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NCBI: db=pubmed; Term=adrenal tumor
Updated: 1 day 11 hours ago

A novel pipeline for adrenal tumour segmentation.

Tue, 10/23/2018 - 18:42
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A novel pipeline for adrenal tumour segmentation.

Comput Methods Programs Biomed. 2018 Jun;159:77-86

Authors: Koyuncu H, Ceylan R, Erdogan H, Sivri M

Abstract
BACKGROUND AND OBJECTIVE: Adrenal tumours occur on adrenal glands surrounded by organs and osteoid. These tumours can be categorized as either functional, non-functional, malign, or benign. Depending on their appearance in the abdomen, adrenal tumours can arise from one adrenal gland (unilateral) or from both adrenal glands (bilateral) and can connect with other organs, including the liver, spleen, pancreas, etc. This connection phenomenon constitutes the most important handicap against adrenal tumour segmentation. Size change, variety of shape, diverse location, and low contrast (similar grey values between the various tissues) are other disadvantages compounding segmentation difficulty. Few studies have considered adrenal tumour segmentation, and no significant improvement has been achieved for unilateral, bilateral, adherent, or noncohesive tumour segmentation. There is also no recognised segmentation pipeline or method for adrenal tumours including different shape, size, or location information.
METHODS: This study proposes an adrenal tumour segmentation (ATUS) pipeline designed to eliminate the above disadvantages for adrenal tumour segmentation. ATUS incorporates a number of image methods, including contrast limited adaptive histogram equalization, split and merge based on quadtree decomposition, mean shift segmentation, large grey level eliminator, and region growing.
RESULTS: Performance assessment of ATUS was realised on 32 arterial and portal phase computed tomography images using six metrics: dice, jaccard, sensitivity, specificity, accuracy, and structural similarity index. ATUS achieved remarkable segmentation performance, and was not affected by the discussed handicaps, on particularly adherence to other organs, with success rates of 83.06%, 71.44%, 86.44%, 99.66%, 99.43%, and 98.51% for the metrics, respectively, for images including sufficient contrast uptake.
CONCLUSIONS: The proposed ATUS system realises detailed adrenal tumour segmentation, and avoids known disadvantages preventing accurate segmentation.

PMID: 29650321 [PubMed - indexed for MEDLINE]

[Bronchial adenoid cystic carcinoma masquerading as bronchial asthma: a case report].

Tue, 10/23/2018 - 18:42
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[Bronchial adenoid cystic carcinoma masquerading as bronchial asthma: a case report].

Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Apr 18;50(2):378-380

Authors: Lu M, Wang M, Zhu X, Chen YH, Yao WZ

Abstract
Here we reported a case of bronchial adenoid cystic carcinoma from Peking University Third Hospital. A 40-year-old female presented with dry cough for 1 year and nocturnal paroxysmal attacks of wheezing for 4 months. She was a non-smoker, and did not have past histories of asthma or allergy. On physical examination, no stridor, wheezing and cyanosis were present and the general appearance was good. The results of the laboratory analysis, including blood eosinophils count, immunoglobulin E level and chest X-ray were normal. Spirometry revealed reversible airflow obstruction, and post-bronchodilator forced expiratory volume in one second (FEV1) showed an increase of 12% and 230 mL from baseline. Bronchial asthma was diagnosed, however, she responded poorly despite the adequate anti-asthma therapy including high dose inhaled corticosteroid plus long-acting beta2-agonist, theophylline and montelukast. Then chest computed tomography (CT) was performed which showed a polypoid mass occupying the lumen of left main bronchus. Then the bronchoscopy revealed a polypoid endo-bronchial mass arising from the left main bronchus, causing subtotal obstruction of the lumen. Biopsy was carried out through the bronchoscopy, the pathological findings showed characteristic cribriform and tubular pattern which was formed by two-layered cells with ductal and myoepithelial phenotypes, which were consistent with adenoid cystic carcinoma. Re-examining the patient, the lung was clear without any wheeze when she was seated. However, inspiratory wheeze was heard in her left upper lung when she was supine, and disappeared after sitting up again. Subsequently the patient underwent a resection surgery. At the operational site, the tumor was seen on the anterolateral wall of the left main bronchus, without submucosally expanding histologically. Therefore, a sleeve resection surgery of the left main bronchus was performed. Following surgery, chest CT scan revealed complete resolution of the tumor. Her symptoms improved significantly, as did her pulmonary function tests, although all the medicines for asthma were stopped. Now, two years after the operation, the patient remained asymptomatic, and spirometry was performed again which showed normal completely. The presenting case report emphasizes the fact that not all wheezes and reversible airflow obstruction are asthma. It is critical to bear in mind that if a "difficult asthma" patient does not respond to appropriate anti-asthma therapy; localized obstructions should be differentiated.

PMID: 29643544 [PubMed - indexed for MEDLINE]

Serum Cortisol Levels via Radioimmunoassay vs Liquid Chromatography Mass Spectrophotometry in Healthy Control Subjects and Patients With Adrenal Incidentalomas.

Tue, 10/23/2018 - 18:42
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Serum Cortisol Levels via Radioimmunoassay vs Liquid Chromatography Mass Spectrophotometry in Healthy Control Subjects and Patients With Adrenal Incidentalomas.

Lab Med. 2018 Jul 05;49(3):259-267

Authors: Huayllas MKP, Netzel BC, Singh RJ, Kater CE

Abstract
Background: Adrenal incidentalomas (AIs) are present in 4% of adults. As many as 30% may secrete cortisol autonomously in the absence of specific signs of overt hypercortisolism, in a phenomenon called subclinical hypercortisolism (SH). Diagnosis of SH is established by serum cortisol resistance to dexamethasone suppression.
Methods: We compared serum cortisol concentrations, as determined by radioimmunoassay (RIA) and liquid chromatography/tandem mass spectronomy (LC/MS-MS), in 73 patients with AI group (52 with unilateral AI) and 34 control subjects in 3 scenarios: basal; after 1-mg dexamethasone suppression; and after 0.25-mg stimulation with cosyntropin, a synthetic derivative of adrenocorticotropic hormone (ACTH). To bolster evidence for the diagnosis of SH, we also measured salivary cortisol levels at 11 PM and after DST, as well as plasma ACTH and serum dehydroepiandrosterone sulfate (DHEA-S) levels.
Results: We observed significant positive correlation (r = 0.9345, P <.001) for all 318 pairs of serum cortisol values, as measured by both methods.
Conclusions: Serum cortisol concentrations in patients with AI and in control subjects were very similar, as measured by RIA and LC/MS-MS.

PMID: 29608696 [PubMed - indexed for MEDLINE]

A rare cause of chronic ataxia in childhood: ganglioneuroma.

Tue, 10/23/2018 - 18:42
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A rare cause of chronic ataxia in childhood: ganglioneuroma.

World J Pediatr. 2018 04;14(2):204-206

Authors: Arslan EA, Kamaşak T, Turgut BD, Saygın İ, Sarıhan H, Cansu A

PMID: 29532434 [PubMed - indexed for MEDLINE]

The penetrance of MEN2 pheochromocytoma is not only determined by RET mutations.

Tue, 10/23/2018 - 18:42
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The penetrance of MEN2 pheochromocytoma is not only determined by RET mutations.

Endocr Relat Cancer. 2017 08;24(8):L63-L67

Authors: Castinetti F, Maia AL, Peczkowska M, Barontini M, Hasse-Lazar K, Links TP, Toledo RA, Dvorakova S, Mian C, Bugalho MJ, Zovato S, Alevizaki M, Kvachenyuk A, Bausch B, Loli P, Bergmann SR, Patocs A, Pfeifer M, Costa JB, von Dobschuetz E, Letizia C, Valk G, Barczynski M, Czetwertynska M, Plukker JTM, Sartorato P, Zelinka T, Vlcek P, Yaremchuk S, Weryha G, Canu L, Wohllk N, Sebag F, Walz MK, Eng C, Neumann HPH

PMID: 28649091 [PubMed - indexed for MEDLINE]

SDHB mutation carriers with malignant pheochromocytoma respond better to CVD.

Tue, 10/23/2018 - 18:42
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SDHB mutation carriers with malignant pheochromocytoma respond better to CVD.

Endocr Relat Cancer. 2017 08;24(8):L51-L55

Authors: Fishbein L, Ben-Maimon S, Keefe S, Cengel K, Pryma DA, Loaiza-Bonilla A, Fraker DL, Nathanson KL, Cohen DL

PMID: 28566531 [PubMed - indexed for MEDLINE]

KIF1B and NF1 are the most frequently mutated genes in paraganglioma and pheochromocytoma tumors.

Tue, 10/23/2018 - 18:42
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KIF1B and NF1 are the most frequently mutated genes in paraganglioma and pheochromocytoma tumors.

Endocr Relat Cancer. 2017 08;24(8):L57-L61

Authors: Evenepoel L, Helaers R, Vroonen L, Aydin S, Hamoir M, Maiter D, Vikkula M, Persu A

PMID: 28515046 [PubMed - indexed for MEDLINE]

StatPearls

Tue, 10/23/2018 - 18:42
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StatPearls

Book. 2018 01

Authors:

Abstract
In 1969, a remarkable cancer predisposition syndrome was reported by Li and Fraumeni.[1] Li-Fraumeni syndrome (LFS) is an inherited autosomal dominant disorder that is usually associated with abnormalities in the tumor suppressor protein P53 gene (TP53) located on chromosome 17p13.[2] It is also known as the sarcoma, breast, leukemia, and adrenal gland (SBLA) cancer syndrome. LFS variants include LFS1, LFS2, LFSL. LFS1 is associated with mutations in TP53, tumor suppressor gene. LFS2 is associated with mutations in CHEK2 (checkpoint kinase two), a tumor suppressor gene. LFS-L  are individuals that do not have detectable mutations in P53.


PMID: 30335319

adrenal tumor; +23 new citations

Tue, 10/16/2018 - 18:02

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 2018/10/16

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; +32 new citations

Tue, 10/09/2018 - 17:52

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 2018/10/09

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.

Robotic Adrenalectomy: Are We Expanding the Indications of Minimally Invasive Surgery?

Tue, 10/02/2018 - 15:14
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Robotic Adrenalectomy: Are We Expanding the Indications of Minimally Invasive Surgery?

J Laparoendosc Adv Surg Tech A. 2018 Sep 28;:

Authors: Quadri P, Esposito S, Coleoglou A, Danielson KK, Masrur M, Giulianotti PC

Abstract
INTRODUCTION: Laparoscopic adrenalectomy (LA) is accepted as the gold standard treatment for most adrenal pathologies. Open surgery is still considered the standard of care for large tumors and malignancies. In the past decade, robotic adrenalectomy (RA) has become an alternative to the laparoscopic and open approaches. The aim of this study was to analyze perioperative and postoperative outcomes in a series of consecutive nonselected patients undergoing a RA, to determine whether factors that negatively affect outcomes in LA (body mass index [BMI], size, and side of the tumor) have the same impact in RA.
MATERIALS AND METHODS: This is a single-center single-surgeon retrospective study with 43 patients who underwent a RA. Patients were divided into different groups according to tumor size (cutoff values of 5 or 8 cm), tumor side (left/right), and BMI (cutoff value of kg/m2). Perioperative and postoperative outcomes included operative time, length of hospital stay, blood loss, readmissions, complications, and conversions to open.
RESULTS: There were no significant differences between the groups with tumors <5 cm versus ≥5 cm regarding gender, age, race, BMI, American Society of Anesthesiologists (ASA) score, history of previous abdominal surgery, tumor side, and histopathological diagnosis (all P values ≥.06). There were no significant differences in any of the outcomes analyzed with respect to the tumor size (all P values ≥.14) except for a higher occurrence of complications in patients with tumors ≥8 cm versus <8 cm (P = .03). There were no significant differences in any outcomes related to side (left versus right) of the tumor nor BMI (<30 versus ≥30 kg/m2). The overall readmission and conversion rates were both 2.3% and no mortalities were registered.
CONCLUSION: Patient's BMI, tumor side, and size did not demonstrate a negative impact on perioperative and postoperative outcomes of RA. This approach could potentially expand the indications of minimally invasive surgery.

PMID: 30265584 [PubMed - as supplied by publisher]

Pheochromocytoma Secreting Large Quantities of Both Epinephrine and Norepinephrine Presenting with Episodes of Hypotension and Severe Electrolyte Imbalance.

Tue, 10/02/2018 - 15:14
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Pheochromocytoma Secreting Large Quantities of Both Epinephrine and Norepinephrine Presenting with Episodes of Hypotension and Severe Electrolyte Imbalance.

Cureus. 2018 Jul 25;10(7):e3050

Authors: Shahbaz A, Aziz K, Fransawy Alkomos M, Nabi U, Zarghamravanbakhsh P, Sachmechi I

Abstract
Pheochromocytoma is a rare tumor usually arising from the adrenal medulla (strictly speaking, those arising outside the adrenal gland are called paragangliomas). We report a case of pheochromocytoma presenting as orthostatic hypotension and electrolyte imbalance. A 51-year-old woman was admitted because of vomiting and chest pain. She had fluctuating blood pressure (BP) with episodes of orthostatic hypotension. Computed tomography pulmonary angiogram was performed to rule out pulmonary embolism; it showed a clear chest, but an incidental right suprarenal mass. The biochemical analysis supports the diagnosis of pheochromocytoma. Her electrolyte panel revealed persistently low potassium, calcium, and magnesium levels despite aggressive replacement. We speculated that hypotension was mainly due to vasodilatation caused by excess plasma epinephrine and prescribed doxazosin and a nonselective beta-adrenergic blocker which stabilized BP. The right adrenal tumor excised, and postoperatively she remained hemodynamically stable with no hypotensive episode. Laboratory data taken six weeks after surgery show normal 24-hour urine metanephrine and normetanephrine and normal serum magnesium and calcium levels. This case report highlights the variable presentation of pheochromocytoma. We also discuss the probable mechanisms of electrolyte imbalance in our case.

PMID: 30263879 [PubMed]

[Minimally invasive surgery of neural tumors in childhood].

Tue, 10/02/2018 - 15:14
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[Minimally invasive surgery of neural tumors in childhood].

Cir Pediatr. 2018 Aug 03;31(3):140-145

Authors: Crehuet Gramatyka D, Gómez-Chacón Villalba J, Cortés Sáez J, Marco Macián A, Vila Carbó JJ

Abstract
PURPOUSE: The aim of the paper is to describe the experience in our center with the use of minimally invasive surgery (MIS) of neural tumors in childhood.
METHODS: Descriptive and retrospective study of patients diagnosed with neural neoplasia (neuroblastoma and neuroganglioma) on whom MIS technique surgery has been performed between October 2012 and December 2017. The inclusion criteria were patients with a neural tumor diagnosis who, at the time of the intervention, did not have imaging-defined risk factors (IDRFs). Patients with a different diagnosis than neural tumor or with IDRFs were excluded from the study.
RESULTS: The study comprises 19 cases (6 female and 13 male) with a median age of 47 months. According to the International Neuroblastoma Risk Group Staging System (INRGSS) classification, nine cases were in L1 stage, six in L2, two in M and two in MS. Laparoscopy was used in 14 patients (12 adrenal and 2 abdominal tumors) and thoracoscopy was used in the other 5. In 4 of the 19 cases (21%), conversion to open surgery was needed due to fibrosis in 2 cases and vascular structures entrapment in another 2 (3 in laparoscopy and 1 in thoracoscopy). There were no surgical complications, achieving complete resection in all cases. Three cases showed postsurgical adverse effects grade I and II, according to Clavien-Dindo classification. After a median of 27 months of follow up, two patients showed disease progression without local recurrence.
CONCLUSIONS: In conclusion, MIS are useful techniques in the surgical exeresis of non-disseminated neural tumors without IDRFs.

PMID: 30260107 [PubMed - in process]

Multiple Endocrine Neoplasia Type 1: A Case Report With Review of Imaging Findings.

Tue, 10/02/2018 - 15:14
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Multiple Endocrine Neoplasia Type 1: A Case Report With Review of Imaging Findings.

Ochsner J. 2018;18(2):170-175

Authors: Keller HR, Record JL, Lall NU

Abstract
Background: Multiple endocrine neoplasia type 1 (MEN1) is a rare, autosomal dominant inherited syndrome caused by mutations in the MEN1 tumor suppressor gene. The diagnosis is defined clinically by the presence of 2 or more primary MEN1 tumors (parathyroid, anterior pituitary, and pancreatic islet). We describe the case of a patient who presented with classic history and imaging findings for MEN1.
Case Report: A male in his early thirties with a history of hyperparathyroidism and a transsphenoidal prolactinoma resection presented years later with abdominal symptoms concerning for Zollinger-Ellison syndrome: worsening epigastric abdominal pain, nausea, vomiting, and diarrhea. Contrast-enhanced computed tomography (CT) of the abdomen revealed hyperenhancing pancreatic lesions and duodenal inflammation, suggesting pancreatic neuroendocrine tumor (gastrinoma) with secondary duodenitis. Bilateral indeterminate hypoattenuating adrenal nodules were also seen on contrast-enhanced CT, and follow-up magnetic resonance imaging confirmed benign adrenal adenomas. Furthermore, thyroid ultrasound and sestamibi scintigraphy revealed a parathyroid adenoma. With confirmatory imaging findings, history, and presenting symptoms, the patient was clinically diagnosed with MEN1 syndrome and underwent surgical and medical management.
Conclusion: This case exhibits the classic history with corresponding imaging findings of MEN1 syndrome, including pancreatic neuroendocrine tumors, parathyroid adenoma, and adrenal adenomas. High clinical suspicion for MEN1 should lead to endocrinology evaluation with appropriate laboratory workup and targeted imaging evaluation of the typical endocrine organs as described for this patient.

PMID: 30258300 [PubMed]

MAPK/ERK pathway inhibition is a promising treatment target for adrenocortical tumors.

Tue, 10/02/2018 - 15:14
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MAPK/ERK pathway inhibition is a promising treatment target for adrenocortical tumors.

J Cell Biochem. 2018 Sep 06;:

Authors: Pereira SS, Monteiro MP, Costa MM, Ferreira J, Alves MG, Oliveira PF, Jarak I, Pignatelli D

Abstract
Unraveling molecular mechanisms that regulate tumor development and proliferation is of the utmost importance in the quest to decrease the high mortality rate of adrenocortical carcinomas (ACC). Our aim was to evaluate the role of two of the mitogen-activated protein kinase (MAPK) signaling pathways (extracellular signal-regulated protein kinases [ERKs 1/2] and p38) in the adrenocortical tumorigenesis, as well as the therapeutic potential of MAPK/ERK inhibition. ERKs 1/2 and p38 activation were evaluated in incidentalomas (INC; n = 10), benign Cushing's syndrome (BCS; n = 12), malignant Cushing's syndrome (MCS; n = 6) and normal adrenal glands (NAG; 8). ACC cell line (H295R) was used to evaluate the ability of PD184352 (0.1, 1, and 10 µM), a specific MEK-MAPK-ERK pathway inhibitor, to modulate cell proliferation, viability, metabolism, and steroidogenesis. ERKs 1/2 activation was significantly higher in MCS (2.83 ± 0.17) compared with NAG (1.00 ± 0.19 "arbitrary units"), INC (1.20 ± 0.13) and BCS (2.09 ± 0.09). Phospho-p38 expression was absent in all the MCS analyzed. MAPK/ERK kinase (MEK) inhibition with PD184352 significantly decreased proliferation as well as steroidogenesis and also increased the redox state of the H295R cells. This data suggests that MEK-MAPK-ERK signaling has a role in adrenocortical tumorigenesis that could be potentially used as a diagnostic marker for malignancy and targeted treatment in ACC.

PMID: 30256438 [PubMed - as supplied by publisher]

Multiple endocrine neoplasia-like syndrome in 24 baboons (Papio spp.).

Tue, 10/02/2018 - 15:14
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Multiple endocrine neoplasia-like syndrome in 24 baboons (Papio spp.).

J Med Primatol. 2018 Sep 06;:

Authors: Confer A, Owston MA, Kumar S, Dick EJ

Abstract
Multiple endocrine neoplasia (MEN) has not been reported in baboons, but this condition is well described in humans. An internal database was searched for all cases of concurrent endocrine hyperplasia and neoplasia in baboons. Twenty-four baboons (Papio spp.) with concurrent endocrine hyperplasia and neoplasia were identified. Twenty-one baboons had lesions in two endocrine organs, two baboons had lesions in three organs, and one baboon had lesions in four organs. Ten baboons aligned with the MEN1 classification; 14 baboons did not match any current human MEN classification. We report 24 cases of MEN-like syndrome in baboons. MEN1-like lesions accounted for nearly half (41%) of the affected animals. Genetic analysis of baboons with MEN-like syndrome could further elucidate the mechanisms of MEN and support the use of baboons as animal models for human MEN.

PMID: 30256416 [PubMed - as supplied by publisher]

Does Urinary Tract Ultrasound Have Its Place in the Treatment of Early Neonatal Jaundice? Neonatal Bilateral Adrenal Hemorrhage: Case Report.

Tue, 10/02/2018 - 15:14
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Does Urinary Tract Ultrasound Have Its Place in the Treatment of Early Neonatal Jaundice? Neonatal Bilateral Adrenal Hemorrhage: Case Report.

Acta Clin Croat. 2018 Mar;57(1):161-165

Authors: Trutin I, Valent Morić B, Borošak J, Stipančić G

Abstract
Adrenal hemorrhage is a rare clinical entity in the neonatal period, with an incidence of 1.7-2.1/1000 births. It is more often diagnosed on the right side, whilst bilateral hemorrhage occurs in 10%-15% of cases. Clinical presentation shows a wide range of symptoms, from the signs of adrenal insufficiency to asymptomatic course of illness with incidental finding of changes on testing. Neonatal jaundice due to hemolysis of hemorrhagic content often is an accompanying sign. We present a male neonate born at term, with early neonatal jaundice of unknown cause and without evi-dence of perinatal infection. Ultrasound of the urinary tract revealed hypoechoic formations in the upper poles of both kidneys, confirmed by magnetic resonance imaging of the abdomen. Clinical and laboratory test results showed no signs of adrenal insufficiency. There was no confirmation of em-bryonic tumor or neuroblastoma. Ultrasound of the urinary tract as an available and noninvasive test has its place in the treatment of early neonatal jaundice of unknown cause. Additional invasive treat-ment and unnecessary laparotomy can be avoided with ultrasound monitoring of the formation re-gression.

PMID: 30256026 [PubMed - in process]

Circulating epinephrine is not required for chronic stress to enhance metastasis.

Tue, 10/02/2018 - 15:14
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Circulating epinephrine is not required for chronic stress to enhance metastasis.

Psychoneuroendocrinology. 2018 Sep 15;99:191-195

Authors: Walker AK, Martelli D, Ziegler AI, Lambert GW, Phillips SE, Hill SJ, McAllen RM, Sloan EK

Abstract
Signaling through β-adrenergic receptors drives cancer progression and β-blockers are being evaluated as a novel therapeutic strategy to prevent metastasis. Orthotopic mouse models of breast cancer show that β-adrenergic signaling induced by chronic stress accelerates metastasis, and that β2-adrenergic receptors on tumor cells are critical for this. Endogenous catecholamines are released during chronic stress: norepinephrine from the adrenal medulla and sympathetic nerves, and epinephrine from the adrenal medulla. β2-adrenergic receptors are much more sensitive to epinephrine than to norepinephrine. To determine if epinephrine is necessary in the effects of stress on cancer progression, we used a denervation strategy to eliminate circulating epinephrine, and quantified the effect on metastasis. Using both human xenograft and immune-intact murine models of breast cancer, we show that circulating epinephrine is dispensable for the effects of chronic stress on cancer progression. Measured levels of circulating norepinephrine were sufficiently low that they were unlikely to influence β2-adrenergic signaling, suggesting a possible role for norepinephrine release from sympathetic nerve terminals.

PMID: 30253326 [PubMed - as supplied by publisher]

Current Standards and Recent Advances in Biomarkers of Major Endocrine Tumors.

Tue, 10/02/2018 - 15:14
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Current Standards and Recent Advances in Biomarkers of Major Endocrine Tumors.

Front Pharmacol. 2018;9:963

Authors: Luo Y, Zhu H, Tan T, He J

Abstract
The complexity of endocrine tumor diagnosis stems from its variable symptoms and presentation that may mimic many other disease states, or display asymptomatic properties for a prolonged amount of time. Early and accurate disease identification is needed for better patient prognosis. The key to this may be in using validated biomarkers with enhanced sensitivity and specificity. Several biomarkers are consistently used across various endocrine tumor types, possibly indicating a deeper pathophysiological mechanism behind endocrine cancer genesis and development. For example, carbohydrate antigen (CA) is measured in both pancreatic adenocarcinoma as well as ovarian cancer for diagnosis, surveillance, and risk stratification. The discovery of measuring miRNAs that are highly expressed in malignant tumors is also a novel strategy across multiple endocrine tumor types, and is propelling the future advancement of biomarker development. This review introduces currently utilized biomarkers in some of the commonly known endocrine tumors, including thyroid, adrenal, pituitary, pancreatic, and gonadal carcinoma, as well as future research directions.

PMID: 30250431 [PubMed]

Genomic insights into Cushing syndrome.

Tue, 10/02/2018 - 15:14
Related Articles

Genomic insights into Cushing syndrome.

Ann Endocrinol (Paris). 2018 Jun;79(3):119-122

Authors: Assié G

Abstract
In the setting of Cushing syndrome, genomic analyses can be performed either in tumors responsible for endogenous Cushing, or in patients exposed to glucocorticoid excess. Genomics of tumors identified several new genes - including ZNRF3 in adrenocortical carcinomas, PRKACA in cortisol-producing adrenal adenomas, ARMC5 in primary macronodular adrenal hyperplasia and USP8 in pituitary corticotroph adenomas. These genes shed new lights on the mechanisms responsible for these tumors. Integrated genomic studies of adrenal carcinomas identified distinct molecular classes, with remarkably different prognostic outcome. Beyond the mechanistic novelties, a new generation of prognostic markers emerges, with potentially important impact on patients care. For the future, genomic efforts should be pursued, focusing on poorly characterized tumors responsible for Cushing syndrome - including endocrine tumors secreting ACTH. In addition, epigenomics is emerging as an outstanding set of tools for characterizing tumors, unraveling unprecedented aspects of tumorigenesis. Applying these tools to endocrine tumors responsible for Cushing syndrome may also lead to important discoveries. Genomics of patients exposed to glucocorticoid excess is an emerging research field. Proof of principle studies have been performed, identifying molecular markers of glucocorticoid excess in blood. Research efforts should now concentrate on markers of mild glucocorticoid excesses - endogenous or exogenous -, owing to their high prevalence in general population. In addition, markers of individual susceptibility to each type of glucocorticoid complication are needed. It remains to be determined whether genomics can identify such markers.

PMID: 29735160 [PubMed - indexed for MEDLINE]

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