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NCBI: db=pubmed; Term=adrenal tumor
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Mutation screening in a Norwegian cohort with pheochromocytoma.

Fri, 05/23/2014 - 08:40
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Mutation screening in a Norwegian cohort with pheochromocytoma.

Fam Cancer. 2013 Sep;12(3):529-35

Authors: Sjursen W, Halvorsen H, Hofsli E, Bachke S, Berge A, Engebretsen LF, Falkmer SE, Falkmer UG, Varhaug JE

Abstract
Pheochromocytomas (PHEOs) are neuroendocrine tumours, originating from chromaffin cells in the adrenal medulla. They are either sporadic or hereditary. It is important to identify the hereditary cases, so that patients and relatives with germline mutations can be offered regular surveillance. The objective of this study was the detection of pathogenic germline mutations in a cohort of Norwegian PHEO patients. Blood samples and/or formalin-fixed, paraffin-embedded tissue specimens, were collected from 60 patients who were operated upon between 1986 and 2004 at two university hospitals in Norway. DNA mutation analyses were performed successfully in the 42 blood samples and in one of the paraffin-embedded tissue specimen in VHL, RET, SDHB, SDHC, SDHD and NF1. In all, 32 different DNA variants were observed, of which 8 were classified as pathogenic (19 %), or possibly pathogenic; three in NF1, two in RET and VHL and one in SDHB. Two variants were observed in one patient, one in SDHB and one in NF1. Three of these variants are, to the best of our knowledge, new ones; two in NF1 [c.950_51insGCTGA, (p.Glu318LeufsX59) and c.1588G > A, (p.Val530Ile)] and one in VHL (c.308C > T, p.Pro103Leu). In conclusion the overall incidence of germline mutations in genes associated with familial PHEO was found to be of the same order of magnitude in the present Norwegian series as in those from other countries. Two new NF1 variants and one new VHL gene variant were detected.

PMID: 23407919 [PubMed - indexed for MEDLINE]

From the Radiologic Pathology Archives: Adrenal Tumors and Tumor-like Conditions in the Adult: Radiologic-Pathologic Correlation.

Wed, 05/14/2014 - 11:15
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From the Radiologic Pathology Archives: Adrenal Tumors and Tumor-like Conditions in the Adult: Radiologic-Pathologic Correlation.

Radiographics. 2014 May-Jun;34(3):805-29

Authors: Lattin GE, Sturgill ED, Tujo CA, Marko J, Sanchez-Maldonado KW, Craig WD, Lack EE

Abstract
Advanced imaging often reveals adrenal tumors and tumor-like conditions in both symptomatic and asymptomatic patients. When adrenal disease is clinically suspected, cross-sectional imaging can be helpful in evaluating the etiology of the patient's symptoms. When adrenal disease is incidentally identified, what the clinician and patient really want to know is whether the findings are benign or malignant, as this ultimately will affect their next step in management. Using radiologic-pathologic correlation, we broadly classify common, uncommon, and rare tumors and tumor-like conditions that can occur in the adrenal as benign or malignant. This classification follows predominant trends in observed biologic behavior while acknowledging those tumors that may behave in the minority in an unpredictable manner. We review the clinical background and presentation of functional adrenal tumors including Conn syndrome, Cushing syndrome, and catecholamine-secreting tumors, as well as their relationship with adrenal anatomy. We discuss a variety of benign tumors, including adrenal cortical adenoma (including oncocytoma) and pheochromocytoma, as well as uncommonly and rarely encountered tumors such as myelolipoma, hemangioma, lymphangioma, schwannoma, ganglioneuroma, and adenomatoid tumor. A variety of tumefactive but nonneoplastic lesions are addressed, including adrenal cortical hyperplasia, adrenal hemorrhage, adrenal cysts, and infections. Malignant tumors discussed include adrenal cortical carcinoma, the rare malignant pheochromocytoma, lymphoma, metastases, and sarcomas. For each tumor and tumor-like lesion, the clinical presentation, epidemiology, key imaging findings, diagnostic differential considerations, and management options are briefly addressed. Finally, an approach to the workup of suspected or incidentally discovered tumors is presented based on a selected literature survey and our clinical experience. Radiologists play an important role in identification and diagnosis of adrenal tumors and tumor-like conditions in both symptomatic and asymptomatic patients. ©RSNA, 2014.

PMID: 24819798 [PubMed - in process]

Adrenal incidentalomas: should we operate on small tumors in the era of laparoscopy?

Wed, 05/14/2014 - 11:15
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Adrenal incidentalomas: should we operate on small tumors in the era of laparoscopy?

Int J Endocrinol. 2014;2014:658483

Authors: Pędziwiatr M, Natkaniec M, Kisialeuski M, Major P, Matłok M, Kołodziej D, Zub-Pokrowiecka A, Budzyński P, Budzyński A

Abstract
Tumor size smaller than 4 cm as an indication for surgical treatment of incidentaloma is still a subject of discussion. Our aim was the estimation of the incidence of malignancy and analysis of treatment outcomes in patients with incidentaloma smaller than 4 cm in comparison to bigger lesions. 132 patients who underwent laparoscopic adrenalectomy for nonsecreting tumors were divided into two groups: group 1 (55 pts., size < = 40 mm) and group 2 (77 pts., size > 40 mm). Operation parameters and histopathological results were analyzed. No differences in group characteristics, mean operation time, and estimated blood loss were noted. Complications in groups 1 and 2 occurred in 3.6% and 5.2% of patients, respectively (P = 0.67). Malignancy in groups 1 and 2 was present in 1 and 6 patients, respectively (P = 0.13). Potentially malignant lesions were identified in 4 patients in group 1 and 4 patients in group 2 (P = 0.39). The results do not allow for straightforward recommendations for surgical treatment of smaller adrenal tumors. The safety of laparoscopy and minimal, but impossible to omit, risk of malignancy support decisions for surgery. On the other hand, the risk of malignancy in smaller adrenal tumors is lower than surgical complications, which provides an important argument against surgery.

PMID: 24817886 [PubMed]

Effects of fatigue from sleep deprivation on experimental periodontitis in rats.

Wed, 05/14/2014 - 11:15
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Effects of fatigue from sleep deprivation on experimental periodontitis in rats.

J Periodontal Res. 2014 May 12;

Authors: Nakada T, Kato T, Numabe Y

Abstract
BACKGROUND AND OBJECTIVE: Factors such as vascularization of the periodontium, inflammatory reactions and immune response affect the oral environment and ecology, decreasing host resistance and promoting the development of symptoms and the advancement of periodontal disease. Fatigue also influences the hypothalamic-pituitary-adrenal axis and reports relate it to systemic resistance. The aim of this study was to evaluate whether fatigue is a modifying factor for periodontal disease in rats.
MATERIAL AND METHODS: We divided 24 3-wk-old male Sprague-Dawley rats randomly into the following four groups: control; fatigue (deep sleep deprivation for 7 d); infection (rats inoculated with carboxymethyl cellulose containing periodontopathic bacteria); and compound (combined fatigue and infection conditions). Weight, serum corticosterone levels, serum albumin levels, interleukin-1β and tumor necrosis factor-α expression levels and distance from the cement-enamel junction to the alveolar bone crest were measured at baseline, and on the 36th (before sleep deprivation), 43rd (immediately after sleep deprivation) and 57th d (end of experiment).
RESULTS: Immediately after sleep deprivation and at the end of the experiment, weight gain in the fatigue and compound groups was significantly lower than in controls (p < 0.05). Immediately after sleep deprivation, serum corticosterone levels were significantly higher in the fatigue and compound groups than in controls (p < 0.05). Moreover, serum albumin levels were significantly lower in the fatigue and compound groups than in controls (p < 0.05). Immediately after sleep deprivation, gene expression of interleukin-1β was significantly higher in the infection and compound groups than in controls (p < 0.05). Moreover, gene expression of tumor necrosis factor-α was significantly higher in the compound group than in controls (p < 0.05). At the end of the experiment, the distance from the cement-enamel junction to the alveolar bone crest was significantly higher in the infection and compound groups than in controls (p < 0.05). Moreover, the distance was significantly higher in the compound group than in the infection group.
CONCLUSIONS: Fatigue worsened systemic health in rats and increased gingival inflammation and alveolar bone loss in experimental periodontitis. In conclusion, our results suggest that fatigue is a modifying factor for periodontal disease in rats.

PMID: 24815330 [PubMed - as supplied by publisher]

Lichen striatus associated with etanercept treatment of rheumatoid arthritis.

Wed, 05/14/2014 - 11:15
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Lichen striatus associated with etanercept treatment of rheumatoid arthritis.

J Am Acad Dermatol. 2014 Apr;70(4):e90-2

Authors: Lora V, Kanitakis J, Latini A, Cota C

PMID: 24629374 [PubMed - indexed for MEDLINE]

Psoriasiform reactions to anti-tumor necrosis factor α therapy.

Wed, 05/14/2014 - 11:15
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Psoriasiform reactions to anti-tumor necrosis factor α therapy.

J Clin Rheumatol. 2013 Oct;19(7):377-81

Authors: Nguyen K, Vleugels RA, Velez NF, Merola JF, Qureshi AA

Abstract
OBJECTIVE: Given increasing concern about the adverse effects of anti-tumor necrosis factor α (anti-TNF-α) medications, we sought to characterize psoriasiform eruptions in patients on these medications.
METHODS: In a retrospective review of patients at the Brigham and Women's Hospital combined dermatology-rheumatology clinic, we identified 13 patients (1 male and 12 female patients) who developed psoriasiform eruptions while on anti-TNF-α medications.
RESULTS: Inciting medications were adalimumab, etanercept, and infliximab. Patients were on their inciting medication for a median time of 24 months and a mean time of 31.3 months before developing eruptions. Five of 7 patients experienced complete resolution of lesions with topical corticosteroids and discontinuation of anti-TNF-α medications with the remaining 2 patients having partial improvement. One of the other 6 patients experienced complete resolution with topical corticosteroid treatment only, with the remaining 5 patients experiencing partial improvement. After changing anti-TNF-α agents, 1 patient had partial improvement of psoriasiform lesions, and 7 patients had no improvement.
CONCLUSIONS: All of the main anti-TNF-α medications currently used are capable of causing psoriasiform eruptions. Poor responders to topical agents, such as corticosteroids, may benefit from supplemental therapy aimed at the psoriasiform eruption or changing to a different class of immunomodulatory agents. Switching anti-TNF-α medications had a low likelihood of improving psoriasiform skin reactions, further suggesting that these eruptions are a drug class effect.

PMID: 24048106 [PubMed - indexed for MEDLINE]

IgG4 related pseudotumour (calcifying fibrous tumour) of adrenal gland.

Wed, 05/14/2014 - 11:15
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IgG4 related pseudotumour (calcifying fibrous tumour) of adrenal gland.

Pathology. 2013 Aug;45(5):519-21

Authors: Lynnhtun K, Achan A, Lam V

PMID: 23842043 [PubMed - indexed for MEDLINE]

Oncocytic adrenocortical carcinoma in a putty-nosed monkey (Cercopithecus nictitans) with hyperadrenocorticism.

Wed, 05/14/2014 - 11:15
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Oncocytic adrenocortical carcinoma in a putty-nosed monkey (Cercopithecus nictitans) with hyperadrenocorticism.

J Comp Pathol. 2013 Nov;149(4):509-13

Authors: Gruber-Dujardin E, Jurczynski K, Kaup FJ, Mätz-Rensing K

Abstract
Oncocytic adrenocortical tumours are rare in man and have never been described in non-human primates. An oncocytic adrenocortical carcinoma was identified in an 18-year-old female putty-nosed monkey (Cercopithecus nictitans) with hyperadrenocorticism and invasive aspergillosis. Microscopically, the tumour consisted of large cells with abundant eosinophilic, granular cytoplasm containing numerous mitochondria as identified by electron microscopy. Tumour cells had large nuclei with occasional intranuclear cytoplasmic pseudoinclusions. Immunohistochemically, tumour cells expressed vimentin, synaptophysin and neuron-specific enolase, while they were negative for cytokeratin, chromogranin-A, melan-A and S100.

PMID: 23746483 [PubMed - indexed for MEDLINE]

Long-term outcome of primary endocrine non-Hodgkin lymphomas: does the site make the difference?

Wed, 05/14/2014 - 11:15
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Long-term outcome of primary endocrine non-Hodgkin lymphomas: does the site make the difference?

QJM. 2013 Jul;106(7):623-30

Authors: Hatjiharissi E, Diamantidis MD, Papaioannou M, Dimou T, Chrisoulidou A, Patakiouta F, Constantinou N, Pazaitou-Panayiotou K

Abstract
AIM: Primary lymphomas of endocrine glands are extremely rare. Our study adds more data to the few published series regarding the incidence, clinical characteristics, management and overall survival (OS) by comparing the various diffuse large B-cell endocrine lymphomas. Moreover, it contributes to a better understanding of these neoplasms and provides concepts for future research.
METHODS: We retrospectively evaluated the clinical profile and the patterns of outcome among patients who were treated in our center with the diagnosis of aggressive, B-cell, primary endocrine lymphoma.
RESULTS: Between May 1980 and December 2011, 450 patients were diagnosed as primary extranodal non-Hodgkin lymphomas. Among them, 18 cases (4%) were primary testicular lymphoma (PTL), 8 cases (2%) were primary thyroid lymphoma (PTHL) and 4 cases (1%) were primary adrenal lymphoma (PAL). The therapeutic approaches employed were variable, including mainly chemotherapy in combination with radiotherapy and surgery. The median OS for the patients with PTL and PAL was 27 and 6 months, respectively. Better outcome was observed in patients with PTHL for whom the median OS has not been reached yet, whereas the PAL group had the worst prognosis.
CONCLUSIONS: The discrepancies in the outcome among endocrine lymphomas could be partly attributed to their biologic variability, which might be determined by the initial site involved. We conclude that treatment decisions should be made according to a multi-disciplinary approach to avoid unnecessary surgery. Existing treatment strategies for PTL and PAL fail to provide long-term survival, rendering the application of novel therapeutic approaches essential.

PMID: 23426729 [PubMed - indexed for MEDLINE]

Medical image. Adrenocortical carcinoma presenting with hirsutism: an uncommon cause of a common complaint.

Wed, 05/14/2014 - 11:15
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Medical image. Adrenocortical carcinoma presenting with hirsutism: an uncommon cause of a common complaint.

N Z Med J. 2014 Mar 7;127(1390):70-2

Authors: Syed AA, Demssi YN

PMID: 24670593 [PubMed - indexed for MEDLINE]

High affinity of 18F-FDG in rare tumors. Initial study and monitoring by PET/CT in a case of adrenal adenocarcinoma.

Wed, 05/14/2014 - 11:15
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High affinity of 18F-FDG in rare tumors. Initial study and monitoring by PET/CT in a case of adrenal adenocarcinoma.

Rev Esp Med Nucl Imagen Mol. 2013 Jul-Aug;32(4):266-8

Authors: González Escalante M, Miranda J, Soler M, Moragas M, Riera E, García JR

PMID: 23218516 [PubMed - indexed for MEDLINE]

Diagnosis and management of pheochromocytoma: a practical guide to clinicians.

Wed, 05/07/2014 - 10:01

Diagnosis and management of pheochromocytoma: a practical guide to clinicians.

Curr Hypertens Rep. 2014 Jul;16(7):442

Authors: Pappachan JM, Raskauskiene D, Sriraman R, Edavalath M, Hanna FW

Abstract
Pheochromocytomas (PCCs) are rare catecholamine producing neuroendocrine tumors. The majority of these tumors (85 %) arise from the adrenal medulla. Those arising from the extra-adrenal neural ganglia are called paragangliomas (PGLs). Paroxysmal hypertension with sweating, headaches and palpitation are the usual presenting features of PCCs/ PGLs. Gene mutations are reported in 32-79 % of cases, making genetic screening mandatory in all the cases. The malignancy rates are 10-15 % for PCCs and 20-50 % for PGLs. Measurement of plasma or 24-hour urinary fractionated metanephrines is the best biochemical diagnostic test. Computed tomography or magnetic resonance imaging has high sensitivity (90-100 %) and reasonable specificity (70-90 %) for the anatomical localization. The functionality is assessed by different radionuclide imaging modalities such as metaiodobenzylguanidine (MIBG) scintigraphy, positron emission tomography or single photon emission computed tomography. The only modality of curative treatment is tumor excision. Proper peri-operative management improves the surgical outcomes. Annual follow up with clinical and biochemical assessment is recommended in all the cases after treatment. Children, pregnant women and older people have higher morbidity and mortality risk. De-bulking surgery, chemotherapy, radiotherapy, molecular agents like sunitinib and everolimus, radionuclide agents and different ablation procedures may be useful in the palliation of inoperable/metastatic disease. An update on the diagnostic evaluation and management of PCCs and PGLs is presented here.

PMID: 24792093 [PubMed - in process]

Surgical curability of medullary thyroid cancer in multiple endocrine neoplasia 2B: a changing perspective.

Wed, 05/07/2014 - 10:01
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Surgical curability of medullary thyroid cancer in multiple endocrine neoplasia 2B: a changing perspective.

Ann Surg. 2014 Apr;259(4):800-6

Authors: Brauckhoff M, Machens A, Lorenz K, Bjøro T, Varhaug JE, Dralle H

Abstract
OBJECTIVE: This investigation aimed at exploring the suitability of nonendocrine manifestations preceding medullary thyroid cancer (MTC) for early diagnosis of multiple endocrine neoplasia type 2B (MEN 2B).
BACKGROUND: MEN 2B patients, running a high risk of metastatic MTC, must be diagnosed early for biochemical cure.
METHODS: Forty-four MEN 2B patients carrying inherited (3 patients) and de novo (41 patients) M918T RET mutations were examined for signs and symptoms prompting MEN 2B.
RESULTS: All 3 patients with inherited mutations were diagnosed before the age of 1 year and cured of their C-cell disease. Among 41 patients with de novo mutations, MEN 2B was diagnosed in 12 patients after recognition of nonendocrine manifestations [intestinal ganglioneuromatosis (6 patients), oral symptoms (5 patients), ocular ("tearless crying") (4 patients), and skeletal stigmata (1 patient) alone or concomitantly]. In the remaining 29 patients with de novo mutations, the diagnosis of MEN 2B was triggered by symptomatic MTC (28 patients) or pheochromocytoma (1 patient). The former patients, being significantly (P < 0.001) younger (means of 5.3 vs 17.6 years) and having lower calcitonin levels (means of 115 vs 25,519 pg/mL), smaller tumors (67% vs 0% were ≤10 mm) and less often extrathyroidal extension (0% vs 81%), lymph node (42% vs 100%), and distant metastases (8% vs 79%), were biochemically cured more often (58% vs 0%).
CONCLUSIONS: MTC is curable in patients with de novo mutations when nonendocrine MEN 2B components are quickly appreciated and surgical intervention is performed before patients turn 4 years old.

PMID: 23979292 [PubMed - indexed for MEDLINE]

Pheochromocytoma-induced takotsubo-like cardiomyopathy and global heart failure with need for extracorporal life support.

Wed, 05/07/2014 - 10:01
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Pheochromocytoma-induced takotsubo-like cardiomyopathy and global heart failure with need for extracorporal life support.

Intensive Care Med. 2013 Aug;39(8):1473-4

Authors: Kaese S, Schülke C, Fischer D, Lebiedz P

PMID: 23670051 [PubMed - indexed for MEDLINE]

Contemporary review of large adrenal tumors in a tertiary referral center.

Wed, 04/30/2014 - 09:20
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Contemporary review of large adrenal tumors in a tertiary referral center.

Anticancer Res. 2014 May;34(5):2581-8

Authors: Mege D, Taieb D, Lowery A, Loundou A, DE Micco C, Castinetti F, Morange I, Henry JF, Sebag F

Abstract
BACKGROUND: Large adrenal tumors (LATs, ≥6 cm) are uncommon and associated with malignancy in 25% of cases. Their surgical management remains debatable. The aim of the present report was to evaluate the current incidence, nature and management of LAT.
PATIENTS AND METHODS: We carried out a retrospective review of LATs managed in a tertiary referral center (2002-2011).
RESULTS: Eighty-one patients were included (out of a total of 750 with adrenal tumors, 11%). Nine patients had no surgical intervention (11%). Fifty-two LATs were malignant (64%): adrenocortical carcinoma (44%), metastasis (27%) and pheochromocytoma (21%). Patients with malignant tumors exhibited a poorer 5-year overall survival than those with benign tumors (53.4% versus 96.3%, p=0.001). Disease-related mortality was approximately 60%, 29% and 0% for those with metastasis, adrenal carcinoma and malignant pheochromocytoma, respectively. The recurrence rate was the same for the three malignant sub-groups (30%).
CONCLUSION: LATs are rare and more frequently malignant than previously reported. Some are benign and do not require for surgical intervention. Surgical indication and approach should be tailored for each patient.

PMID: 24778080 [PubMed - in process]

Practical guide to the use of abiraterone in castration resistant prostate cancer.

Wed, 04/30/2014 - 09:20
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Practical guide to the use of abiraterone in castration resistant prostate cancer.

Can J Urol. 2014 Apr;21(2 Supp 1):57-63

Authors: Mostaghel EA, Lin DW

Abstract
INTRODUCTION: While androgen deprivation therapy remains the primary treatment modality for patients with metastatic prostate cancer, treatment is uniformly marked by progression to castration resistant prostate cancer (CRPC). Abiraterone is the first new drug to enter clinical practice in a series of novel agents designed to potently target adrenal and tumor androgen production.
MATERIALS AND METHODS: Herein, we review the mechanism of action of abiraterone and the phase III data supporting its approval for patients with metastatic CRPC. We discuss practical treatment considerations, including the incidence and management of side effect and monitoring requirements, and conclude by discussing future directions in the use of abiraterone, including early data supporting an expanded role for abiraterone in castration sensitive disease.
RESULTS: Accumulating data emphasize that "androgen independent" or "hormone refractory" tumors remain sensitive to hormonal activation and suggest that despite suppression of circulating testosterone (T), residual tumor androgens play a prominent role in mediating CRPC progression.
CONCLUSIONS: Accordingly, therapeutic strategies such abiraterone that more effectively target production of intratumoral androgens are necessary.

PMID: 24775725 [PubMed - in process]

The sympathetic neural hyperalgesia/edema syndrome, a common cause of female pelvic pain, manifesting as a pseudopheochromocytoma with marked clinical improvement with sympathomimetic amines.

Wed, 04/30/2014 - 09:20
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The sympathetic neural hyperalgesia/edema syndrome, a common cause of female pelvic pain, manifesting as a pseudopheochromocytoma with marked clinical improvement with sympathomimetic amines.

Clin Exp Obstet Gynecol. 2014;41(1):75-7

Authors: Check JH, Cohen R, Katsoff B

Abstract
PURPOSE: To show that a common but not well-known disorder of the sympathetic nervous system can present with symptoms suggesting a pheochromocytoma.
MATERIALS AND METHODS: The standard treatment of this disorder (which is characterized by an abnormal water load test), i.e., sympathomimetic amine therapy, was given to a woman with paroxysmal tachycardia and hypertension.
RESULTS: Over a period of six months, the treatment eradicated the paroxysmal symptoms to which all other therapies had failed.
CONCLUSIONS: This condition recently named as sympathetic neural hyperalgesia edema syndrome can present with symptoms of a pheochromocytoma and will respond to therapy with low dosages of dextroamphetamine sulfate.

PMID: 24707689 [PubMed - indexed for MEDLINE]

Benign adrenal hemangiomas may mimic metastases on PET.

Wed, 04/30/2014 - 09:20
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Benign adrenal hemangiomas may mimic metastases on PET.

Clin Nucl Med. 2013 Nov;38(11):888-90

Authors: Calata JF, Sukerkar AN, August CZ, Maker AV

Abstract
CT or MRI are utilized in the initial evaluation of adrenal incidentalomas; however, overlap exists between benign and malignant lesions on these examinations. The American College of Radiology recommends PET scans to complement CT and MRI for patients with adrenal masses and a moderate-to-high likelihood of neoplastic disease. We present images of a PET-avid adrenal lesion in a patient with pulmonary and pancreatic neoplasms that mimicked metastasis, but was found to be a benign adrenal hemangioma on surgical resection. The use of PET for adrenal tumors, specifically adrenal hemangiomas, will be reviewed.

PMID: 24089061 [PubMed - indexed for MEDLINE]

Diagnosis and management of psoriatic arthritis.

Wed, 04/30/2014 - 09:20
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Diagnosis and management of psoriatic arthritis.

Indian J Dermatol Venereol Leprol. 2013 Jul;79 Suppl 7:S18-24

Authors: Balakrishnan C, Madnani N

Abstract
Psoriatic arthritis (PsA) is a multi-faceted disease marked by varying combinations of peripheral arthritis, dactylitis, spondylitis, and enthesitis. Rarely, recurrent uveitis occurs. Skin involvement may or may not exist. However, patients with nail psoriasis have a higher probability of developing PsA. Untreated patients have significant morbidity and mortality. Timely diagnosis and aggressive treatment of the disease can lead to lower morbidity. Drug therapy of PsA includes symptomatic therapy and therapy with disease-modifying anti-rheumatic drugs. Biologics are the only agents that address all the pathological changes, of this chronic condition.

PMID: 23974691 [PubMed - indexed for MEDLINE]

Oncocytic adrenocortical neoplasm arising from adrenal rest in the broad ligament of the uterus.

Wed, 04/23/2014 - 08:46
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Oncocytic adrenocortical neoplasm arising from adrenal rest in the broad ligament of the uterus.

Pathol Int. 2014 Apr;64(4):183-8

Authors: Kasajima A, Nakamura Y, Adachi Y, Takahashi Y, Fujishima F, Chiba Y, Uehara S, Watanabe M, Sasano H

Abstract
Oncocytic adrenocortical neoplasm is characterized by abundant eosinophilic cytoplasm containing mitochondria, occasional nuclear atypia and diffuse growth pattern. Oncocytic adrenocortical neoplasm arising in adrenal rest is, however, extremely rare. We report a case of oncocytic adrenocortical neoplasm arising in adrenal rest of the broad ligament with associated marked lipomatous metaplasia. A well circumscribed tumor was accidentally detected in the pelvic cavity of a 29 year old Japanese woman, adjacent to the broad ligament of the uterus. The tumor was composed of large eosinophilic cells associated with diffuse growth pattern and abundant mature adipose tissue admixed with foci of clear cells. Both steroidgenic factor 1 (SF-1) and alpha-inhibin were immunohistochemically positive in tumor cells. Abundant mitochondria detected by immunohistochemical and electron microscopic examination confirmed the diagnosis of oncocytic adrenocortical neoplasm. The absence of necrosis, capsular and vascular invasion as well as the low mitotic index indicated the benign potential of this tumor. The tumor cells were also positive for dehydroepiandrosteron-sulfotransferase (DHEA-ST), 17β-hydroxysteroid dehydrogenase type 5 (17β-HSD5), 3β-hydroxysteroid dehydrogenase (3β-HSD) and steroid 17α-hydroxylase (P450-c17), suggesting a possible production of testosterone of this tumor. This is the first reported case of oncocytic adrenocortical adenoma arising in adrenal rest of the broad ligament.

PMID: 24750189 [PubMed - in process]

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