MS based profiling and dynamic modelling of the steroidogenesis pathway in adrenocarcinoma H295R cells.

Toxicol In Vitro. 2018 Oct;52:332-341

Authors: Ahmed KEM, Frøysa HG, Karlsen OA, Sagen JV, Mellgren G, Verhaegen S, Ropstad E, Goksøyr A, Kellmann R

Abstract
Endocrine disrupting chemicals have been reported to exert effects directly on enzymes involved in steroid biosynthesis. Here, we present a new liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for profiling the steroid metabolome of H295R human adrenocarcinoma cells. Our method can simultaneously analyse 19 precursors, intermediates and end-products, representing the adrenal steroid biosynthesis pathway. In order to obtain better insights into the processes of steroidogenesis, we investigated the dose-response relationship of forskolin, an activator of adenylate cyclase, on steroid production in H295R cells. We observed that 1.5 μM forskolin stimulated steroid production at approximately 50% of the maximum rate for most steroids. Hence, we studied the time course for steroid synthesis over 72 h in H295R cells that were stimulated with forskolin. At 24 h, we observed a peak in steroid levels for the intermediate metabolites, such as progesterone and pregnenolone, while end-products such as testosterone and cortisol continued to increase until 72 h. Finally, we show how global data provide a unique basis to develop a comprehensive, dynamic model for steroidogenesis using first order kinetics. The timeline data made it possible to estimate all reaction rate constants of the network. We propose this method as a unique and sensitive screening tool to identify effects on adrenal steroidogenesis by endocrine disrupting compounds.

PMID: 30017865 [PubMed - indexed for MEDLINE]

Golimumab effectiveness and safety in clinical practice for moderately active ulcerative colitis.

Wed, 11/28/2018 - 02:39
Related Articles

Golimumab effectiveness and safety in clinical practice for moderately active ulcerative colitis.

Eur J Gastroenterol Hepatol. 2018 09;30(9):1019-1026

Authors: O'Connell J, Rowan C, Stack R, Harkin G, Parihar V, Chan G, Breslin N, Cullen G, Dunne C, Egan L, Harewood G, Leyden J, MacCarthy F, MacMathuna P, Mahmud N, McKiernan S, McNamara D, Mulcahy H, Murray F, O'Connor A, O'Toole A, Patchett S, Ryan B, Sheridan J, Slattery E, Doherty G, Kevans D

Abstract
BACKGROUND AND AIMS: Golimumab (GLB) is an antitumour necrosis factor-α (anti-TNF) therapy that has shown efficacy as induction and maintenance therapy for ulcerative colitis (UC). We aimed to describe the outcome of GLB therapy for UC in a real-world clinical practice.
PATIENTS AND METHODS: Consecutive patients receiving GLB for UC in six Irish Academic Medical Centres were identified. The primary study endpoint was the 6-month corticosteroid-free remission rate. The secondary endpoints included the 3-month clinical response, time free of GLB discontinuation and adverse events.
RESULTS: Seventy-two patients were identified [57% men; median (range) age of 41.4 years (20.3-76.8); disease duration 6.6 years (0-29.9); follow-up 8.7 months (0.4-39.2)]. Sixty-four percent of patients were anti-TNF naive. The 3-month clinical response and the 6-month corticosteroid-free remission rates were 55 and 39%, respectively. Forty-four percent of patients discontinued GLB during the follow-up, median (95% confidence interval) time to GLB discontinuation 18.7 months (9.2-28.1). A C-reactive protein more than 5 mg/l at baseline was associated with failure to achieve 6-month corticosteroid-free remission and a shorter time to GLB discontinuation, odds ratio 0.2 (0.1-0.7), P=0.008, and hazard ratio (95% confidence interval) 2.8 (1.3-5.7), P=0.007, respectively. Adverse events occurred in 7% of patients (n=5), all of which were minor and self-limiting.
CONCLUSION: These real-world clinical data suggest that GLB is an effective and safe therapy for a UC cohort with significant previous anti-TNF exposure. An elevated baseline C-reactive protein, likely reflective of increased inflammatory burden, is associated with a reduced likelihood of a successful outcome of GLB therapy.

PMID: 29878945 [PubMed - indexed for MEDLINE]

Brown tumor of the jaws as a manifestation of tertiary hyperparathyroidism: A literature review and case report.

Wed, 11/28/2018 - 02:39
Related Articles

Brown tumor of the jaws as a manifestation of tertiary hyperparathyroidism: A literature review and case report.

Spec Care Dentist. 2018 May;38(3):163-171

Authors: Dos Santos B, Koth VS, Figueiredo MA, Salum FG, Cherubini K

Abstract
Brown tumor of the jaws is a manifestation of hyperparathyroidism consisting of osteolytic lesions that show proliferation of multinucleated giant cells in the maxilla and/or mandible. Differential diagnosis of these lesions from local central giant-cell granuloma is mandatory for the correct treatment of the patient. Radiographic and histopathological exams of the jaw lesion are not sufficient to determine the diagnosis, which requires laboratory tests including serum levels of calcium, alkaline phosphatase, parathyroid hormone (PTH) and phosphate, and radiographic examination of other bones as well, such as hand-wrist, pelvis, and femur. We present here a brief literature review focusing on the clinical and radiographic features, diagnostic criteria and treatment of brown tumor and also report a case of the disease affecting the jaw.

PMID: 29603323 [PubMed - indexed for MEDLINE]

Targeting CXCR4 (CXC Chemokine Receptor Type 4) for Molecular Imaging of Aldosterone-Producing Adenoma.

Wed, 11/28/2018 - 02:39
Related Articles

Targeting CXCR4 (CXC Chemokine Receptor Type 4) for Molecular Imaging of Aldosterone-Producing Adenoma.

Hypertension. 2018 02;71(2):317-325

Authors: Heinze B, Fuss CT, Mulatero P, Beuschlein F, Reincke M, Mustafa M, Schirbel A, Deutschbein T, Williams TA, Rhayem Y, Quinkler M, Rayes N, Monticone S, Wild V, Gomez-Sanchez CE, Reis AC, Petersenn S, Wester HJ, Kropf S, Fassnacht M, Lang K, Herrmann K, Buck AK, Bluemel C, Hahner S

Abstract
Primary aldosteronism is the most frequent cause of secondary hypertension and is associated with increased morbidity and mortality compared with hypertensive controls. The central diagnostic challenge is the differentiation between bilateral and unilateral disease, which determines treatment options. Bilateral adrenal venous sampling, currently recommended for differential diagnosis, is an invasive procedure with several drawbacks, making it desirable to develop novel noninvasive diagnostic tools. When investigating the expression pattern of chemokine receptors by quantitative real-time polymerase chain reaction and immunohistochemistry, we observed high expression of CXCR4 (CXC chemokine receptor type 4) in aldosterone-producing tissue in normal adrenals, adjacent adrenal cortex from adrenocortical adenomas, and in aldosterone-producing adenomas (APA), correlating strongly with the expression of CYP11B2 (aldosterone synthase). In contrast, CXCR4 was not detected in the majority of nonfunctioning adenomas that are frequently found coincidently. The specific CXCR4 ligand 68Ga-pentixafor has recently been established as radiotracer for molecular imaging of CXCR4 expression and showed strong and specific binding to cryosections of APAs in our study. We further investigated 9 patients with primary aldosteronism because of APA by 68Ga-pentixafor-positron emission tomography. The tracer uptake was significantly higher on the side of increased adrenocortical aldosterone secretion in patients with APAs compared with patients investigated by 68Ga-pentixafor-positron emission tomography for other causes. Molecular imaging of aldosterone-producing tissue by a CXCR4-specific ligand may, therefore, be a highly promising tool for noninvasive characterization of patients with APAs.

PMID: 29279316 [PubMed - indexed for MEDLINE]

Molecular and phenotypic evaluation of a novel germline TMEM127 mutation with an uncommon clinical presentation.

Wed, 11/28/2018 - 02:39
Related Articles

Molecular and phenotypic evaluation of a novel germline TMEM127 mutation with an uncommon clinical presentation.

Endocr Relat Cancer. 2017 11;24(11):L79-L82

Authors: Deng Y, Flores SK, Cheng Z, Qin Y, Schwartz RC, Malchoff C, Dahia PLM

PMID: 28855235 [PubMed - indexed for MEDLINE]

Slowly Growing Adrenal Mass: A 20-Year Incubation.

Wed, 11/28/2018 - 02:39
Related Articles

Slowly Growing Adrenal Mass: A 20-Year Incubation.

Am J Med. 2017 11;130(11):e479-e483

Authors: Takahashi N, Tanabe A, Yamazaki Y, Sasano H, Kajio H

PMID: 28756269 [PubMed - indexed for MEDLINE]

Rapidly progressive lupus nephritis associated with golimumab in a patient with systemic lupus erythematosus and rheumatoid arthritis.

Wed, 11/28/2018 - 02:39
Related Articles

Rapidly progressive lupus nephritis associated with golimumab in a patient with systemic lupus erythematosus and rheumatoid arthritis.

Lupus. 2017 04;26(4):447-448

Authors: Saka Y, Taniguchi Y, Nagahara Y, Yamashita R, Karasawa M, Naruse T, Watanabe Y

PMID: 27510604 [PubMed - indexed for MEDLINE]

adrenal tumor; +23 new citations

Wed, 11/21/2018 - 01:23

23 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 2018/11/21

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 tumor; +28 new citations

Tue, 11/13/2018 - 23:18

28 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 2018/11/13

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.

Juxta-adrenal schwannoma presenting as a giant adrenal tumor: A case report and a literature review.

Tue, 11/06/2018 - 21:05
Related Articles

Juxta-adrenal schwannoma presenting as a giant adrenal tumor: A case report and a literature review.

Int J Surg Case Rep. 2018 Oct 15;53:132-136

Authors: Abdessater M, El Mokdad M, Gas J, Sleiman W, Coloby P, Bart S

Abstract
INTRODUCTION: Retroperitoneal schwannomas (RS) are rare, benign tumors that originate in the neural sheath. Juxta-adrenal schwannomas may be misdiagnosed with giant adrenal tumors. This article reports the case of a RS that presented as an asymptomatic adrenal mass in a 50 Y.O female.
PRESENTATION OF CASE: An abdominal ultrasound of our asymptomatic patient showed right adrenal lesion of 9 cm of diameter. Endocrinological evaluation was negative. The patient was considered to have a non-secreting right adrenal mass confirmed by adrenal scan. We began a right laparoscopic trans peritoneal adrenalectomy, but when we discovered intra operatively that the wall of the IVC and the renal vein were very adherent to the mass which had a lot of small vessels that were bleeding, we converted to open surgery that allowed us to remove the mass safely. The operative time was 200 min, the blood loss was 850 cc and the patient was discharged uneventfully on the sixth day after surgery.
DISCUSSION: Although we thought that we removed a huge adrenal tumor from the retroperitoneum of our patient, the pathological exam revealed a RS that comprises the adrenal gland which was normal. Preoperative establishment of diagnosis is difficult in case of RS that can be misdiagnosed, especially when they stick to other structures (the adrenal in our case).
CONCLUSION: Complete surgical resection is the treatment of choice for RS and open surgery is the safest option when we have big tumors. Histology and Immunohistochemistry confirms the diagnosis that can be easily missed preoperatively.

PMID: 30391738 [PubMed - as supplied by publisher]

CT characteristics of pheochromocytoma - Relevance for the evaluation of adrenal incidentaloma.

Tue, 11/06/2018 - 21:05
Related Articles

CT characteristics of pheochromocytoma - Relevance for the evaluation of adrenal incidentaloma.

J Clin Endocrinol Metab. 2018 Oct 31;:

Authors: Canu L, Van Hemert JAW, Kerstens M, Hartman RP, Khanna A, Kraljevic I, Kastelan D, Badiu C, Ambroziak U, Tabarin A, Haissaguerre M, Buitenwerf E, Visser A, Mannelli M, Arlt W, Chortis V, Bourdeau I, Gagnon N, Buchy M, Borson-Chazot F, Deutschbein T, Fassnacht M, Hubalewska Dydejczyk HA, Motyka M, Rzepka E, Casey RT, Challis BG, Quinkler M, Vroonen L, Spyroglou A, Beuschlein F, Lamas C, Young WF, Bancos I, Timmers HJLM

Abstract
Background: Up to 7% of all adrenal incidentalomas (AIs) are pheochromocytomas (PCCs). In the evaluation of AI, it is generally recommended to exclude PCC by measurement plasma free or 24h urinary fractionated metanephrines. However, recent studies suggest to abstain from biochemical exclusion of PCC in cases of lesions with computed tomography (CT) characteristics of an adrenocortical adenoma (ACA).
Aim: To determine the proportion of PCCs with ACA-like attenuation or contrast washout on CT.
Methods: For this multicenter retrospective study, two central investigators independently analyzed the CT reports of 533 patients with 548 histologically confirmed PCCs. Data on tumor size, unenhanced Hounsfield Units (HU), absolute percentage washout (APW) and relative percentage washout (RPW) were collected besides clinical parameters.
Results: Among the 376 PCCs for which unenhanced attenuation data were available, 374 had an attenuation of >10 HU (99.5%). In the two exceptions (0,5%), unenhanced attenuation was exactly 10 HU, which lies just within the range of ≤10 HU that would suggest a diagnosis of ACA. Of 76 PCCs with unenhanced HU >10 and available washout data, 22 (28,9%) had a high APW and/or RPW, suggestive of ACA.
Conclusion: Based on the lack of PCCs with an unenhanced attenuation of <10 HU, and the low proportion (0,5%) of PCCs with an attenuation of =10 HU, it seems reasonable to abstain from biochemical testing for PCC in AIs with an unenhanced attenuation ≤10 HU. The assessment of contrast washout, however, is unreliable to rule out PCC.

PMID: 30383267 [PubMed - as supplied by publisher]

Pheochromocytoma with Brain Metastasis: A Extremely Rare Case in Worldwide.

Tue, 11/06/2018 - 21:05
Related Articles

Pheochromocytoma with Brain Metastasis: A Extremely Rare Case in Worldwide.

Brain Tumor Res Treat. 2018 Oct;6(2):101-104

Authors: Cho YS, Ryu HJ, Kim SH, Kang SG

Abstract
Pheochromocytoma (PCC) is a neuroendocrine tumor that mainly arises from the medulla of the adrenal gland. Some PCCs become malignant and metastasize to other organs. For example, it typically involves skeletal system, liver, lung, and regional lymph nodes. However, only a few cases of PCC with brain metastasis have been reported worldwide. We report a case of metastatic brain tumor from PCC in South Korea in 2016. A 52-year-old man presented with headache, dizziness and motor aphasia. He had a medical history of PCC with multi-organ metastasis, previously underwent several operations, and was treated with chemotherapy and radiotherapy. Brain MRIs showed a brain tumor on the left parietal lobe. Postoperative pathology confirmed that the metastatic brain tumor derived from malignant PCC. This is the first report PCC with brain metastasis in South Korea.

PMID: 30381926 [PubMed]

Fractionated stereotactic radiation therapy for adrenal metastases: contributing to local tumor control with low toxicity.

Tue, 11/06/2018 - 21:05
Related Articles

Fractionated stereotactic radiation therapy for adrenal metastases: contributing to local tumor control with low toxicity.

Strahlenther Onkol. 2018 Oct 29;:

Authors: Burjakow K, Fietkau R, Putz F, Achterberg N, Lettmaier S, Knippen S

Abstract
PURPOSE: To report on the Erlangen (UK-Er) experience with linear accelerator stereotactic body radiation therapy (LINAC SBRT) for adrenal metastasis from various primary tumors.
MATERIALS AND METHODS: 33 patients were treated. Primary sites included lung (n = 19), melanoma (n = 8), colorectal (n = 2), hepatocellular (n = 1), esophageal (n = 2), and breast cancer (n = 1). 14 patients were treated palliatively, 19 patients were treated with local curative intent.
RADIATION TREATMENT: Treatment planning was done based on an exhale, mid-ventilation, and inspiration CT series. Further planning CTs were done to check for the correctness of the breathing pattern. Irradiation was performed using a NOVALIS (Varian, Palo Alto, CA, USA; Brainlab AG, München, Germany) linear accelerator. The isocenter was verified before each treatment session using the BrainLab ExacTrac® (Brainlab AG, München, Germany) system to minimize setup errors. Dose was prescribed to the planning target volume (PTV) surrounding 90% isodose.
FOLLOW-UP: Depending on their overall performance status and prognosis, patients received clinical check-ups and radiological imaging. Median follow-up was 11 months.
STATISTICAL ANALYSIS: IBM SPSS v. 24 was used for univariate analysis using Kaplan-Meier curves, nonparametric Kruskal-Wallis test, and the chi-square test for frequency distributions. Toxicity was graded according to NCI CTCAE v4.0. Depending on radiologic imaging, patients were classified as stable, regression, and progression.
RESULTS: Median survival was 11 months, median PFS was 5 months. Median local failure-free survival was 21 months. Patients who were treated with curative intent showed a better survival curve (p < 0.0001) and PFS (p = 0.004). BED ranged from 42 to 108.8 Gy, median BED was 67.2 Gy. Three BED groups were formed. Overall survival curves differed significantly (p = 0.046), favoring the high-dose group. 21 patients were free from any adverse events or discomfort. In 7 cases, a grade I toxicity was noted.

PMID: 30374590 [PubMed - as supplied by publisher]

Pages