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PubMed - Adrenal Cancer (100 unread)

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Catecholamine-induced cardiomyopathy and paraganglioneuroma in a pediatric patient.

Fetched: May 20th, 2012, 11:00pm MDT

Catecholamine-induced cardiomyopathy and paraganglioneuroma in a pediatric patient.

Anadolu Kardiyol Derg. 2011 Dec;11(8):743-4

Authors: Narin N, Baykan A, Sezer S, Onan SH, Uzüm K, Küçükaydın M

PMID: 22137946 [PubMed - indexed for MEDLINE]

Editorial comment.

Fetched: May 20th, 2012, 11:00pm MDT

Editorial comment.

Urology. 2012 Mar;79(3):583; author reply 583-4

Authors: Autorino R, De Sio M

PMID: 22386403 [PubMed - indexed for MEDLINE]

Permalink for 'Comparison of single-surgeon series of transperitoneal laparoendoscopic single-site surgery and standard laparoscopic adrenalectomy.'

Comparison of single-surgeon series of transperitoneal laparoendoscopic single-site surgery and standard laparoscopic adrenalectomy.

Fetched: May 20th, 2012, 11:00pm MDT

Comparison of single-surgeon series of transperitoneal laparoendoscopic single-site surgery and standard laparoscopic adrenalectomy.

Urology. 2012 Mar;79(3):577-83

Authors: Wang L, Liu B, Wu Z, Yang Q, Chen W, Sheng H, Xu Z, Xiao L, Wang C, Sun Y

Abstract
OBJECTIVE: To assess the feasibility, safety, and efficacy of transperitoneal laparoendoscopic single-site (LESS) adrenalectomy and determine whether it shows any objective advantage compared with standard laparoscopy.
METHODS: From August 2009 to May 2011, 13 transperitoneal LESS adrenalectomies were performed through a 2-3-cm skin incision using the TriPort access system. This cohort was compared with a contemporary 1:2 matched-pair group of 26 patients undergoing standard laparoscopic adrenalectomy by the same urologist. The perioperative outcomes, including cosmetic satisfaction scores, were statistically analyzed.
RESULTS: The 2 groups were comparable with respect to patient demographics, estimated blood loss, and postoperative hospitalization (P > .05). The LESS procedures had a longer mean operative time (148.5 vs 112.9 minutes, P = .032) but a significantly lower postoperative visual analog pain scale score (2.3 vs 3.7, P = .001), fewer patients requiring analgesics (30.8% vs 73.1%, P = .011), and an earlier resumption of oral intake (21.6 vs 26.0 hours, P = .002). The mean length of the scar in the LESS group was much smaller (2.3 vs 5.9 cm, P < .0001) with a statistically significant greater mean cosmetic satisfaction score (9.5 vs 9.1, P = .042).
CONCLUSION: The perioperative outcomes of transperitoneal LESS adrenalectomy for small adrenal tumors were comparable to those with the standard laparoscopic approach. It also provides better postoperative pain control, faster recovery of bowel function, and better cosmetic satisfaction than standard laparoscopy, albeit with a longer operative time.

PMID: 22386401 [PubMed - indexed for MEDLINE]

Mucinous adenocarcinoma developed from human fallopian tube epithelial cells through defined genetic modifications.

Fetched: May 19th, 2012, 11:00pm MDT

Mucinous adenocarcinoma developed from human fallopian tube epithelial cells through defined genetic modifications.

Cell Cycle. 2012 Jun 1;11(11)

Authors: Shan W, Mercado-Uribe I, Zhang J, Rosen D, Zhang S, Wei J, Liu J

Abstract
Recent studies have suggested that some ovarian and pelvic serous carcinomas could originate from the fimbriated end of the distal fallopian tube. To test this hypothesis, we immortalized a normal human fallopian tube epithelial (FTE) cell line by using retrovirus-mediated overexpression of the early region of the SV40 T/t antigens and the human telomerase reverse transcriptase subunit (hTERT). These immortalized FTEs were then transformed by ectopic expression of oncogenic human HRAS (V12) . Tumorigenicity of the immortalized and/or transformed cells was subsequently tested by anchorage-independence growth assay and inoculation into nude mice via subcutaneous and intraperitoneal injection. As expected, the HRAS (V12) -transformed FTEs produced tumors through both subcutaneous and intraperitoneal injections, whereas no tumor growth was observed in immortalized FTEs. Unexpectedly, histopathological examination of tumors resulting from subcutaneous as well as intraperitoneal injections revealed largely poorly differentiated mucinous adenocarcinoma mixed with undifferentiated carcinoma. The tumor implants invaded extensively to the liver, colon, spleen, omentum, adrenal gland and renal capsule. Immunohistochemical staining of tumor cells showed positive staining for the epithelial cell markers cytokeratin AE1/AE3 and Müllerian lineage marker PAX8. Our study demonstrates that FTEs can generate poorly differentiated mucinous adenocarcinoma mixed with undifferentiated carcinoma through genetic modifications. Thus, we provide the first experimental evidence that fimbrial epithelial cells of the fallopian tube could be a potential source of ovarian mucinous adenocarcinoma.

PMID: 22592533 [PubMed - as supplied by publisher]

An unusual cause of hyperandrogenism.

Fetched: May 19th, 2012, 11:00pm MDT

An unusual cause of hyperandrogenism.

Neth J Med. 2012 Jan;70(1):41, 45

Authors: Wendker-van Wattum M, Wouters RS, van der Wal JE, Glaudemans AW, Wolffenbuttel BH

PMID: 22271814 [PubMed - indexed for MEDLINE]

Castleman's disease mimicking right adrenal neoplasm: a case report.

Fetched: May 19th, 2012, 11:00pm MDT

Castleman's disease mimicking right adrenal neoplasm: a case report.

Turk J Gastroenterol. 2011 Oct;22(5):551-4

Authors: Çolakoğlu T, Ezer A, Koçer E, Yildirim S, Bellı S

Abstract
Castleman's disease usually manifests as a solitary mediastinal tumor and only rarely as an isolated retroperitoneal mass. This disorder is often undiagnosed or misdiagnosed. Thus, only very few patients have been reported and little information is available in the literature. The definitive diagnosis is based on postoperative pathological findings. We report a case of a 57-year-old female with a Castleman's tumor located superomedial to the upper pole of the right kidney that mimicked an adrenal neoplasm. The mass was surgically resected, and the histopathological diagnosis of the resected tissue was hyaline-vascular type of Castleman's disease. Although retroperitoneal Castleman's disease is rare, it should be considered in the differential diagnosis of retroperitoneal masses.

PMID: 22234768 [PubMed - indexed for MEDLINE]

Bilateral primary adrenal lymphoma accompanying hypertension.

Fetched: May 19th, 2012, 11:00pm MDT

Bilateral primary adrenal lymphoma accompanying hypertension.

Urology. 2012 Feb;79(2):e27-8

Authors: Wang Q, Cao X, Jiang J, Wang T, Jin MS

Abstract
Primary adrenal lymphoma (PAL) accompanied by hypertension is extremely rare. We present a case of PAL with hypertension, whom was treated with bilateral adrenalectomy and a combination of the modified Appleby operation and chemotherapy. Computed tomography and biopsy is helpful to aid diagnosis.

PMID: 21862117 [PubMed - indexed for MEDLINE]

Adrenocortical carcinoma masquerading as a benign adenoma on computed tomography washout study.

Fetched: May 19th, 2012, 11:00pm MDT

Adrenocortical carcinoma masquerading as a benign adenoma on computed tomography washout study.

Urology. 2012 Feb;79(2):e19-20

Authors: Simhan J, Canter D, Teper E, Smaldone MC, Patil N, Patchefsky A, Guttmann MC, Milestone B, Wong YN, Hicks LA, Uzzo RG, Kutikov A

Abstract
An incidental adrenal mass is a common finding on cross-sectional imaging, with most of these lesions being benign adenomas. Indications for adrenalectomy turn on the likelihood that a mass is malignant or whether it exhibits metabolic activity. Modern imaging is considered highly accurate in differentiating adrenal adenomas from other adrenal pathology. We present a case of a 5-cm adrenal lesion with computed tomography washout characteristics consistent with a benign adenoma, which proved upon resection to be an adrenocortical carcinoma.

PMID: 21813169 [PubMed - indexed for MEDLINE]

Permalink for 'The glucocorticoid receptor and its expression in the anterior pituitary and the adrenal cortex: a source of variation in hypothalamic-pituitary-adrenal axis function; implications for pituitary and adrenal tumors.'

The glucocorticoid receptor and its expression in the anterior pituitary and the adrenal cortex: a source of variation in hypothalamic-pituitary-adrenal axis function; implications for pituitary and adrenal tumors.

Fetched: May 19th, 2012, 11:00pm MDT

The glucocorticoid receptor and its expression in the anterior pituitary and the adrenal cortex: a source of variation in hypothalamic-pituitary-adrenal axis function; implications for pituitary and adrenal tumors.

Endocr Pract. 2011 Nov-Dec;17(6):941-8

Authors: Briassoulis G, Damjanovic S, Xekouki P, Lefebvre H, Stratakis CA

Abstract
OBJECTIVE: To review the expression of the glucocorticoid receptor (GR) in anterior pituitary and adrenocortical cells and tumors derived from these tissues as well as factors that may influence its expression.
METHODS: We present an overview of the relevant literature, with a focus on data generated from our studies.
RESULTS: The expression of the GR is an essential element of the negative feedback that closes the loop formed by corticotropin-releasing hormone, adrenocorticotropic hormone, and cortisol in the context of the hypothalamic-pituitary-adrenal (HPA) axis. Although the GR expression in anterior pituitary cells-and in particular the corticotrophs-was first demonstrated several years ago, it was not known until relatively recently where, by what cells, and in what form the GR is expressed in the adrenal cortex. The variability in the expression of the GR in pituitary and adrenocortical cells may underlie the substantial differences in HPA axis function across individuals, especially when testing for tumors associated with hypercortisolemia. This expression is influenced by a multitude of tissue-specific factors, which may explain why it is so difficult to interpret (or reproduce) studies that are based on GR functional polymorphisms on different cohorts of patients or even different sets of laboratory animals.
CONCLUSION: This review highlights the variability in expression and function of the GR in pituitary and adrenocortical cells as one of the reasons for the appreciable differences in HPA axis function across individuals. Particular attention was paid to interactions that may affect the interpretation of diagnostic testing of the HPA axis in patients with pituitary adenomas (Cushing disease) or adrenocortical tumors (Cushing syndrome).

PMID: 21742609 [PubMed - indexed for MEDLINE]

Acquisition Order of Ras and p53 Gene Alterations Defines Distinct Adrenocortical Tumor Phenotypes.

Fetched: May 18th, 2012, 11:00pm MDT

Acquisition Order of Ras and p53 Gene Alterations Defines Distinct Adrenocortical Tumor Phenotypes.

PLoS Genet. 2012 May;8(5):e1002700

Authors: Herbet M, Salomon A, Feige JJ, Thomas M

Abstract
Sporadic adrenocortical carcinomas (ACC) are rare endocrine neoplasms with a dismal prognosis. By contrast, benign tumors of the adrenal cortex are common in the general population. Whether benign tumors represent a separate entity or are in fact part of a process of tumor progression ultimately leading to an ACC is still an unresolved issue. To this end, we have developed a mouse model of tumor progression by successively transducing genes altered in adrenocortical tumors into normal adrenocortical cells. The introduction in different orders of the oncogenic allele of Ras (H-Ras(G12V)) and the mutant p53(DD) that disrupts the p53 pathway yielded tumors displaying major differences in histological features, tumorigenicity, and metastatic behavior. Whereas the successive expression of Ras(G12V) and p53(DD) led to highly malignant tumors with metastatic behavior, reminiscent of those formed after the simultaneous introduction of p53(DD) and Ras(G12V), the reverse sequence gave rise only to benign tumors. Microarray profiling revealed that 157 genes related to cancer development and progression were differentially expressed. Of these genes, 40 were up-regulated and 117 were down-regulated in malignant cell populations as compared with benign cell populations. This is the first evidence-based observation that ACC development follows a multistage progression and that the tumor phenotype is directly influenced by the order of acquisition of genetic alterations.

PMID: 22589739 [PubMed - in process]

Characterization of two mouse models of metastatic pheochromocytoma using bioluminescence imaging.

Fetched: May 18th, 2012, 11:00pm MDT

Characterization of two mouse models of metastatic pheochromocytoma using bioluminescence imaging.

Cancer Lett. 2012 Mar;316(1):46-52

Authors: Giubellino A, Woldemichael GM, Sourbier C, Lizak MJ, Powers JF, Tischler AS, Pacak K

Abstract
Pheochromocytoma is the most common tumor of the adrenal medulla in adults. The lack of sensitive animal models of pheochromocytoma has hindered the study of this tumor and in vivo evaluation of antitumor agents. In this study we generated two sensitive luciferase models using bioluminescent pheochromocytoma cells: an experimental metastasis model to monitor tumor spreading and a subcutaneous model to monitor tumor growth and spontaneous metastasis. These models offer a platform for sensitive, non-invasive and real-time monitoring of pheochromocytoma primary growth and metastatic burden to follow the course of tumor progression and for testing relevant antitumor treatments in metastatic pheochromocytoma.

PMID: 22154086 [PubMed - indexed for MEDLINE]

Hypertensive retinopathy in a child caused by pheochromocytoma: identification after a failed school vision screening.

Fetched: May 17th, 2012, 11:00pm MDT

Hypertensive retinopathy in a child caused by pheochromocytoma: identification after a failed school vision screening.

J AAPOS. 2012 Feb;16(1):97-9

Authors: Tibbetts MD, Wise R, Forbes B, Hedrick HL, Levin AV

Abstract
A 7-year-old girl was referred for ophthalmological examination after the result of a routine school vision screening identified unilateral vision loss. Fundus examination showed bilateral but markedly asymmetric macular exudates and optic disk edema. After the results of two blood pressure measurements were within normal limits, a third markedly elevated measurement revealed malignant hypertension and led to a diagnosis of pheochromocytoma, a rare catecholamine-secreting tumor. The tumor was resected, and 6 months later the patient's blood pressure had normalized; however, although visual acuity had improved to 20/20 in the right eye, it remained 20/200 in the left eye, with decreased disk edema but the persistence of the macular exudates. The identification of an abdominal malignancy through a school vision screening may have saved this child's life. The need for repeated blood pressure measurement is also highlighted.

PMID: 22245022 [PubMed - indexed for MEDLINE]

CEUS of adrenal mass lesions--the break-through?

Fetched: May 17th, 2012, 11:00pm MDT

CEUS of adrenal mass lesions--the break-through?

Ultraschall Med. 2011 Oct;32(5):437-9

Authors: Mostbeck G

PMID: 21986924 [PubMed - indexed for MEDLINE]

Permalink for 'Feminizing adrenocortical carcinoma with selective suppression of follicle-stimulating hormone secretion and disorganized steroidogenesis: a case report and literature review.'

Feminizing adrenocortical carcinoma with selective suppression of follicle-stimulating hormone secretion and disorganized steroidogenesis: a case report and literature review.

Fetched: May 17th, 2012, 11:00pm MDT

Feminizing adrenocortical carcinoma with selective suppression of follicle-stimulating hormone secretion and disorganized steroidogenesis: a case report and literature review.

Intern Med. 2011;50(13):1419-24

Authors: Saito T, Tojo K, Furuta N, Ono K, Sasano H, Utsunomiya K

Abstract
We report a 61-year-old male with gynecomastia, poor libido and erectile dysfunction. Endocrinological studies showed high levels of estradiol and dehydroepiandrosterone sulfate. Although luteinizing hormone (LH) level was within the normal limit, the concentration of follicle-stimulating hormone (FSH) was under the normal limit. Delayed response of LH and poor response of FSH to gonadotropin-releasing hormone administration were detected. Magnetic resonance imaging of the abdomen revealed a left adrenal tumor. Although the surgically-resected tumor was diagnosed as a high grade ACC based on Weiss's criteria of adrenocortical malignancy, no metastasis was detected. Since estrogen levels normalized after resection, feminizing ACC was confirmed. While LH concentration increased slightly after operation, FSH level became transiently elevated over the normal limit, and finally reached the normal range. These data may suggest that FSH was suppressed selectively by hormone produced by ACC different from estrogen.

PMID: 21720063 [PubMed - indexed for MEDLINE]

Differentiation between benign and malignant adrenal mass using contrast-enhanced ultrasound.

Fetched: May 17th, 2012, 11:00pm MDT

Differentiation between benign and malignant adrenal mass using contrast-enhanced ultrasound.

Ultraschall Med. 2011 Oct;32(5):460-71

Authors: Friedrich-Rust M, Glasemann T, Polta A, Eichler K, Holzer K, Kriener S, Herrmann E, Nierhoff J, Bon D, Bechstein WO, Vogl T, Zeuzem S, Bojunga J

Abstract
PURPOSE: Adrenal masses can be detected by ultrasound with high sensitivity and specificity. The aim of the present study was to evaluate CEUS in a large patient population using CEUS patterns identified in a previous pilot study.
MATERIALS AND METHODS: 116 adrenal masses were evaluated by ultrasound, including CEUS with the contrast agent Sonovue®. The dynamic of contrast enhancement (CE) was analyzed using time-intensity curves. The time of the first CE in the adrenal mass was used to define four CEUS patterns: pattern I = early arterial CE, pattern II = arterial CE, pattern III = late CE, pattern IV = no CE. In addition, all patients received CT/MRI and hormonal testing. In suspicious cases biopsy or adrenalectomy was performed.
RESULTS: CEUS patterns I&II were seen in all patients with primary or secondary malignant lesions of the adrenal gland (n = 16). The sensitivity and specificity of CEUS for the diagnosis of malignant adrenal mass were 100 % (CI [75;100]) and 67 % (CI [56;75]), respectively. Overall histology was available as a reference method for 40 adrenal masses. In 68 % of histologically diagnosed adrenal masses, MRI/CT and CEUS were congruent concerning the characterization of malignant versus benign adrenal mass.
CONCLUSION: Contrast-enhanced ultrasound may be a useful method in the diagnostic work-up of adrenal mass with excellent sensitivity for the diagnosis of malignancy.

PMID: 21667434 [PubMed - indexed for MEDLINE]

ULTRASONOGRAPHIC IDENTIFICATION OF VASCULAR INVASION BY ADRENAL TUMORS IN DOGS.

Fetched: May 17th, 2012, 11:00pm MDT

ULTRASONOGRAPHIC IDENTIFICATION OF VASCULAR INVASION BY ADRENAL TUMORS IN DOGS.

Vet Radiol Ultrasound. 2012 May 14;

Authors: Davis MK, Schochet RA, Wrigley R

Abstract
Adrenalectomy is the treatment of choice for adrenal tumors that are producing adverse clinical signs. Surgical planning prior to adrenalectomy is aided by identifying tumors with invasion into adjacent vessels or the presence of a tumor thrombus extending into the caudal vena cava. In this paper, we evaluated the sensitivity and specificity of ultrasound in determining if vascular invasion or tumor thrombus is present. Thirty-four dogs with 36 adrenal tumors were reviewed retrospectively. Overall, 36% of tumors had vascular invasion. Abdominal ultrasound was 100% sensitive and 96% specific in identifying the presence of a tumor thrombus in the caudal vena cava. The sensitivity and specificity was 76% and 96%, respectively, when all forms of vascular invasion were evaluated and included patients with vascular wall invasion without concurrent thrombus. Abdominal ultrasound is a good screening tool for identifying vascular invasion or tumor thrombus associated with adrenal tumors in dogs.

PMID: 22583157 [PubMed - as supplied by publisher]

Permalink for 'Serious gastric ulcer event after stereotactic body radiotherapy (SBRT) delivered with concomitant vinorelbine in a patient with left adrenal metastasis of lung cancer.'

Serious gastric ulcer event after stereotactic body radiotherapy (SBRT) delivered with concomitant vinorelbine in a patient with left adrenal metastasis of lung cancer.

Fetched: May 17th, 2012, 11:00pm MDT

Serious gastric ulcer event after stereotactic body radiotherapy (SBRT) delivered with concomitant vinorelbine in a patient with left adrenal metastasis of lung cancer.

Acta Oncol. 2012 May;51(5):624-8

Authors: Onishi H, Ozaki M, Kuriyama K, Komiyama T, Marino K, Araya M, Saito R, Aoki S, Maehata Y, Tomiaga L, Oguri M, Watanabe I, Onohara K, Sano N, Araki T

PMID: 22582719 [PubMed - in process]

Permalink for 'Localization of breast cancer resistance protein (Bcrp) in endocrine organs and inhibition of its transport activity by steroid hormones.'

Localization of breast cancer resistance protein (Bcrp) in endocrine organs and inhibition of its transport activity by steroid hormones.

Fetched: May 17th, 2012, 11:00pm MDT

Localization of breast cancer resistance protein (Bcrp) in endocrine organs and inhibition of its transport activity by steroid hormones.

Cell Tissue Res. 2012 May 13;

Authors: Dankers AC, Sweep FC, Pertijs JC, Verweij V, van den Heuvel JJ, Koenderink JB, Russel FG, Masereeuw R

Abstract
Breast cancer resistance protein (BCRP) is known for its protective function against the toxic effects of exogenous compounds. In addition to this, a role in the transport of endogenous compounds has been described. Since BCRP in the plasma membrane was shown to be regulated by sex steroids, we investigated the presence and possible role of BCRP in steroid hormone-producing organs. Therefore, the presence and localization of Bcrp was investigated in endocrine organs of wild-type mice. Furthermore, the interaction of various steroid hormones with human BCRP activity was studied. Quantitative PCR revealed Bcrp mRNA in the pituitary and adrenal glands, pancreas, ovary, testis and adipose tissue. Immunohistochemistry revealed the presence of Bcrp in the cortex of the adrenal gland and in plasma membranes of adipocytes. In the pituitary gland, pancreas, ovary and testis, Bcrp was mainly located in the capillaries. The interaction between BCRP and 12 steroid hormones was studied using membrane vesicles of HEK293-BCRP cells. Estradiol, testosterone, progesterone and androstenedione inhibited BCRP-mediated uptake of (3)H-estrone sulphate (E(1)S) most potently, with calculated inhibitory constant (Ki) values of 5.0 ± 0.2, 36 ± 14, 14.7 ± 1.3 and 217 ± 13 μM, respectively. BCRP function was attenuated non-competitively, which implies an allosteric inhibition of BCRP-mediated E(1)S transport by these steroids. In conclusion, localization of Bcrp in endocrine organs together with the efficient allosteric inhibition of the efflux pump by steroid hormones are suggestive for a role for BCRP in steroid hormone regulation.

PMID: 22581381 [PubMed - as supplied by publisher]

Transcriptional silencing of the inhibin-α gene in human gastric carcinoma cells.

Fetched: May 17th, 2012, 11:00pm MDT

Transcriptional silencing of the inhibin-α gene in human gastric carcinoma cells.

Int J Oncol. 2012 May 10;

Authors: Kim YI, Shim J, Kim BH, Lee SJ, Lee HK, Cho C, Cho BN

Abstract
Although inhibin was first identified as a hormone regulating pituitary FSH secretion, it was later recognized to act as a tumor suppressor in the gonad and adrenal glands. Recently, the alpha subunit of this dimeric hormone (inhibin‑α) was reported to be involved in prostate tumorigenesis. To identify additional roles outside the reproductive axis, we investigated inhibin‑α gene activity and subsequent cell fate in human gastric cancer cells. The results were as follows: all the gastric cancer cells had at least one of a set of abnormalities including hypermethylation of the promoter, mutation of the 5'‑UTR or allelic imbalance including LOH in the inhibin‑α gene. Hypermethylation of the promoter and mutation of the 5'‑UTR in inhibin‑α were observed in SNU‑1, SNU‑5 and SNU‑484 cells. LOH was observed in AGS, KATO III, SNU‑5, SNU‑484 and SNU‑668 cells. Treatment with 5‑AzaC, a demethylating agent, induced demethylation of the inhibin‑α promoter in the SNU‑1, SNU‑5 and SNU‑484 cell lines, with the CpG5 site being strongly influenced by 5‑AzaC. In addition, inhibin‑α mRNA and protein were maintained at low levels in most of the gastric cancer cell lines. These low levels of mRNA and protein expression could be increased in most lines by treatment with 5‑AzaC. These increased inhibin‑α expression levels seemed to be closely associated with apoptosis and suppression of cell growth. Taken together, our results reveal that the inhibin‑α gene is transcriptionally silenced in human gastric cancer cells, and that reactivation of the gene suppresses their growth characteristics. This suggests that inhibin‑α may have a more general tumor suppressor activity outside the reproductive axis.

PMID: 22581369 [PubMed - as supplied by publisher]

Permalink for 'Deficiency in androgens and upregulation of insulin-like growth factor-1 are involved in high bone turnover in men receiving androgen deprivation therapy for prostate cancer.'

Deficiency in androgens and upregulation of insulin-like growth factor-1 are involved in high bone turnover in men receiving androgen deprivation therapy for prostate cancer.

Fetched: May 17th, 2012, 11:00pm MDT

Deficiency in androgens and upregulation of insulin-like growth factor-1 are involved in high bone turnover in men receiving androgen deprivation therapy for prostate cancer.

Growth Horm IGF Res. 2012 May 11;

Authors: Ishizaki F, Hara N, Takizawa I, Nishiyama T, Isahaya E, Kawasaki T, Takahashi K

Abstract
OBJECTIVE: This study was performed to elucidate the mechanism of high bone turnover during androgen deprivation therapy (ADT) in terms of osteogenic endocrine activity by testosterone, adrenal androgens, and insulin-like growth factor-1 (IGF-I), and to identify markers reflecting the bone mineral density (BMD) during ADT. DESIGN: BMD and samples of blood and urine were studied before and after 6months of ADT in 70 patients with localized prostate cancer. RESULTS: Before ADT, serum free-testosterone, dehydroepiandrosterone sulfate (DHEA-S), androstenedione, and IGF-I levels were correlated with BMD (rs=0.344, p=0.004; rs=0.264, p=0.027; rs=0.329, p=0.005; rs=0.300, p=0.012, respectively). The serum IGF-I level was independently correlated with the pretreatment BMD (Multivariate p=0.001). These relationships disappeared after ADT (p=0.519, 0.316, 0.116, and 0.597, respectively). After ADT, serum levels of free-testosterone decreased (7.9 to 0.2pg/mL), and DHEA-S and androstenedione were also reduced (3.6 to 2.3μmol/L and 5.6 to 2.9nmol/L, respectively) (p<0.001 in all). In contrast, IGF-I levels were elevated after ADT by 11.6% (19.9 to 22.3nmol/L, p<0.001). Delta-values of IGF-I (post- minus pretreatment levels, mean: +2.2, ranged between -7.1 and +15.3) were inversely correlated with the pretreatment (rs=-0.333 p=0.005) and post-treatment (rs=-0.408, p=0.001) BMD. After ADT, the serum IGF-I level was closely correlated with the serum level of the bone formation marker bone-specific alkaline phosphatase (BAP) (rs=0.328, p=0.006), and delta-IGF-I and delta-BAP showed a close positive correlation (rs=0.388, p=0.001). The post-treatment BMD was correlated only with the urine deoxypyridinoline (DPD) concentration (rs=-0.302, p=0.024) among the bone formation/resorption markers including serum/urine N-telopeptide. CONCLUSIONS: Serum IGF-I levels increased during ADT in men with a low BMD. Coupled with reduced androgen levels, elevated IGF-I levels, which were positively correlated with BAP during ADT, possibly explain the mechanism of ADT-related high bone turnover. The increase of IGF-I is more prominent in men whose BMD is already low at the baseline, and urine DPD might be a marker that reflects BMD during ADT.

PMID: 22579549 [PubMed - as supplied by publisher]

What is your diagnosis? Splenic myelolipoma.

Fetched: May 17th, 2012, 11:00pm MDT

What is your diagnosis? Splenic myelolipoma.

J Am Vet Med Assoc. 2012 Feb 15;240(4):375-6

Authors: Carrillo JD, Boza S, Soler M, Belda E, Agut A

PMID: 22309007 [PubMed - indexed for MEDLINE]

Permalink for 'High-throughput molecular and histopathologic profiling of tumor tissue in a novel transplantable model of murine neuroblastoma: new tools for pediatric drug discovery.'

High-throughput molecular and histopathologic profiling of tumor tissue in a novel transplantable model of murine neuroblastoma: new tools for pediatric drug discovery.

Fetched: May 13th, 2012, 11:00pm MDT

High-throughput molecular and histopathologic profiling of tumor tissue in a novel transplantable model of murine neuroblastoma: new tools for pediatric drug discovery.

Cancer Invest. 2012 Jun;30(5):343-63

Authors: Stauffer JK, Orentas RJ, Lincoln E, Khan T, Salcedo R, Hixon JA, Back TC, Wei JS, Patidar R, Song Y, Hurd L, Tsokos M, Lai EW, Eisenhofer G, Weiss W, Khan J, Wigginton JM

Abstract
Using two MYCN transgenic mouse strains, we established 10 transplantable neuroblastoma cell lines via serial orthotopic passage in the adrenal gland. Tissue arrays demonstrate that by histochemistry, vascularity, immunohistochemical staining for neuroblastoma markers, catecholamine analysis, and concurrent cDNA microarray analysis, there is a close correspondence between the transplantable lines and the spontaneous tumors. Several genes closely associated with the pathobiology and immune evasion of neuroblastoma, novel targets that warrant evaluation, and decreased expression of tumor suppressor genes are demonstrated. These studies describe a unique and generalizable approach to expand the utility of transgenic models of spontaneous tumor, providing new tools for preclinical investigation.

PMID: 22571338 [PubMed - in process]

Persistent hypokalaemia in a Jamaican hypertensive patient.

Fetched: May 13th, 2012, 11:00pm MDT

Persistent hypokalaemia in a Jamaican hypertensive patient.

West Indian Med J. 2011 Dec;60(6):674-7

Authors: Potu C, Mohammed H, Tulloch-Reid MK

Abstract
We report the case of a 48-year old man with uncontrolled hypertension and persistent hypokalaemia from an aldosterone producing adrenal adenoma treated by laparoscopic adrenalectomy. Clinicians' identification of primary hyperaldosteronism is critical as the correct treatment results in improved blood pressure control and reduced risk of complications.

PMID: 22512228 [PubMed - indexed for MEDLINE]

Cushing's syndrome during pregnancy secondary to adrenal adenoma.

Fetched: May 13th, 2012, 11:00pm MDT

Cushing's syndrome during pregnancy secondary to adrenal adenoma.

Acta Med Iran. 2012;50(1):76-8

Authors: Borna S, Akbari S, Eftekhar T, Mostaan F

Abstract
Pregnancy rarely occurs in untreated cases of Cushing's syndrome (CS) , because most of them are infertile due to significant maternal and fetal complications during pregnancy. Diagnosis of CS may be difficult during pregnancy. Since physiological changes of pregnancy are overlapped by classical presentation and biological confirmation of CS. Therefore the high clinical suspicious is needed for diagnosis. We present a 33 years old pregnant woman with a history of chronic hypertension from 10 years ago that referred to Imam Khomeini hospital for uncontrolled hypertension, gestational diabetes and fetal tachycardia at the 30 weeks of gestation. After initial studies abdominal MRI detected a 43 x 35 x 29 mm right adrenal mass. She was treated by anti-hypertensive drugs. But at 31.5 weeks of gestational age cesarean section was performed due to severe preeclampsia. Then two weeks after delivery open right adrenalectomy was carried out without any complications and in the histopathological evaluation benign adrenocortical adenoma was reported. CS is associated with considerable fetal and maternal morbidity and mortality. Selection of treatment method is variable and it depends on gestational age. Medical and surgical approaches have been used in managing CS in pregnancy. Surgical treatment is the first choice for CS which is recommended at the second trimester and in the late pregnancy medical treatment is preferred.

PMID: 22267384 [PubMed - indexed for MEDLINE]

Drug interactions with mitotane by induction of CYP3A4 metabolism in the clinical management of adrenocortical carcinoma.

Fetched: May 13th, 2012, 11:00pm MDT

Drug interactions with mitotane by induction of CYP3A4 metabolism in the clinical management of adrenocortical carcinoma.

Clin Endocrinol (Oxf). 2011 Nov;75(5):585-91

Authors: Kroiss M, Quinkler M, Lutz WK, Allolio B, Fassnacht M

Abstract
Mitotane [1-(2-chlorophenyl)-1-(4-chlorophenyl)-2,2-dichloroethane, (o,p'-DDD)] is the only drug approved for the treatment for adrenocortical carcinoma (ACC) and has also been used for various forms of glucocorticoid excess. Through still largely unknown mechanisms, mitotane inhibits adrenal steroid synthesis and adrenocortical cell proliferation. Mitotane increases hepatic metabolism of cortisol, and an increased replacement dose of glucocorticoids is standard of care during mitotane treatment. Recently, sunitinib, a multityrosine kinase inhibitor (TKI), has been found to be rapidly metabolized by CYP3A4 during mitotane treatment, indicating clinically relevant drug interactions with mitotane. We here summarize the current evidence concerning mitotane-induced changes in hepatic monooxygenase expression, list drugs potentially affected by mitotane-related CYP3A4 induction and suggest alternatives. For example, using standard doses of macrolide antibiotics is unlikely to reach sufficient plasma levels, making fluoroquinolones in many cases a superior choice. Similarly, statins such as simvastatin are metabolized by CYP3A4, whereas others like pravastatin are not. Importantly, in the past, several clinical trials using cytotoxic drugs but also targeted therapies in ACC yielded disappointing results. This lack of antineoplastic activity may be explained in part by insufficient drug exposure owing to enhanced drug metabolism induced by mitotane. Thus, induction of CYP3A4 by mitotane needs to be considered in the design of future clinical trials in ACC.

PMID: 21883349 [PubMed - indexed for MEDLINE]

The effect of treatment on monocyte and lymphocyte cytokine release in patients with aldosteronoma.

Fetched: May 13th, 2012, 11:00pm MDT

The effect of treatment on monocyte and lymphocyte cytokine release in patients with aldosteronoma.

Hypertens Res. 2012 Jan;35(1):123-5

Authors: Krysiak R, Okopien B

PMID: 21866108 [PubMed - indexed for MEDLINE]

Retroperitoneal cystic teratoma masquerading as an incidentally discovered adrenal mass.

Fetched: May 13th, 2012, 11:00pm MDT

Retroperitoneal cystic teratoma masquerading as an incidentally discovered adrenal mass.

Endocr Pract. 2011 Sep 1;17(5):e130-4

Authors: Chen JC, Khiyami A, McHenry CR

Abstract
OBJECTIVE: To report a case of a retroperitoneal cystic teratoma that obscured and compressed the adrenal gland, mimicking a primary adrenal tumor.
METHODS: The presenting manifestations, radiographic characteristics, gross and microscopic pathologic features, and results of surgical therapy and long-term follow-up are described.
RESULTS: A 50-year-old African American woman with a 2-year history of low back pain and night sweats had a computed tomographic scan of the abdomen, which revealed an incidental 8 by 4 by 3.5-cm left adrenal mass without a clear plane between the mass and the left crus of the diaphragm. Laboratory studies excluded a functioning adrenal tumor. The tumor was resected laparoscopically. It was compressing but not involving the adrenal gland, nor was it involving the diaphragm. Microscopic evaluation revealed a benign mature cystic teratoma characterized by cystic spaces lined by respiratory epithelium with cartilage, bone, lymphoid tissue, smooth muscle, and ganglionic tissue in the cyst wall. The patient had an uneventful postoperative course and is free of recurrence after 18 months of follow-up.
CONCLUSION: Although rare, a mature cystic teratoma of the retroperitoneum that compresses the normal adrenal gland may masquerade as a primary adrenal tumor and should be included in the differential diagnosis of a nonfunctioning adrenal incidentaloma.

PMID: 21803708 [PubMed - indexed for MEDLINE]

$Permalink for 'Performance of plasma fractionated free metanephrines by enzyme immunoassay in the diagnosis of pheochromocytoma and paraganglioma.'$

Performance of plasma fractionated free metanephrines by enzyme immunoassay in the diagnosis of pheochromocytoma and paraganglioma.

Fetched: May 13th, 2012, 11:00pm MDT

Performance of plasma fractionated free metanephrines by enzyme immunoassay in the diagnosis of pheochromocytoma and paraganglioma.

Endocr Pract. 2011 Sep 1;17(5):759-65

Authors: Sarathi V, Pandit R, Jagtap V, Lila AR, Bandgar TR, Menon PS, Varthakavi P, Raghavan VP, Shah NS

Abstract
OBJECTIVE: To study the performance of measuring plasma fractionated free metanephrines by enzyme immunoassay (EIA) in the diagnosis of pheochromocytoma and catecholamine-secreting paraganglioma.
METHODS: Consecutive patients attending the endocrine clinic at King Edward Memorial Hospital, Mumbai, India, for suspicion of catecholamine-secreting tumors were included. Plasma fractionated free metanephrines were measured by EIA, and computed tomography of the neck, chest, abdomen, and pelvis was performed. Those with tumor identified by imaging underwent 131I m-iodobenzylguanidine scintigraphy. All patients with adrenal masses larger than 3 cm and patients with secretory tumors, irrespective of their size, underwent tumor excision. The rest were followed up for 6 to 12 months.
RESULTS: One hundred patients with a clinical suspicion of pheochromocytoma or paraganglioma were included. Plasma free normetanephrine alone had a sensitivity of 94.1% (cutoff: 180 ng/mL), while plasma free metanephrine had a sensitivity of 14.7% (cutoff: 90 pg/mL). Both had 96.9% specificity. When combined (either test positive), the sensitivity was 94.1% with a specificity of 93.75%. Thirty-four patients had a histopathologically proven pheochromocytoma or paraganglioma. It was concluded that 66 patients did not harbor a pheochromocytoma or catecholamine-secreting paraganglioma.
CONCLUSION: Plasma fractionated free metanephrines measured by EIA have good sensitivity and specificity in the diagnosis of pheochromocytoma and catecholamine-secreting paraganglioma.

PMID: 21742610 [PubMed - indexed for MEDLINE]

Permalink for 'Random postoperative day-3 cortisol concentration as a predictor of hypothalamic-pituitary-adrenal axis integrity after transsphenoidal surgery.'

Random postoperative day-3 cortisol concentration as a predictor of hypothalamic-pituitary-adrenal axis integrity after transsphenoidal surgery.

Fetched: May 13th, 2012, 11:00pm MDT

Random postoperative day-3 cortisol concentration as a predictor of hypothalamic-pituitary-adrenal axis integrity after transsphenoidal surgery.

Endocr Pract. 2011 Sep 1;17(5):717-26

Authors: Khan MI, Habra MA, McCutcheon IE, Nogueras-González GM, Devin JK, Busaidy NL, Levine NB, Lindstrom W, Kagan D, Jimenez C, Waguespack SG

Abstract
OBJECTIVE: To determine whether a random postoperative day-3 cortisol value of 10 μg/dL or greater is predictive of adrenal sufficiency 3 to 10 weeks after transsphenoidal surgery (TSS) and during long-term clinical follow-up.
METHODS: We retrospectively reviewed the case records of patients who underwent TSS at our institution between 1991 and 2008. Inclusion criteria were as follows: random cortisol measured on the morning of postoperative day 3, adrenal dynamic testing performed 3 to 10 weeks after TSS, and clinical assessment of the hypothalamic-pituitary-adrenal (HPA) axis at least 6 months after TSS.
RESULTS: A total of 466 patients underwent TSS at our institution during the study period. Eighty-three patients met study inclusion criteria. Sensitivity of a random postoperative day-3 serum cortisol value of 10 μg/dL or greater for the prediction of adrenal sufficiency at a median follow-up of 42 days was 64.81% (95% confidence interval, 50.6%-77.32%), with an odds ratio of 3.1 (95% confidence interval, 1.08-8.58). Specificity was 62.1% (95% confidence interval, 42.3%-79.3%). At a median follow-up of 500 days, only 2 patients with a postoperative day-3 cortisol value of 10 μg/dL or greater required hydrocortisone replacement, both of whom had multiple anterior pituitary hormone deficiencies and evidence of pituitary dysfunction during the perioperative period.
CONCLUSIONS: In the appropriate clinical context, a postoperative day-3 cortisol value of 10 μg/dL or greater accurately predicts the integrity of the HPA axis. The final decision regarding corticosteroid replacement should be personalized, considering the postoperative day-3 cortisol level, the clinical context in which the measurement was obtained, and any evidence of concomitant pituitary dysfunction in the perioperative period.

PMID: 21454228 [PubMed - indexed for MEDLINE]

Biological tissue diagnostics using needle biopsy and spray ionization mass spectrometry.

Fetched: May 11th, 2012, 11:00pm MDT

Biological tissue diagnostics using needle biopsy and spray ionization mass spectrometry.

Anal Chem. 2011 Dec 15;83(24):9221-5

Authors: Liu J, Cooks RG, Ouyang Z

Abstract
Needle biopsy is a routine medical procedure for examining tissue or biofluids for the presence of disease using standard methods of pathology. In this work, spray ionization directly from tissue in the biopsy needle is shown to provide highly specific molecular information through mass spectrometry analysis. The data are available within a minute after the tissue biopsy, a time scale that allows immediate medical decisions to be made. This method has been performed for tissues in a variety of organs including brain, liver, kidney, adrenal gland, stomach, and spinal cord. Amino acids, hormones, fatty acids, anesthetics, and phospholipids are detected from the tissues and identified using exact mass measurement and tandem mass spectrometry. Lipid profiles are rich in information and, as in imaging MS methods, they have the potential to serve to distinguish diseased from healthy tissue. Needle biopsies allow a crude form of depth profiling that is demonstrated with the analysis of tissue samples taken by a needle inserted into a porcine kidney at various depths.

PMID: 22103750 [PubMed - indexed for MEDLINE]

Permalink for 'Extravasation of pegylated-liposomal doxorubicin: favorable outcome after immediate subcutaneous administration of corticosteroids.'

Extravasation of pegylated-liposomal doxorubicin: favorable outcome after immediate subcutaneous administration of corticosteroids.

Fetched: May 10th, 2012, 11:00pm MDT

Extravasation of pegylated-liposomal doxorubicin: favorable outcome after immediate subcutaneous administration of corticosteroids.

Nagoya J Med Sci. 2012 Feb;74(1-2):189-92

Authors: Mitsuma A, Sawaki M, Shibata T, Morita S, Inada M, Shimokata T, Sugishita M, Kitagawa K, Sawada M, Nawa A, Ando Y

Abstract
A massive extravasation of pegylated-liposomal doxorubicin (Doxil) accidentally occurred, affecting the right forearm of a 54-year-old woman with metastatic ovarian cancer who was receiving an intravenous infusion of the drug. In accordance with the institutional guidelines for vesicant drugs, a corticosteroid preparation was immediately injected subcutaneously into the surrounding tissues. Clobetasol propionate and an ice pack were then topically applied to the affected region. There were no serious complications at the extravasation site, such as tissue necrosis or severe pain, and only a transient erythema of the skin and desquamation remained after 2 months.

PMID: 22515126 [PubMed - indexed for MEDLINE]

Permalink for 'Visinin-like 1 is upregulated in aldosterone-producing adenomas with KCNJ5 mutations and protects from calcium-induced apoptosis.'

Visinin-like 1 is upregulated in aldosterone-producing adenomas with KCNJ5 mutations and protects from calcium-induced apoptosis.

Fetched: May 10th, 2012, 11:00pm MDT

Visinin-like 1 is upregulated in aldosterone-producing adenomas with KCNJ5 mutations and protects from calcium-induced apoptosis.

Hypertension. 2012 Apr;59(4):833-9

Authors: Williams TA, Monticone S, Crudo V, Warth R, Veglio F, Mulatero P

Abstract
Visinin-like 1 (VSNL1) is upregulated in aldosterone-producing adenomas (APAs) compared with normal adrenals. We demonstrate that VSNL1 overexpression in adrenocortical carcinoma cells (NCI H295R) upregulates basal and angiotensin II-stimulated CYP11B2 gene expression 3.2- and 1.5-fold, respectively. Conversely, silencing VSNL1 by RNA interference decreases angiotensin II-stimulated CYP11B2 expression and aldosterone secretion by 41.0% and 34.5%, respectively. Mutations in the potassium channel KCNJ5 have been identified in APAs that result in sodium influx and membrane depolarization and are postulated to result in calcium influx in adrenal glomerulosa cells. VSNL1 and CYP11B2 are 8.1- and 6.0-fold more highly expressed, respectively, in APAs harboring KCNJ5 mutations compared with those without, and the upregulation of VSNL1 in these APAs accounts for the overexpression of VSNL1 in the total APA sample set compared with normal adrenals. Silencing VSNL1 in H295R cells renders them sensitive to ionomycin-induced apoptosis, indicating that VSNL1 protects these cells against calcium-induced cell death. Concomitant expression of mutated KCNJ5 (G151R) and silencing VSNL1 results in apoptosis of H295R cells, an effect that is blocked by nifedipine and is absent using a control small-interfering RNA or when wild-type KCNJ5 is expressed and VSNL1 is silenced. These data demonstrate that VSNL1 plays a dual function in vitro in the regulation of CYP11B2 gene expression and in the inhibition of calcium-induced apoptosis. In addition, VSNL1 may play a role in the pathophysiology of APAs harboring mutations in the potassium channel KCNJ5 via its antiapoptotic function in response to calcium cytotoxicity and its effect on aldosterone production.

PMID: 22331379 [PubMed - indexed for MEDLINE]

The current TNM staging system of renal cell carcinoma: are further improvements needed?

Fetched: May 10th, 2012, 11:00pm MDT

The current TNM staging system of renal cell carcinoma: are further improvements needed?

Arch Esp Urol. 2011 Dec;64(10):929-37

Authors: Billia M, Volpe A, Terrone C

Abstract
Objective of the study is to review the current 7th edition of the TNM classification of renal tumors and to perform a critical analysis of the recent evidence in order to identify the limitations of this new staging system. A search of the english literature was performed through the Medline and Pubmed database using the following keywords: renal cell carcinoma, staging system and TNM. Overall, 2600 references were initially scrutinized. Forty papers were selected based on their pertinence with the topic of the review, level of evidence provided and overall contribution to the field. Few changes have been made in the current version of the TNM staging system of renal tumors. pT2 tumors have been divided in 2 subgroups based on tumor size with a cut-off at 10 cm; the invasion of the renal vein was classified as pT3a; finally, the invasion of the ispsilateral adrenal gland was classified as pT4. However, other changes were suggested by the analysis of the recent literature and have not been introduced in this new version. Further improvements of the TNM classification for renal tumors are needed especially with regard to locally advanced tumors and node-positive disease, in order to improve the accuracy of this important prognostic tool in renal oncology.

PMID: 22228888 [PubMed - indexed for MEDLINE]

Adalimumab induces and maintains clinical remission in patients with moderate-to-severe ulcerative colitis.

Fetched: May 10th, 2012, 11:00pm MDT

Adalimumab induces and maintains clinical remission in patients with moderate-to-severe ulcerative colitis.

Gastroenterology. 2012 Feb;142(2):257-65.e1-3

Authors: Sandborn WJ, van Assche G, Reinisch W, Colombel JF, D'Haens G, Wolf DC, Kron M, Tighe MB, Lazar A, Thakkar RB

Abstract
BACKGROUND & AIMS: Adalimumab is a fully human monoclonal antibody that binds tumor necrosis factor (TNF)-α. Its efficacy as maintenance therapy for patients with ulcerative colitis has not been studied in a controlled, double-blind trial.
METHODS: Ulcerative colitis long-term remission and maintenance with adalimumab 2 (ULTRA 2) was a randomized, double-blind, placebo-controlled trial to evaluate the efficacy of adalimumab in induction and maintenance of clinical remission in 494 patients with moderate-to-severe ulcerative colitis who received concurrent treatment with oral corticosteroids or immunosuppressants. Patients were stratified based on prior exposure to TNF-α antagonists (either had or had not been previously treated with anti-TNF-α) and randomly assigned to groups given adalimumab 160 mg at week 0, 80 mg at week 2, and then 40 mg every other week or placebo. Primary end points were remission at weeks 8 and 52.
RESULTS: Overall rates of clinical remission at week 8 were 16.5% on adalimumab and 9.3% on placebo (P = .019); corresponding values for week 52 were 17.3% and 8.5% (P = .004). Among anti-TNF-α naïve patients, rates of remission at week 8 were 21.3% on adalimumab and 11% on placebo (P = .017); corresponding values for week 52 were 22% and 12.4% (P = .029). Among patients who had previously received anti-TNF agents, rates of remission at week 8 were 9.2% on adalimumab and 6.9% on placebo (P = .559); corresponding values for week 52 were 10.2% and 3% (P = .039). Serious adverse events occurred in 12% of patients given adalimumab or placebo. Serious infections developed in 1.6% of patients given adalimumab and 1.9% given placebo. In the group given adalimumab, 1 patient developed squamous cell carcinoma and 1 developed gastric cancer.
CONCLUSIONS: Adalimumab was safe and more effective than placebo in inducing and maintaining clinical remission in patients with moderate-to-severe ulcerative colitis who did not have an adequate response to conventional therapy with steroids or immunosuppressants.

PMID: 22062358 [PubMed - indexed for MEDLINE]

Pheochromocytoma and abdominal paraganglioma.

Fetched: May 10th, 2012, 11:00pm MDT

Pheochromocytoma and abdominal paraganglioma.

J Visc Surg. 2011 Dec;148(6):e409-16

Authors: Renard J, Clerici T, Licker M, Triponez F

Abstract
Pheochromocytomas (PHEO) and paragangliomas (PGL) are tumors derived from the sympathetic and parasympathetic nervous system. The parasympathetic-associated paragangliomas arising in the neck are usually non-functioning and are rarely encountered by general and visceral surgeons. The sympathetic-associated PHEO and PGL are usually functioning and most often arise in the abdomen. Because they harbor very specific characteristics (hypersecretion of catecholamines, familial origin in up to 30% of them, multiple locations, etc.) their perioperative management needs to be known by surgeons taking care of these patients in order to avoid operative disasters. Surgery can lead to perioperative hemodynamic modifications and sometimes catecholamine storm even in normotensive patients with PHEO and PGL. This emphasizes the need to exclude PHEO before any adrenal surgery as well as to medically prepare all patients with PHEO and PGL preoperatively. We review in this paper the pathophysiology and current perioperative management of patients with apparently sporadic PHEO and PGL.

PMID: 21862435 [PubMed - indexed for MEDLINE]

Metastatic mandibular neuroblastoma: a rare cause of tooth mobility.

Fetched: May 10th, 2012, 11:00pm MDT

Metastatic mandibular neuroblastoma: a rare cause of tooth mobility.

J Clin Pediatr Dent. 2011;36(2):203-6

Authors: Kürklü E, Emiroğlu HH, Kebudi R, Ozdaş DO, Ayan I, Görgün O, Zülfikar B, Yekeler E, Gülsüm AK

Abstract
Neuroblastoma (NBL), a malignant embryonic tumor derived from neural crest cells, is the most common tumor worldwide among children less than 1 year of age. Metastasis to the mandible is uncommon. This article reports the case of a 15-month-old male diagnosed with NBL with bone metastasis including the mandible which resulted in severe tooth mobility. Dentists or pediatricians should consider the primary or metastatic tumors of the maxillofacial region in the differential diagnosis in children presenting with premature loss of teeth related to tooth mobility.

PMID: 22524085 [PubMed - indexed for MEDLINE]

A rare case of primary hyperparathyroidism associated with primary aldosteronism, hürthle cell thyroid cancer and meningioma.

Fetched: May 10th, 2012, 11:00pm MDT

A rare case of primary hyperparathyroidism associated with primary aldosteronism, hürthle cell thyroid cancer and meningioma.

J Korean Med Sci. 2012 May;27(5):560-4

Authors: Kim YL, Jang YW, Kim JT, Sung SA, Lee TS, Lee WM, Kim HJ

Abstract
Multiple endocrine neoplasia type 1 (MEN1) syndrome includes varying combinations of endocrine and non-endocrine tumors. There are also a considerable number of atypical MEN1 syndrome. In this case, a 68-yr-old woman was referred to the Department of Endocrinology for hypercalcemia. Five years ago, she had diagnosed as primary hyperaldosteronism and now newly diagnosed as parathyroid hyperplasia with laboratory and pathologic findings. Hürthle-cell thyroid cancer was also resected during the parathyroid exploration and small meningioma was found on brain MRI. Her general condition has markedly improved and her adrenal mass and meningioma are being closely observed now. We could find the loss of heterozygosity of the MEN1 locus in parathyroid glands, suggesting a MEN1-related tumor, but not a germline mutation. Considering a variety of phenotypic expression and a limitation of current molecular analysis, periodic follow up will be needed in patients with a MEN1-like phenotype.

PMID: 22563225 [PubMed - in process]

Rectal metastases from squamous cell carcinoma: a case report and review of the literature.

Fetched: May 10th, 2012, 11:00pm MDT

Rectal metastases from squamous cell carcinoma: a case report and review of the literature.

Case Report Med. 2012;2012:947524

Authors: Cedrés S, Mulet-Margalef N, Montero MA, Martinez P, Martínez A, Felip E

Abstract
Non-small-cell lung cancer (NSCLC) represents 85% of lung cancer. The most frequent sites of distant metastasis are the liver, adrenal glands, bones and brain. Gastrointestinal metastases are uncommon and rectal metastases are extremely rare. Here we report a case of squamous cell carcinoma of the lung with rectal metastases.

PMID: 22567021 [PubMed - in process]

Permalink for 'High-anxious individuals show increased chronic stress burden, decreased protective immunity, and increased cancer progression in a mouse model of squamous cell carcinoma.'

High-anxious individuals show increased chronic stress burden, decreased protective immunity, and increased cancer progression in a mouse model of squamous cell carcinoma.

Fetched: May 6th, 2012, 11:00pm MDT

High-anxious individuals show increased chronic stress burden, decreased protective immunity, and increased cancer progression in a mouse model of squamous cell carcinoma.

PLoS One. 2012;7(4):e33069

Authors: Dhabhar FS, Saul AN, Holmes TH, Daugherty C, Neri E, Tillie JM, Kusewitt D, Oberyszyn TM

Abstract
In spite of widespread anecdotal and scientific evidence much remains to be understood about the long-suspected connection between psychological factors and susceptibility to cancer. The skin is the most common site of cancer, accounting for nearly half of all cancers in the US, with approximately 2-3 million cases of non-melanoma cancers occurring each year worldwide. We hypothesized that a high-anxious, stress-prone behavioral phenotype would result in a higher chronic stress burden, lower protective-immunity, and increased progression of the immuno-responsive skin cancer, squamous cell carcinoma. SKH1 mice were phenotyped as high- or low-anxious at baseline, and subsequently exposed to ultraviolet-B light (1 minimal erythemal dose (MED), 3 times/week, 10-weeks). The significant strengths of this cancer model are that it uses a normal, immunocompetent, outbred strain, without surgery/injection of exogenous tumor cells/cell lines, and produces lesions that resemble human tumors. Tumors were counted weekly (primary outcome), and tissues collected during early and late phases of tumor development. Chemokine/cytokine gene-expression was quantified by PCR, tumor-infiltrating helper (Th), cytolytic (CTL), and regulatory (Treg) T cells by immunohistochemistry, lymph node T and B cells by flow cytometry, adrenal and plasma corticosterone and tissue vascular-endothelial-growth-factor (VEGF) by ELISA. High-anxious mice showed a higher tumor burden during all phases of tumor development. They also showed: higher corticosterone levels (indicating greater chronic stress burden), increased CCL22 expression and Treg infiltration (increased tumor-recruited immuno-suppression), lower CTACK/CCL27, IL-12, and IFN-γ gene-expression and lower numbers of tumor infiltrating Th and CTLs (suppressed protective immunity), and higher VEGF concentrations (increased tumor angiogenesis/invasion/metastasis). These results suggest that the deleterious effects of high trait anxiety could be: exacerbated by life-stressors, accentuated by the stress of cancer diagnosis/treatment, and mediate increased tumor progression and/or metastasis. Therefore, it may be beneficial to investigate the use of chemotherapy-compatible anxiolytic treatments immediately following cancer diagnosis, and during cancer treatment/survivorship.

PMID: 22558071 [PubMed - in process]

Mining the proteome - the application of tandem mass spectrometry to endocrine cancer research.

Fetched: May 6th, 2012, 11:00pm MDT

Mining the proteome - the application of tandem mass spectrometry to endocrine cancer research.

Endocr Relat Cancer. 2012 May 3;

Authors: Sharma N, Martin A, McCabe CJ

Abstract
Tandem mass spectrometry (MS/MS) is at the forefront of proteome based cancer research, permitting the detection of femtomolar amounts of protein from a wide variety of tissue sources. As endocrine cancers are frequently aetiologically complex, they are particularly amenable to mass spectrometry. The most widely studied aspect is the search for novel, reliable biomarkers which will allow cancers to be diagnosed earlier and distinguished from benign tumours. MS/MS allows for the rapid analysis of blood and urine in addition to tumour tissue, and in this regard has been applied to research involving thyroid, pancreatic, adrenal and ovarian cancer with varying degrees of success. The description of an individual cancer proteome potentially allows for personalised management of each patient, avoiding unnecessary therapies and targeting treatments to those which will have the most effect. The application of MS/MS to interaction proteomics is a field that has generated recent novel targets for chemotherapy. However, the technology involved in MS/MS has a number of drawbacks that at present prevent its widespread use in translational cancer research. There is poor reproducibility of results, in part due to the large amount of data generated and the inability to accurately differentiate true from false positive results. Further, current cost of running MS/MS restricts the number of times experiments can be repeated, contributing to the lack of significance and concordance between studies. Despite these problems, however, MS/MS is emerging as a front line tool in endocrine cancer research and it is likely that this will continue over the next decade.

PMID: 22555494 [PubMed - as supplied by publisher]

Prognostic factors in renal cell carcinoma: analysis of 227 patients treated at the Brazilian National Cancer Institute.

Fetched: May 6th, 2012, 11:00pm MDT

Prognostic factors in renal cell carcinoma: analysis of 227 patients treated at the Brazilian National Cancer Institute.

Int Braz J Urol. 2012 Mar;38(2):185-94

Authors: Ornellas AA, Andrade DM, Ornellas P, Wisnescky A, Schwindt AB

Abstract
Purpose: We evaluated the role of several prognostic factors in predicting death and/or progressive disease in patients with renal cell carcinoma. Materials and Methods: Between 2004 and 2010, 227 consecutive patients with renal cell carcinoma underwent radical nephrectomy at our Institute. All histological specimens were examined by the same pathologist. We considered certain histological parameters, including histological subtype, conventional Fuhrman grade, presence of sarcomatoid features, adrenal gland infi ltration, invasion of the perinephric fat, vascular embolization, collecting system invasion, presence or absence of tumour necrosis (0 %, 1 % to 49 %, or 50 % or greater) and regional lymph node metastasis. Results: Variables signifi cantly associated with death and/or progressive disease on univariate analysis were histological subtype (p = 0.006), Fuhrman grade (p < 0.0001), tumor necrosis (p = 0.009), perinephric fat invasion (p = 0.002), vascular embolization (p = 0.0002), presence of lymph node involvement (p < 0.002), tumor size (p = 0.0006), TNM stage (p < 0.00001) and presence of metastasis (p < 0.00001). In the multivariable model histological subtype, tumor necrosis, lymph node involvement and presence of metastasis were independent risk factors for disease-free survival (p = 0.011, 0.042, 0.025 and p < 0.0001, respectively). Conclusion: Histological subtype, tumor necrosis, lymph node involvement and presence of metastasis proved to be independent prognostic factors for disease-free survival. Therefore, the presence and rate of tumor necrosis should always be informed by the pathologist and lymphadenectomy should be performed in all patients.

PMID: 22555027 [PubMed - in process]

Permalink for 'Robotic posterior retroperitoneal adrenalectomy: for what benefit and at what cost?: Comment on "Robotic vs laparoscopic posterior retroperitoneal adrenalectomy".'

Robotic posterior retroperitoneal adrenalectomy: for what benefit and at what cost?: Comment on "Robotic vs laparoscopic posterior retroperitoneal adrenalectomy".

Fetched: May 6th, 2012, 11:00pm MDT

Robotic posterior retroperitoneal adrenalectomy: for what benefit and at what cost?: Comment on "Robotic vs laparoscopic posterior retroperitoneal adrenalectomy".

Arch Surg. 2012 Mar;147(3):275-6

Authors: Kebebew E

PMID: 22430912 [PubMed - indexed for MEDLINE]

Robotic vs laparoscopic posterior retroperitoneal adrenalectomy.

Fetched: May 6th, 2012, 11:00pm MDT

Robotic vs laparoscopic posterior retroperitoneal adrenalectomy.

Arch Surg. 2012 Mar;147(3):272-5

Authors: Agcaoglu O, Aliyev S, Karabulut K, Siperstein A, Berber E

Abstract
OBJECTIVE: To compare robotic vs laparoscopic posterior retroperitoneal adrenalectomy with regard to perioperative outcomes.
DESIGN: Prospectively study.
SETTING: Tertiary academic center.
PATIENTS: Thirty-one patients who underwent robotic posterior retroperitoneal adrenalectomy and 31 consecutive patients who underwent laparoscopic posterior retroperitoneal adrenalectomy from a prospective institutional review board-approved database.
MAIN OUTCOME MEASURES: Demographic and clinical parameters, operative time, presence of complications, length of hospital stay, and pain score on postoperative days 1 and 14.
RESULTS: The mean (SEM) tumor sizes for the robotic and laparoscopic groups were similar (3.1 [0.2] and 3.0 [0.2] cm, respectively; P = .48). For all patients, the mean (SEM) skin-to-skin operative times were similar in both groups (163.2 [10.1] and 165.7 [9.5] minutes, respectively; P = .43). When the last 21 patients who underwent robotic posterior retroperitoneal adrenalectomy were compared with the 31 patients from the laparoscopic series, it was seen that the mean (SEM) operative time was shorter for the robotic group than for the laparoscopic group (139.1 [10.9] vs 166.9 [8.2] minutes; P = .046). The mean (SEM) estimated blood losses and hospital stays were similar between groups. The mean (SEM) pain score on postoperative day 1 was lower in the robotic group than in the laparoscopic group (2.5 [0.3] vs 4.2 [0.4]; P = .008); however, the mean (SEM) pain scores for the groups were similar on postoperative day 14 (P = .53). There were no deaths or cases of morbidity in either group.
CONCLUSIONS: Our study shows that, beyond the learning curve for experienced laparoscopic surgeons, robotic posterior retroperitoneal adrenalectomy shortens the skin-to-skin operative time compared with the laparoscopic approach. Our results also suggest that the immediate postoperative pain may be less severe for patients who undergo robotic posterior retroperitoneal adrenalectomy.

PMID: 22430911 [PubMed - indexed for MEDLINE]

A case of primary retroperitoneal teratoma presenting as an adrenal incidentaloma.

Fetched: May 6th, 2012, 11:00pm MDT

A case of primary retroperitoneal teratoma presenting as an adrenal incidentaloma.

J Endocrinol Invest. 2011 Sep;34(8):645-6

Authors: Giordano R, Giraudo G, Forno D, Bosco M, Delsedime L, Morino M, Arvat E

PMID: 22080648 [PubMed - indexed for MEDLINE]

Mixed Corticomedullary Carcinoma of the Adrenal Gland: A Case Report.

Fetched: May 5th, 2012, 11:00pm MDT

Mixed Corticomedullary Carcinoma of the Adrenal Gland: A Case Report.

Endocr Pract. 2012 May 1;:1-17

Authors: Turk AT, Asad H, Trapasso J, Perilli G, Livolsi VA

Abstract
Objective: To report the case of a 78-year-old woman with mixed corticomedullary carcinoma of the adrenal gland, and review other lesions that exhibit clinical and/or histopathologic features of both adrenal cortical and medullary differentiation.Methods: We describe the patient's clinical case and laboratory test results, as well as the gross and histopathologic features of her tumor. We also review the literature pertaining to mixed corticomedullary adenomas, as well as adrenal cortical tumors with clinical features of pheochromocytoma, and vice versa.Results: A 78-year-old woman with a 10-cm left adrenal mass was hospitalized for management of hypertensive urgency. Laboratory work-up revealed elevated urinary metanephrine levels, as well as elevated serum dehydroepiandrosterone sulfate (DHEAS). She underwent left adrenalectomy. Pathologic examination of the lesion showed mixed cortical and medullary histology, as well as gross and microscopic evidence of malignancy. Including the present case, we identified 17 cases of neoplasms that exhibit features of mixed corticomedullary differentiation, among which this case represents the first malignant tumor.Conclusion: We believe this report represents the first documented case of mixed corticomedullary carcinoma. Several benign lesions combine clinical, biochemical, and/or histopathologic evidence of both adrenal cortical and medullary differentiation, including mixed corticomedullary adenomas, ACTH-secreting pheochromocytomas, et cetera. This report indicates that the differential diagnosis of a lesion with mixed cortical and medullary features should also include a malignant neoplasm.

PMID: 22548942 [PubMed - as supplied by publisher]

Multicentric neurofibromatosis with rectal prolapse in a California sea lion (Zalophus californianus).

Fetched: May 5th, 2012, 11:00pm MDT

Multicentric neurofibromatosis with rectal prolapse in a California sea lion (Zalophus californianus).

J Zoo Wildl Med. 2012 Mar;43(1):110-9

Authors: Rush EM, Ogburn AL, Garner MM

Abstract
An approximately 31-yr-old California sea lion (Zalophus californianus) with a history of chronic visual impairment and corneal disease presented with slow onset, progressive neurologic deficits. Treatment for rear flipper paresis was not effective and the animal was euthanatized. Histopathologic findings included hepatocellular and biliary neoplasia, ocular amyloidosis, adrenal adenoma and pheochromocytoma, and spinal cord changes consistent with multicentric neurofibromatosis. This is the first documentation of these conditions in a California sea lion.

PMID: 22448517 [PubMed - indexed for MEDLINE]

Permalink for 'Mitotane exhibits dual effects on steroidogenic enzymes gene transcription under basal and cAMP-stimulating microenvironments in NCI-H295 cells.'

Mitotane exhibits dual effects on steroidogenic enzymes gene transcription under basal and cAMP-stimulating microenvironments in NCI-H295 cells.

Fetched: May 3rd, 2012, 11:00pm MDT

Mitotane exhibits dual effects on steroidogenic enzymes gene transcription under basal and cAMP-stimulating microenvironments in NCI-H295 cells.

Toxicology. 2012 Apr 23;

Authors: Lin CW, Chang YH, Pu HF

Abstract
Adrenocortical carcinoma (ACC) is an extremely rare and aggressive endocrine malignancy with a poor prognosis. The most common symptom of ACC is hypercortisolism (Cushing's syndrome), which has the highest mortality. Mitotane is used as a steroidogenesis inhibitor for Cushing's syndrome or as a chemical adrenalectomy drug for ACC. Mitotane induces adrenal cortex necrosis, mitochondrial membrane impairment, and irreversible binding to CYP proteins. In this study, we explored the molecular effect of mitotane on steroidogenesis in human adrenocortical cancer NCI-H295 cells. Mitotane (10-40μM) inhibited basal and cAMP-induced cortisol secretion but did not cause cell death. Mitotane exhibited an inhibitory effect on the basal expression of StAR and P450scc protein. Furthermore, 40μM of mitotane significantly diminished StAR, CYP11A1 and CYP21 mRNA expression. HSD3B2 and CYP17 seem to be insensitive to mitotane. The stimulatory effects of mitotane on CYP11B1 were more remarkable than its inhibitory effects. In contrast, the activation of cAMP signaling strongly elevated the expression of all these genes. Mitotane (40μM) almost completely neutralized this positive effect and returned 8-Br-cAMP-induced StAR, CYP11A1, CYP17 and CYP21 mRNA to control levels. After cAMP activation, mitotane did not change the levels of CYP11B1 mRNA. The present study demonstrates that mitotane can inhibit cortisol biosynthesis due to a non-specific interference with the gene transcription of steroidogenic enzymes under both basal and 8-Br-cAMP-activated conditions in NCI-H295 cells. We also identified that StAR and CYP11A1 key enzymes that participate in the rate-limiting step of steroidogenesis, were more sensitive to mitotane. In addition, the biphasic effect of mitotane on CYP11B1 was also elucidated.

PMID: 22546480 [PubMed - as supplied by publisher]

Cancer detection and biopsy classification using concurrent histopathological and metabolomic analysis of core biopsies.

Fetched: May 3rd, 2012, 11:00pm MDT

Cancer detection and biopsy classification using concurrent histopathological and metabolomic analysis of core biopsies.

Genome Med. 2012 Apr 30;4(4):33

Authors: Brown MV, McDunn JE, Gunst PR, Smith EM, Milburn MV, Troyer DA, Lawton KA

Abstract
ABSTRACT: BACKGROUND: Metabolomics, the non-targeted interrogation of small molecules in a biological sample, is an ideal technology for identifying diagnostic biomarkers. Current tissue extraction protocols involve sample destruction, precluding additional uses of the tissue. This is particularly problematic for high value samples with limited availability, such as clinical tumor biopsies that require structural preservation to histologically diagnose and gauge cancer aggressiveness. To overcome this limitation and increase the amount of information obtained from patient biopsies, we developed and characterized a workflow to perform metabolomic analysis and histological evaluation on the same biopsy sample. METHODS: Biopsies of ten human tissues (muscle, adrenal gland, colon, lung, pancreas, small intestine, spleen, stomach, prostate, kidney) were placed directly in a methanol solution to recover metabolites, precipitate proteins, and fix tissue. Following incubation, biopsies were removed from the solution and processed for histology. Kidney and prostate cancer tumor and benign biopsies were stained with hemotoxylin and eosin and prostate biopsies were subjected to PIN-4 immunohistochemistry. The methanolic extracts were analyzed for metabolites on GC/MS and LC/MS platforms. Raw mass spectrometry data files were automatically extracted using an informatics system that includes peak identification and metabolite identification software. RESULTS: Metabolites across all major biochemical classes (amino acids, peptides, carbohydrates, lipids, nucleotides, cofactors, xenobiotics) were measured. The number (ranging from 260 in prostate to 340 in colon) and identity of metabolites were comparable to results obtained with the current method requiring 30 mg ground tissue. Comparing relative levels of metabolites, cancer tumor from benign kidney and prostate biopsies could be distinguished. Successful histopathological analysis of biopsies by chemical staining (hematoxylin, eosin) and antibody binding (PIN-4, in prostate) showed cellular architecture and immunoreactivity were retained. CONCLUSIONS: Concurrent metabolite extraction and histological analysis of intact biopsies is amenable to the clinical workflow. Methanol fixation effectively preserves a wide range of tissues and is compatible with chemical staining and immunohistochemistry. The method offers an opportunity to augment histopathological diagnosis and tumor classification with quantitative measures of biochemicals in the same tissue sample. Since certain biochemicals have been shown to correlate with disease aggressiveness, this method should prove valuable as an adjunct to differentiate cancer aggressiveness.

PMID: 22546470 [PubMed - as supplied by publisher]

Recurrent ventricular tachycardia in malignant metastatic pheochromocytoma.

Fetched: May 3rd, 2012, 11:00pm MDT

Recurrent ventricular tachycardia in malignant metastatic pheochromocytoma.

Circulation. 2012 Mar 13;125(10):e435-8

Authors: Park JW, Park SJ, Hur KY, Kim JH, Choi YL, Park SM, Kim SM, Koo EH, Kim JS

PMID: 22412096 [PubMed - indexed for MEDLINE]

Permalink for 'Clinical characteristics of patients with remitting seronegative symmetrical synovitis with pitting edema compared to patients with pure polymyalgia rheumatica.'

Clinical characteristics of patients with remitting seronegative symmetrical synovitis with pitting edema compared to patients with pure polymyalgia rheumatica.

Fetched: May 3rd, 2012, 11:00pm MDT

Clinical characteristics of patients with remitting seronegative symmetrical synovitis with pitting edema compared to patients with pure polymyalgia rheumatica.

J Rheumatol. 2012 Jan;39(1):148-53

Authors: Kimura M, Tokuda Y, Oshiawa H, Yoshida K, Utsunomiya M, Kobayashi T, Deshpande GA, Matsui K, Kishimoto M

Abstract
OBJECTIVE: To compare clinical features of patients with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) and patients with polymyalgia rheumatica (PMR) and to explore the purported association between RS3PE and malignancy.
METHODS: We did a retrospective chart review of patients with RS3PE and PMR treated in a community-based hospital between January 2000 and December 2009. Outcomes assessed were clinical course of disease and associated malignancies.
RESULTS: We identified 28 patients with RS3PE and 123 with pure PMR. All patients with RS3PE fulfilled PMR criteria as well. Age, comorbidity, erythrocyte sedimentation rate, duration and progression of symptoms, treatment response to initial low-dose steroids, and steroid complication rates were similar in both groups. Patients with RS3PE were more likely to be male (79% vs 41%; p = 0.001) and to have a history of smoking (39% vs 15%; p = 0.008) and a higher rate of depression (11% vs 2%; p = 0.044) at diagnosis. Among those with RS3PE, hip pain was less common (39% vs 74%; p = 0.001) than in the PMR group. No patients with RS3PE and 6 patients with pure PMR (4.9%) developed another rheumatological disease during followup. Seven of 9 patients (78%) with concurrent cancer presented slightly more frequently with systemic symptoms compared to patients without cancer (48%; p = 0.098), especially with fatigue (56% vs 22%; p = 0.037) and anorexia (33% vs 9.0%; p = 0.047). Despite rigorous cancer screening in patients with RS3PE, however, the rate of associated malignancy was not statistically different from that of patients with pure PMR [2 (7%) vs 7 (6%), respectively; p = 0.673].
CONCLUSION: Despite evidence that RS3PE is clinically distinct from PMR, we observed characteristics, treatment response, and outcomes like those expected in pure PMR. Compared to patients with pure PMR, patients with RS3PE are more likely to be male, to be depressed, and to smoke. Contrary to earlier studies, no clear association of RS3PE with malignancy was found despite rigorous cancer screening, although clinicians should be aware that patients with concurrent cancer may manifest more systemic signs and symptoms, as well as steroid resistance.

PMID: 22174210 [PubMed - indexed for MEDLINE]

Metastatic clear cell renal cell carcinoma to the adrenal gland without an identifiable primary tumor.

Fetched: May 3rd, 2012, 11:00pm MDT

Metastatic clear cell renal cell carcinoma to the adrenal gland without an identifiable primary tumor.

Int J Urol. 2012 Jan;19(1):92-3

Authors: Johnson MT, Bahnson RR, Zynger DL

PMID: 22146098 [PubMed - indexed for MEDLINE]

[Role of endoscopic adrenalectomy in adrenal gland surgery].

Fetched: May 3rd, 2012, 11:00pm MDT

[Role of endoscopic adrenalectomy in adrenal gland surgery].

Zentralbl Chir. 1998;123(5):495-500

Authors: Heintz A, Junginger T

Abstract
Endoscopic techniques are used increasingly in adrenal gland surgery. In this paper the indications and results of the laparoscopic and retroperitoneoscopic approach are compared to the results of the conventional trans- and extraperitoneal approach. Endoscopic adrenalectomy can be performed safely and with the benefits associated with minimally invasive surgery. Disadvantages of the laparoscopic, transperitoneal approach are the risk of an intraabdominal injury and the problems caused by adhesions after abdominal operations. The retroperitoneoscopic approach avoids these disadvantages. Anatomical orientation is more difficult using the retroperitoneoscopic access. In case of large tumors of the adrenal gland suspected for malignancy we see the indication for the conventional transperitoneal approach.

PMID: 22462217 [PubMed - indexed for MEDLINE]

Three uncommon adrenal incidentalomas: a 13-year surgical pathology review.

Fetched: May 2nd, 2012, 11:00pm MDT

Three uncommon adrenal incidentalomas: a 13-year surgical pathology review.

World J Surg Oncol. 2012 Apr 27;10(1):64

Authors: Kanthan R, Senger JL, Kanthan SC

Abstract
ABSTRACT: BACKGROUND: The discovery of adrenal incidentalomas due to the widespread use of sophisticated abdominal imaging techniques has resulted in an increasing trend of adrenal gland specimens being received in the pathology laboratory. In this context, we encountered three uncommon adrenal incidentalomas. The aim of this manuscript is to report in detail the three index cases of adrenal incidentalomas in the context of a 13-year retrospective surgical pathology review. METHODS: The three index cases were investigated and analyzed in detail with relevant review of the English literature as available in PubMed and Medline. A 13-year retrospective computer-based histopathological surgical review was conducted in our laboratory and the results were analyzed in the context of evidence-based literature on adrenal incidentalomas. RESULTS: A total of 94 adrenal specimens from incidentalomas were identified, accounting for 0.025% of all surgical pathology cases. In all 76.6% were benign and 23.4% were malignant. A total of 53 females (56.4%) and 41 males (43.6%) aged 4 to 85 years were identified. The benign lesions included cortical adenoma (43.1%), pheochromocytoma (29.3%) and inflammation/fibrosis/hemorrhage (8.3%). Metastatic neoplasms were the most common malignant lesions (50%) followed by primary adrenocortical carcinomas (31.8%) and neuroblastoma (13.6%). These cases were discovered as adrenal incidentalomas that led to surgical exploration.The three index cases of adrenal incidentalomas with unusual pathologies were encountered that included (a) adrenal ganglioneuroma, (b) periadrenal schwannoma and (c) primary adrenal pleomorphic leiomyosarcoma. These cases are discussed, with a literature and clinicopathological review. CONCLUSIONS: Adrenal lesions are uncommon surgical specimens in the pathology laboratory. However, higher detection rates of adrenal incidentalomas aided by the ease of laparoscopic adrenalectomy has resulted in increased adrenal surgical specimens leading to unsuspected diagnostic and management dilemmas. Accurate pathological identification of common and uncommon adrenal incidentalomas is essential for optimal patient management.

PMID: 22540324 [PubMed - as supplied by publisher]

Permalink for 'Transarterial embolization and doxorubicin eluting beads-transarterial chemoembolization (DEB-TACE) of malignant extra-adrenal pheochromocytoma.'

Transarterial embolization and doxorubicin eluting beads-transarterial chemoembolization (DEB-TACE) of malignant extra-adrenal pheochromocytoma.

Fetched: April 30th, 2012, 11:00pm MDT

Transarterial embolization and doxorubicin eluting beads-transarterial chemoembolization (DEB-TACE) of malignant extra-adrenal pheochromocytoma.

Cardiovasc Intervent Radiol. 2011 Dec;34(6):1325-9

Authors: Kumar P, Bryant T, Breen D, Stedman B, Hacking N

PMID: 21437761 [PubMed - indexed for MEDLINE]

[Adrenal oncocytoma].

Fetched: April 30th, 2012, 11:00pm MDT

[Adrenal oncocytoma].

Cir Esp. 2011 Dec;89(10):692-3

Authors: Reyna-Villasmil E, Santos-Bolívar J, Prieto-Montaño J

PMID: 21419397 [PubMed - indexed for MEDLINE]

[Adrenal extramedullary plasmacytoma].

Fetched: April 30th, 2012, 11:00pm MDT

[Adrenal extramedullary plasmacytoma].

Cir Esp. 2011 Dec;89(10):690-1

Authors: Blanco Antona F, Bahamonde Cabria S, Blanco Antona L, Marín Pérez-Tabernero A

PMID: 21414618 [PubMed - indexed for MEDLINE]

Traditional and novel cardiovascular risk factors in non-functioning adrenal adenomas.

Fetched: April 30th, 2012, 11:00pm MDT

Traditional and novel cardiovascular risk factors in non-functioning adrenal adenomas.

Eur J Intern Med. 2012 Jan;23(1):83-7

Authors: Yener S, Cömlekci A, Yuksel F, Sevinc A, Ertilav S, Yesil S

Abstract
BACKGROUND: The majority of the incidentally discovered adrenal masses are non-functioning adrenal adenomas; however data regarding traditional and novel cardiovascular risk predictors in these subjects is lacking. The objective of our study was to investigate the levels of PAI-1, IL-6 and Apelin along with several traditional cardiovascular risk markers in subjects with non-functioning adrenal adenomas.
METHODS: 38 subjects with non-functioning adrenal adenomas and 30, age, gender and BMI matched healthy controls were enrolled. Participants underwent hormonal evaluation including morning cortisol, adrenocorticotrophic hormone (ACTH), post dexamethasone suppression test (DST) cortisol, dehydroepiandrosterone sulfate (DHEAS) and urinary cortisol. Anthropometric and metabolic parameters, body composition, PAI-1, IL-6 and Apelin were measured.
RESULTS: Subjects with non-functioning adrenal adenomas had significant elevations in systolic blood pressure, mean arterial pressure, waist circumference, uric acid, and post DST cortisol and had significantly reduced levels of DHEAS when compared to BMI matched controls. No significant difference was observed in terms of PAI-1, IL-6 and Apelin between groups. PAI-1 and IL-6 were significantly correlated with mean arterial pressure, BMI, uric acid, total and LDL-cholesterol. Linear regression analysis showed that morning cortisol and Apelin levels independently predicted HOMA levels in subjects with adrenal adenomas.
CONCLUSION: Subjects with non-functioning adrenal adenomas feature several cardiovascular risk factors even when compared to BMI matched individuals. Subtle cortisol autonomy in adrenal adenomas may be associated with those findings.

PMID: 22153537 [PubMed - indexed for MEDLINE]

Chronic obstructive pulmonary disease.

Fetched: April 30th, 2012, 11:00pm MDT

Chronic obstructive pulmonary disease.

Lancet. 2012 Apr 7;379(9823):1341-51

Authors: Decramer M, Janssens W, Miravitlles M

Abstract
Chronic obstructive pulmonary disease (COPD) is characterised by progressive airflow obstruction that is only partly reversible, inflammation in the airways, and systemic effects or comorbities. The main cause is smoking tobacco, but other factors have been identified. Several pathobiological processes interact on a complex background of genetic determinants, lung growth, and environmental stimuli. The disease is further aggravated by exacerbations, particularly in patients with severe disease, up to 78% of which are due to bacterial infections, viral infections, or both. Comorbidities include ischaemic heart disease, diabetes, and lung cancer. Bronchodilators constitute the mainstay of treatment: β(2) agonists and long-acting anticholinergic agents are frequently used (the former often with inhaled corticosteroids). Besides improving symptoms, these treatments are also thought to lead to some degree of disease modification. Future research should be directed towards the development of agents that notably affect the course of disease.

PMID: 22314182 [PubMed - indexed for MEDLINE]

Laparoscopic adrenalectomy for functioning and non-functioning adrenal tumours.

Fetched: April 28th, 2012, 11:00pm MDT

Laparoscopic adrenalectomy for functioning and non-functioning adrenal tumours.

Endokrynol Pol. 2011;62(6):512-6

Authors: Lubikowski J, Kiedrowicz B, Szajko M, Andrysiak-Mamos E, Pynka S, Wójcicki M, Jarosz K, Koziołek M, Fuchs H, Post M, Safranow K, Syrenicz A

Abstract
BACKGROUND: The purpose of this study was a retrospective analysis of outcomes following laparoscopic adrenalectomy (LA) performed for benign adrenal tumours responsible for various endocrinological disorders. The patients were diagnosed with non-functioning (NFT) and functioning adrenal tumours (FT) including pheochromocytoma (PH), Conn's syndrome (CO) and Cushing's (CS) syndrome.
MATERIAL AND METHODS: A total of 165 LAs were carried out between August 1995 and September 2009 via either the transperitoneal (n = 38) or retroperitoneal (n = 127) approach. The analysed factors included demographic data of patients, the American Association of Anaesthesiology score (ASA), indication for surgery, tumour size and side, intraoperative and postoperative outcome of LA including duration of surgery, blood loss, time until ambulation, length of hospital stay, time until return to normal activity, the complication rate, as well as the conversion rate to open adrenalectomy.
RESULTS: There were 111 patients with NFT and 54 with FT. Patients with NFT were significantly older than those with CO (p < 0.05). The mean size of the lesion differed between CO and other adrenal tumours (p < 0.05) as well as between NFT and PH (p < 0.05). All the lesions except aldosteronomas were detected predominantly in the right adrenal gland (p < 0.05). However, despite the different characteristic and clinical disorders related to laparoscopically removed adrenal tumours, the intraoperative and postoperative outcomes did not significantly differ in most cases between the analysed groups of patients.
CONCLUSION: This study shows that LA is a safe, effective, and well-tolerated procedure despite the hormonal activity of the removed lesions. Minimal invasive surgery may be recommended as the 'gold standard' in the treatment of both functioning and non-functioning benign tumours of the adrenal gland.

PMID: 22144217 [PubMed - indexed for MEDLINE]

Therapeutic management of advanced adrenocortical carcinoma: what do we know in 2011?

Fetched: April 27th, 2012, 11:00pm MDT

Therapeutic management of advanced adrenocortical carcinoma: what do we know in 2011?

Horm Cancer. 2011 Dec;2(6):363-71

Authors: Baudin E, Leboulleux S, Al Ghuzlan A, Chougnet C, Young J, Deandreis D, Dumont F, Dechamps F, Caramella C, Chanson P, Lanoy E, Borget I, Schlumberger M

Abstract
The prognosis of advanced adrenocortical carcinoma (ACC) is dismal but heterogeneous. In 2011, mitotane is the only drug approved in Europe and US for the treatment of advanced ACC. Mitotane exerts both antisecretory and antiproliferative effects, which are delayed over time, and requires careful biological and morphological evaluations coupled with mitotane plasma measurement monitoring. In the absence of demonstration of any superior activity of combined polychemotherapy, the least toxic regimen should be considered in routine care. Locoregional therapies, including surgery of the primary tumor and metastases, should be considered part of the therapeutic arsenal. A prolonged survival can be observed in the case of tumor objective response and/or high plasma mitotane levels. New protocols are urgently needed, coupled with ancillary studies dedicated to progress in the findings of predictors or surrogates. International networks and comprehensive databases gathering clinical and biological data constitute the prerequisites for progress.

PMID: 22161625 [PubMed - indexed for MEDLINE]

Eplerenone use in primary aldosteronism during pregnancy.

Fetched: April 27th, 2012, 11:00pm MDT

Eplerenone use in primary aldosteronism during pregnancy.

Hypertension. 2012 Feb;59(2):e18-9

Authors: Cabassi A, Rocco R, Berretta R, Regolisti G, Bacchi-Modena A

PMID: 22146514 [PubMed - indexed for MEDLINE]

FDG PET in the management of patients with adrenal masses and adrenocortical carcinoma.

Fetched: April 27th, 2012, 11:00pm MDT

FDG PET in the management of patients with adrenal masses and adrenocortical carcinoma.

Horm Cancer. 2011 Dec;2(6):354-62

Authors: Deandreis D, Leboulleux S, Caramella C, Schlumberger M, Baudin E

Abstract
Adrenocortical carcinoma (ACC) is a rare tumor with aggressive behavior, high recurrence rate, and rapid evolution. Surgery is the only curative modality, while systemic treatments such as mitotane and chemotherapy associated to locoregional therapeutic tools remain as palliative options. Imaging has an important role in the management of patients with ACC both at diagnosis and during follow-up. First, it is necessary to characterize undetermined adrenal masses, selecting patients for surgery. Then, in case of malignancy, it is mandatory to assess disease extension, to detect early relapse during follow-up, and to evaluate treatment response. Computed tomography scan and magnetic resonance imaging are actually the most used techniques for these intents as they are widely available in clinical practice. (18)F-fluorodeoxyglucose positron emission tomography (FDG PET) is routinely used for other malignancies and, on the basis of published data, is also becoming a promising tool in the management of ACC. Not only is it a diagnostic tool complementary to morphological imaging in the characterization of adrenal masses and in tumoral lesions detection, but it can be also useful to evaluate tumor response to treatment. New tracers and indications for the clinical use of FDG PET in this specific disease still have to be evaluated to assess its role in clinical practice.

PMID: 22076881 [PubMed - indexed for MEDLINE]

Conventional imaging in adrenocortical carcinoma: update and perspectives.

Fetched: April 27th, 2012, 11:00pm MDT

Conventional imaging in adrenocortical carcinoma: update and perspectives.

Horm Cancer. 2011 Dec;2(6):341-7

Authors: Young WF

Abstract
The objectives of this study were to review how conventional imaging for adrenocortical carcinoma has evolved over the past 100 years and to highlight the current role for computed tomography (CT) and magnetic resonance imaging (MRI). Using historical cases from the Mayo Clinic archives, the approaches to conventional imaging for adrenocortical carcinoma are described, and pertinent literature is reviewed. Limited conventional imaging options in the first 75 years of the twentieth century were supplemented with keen clinical observation and clinical intuition. With the development of CT and MRI, technologic advances in the computed image-based assessment of adrenocortical carcinoma have been truly remarkable. CT and MRI can help determine whether an adrenal mass is an adrenocortical carcinoma and can also assess for local tumor invasion and metastatic disease. CT and MRI provide the clinician and surgeon with key information to guide medical and surgical management. Three decades from now, what we currently view as conventional imaging (e.g., CT and MRI) will be the imaging equivalents to the plain abdominal roentogram and intravenous pyelogram of the mid-twentieth century.

PMID: 21997291 [PubMed - indexed for MEDLINE]

The Weiss score and beyond--histopathology for adrenocortical carcinoma.

Fetched: April 27th, 2012, 11:00pm MDT

The Weiss score and beyond--histopathology for adrenocortical carcinoma.

Horm Cancer. 2011 Dec;2(6):333-40

Authors: Papotti M, Libè R, Duregon E, Volante M, Bertherat J, Tissier F

Abstract
The pathological diagnosis of adrenocortical carcinoma (ACC) is still challenging for its rarity and the presence of special variants (pediatric, oncocytic, myxoid, and sarcomatoid). It is based on the recognition at light microscopy of at least three among nine morphological parameters, according to the Weiss scoring system, which has been introduced 27 years ago and nowadays is the most widely employed. Nevertheless, the diagnostic performance of this system is very high but does not reach a sensitivity and specificity of 100%, its diagnostic applicability is potentially low among non-expert pathologists, and a group of borderline cases with only one or two criteria exist of uncertain behavior. Moreover, it is scarcely reproducible in the ACC morphological variants. In fact, specifically for the pure oncocytic neoplasms that seem to have a better prognosis in comparison to the conventional ACCs, a modified system (the Lin-Weiss-Bisceglia) has been proposed. With the aim to simplify the ACC diagnosis, 2 years ago, the "reticulin" diagnostic algorithm has been proposed, based on the observation that the tumoral reticulin framework (highlighted by reticulin silver-based histochemical staining) is consistently disrupted in malignant cases but only in a small subset of benign cases. Following this algorithm, in the presence of reticulin alterations, malignancy is further defined through the identification of at least one of the following parameters: necrosis, high mitotic rate, and venous invasion. As a complement to the morphological approach, some immunohistochemical markers (such as steroidogenic factor 1) have been proposed as diagnostic and prognostic adjuncts but still lack wide clinical validation.

PMID: 21997290 [PubMed - indexed for MEDLINE]

Unsuspected pheochromocytoma: is it time for a registry?

Fetched: April 27th, 2012, 11:00pm MDT

Unsuspected pheochromocytoma: is it time for a registry?

Can J Anaesth. 2012 Jan;59(1):112-3

Authors: Mackenzie-Feder J, Tsang J, Demyttenaere S

PMID: 21989552 [PubMed - indexed for MEDLINE]

Metronomic therapy concepts in the management of adrenocortical carcinoma.

Fetched: April 27th, 2012, 11:00pm MDT

Metronomic therapy concepts in the management of adrenocortical carcinoma.

Horm Cancer. 2011 Dec;2(6):378-84

Authors: Berruti A, Sperone P, Bellini E, Daffara F, Perotti P, Ardito A, Saini A, Terzolo M

Abstract
Metronomic chemotherapy is the administration of cytotoxic drugs at low doses, on a frequent or continuous schedule, with no extended interruption. This treatment approach can target tumor cells indirectly since it can affect the endothelium of the growing tumor vasculature and stimulates the anticancer immune response. Both the antiangiogenetic and the immunomodulatory roles of metronomic chemotherapy favor a tumor dormancy, a condition that may improve the patient outcome. Prospective clinical trials conducted in several malignancies have shown that metronomic chemotherapy can obtain disease stabilization or responses in tumors that had been made resistant in vivo to conventional chemotherapeutic regimens. Three prospective phase II trials have been conducted in patients with adrenocortical carcinoma (ACC). In all of them, patients heavily pretreated with conventional chemotherapy and mitotane have been enrolled. One trial tested the activity of the association of gemcitabine and fluoropyrimidines administered on a metronomic schedule. In this trial, 40% of patients attained a disease stabilization or disease response that was long lasting in some of them. In the remaining two trials, metronomic chemotherapy was administered in association with antiangiogenetic drugs, and the results were disappointing since no response or stable disease was obtained. In conclusion, metronomic chemotherapy can delay tumor progression in advanced ACC and deserves to be further tested. The concomitant administration of antiangiogenetic drugs may be detrimental. Several important questions remain to be addressed such as the optimal dose and most effective dosing interval, when to use the metronomic approach in the natural history of the disease, the choice of cytotoxic drugs, and the most efficacious way to integrate metronomic chemotherapy with standard therapy protocols.

PMID: 21971765 [PubMed - indexed for MEDLINE]

When is a phaeo not a phaeo? Depression in an adolescent leading to a phaeochromocytoma-like biochemical profile.

Fetched: April 27th, 2012, 11:00pm MDT

When is a phaeo not a phaeo? Depression in an adolescent leading to a phaeochromocytoma-like biochemical profile.

Clin Endocrinol (Oxf). 2011 Oct;75(4):567-8

Authors: Yeshayahu Y, Tallett S, Pacak K, De Souza C, Palmert MR

PMID: 21521331 [PubMed - indexed for MEDLINE]

Surgical analysis of pediatric and adolescent sporadic pheochromocytoma: single center experience.

Fetched: April 27th, 2012, 11:00pm MDT

Surgical analysis of pediatric and adolescent sporadic pheochromocytoma: single center experience.

Int Urol Nephrol. 2011 Dec;43(4):1019-24

Authors: Osman Y, Hussein N, Sarhan O, Shorrab AA, Dawaba M, Ghoneim MA

Abstract
INTRODUCTION: The aim of this study is to review our experience with sporadic pheochromocytoma in pediatrics and adolescents focusing upon surgical approach, incidence of malignancy, and recurrence rate.
MATERIALS AND METHODS: Between 1990 and 2007, 8 pediatric patients were diagnosed with sporadic pheochromocytoma. Demographic data, clinical and radiological findings, laboratory profile, preoperative preparation, surgical approach, operative findings, postoperative course as well as pathologic diagnosis of the removed specimen were reviewed.
RESULTS: Mean age of presentation was 13.1 ± 4.7 years. Five patients had right-sided masses, 1 harbored left-sided mass, and bilaterality was observed in 2 with mean size of 5.7 ± 1.3 cm. Computed tomography showed no evidence of local infiltration, regional lymphadenopathy or distant metastasis in all patients but two. Six masses were excised through thoraco-abdominal approach, 3 were removed laparoscopically, while percutaneous alcohol ablation was adopted for the last. We had one postoperative death (12.5%:1/8), and the remaining 7 patients were followed for a mean of 8.6 ± 3 years. Five patients never had recurrence. Bilateral recurrence developed in 2 patients, where they were safely excised in one patient and was a part of disseminated disease in the other. Malignant nature of the disease was proved in 2 patients and showed poor survival.
CONCLUSION: Under adequate anesthetic control, pediatric pheochromocytoma could be safely managed through both the open and laparoscopic approaches. Advanced radiological stage would suggest the malignant nature of the disease with dismal outcome. Long-term follow-up is warranted for possibility of delayed curable recurrence.

PMID: 21516474 [PubMed - indexed for MEDLINE]

Permalink for 'Cytochrome P450s in the guinea pig adrenal that are immunologically similar to liver forms: estrogen suppression explains male-female differences.'

Cytochrome P450s in the guinea pig adrenal that are immunologically similar to liver forms: estrogen suppression explains male-female differences.

Fetched: April 27th, 2012, 11:00pm MDT

Cytochrome P450s in the guinea pig adrenal that are immunologically similar to liver forms: estrogen suppression explains male-female differences.

J Steroid Biochem Mol Biol. 1992 Dec;43(8):863-8

Authors: Black VH

Abstract
Several cytochrome P450s have been identified in guinea pig adrenal microsomes which are distinct from the known steroidogenic P450s, c17 and c21, and are immunochemically related to cytochrome P450s found in liver. One, a 52 K protein related to P450 I (CYP1), occurs almost exclusively in males, is localized to the inner zone, and is suppressed by ACTH. Its levels correlate with microsomal capacity for xenobiotic metabolism. The others, related to P450s II and III (CYP2 and 3), are more predominant in males, but not exclusive to them, are found in both the inner and outer zones, and are not suppressed by ACTH. Their functions remain to be elucidated. The male predominance of the CYP1-related protein has recently been shown to be due to suppression of the protein in females by estrogen. To determine if estrogen is also involved in the regulation of the CYP2-related proteins, ovariectomized and sham-operated animals were treated with a long-acting estrogen, estradiol valerate, or with the vehicle alone. These P450s reached male levels in ovariectomized females treated only with the vehicle. Their enhanced levels were suppressed by treatment with estrogen. Estrogen treatment also suppressed the levels of the P450s seen in sham-operated females. Endogenous estrogen produced similar effects. In hemi-ovariectomized females the contralateral ovary hypertrophied, a state in which estrogen levels would be maintained or increased. In these females no increase occurred in the immunodetectable P450s. In normal females, estrogen levels are low in prepubertal animals, rise at the time of puberty and drop again after ovarian cycling is completed. The CYP2-related proteins were present in adrenal microsomes of prepubertal females, but were suppressed after puberty. On the other hand, post-estrous females, in whom estrogen levels would be low, acquired male levels of these proteins in their adrenal microsomes. P450c17 and P450c21, as well as 3β-hydroxysteroid dehydrogenase, were not affected by surgery or estrogen. Taken together, these experiments indicate that suppression by estrogen in females can account, in large part, for the predominance of several immunochemical homologs of liver P450s in adult male guinea pig adrenals.

PMID: 22217830 [PubMed - indexed for MEDLINE]

Neuroblastoma stage 4S: a multifocal stem-cell disease of the developing neural crest.

Fetched: April 27th, 2012, 11:00pm MDT

Neuroblastoma stage 4S: a multifocal stem-cell disease of the developing neural crest.

Lancet Oncol. 2012 Mar;13(3):229-30

Authors: van Noesel MM

PMID: 22381931 [PubMed - indexed for MEDLINE]

Hirsutism in women.

Fetched: April 27th, 2012, 11:00pm MDT

Hirsutism in women.

Am Fam Physician. 2012 Feb 15;85(4):373-80

Authors: Bode D, Seehusen DA, Baird D

Abstract
Hirsutism is excess terminal hair that commonly appears in a male pattern in women. Although hirsutism is generally associated with hyperandrogenemia, one-half of women with mild symptoms have normal androgen levels. The most common cause of hirsutism is polycystic ovary syndrome, accounting for three out of every four cases. Many medications can also cause hirsutism. In patients whose hirsutism is not related to medication use, evaluation is focused on testing for endocrinopathies and neoplasms, such as polycystic ovary syndrome, adrenal hyperplasia, thyroid dysfunction, Cushing syndrome, and androgen-secreting tumors. Symptoms and findings suggestive of neoplasm include rapid onset of symptoms, signs of virilization, and a palpable abdominal or pelvic mass. Patients without these findings who have mild symptoms and normal menses can be treated empirically. For patients with moderate or severe symptoms, an early morning total testosterone level should be obtained, and if moderately elevated, it should be followed by a plasma free testosterone level. A total testosterone level greater than 200 ng per dL (6.94 nmol per L) should prompt evaluation for an androgen-secreting tumor. Further workup is guided by history and physical examination, and may include thyroid function tests, prolactin level, 17-hydroxyprogesterone level, and corticotropin stimulation test. Treatment includes hair removal and pharmacologic measures. Shaving is effective but needs to be repeated often. Evidence for the effectiveness of electrolysis and laser therapy is limited. In patients who are not planning a pregnancy, first-line pharmacologic treatment should include oral contraceptives. Topical agents, such as eflornithine, may also be used. Treatment response should be monitored for at least six months before making adjustments.

PMID: 22335316 [PubMed - indexed for MEDLINE]

Is there an optimal scan time for 6-[F-18]fluoro-L-DOPA PET in pheochromocytomas and paragangliomas?

Fetched: April 27th, 2012, 11:00pm MDT

Is there an optimal scan time for 6-[F-18]fluoro-L-DOPA PET in pheochromocytomas and paragangliomas?

Clin Nucl Med. 2012 Feb;37(2):e24-9

Authors: Hentschel M, Rottenburger C, Boedeker CC, Neumann HP, Brink I

Abstract
PURPOSE: To define the appropriate scan time for fluorine-18-labeled dihydroxyphenylalanine (F-18 DOPA) PET in oncological imaging of pheochromocytomas and paragangliomas.
MATERIALS AND METHODS: F-18 DOPA PET examinations were performed in 9 patients with 7 pheochromocytomas and 4 head and neck paragangliomas using a dedicated PET scanner. The acquisition started with a dynamic single-bed scan in the tumor region over the first 60 minutes after tracer injection followed by a late time whole-body scan at approximately 130 minutes. Standard uptake values (SUVs) were calculated in tumors, surrounding background, and adjacent normal tissues of relevance. Furthermore, kinetic analysis was performed using a 2-compartment model with rate constants for uptake (K1'), release (k2'), metabolism (k3'), and reverse reaction (k4') for region of interest and pixel-wise analysis.
RESULTS: All tumors show a marked increased F-18 DOPA uptake, which was visually detectable and distinguishable from the surrounding tissue. The SUV is significantly lower in neck paraganglioma compared with abdominal pheochromocytomas. Mean time-activity curves of F-18 DOPA in tumors show a rapid uptake of the tracer. Already 2 minutes after the injection, the activity in the tumor is beyond that of the blood pool. The average maximum value (SUVmean = 8.2) has already been reached after 20 minutes. Afterward, a very slight decrease of the tumor SUV starts, which still amounts to 80% of the maximum value after 132 minutes. Due to the continuous decrease of activity in the background tissue, the tumor-to-background ratio of SUVs shows a constant increase within the entire period of examination. The mean values of apparent kinetic constants obtained by region of interest analysis averaged over all tumors are as follows: K1' = 2.89 ± 2.56 min(-1), k2' = 2.59 ± 2.81 min(-1), k3' = 0.301 ± 0.395 min(-1), and k4' = 0.044 ± 0.043 min(-1).
CONCLUSIONS: Pheochromocytoma and paraganglioma take up F-18 DOPA very quickly. At best, the acquisition for static clinical PET imaging of paraganglioma with F-18 DOPA can start at 20 minutes postinjection for maximum uptake in tumors. Separation of tumor, background, and adjacent normal tissues is feasible due to their differences in SUV values and kinetics. The kinetic analysis demonstrates an F-18 DOPA accumulation within the tumor due to considerable differences between the rate constants of uptake and metabolism. Second, in contradiction to healthy brain, paraganglionic tumors show a reversible F-18 DOPA metabolism.

PMID: 22228360 [PubMed - indexed for MEDLINE]

Phase II study of weekly paclitaxel and sorafenib as second/third-line therapy in patients with adrenocortical carcinoma.

Fetched: April 27th, 2012, 11:00pm MDT

Phase II study of weekly paclitaxel and sorafenib as second/third-line therapy in patients with adrenocortical carcinoma.

Eur J Endocrinol. 2012 Mar;166(3):451-8

Authors: Berruti A, Sperone P, Ferrero A, Germano A, Ardito A, Priola AM, De Francia S, Volante M, Daffara F, Generali D, Leboulleux S, Perotti P, Baudin E, Papotti M, Terzolo M

Abstract
BACKGROUND: There is a strong rationale in the use of antiangiogenic therapy in the management of adrenocortical carcinoma (ACC). Metronomic administration of chemotherapy and antiangiogenic drugs can be synergistic in targeting endothelial cells.
OBJECTIVE: We assessed the activity of sorafenib plus metronomic paclitaxel as second/third-line therapy in advanced ACC patients. We also tested the activity of sorafenib and paclitaxel against NCI-H295R in vitro.
DESIGN: Multicenter, prospective phase II trial. Setting Referral centers for ACC.
METHODS: Twenty-five consecutive metastatic ACC patients who progressed after mitotane plus one or two chemotherapy lines were planned to be enrolled. The patients received a combination of i.v. paclitaxel (60 mg/m(2) every week) and oral sorafenib (400 mg twice a day) till progression. The primary aim was to measure the progression-free survival rate after 4 months and the secondary aims were to assess the objective response rate and toxicity.
RESULTS: Tumor progression was observed in nine evaluable patients at the first assessment. These results led to the premature interruption of the trial. The treatment was well tolerated. The most relevant toxicities were fatigue, being grade 2 or 3 in four patients, and hypophosphatemia, being grade 3 in three patients. In the in vitro study, sorafenib impaired the viability of H295R cells with dose-response and time-response relationships. The in vitro sorafenib activity was not increased in combination with paclitaxel.
CONCLUSIONS: Despite the in vitro activity, sorafenib plus weekly paclitaxel is an inactive salvage treatment in patients with advanced ACC and should not be recommended.

PMID: 22189997 [PubMed - indexed for MEDLINE]

Targeted therapies for adrenocortical carcinoma: IGF and beyond.

Fetched: April 27th, 2012, 11:00pm MDT

Targeted therapies for adrenocortical carcinoma: IGF and beyond.

Horm Cancer. 2011 Dec;2(6):385-92

Authors: Demeure MJ, Bussey KJ, Kirschner LS

Abstract
Standard chemotherapy for adrenocortical cancer currently is under evaluation in the context of the recently completed FIRM-ACT evaluating the combination of mitotane with either streptozocin or etoposide, cisplatin, and doxorubicin. New agents are eagerly sought by the ACC community that hopes to make progress against this deadly disease. Investigators have begun to dissect the molecular and genomic context of ACC with a goal of identifying potential novel therapeutic agents. One gene consistently overexpressed in ACC is insulin growth factor type 2. Targeting its receptor IGF1R has shown encouraging results in ACC cell lines and against murine xenografts. As a result, clinical trials to evaluate agents targeting the IGF1R have been done including mitotane and IMC-A12 (a monoclonal antibody) and the GALACCTIC trial that has just completed accrual to evaluate OSI-906, a small molecule IGF1R antagonist. On the horizon are other agents targeting other tyrosine kinases, including EGF and FGF, and novel strategies such as individualized tumor analysis to select treatment.

PMID: 22170383 [PubMed - indexed for MEDLINE]

Syndrome of inappropriate secretion of antidiuretic hormone caused by pituitary macroadenoma with hemangiomatous stroma.

Fetched: April 27th, 2012, 11:00pm MDT

Syndrome of inappropriate secretion of antidiuretic hormone caused by pituitary macroadenoma with hemangiomatous stroma.

Tokai J Exp Clin Med. 2011 Dec;36(4):128-33

Authors: Sato H, Takahashi H, Kanai G, Kakuta T, Itoh J, Inomoto C, Osamura RY

Abstract
A 55-year-old Japanese man was referred to our hospital because of disturbance of consciousness and hyponatremia. He had been aware of general fatigue, nausea, and headache for two weeks. Tests revealed hyponatremia, plasma hypoosmolarity with urine hyperosmolarity, an elevated level of urine sodium excretion, and normal functions of the kidney, adrenal gland, and thyroid. These findings were compatible with syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Head magnetic resonance imaging (MRI) demonstrated a pituitary tumor measuring 20 x 22 x 21 mm that pushed the pituitary stalk upward. Endocrinological evaluations suggested that the pituitary adenoma was non-functional. The pituitary adenoma was surgically removed, and histological examination revealed a biphasic appearance characterized by endocrine cells and a hemangiomatous stroma. After surgery, the patient developed pituitary hypothyroidism, pituitary adrenal insufficiency, and pituitary gonadal failure. Therefore, levothyroxine sodium, 50 µg per day, and hydrocortisone, 10 mg per day, were administered orally. Androgen depot, 250 mg every two months, was also injected intramuscularly. The hyponatremia did not recur, and the patient has done well for the last five years. The pituitary adenoma in this case showed two features: one was the cause of SIADH, and the other was a biphasic histological picture of endocrine cells with a hemangiomatous stroma.

PMID: 22167496 [PubMed - indexed for MEDLINE]

Permalink for 'Staging and Functional Characterization of Pheochromocytoma and Paraganglioma by 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography.'

Staging and Functional Characterization of Pheochromocytoma and Paraganglioma by 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography.

Fetched: April 27th, 2012, 11:00pm MDT

Staging and Functional Characterization of Pheochromocytoma and Paraganglioma by 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography.

J Natl Cancer Inst. 2012 Apr 18;

Authors: Timmers HJ, Chen CC, Carrasquillo JA, Whatley M, Ling A, Eisenhofer G, King KS, Rao JU, Wesley RA, Adams KT, Pacak K

Abstract
BackgroundPheochromocytomas and paragangliomas (PPGLs) are rare tumors of the adrenal medulla and extra-adrenal sympathetic chromaffin tissues; their anatomical and functional imaging are critical to guiding treatment decisions. This study aimed to compare the sensitivity and specificity of (18)F-fluorodeoxyglucose positron emission tomography with computed tomography ((18)F-FDG PET/CT) for tumor localization and staging of PPGLs with that of conventional imaging by [(123)I]-metaiodobenzylguanidine single photon emission CT ((123)I-MIBG SPECT), CT, and magnetic resonance imaging (MRI).MethodsA total of 216 patients (106 men, 110 women, aged 45.2 ± 14.9 years) with suspected PPGL underwent CT or MRI, (18)F-FDG PET/CT, and (123)I-MIBG SPECT/CT. Sensitivity and specificity were measured as endpoints and compared by the McNemar test, using two-sided P values only.ResultsSixty (28%) of patients had nonmetastatic PPGL, 95 (44%) had metastatic PPGL, and 61 (28%) were PPGL negative. For nonmetastatic tumors, the sensitivity of (18)F-FDG was similar to that of (123)I-MIBG but less than that of CT/MRI (sensitivity of (18)F-FDG = 76.8%; of (123)I-MIBG = 75.0%; of CT/MRI = 95.7%; (18)F-FDG vs (123)I-MIBG: difference = 1.8%, 95% confidence interval [CI] = -14.8% to 14.8%, P = .210; (18)F-FDG vs CT/MRI: difference = 18.9%, 95% CI = 9.4% to 28.3%, P < .001). The specificity was 90.2% for (18)F-FDG, 91.8% for (123)I-MIBG, and 90.2% for CT/MRI. (18)F-FDG uptake was higher in succinate dehydrogenase complex- and von Hippel-Lindau syndrome-related tumors than in multiple endocrine neoplasia type 2 (MEN2) related tumors. For metastases, sensitivity was greater for (18)F-FDG and CT/MRI than for (123)I-MIBG (sensitivity of (18)F-FDG = 82.5%; of (123)I-MIBG = 50.0%; of CT/MRI = 74.4%; (18)F-FDG vs (123)I-MIBG: difference = 32.5%, 95% CI = 22.3% to 42.5%, P < .001; CT/MRI vs (123)I-MIBG: difference = 24.4%, 95% CI = 11.3% to 31.6%, P < .001). For bone metastases, (18)F-FDG was more sensitive than CT/MRI (sensitivity of (18)F-FDG = 93.7%; of CT/MRI = 76.7%; difference = 17.0%, 95% CI = 4.9% to 28.5%, P = .013).ConclusionsCompared with (123)I-MIBG SPECT and CT/MRI, both considered gold standards for PPGL imaging, metastases were better detected by (18)F-FDG PET. (18)F-FDG PET provides a high specificity in patients with a biochemically established diagnosis of PPGL.

PMID: 22517990 [PubMed - as supplied by publisher]

[The Conceptual Oligometastatic Non-small Cell Lung Cancer and Therapeutic Strategies].

Fetched: April 20th, 2012, 11:00pm MDT

[The Conceptual Oligometastatic Non-small Cell Lung Cancer and Therapeutic Strategies].

Zhongguo Fei Ai Za Zhi. 2012 Apr 20;15(4):242-5

Authors: Kang X, Chen K

Abstract
Non-small cell lung cancer (NSCLC) ranks among the most prevalent malignancies and is the major cause of cancer-related deaths worldwide. Nearly 20%-50% will accompany by metastatic disease and the most common extrapulmonary sites of distant metastases are the brain, bone, liver and adrenal gland. The oligometastatic state is a biologically mild tumor stage and a intermediate state in which spread may be limited to specific organs and metastases might be present in limited numbers. Oligometastases are thought to arise from micrometastases, which have been dormant for a period of time. Local control may be an crucial component of a curative therapeutic strategy in the following four clinical schemes: to prohibit metastases; to cure occult metastatic disease; to remedy oligometastases; and to deracinate any residual lesion after systemic therapy. This review aims to outline the concept of the oligometastatic NSCLC and its strategies of treatment.

PMID: 22510511 [PubMed - in process]

Role of K(+) channels in the pathophysiology of primary aldosteronism.

Fetched: April 19th, 2012, 11:00pm MDT

Role of K(+) channels in the pathophysiology of primary aldosteronism.

Hypertension. 2012 Mar;59(3):534-6

Authors: Carey RM

PMID: 22252399 [PubMed - indexed for MEDLINE]

Permalink for 'Somatic mutations affecting the selectivity filter of KCNJ5 are frequent in 2 large unselected collections of adrenal aldosteronomas.'

Somatic mutations affecting the selectivity filter of KCNJ5 are frequent in 2 large unselected collections of adrenal aldosteronomas.

Fetched: April 19th, 2012, 11:00pm MDT

Somatic mutations affecting the selectivity filter of KCNJ5 are frequent in 2 large unselected collections of adrenal aldosteronomas.

Hypertension. 2012 Mar;59(3):587-91

Authors: Azizan EA, Murthy M, Stowasser M, Gordon R, Kowalski B, Xu S, Brown MJ, O'Shaughnessy KM

Abstract
Primary hyperaldosteronism, one cause of which is aldosterone-producing adenomas (APAs), may account for ≤5% to 10% of cases of essential hypertension. Germline mutations have been identified in 2 rare familial forms of primary hyperaldosteronism, but it has been reported recently that somatic mutations of the KCNJ5 gene, which encodes a potassium channel, are present in some sporadic nonsyndromic APAs. To address this further we screened 2 large collections of sporadic APAs from the United Kingdom and Australia (totalling 73) and found somatic mutations in the selectivity filter of KCNJ5 in 41% (95% CI: 31% to 53%) of the APAs (30 of 73). These included the previously noted nonsynonymous mutations, G151R and L158R, and an unreported 3-base deletion, delI157, in the region of the selectivity filter. APAs containing a somatic KCNJ5 mutation were significantly larger than those without (1.61 cm [95% CI: 1.39-1.83 cm] versus 1.04 cm [95% CI: 0.91-1.17 cm]; P<0.0001) but with substantial overlap in size between genotypes. The APAs carrying a mutation, but not those without, also consistently lacked a postural aldosterone response, suggesting a physiologically distinct subtype. Hence, somatic KCNJ5 mutations are not restricted to large APAs (>2 cm), and their frequency in our unselected series suggests they are common and could be important in the molecular pathogenesis of many sporadic cases of APA.

PMID: 22252394 [PubMed - indexed for MEDLINE]

Permalink for 'Characterization of adrenal lesions using chemical shift MRI: comparison between 1.5 Tesla and two echo time pair selection at 3.0 Tesla MRI.'

Characterization of adrenal lesions using chemical shift MRI: comparison between 1.5 Tesla and two echo time pair selection at 3.0 Tesla MRI.

Fetched: April 19th, 2012, 11:00pm MDT

Characterization of adrenal lesions using chemical shift MRI: comparison between 1.5 Tesla and two echo time pair selection at 3.0 Tesla MRI.

J Magn Reson Imaging. 2012 Jan;35(1):95-102

Authors: Nakamura S, Namimoto T, Morita K, Utsunomiya D, Oda S, Nakaura T, Hirai T, Yamashita Y

Abstract
PURPOSE: To compare chemical shift MRI obtained at 1.5 Tesla (T) and two pairs of echo time (TE) in-phase and opposed-phase 3.0T MRI to assess their usefulness for the differentiation between adrenal adenomas and non-adenomas.
MATERIALS AND METHODS: We evaluated 91 adrenal masses (75 adenomas, 16 non-adenomas) in 85 patients. The MR imaging parameters were: T1-dual-gradient-echo(GRE) [echo times (TEs) = 1.1/2.3 ms (first-echo-pair) or 3.5/4.6 ms (second-echo-pair)] at 3.0T, and T1-dual-GRE (TEs = 2.4/4.8 ms) at 1.5T. Scans were quantitatively assessed for the signal intensity (SI) index, calculated as [(SIin-phase-SIopposed-phase)/(SIin-phase)] × 100(%). To test for differences between adenomas and non-adenomas, we performed quantitative analysis and analysis of variance.
RESULTS: For all images, the SI index differed significantly between adenomas and non-adenomas. The sensitivity /specificity of SI index at the first-echo-pair of 3.0T was 100%/ 100%, that of 95.6%/ 100% at the second-echo-pair of 3.0T, and 91.7%/ 88.9% at 1.5T, respectively. At intra-individual comparisons, the SI indices obtained with the second-echo-pair at 3.0T were significantly lower than on the first-echo-pair at 3.0T and 1.5T.
CONCLUSION: Chemical shift MRI at 3.0T provides more accurate differentiation between adenomas and non-adenomas than at 1.5T. The SI index of the first-echo-pair at 3.0T is the most reliable evaluation method for differentiating adrenal adenomas from non-adenomas.

PMID: 22002867 [PubMed - indexed for MEDLINE]

Molecular cytogenetic characterization in four pediatric pheochromocytomas and paragangliomas.

Fetched: April 18th, 2012, 11:00pm MDT

Molecular cytogenetic characterization in four pediatric pheochromocytomas and paragangliomas.

Pathol Oncol Res. 2011 Dec;17(4):801-8

Authors: Vicha A, Holzerova M, Krepelova A, Musil Z, Prochazka P, Sumerauer D, Kodet R, Eckschlager T, Jarosova M

Abstract
Pheochromocytomas (PCCs) are rare tumors among children and adolescents and therefore are not genetically well characterized. The most frequently observed chromosomal changes in PCC are losses of 1p, 3q and/or 3p, 6q, 17p, 11q, 22q, and gains of 9q and 17q. Aberrations involving chromosome 11 are more common in malignant tumors. Unfortunately information about gene aberrations in childhood PCC's is limited. We used comparative genomic hybridization (CGH) and array comparative genomic hybridization (aCGH) to screen for copy number changes in four children suffering from pheochromocytoma or paraganglioma. Patients were diagnosed at the age 13 or 14 years. Bilateral pheochromocytoma was associated with von Hippel-Lindau syndrome (VHL). Multiple paraganglioma was associated with a germline mutation in SDHB. We found very good concordance between the results of CGH and aCGH techniques. Losses were observed more frequently than gains. All cases had a loss of chromosome 11 or 11p. Other aberrations were loss of chromosome 3 and 11 in sporadic pheochromocytoma, and loss of 3p and 11p in pheochromocytoma, which carried the VHL mutation. The deletion of chromosome 1p and other changes were observed in paragangliomas. We conclude that both array CGH and CGH analysis identified similar chromosomal regions involved in tumorigenesis of pheochromocytoma and paragangliomas, but we found 3 discrepancies between the methods. We didn't find any, of the proposed, molecular markers of malignancy in our benign cases and therefore we speculate that molecular cytogenetic examination may be helpful in separating benign and malignant forms in the future.

PMID: 21461997 [PubMed - indexed for MEDLINE]

Cushing's syndrome due to carcinoma of the adrenal cortex.

Fetched: April 18th, 2012, 11:00pm MDT

Cushing's syndrome due to carcinoma of the adrenal cortex.

Med J Aust. 1949 Jul 23;2(4):131-4

Authors: MADDOX K, FLYNN R, DAY E

PMID: 18136314 [PubMed - indexed for MEDLINE]

Adrenal cortical carcinoma in a male with excess gonadotropin in the urine.

Fetched: April 18th, 2012, 11:00pm MDT

Adrenal cortical carcinoma in a male with excess gonadotropin in the urine.

J Clin Endocrinol Metab. 1949 May;9(5):451-6

Authors: CHAMBERS WL

PMID: 18128432 [PubMed - indexed for MEDLINE]

Cortical carcinoma of the adrenal gland.

Fetched: April 18th, 2012, 11:00pm MDT

Cortical carcinoma of the adrenal gland.

J Pediatr. 1949 May;34(5):650-3

Authors: LEHMANN E, JAMES ES

PMID: 18128111 [PubMed - indexed for MEDLINE]

Adrenal feminism due to carcinoma of the adrenal cortex; a case report and review of the literature.

Fetched: April 18th, 2012, 11:00pm MDT

Adrenal feminism due to carcinoma of the adrenal cortex; a case report and review of the literature.

Br Med J. 1948 Apr 24;1(4555):782-4

Authors: ARMSTRONG CN, SIMPSON J

PMID: 18912707 [PubMed - indexed for MEDLINE]

An unusual case of adrenal carcinoma with a note on the application of a new colour test.

Fetched: April 18th, 2012, 11:00pm MDT

An unusual case of adrenal carcinoma with a note on the application of a new colour test.

Br Med J. 1948 Apr 24;1(4555):781

Authors: BROSTER LR, PATTERSON J

PMID: 18912706 [PubMed - indexed for MEDLINE]

Carcinoma of the adrenal cortex; a case report.

Fetched: April 18th, 2012, 11:00pm MDT

Carcinoma of the adrenal cortex; a case report.

Proc Staff Meet Honol Clin. 1947 Mar;13(3):17-20

Authors: BURGESS CM

PMID: 20293176 [PubMed - indexed for MEDLINE]

Transplantation of an adrenal cortical carcinoma.

Fetched: April 18th, 2012, 11:00pm MDT

Transplantation of an adrenal cortical carcinoma.

Cancer Res. 1946 Dec;6(12):712-7

Authors: WOOLLEY GW, LITTLE CC

PMID: 20276080 [PubMed - indexed for MEDLINE]

Permalink for 'Carcinoma of adrenal cortex with adrenogenital syndrome in children; complete review of the literature and report of a case with recovery in a child 8 months of age.'

Carcinoma of adrenal cortex with adrenogenital syndrome in children; complete review of the literature and report of a case with recovery in a child 8 months of age.

Fetched: April 18th, 2012, 11:00pm MDT

Carcinoma of adrenal cortex with adrenogenital syndrome in children; complete review of the literature and report of a case with recovery in a child 8 months of age.

Am J Dis Child. 1946 Nov;72(5):563-603

Authors: GOLDSTEIN AE, RUBIN SW, ASKIN JA

PMID: 20277002 [PubMed - indexed for MEDLINE]

Adrenal carcinoma causing precocity.

Fetched: April 18th, 2012, 11:00pm MDT

Adrenal carcinoma causing precocity.

Med J Aust. 1946 Jan 12;1:60 passim

Authors: BEGG J

PMID: 21013736 [PubMed - indexed for MEDLINE]

[Not available].

Fetched: April 18th, 2012, 11:00pm MDT

[Not available].

J Med Lyon. 1945 Feb 20;26:109-16

Authors: MARTIN JF, VIGNON G, FEROLDI J

PMID: 21013667 [PubMed - indexed for MEDLINE]

Bilateral carcinoma of the adrenal cortex as a cause of severe backache with report of a case.

Fetched: April 18th, 2012, 11:00pm MDT

Bilateral carcinoma of the adrenal cortex as a cause of severe backache with report of a case.

J Urol. 1945;54:409-12

Authors: ZASLOW J, BERNSTEIN M

PMID: 21005403 [PubMed - indexed for MEDLINE]

Laparoscopic adrenalectomy in children for neuroblastoma: report of case series.

Fetched: April 18th, 2012, 11:00pm MDT

Laparoscopic adrenalectomy in children for neuroblastoma: report of case series.

Surg Laparosc Endosc Percutan Tech. 2012 Feb;22(1):79-81

Authors: de Barros F, Romão RL, de Pinho-Apezzato ML, Prieto Velhote MC, Schilaich Ricardi LR, Gonçalves Leal AJ, Aoun Tannuri AC, Carvalho B, Odone-Filho V, Tannuri U

Abstract
BACKGROUND: Neuroblastoma is one of the most common solid tumors in the pediatric population and the adrenal gland is the main abdominal site of this tumor. The laparoscopic approach has become the standard of care for most benign adrenal tumors in adults, but the role of laparoscopic adrenalectomy in children for malignant tumor is still a point of controversy. However, there is a growing experience with laparoscopic neuroblastoma resection of small lesions and the use of minimally invasive techniques for the initial management of infiltrative neuroblastoma in the last years. The aim of this study is to describe our initial experience with laparoscopic adrenalectomy for neuroblastoma in children, based on surgical outcomes.
METHODS: A retrospective review of 7 laparoscopic adrenalectomies performed in a single institution between October 2008 and October 2009. We focused our analysis on early surgical outcomes.
RESULTS: The mean tumoral size was 2.8±0.9 cm, the average surgical time was 138.6±65.5 minutes, and the mean hospital stay was 2.9±1.6 days. One stage IV patient was submitted to conversion due to bleeding and needed blood transfusion. There were no late complications or deaths and the mean follow-up time was 18.8±6.1 months.
CONCLUSIONS: The laparoscopic approach for adrenal neuroblastoma resection is feasible in children with good outcomes, but should be reserved to patients with small, well-circumscribed adrenal lesions, without invasive or infiltrative disease.

PMID: 22318066 [PubMed - indexed for MEDLINE]

Abstracts of the 17th International Symposium on Bioluminescence and Chemiluminescence - (ISBC 2012).

Fetched: April 18th, 2012, 11:00pm MDT

Abstracts of the 17th International Symposium on Bioluminescence and Chemiluminescence - (ISBC 2012).

Luminescence. 2012 Mar;27(2):95-178

Authors:

PMID: 22505334 [PubMed - as supplied by publisher]

Diagnosis of small-bowel metastasis of hepatocellular carcinoma by double-balloon enteroscopy.

Fetched: April 18th, 2012, 11:00pm MDT

Diagnosis of small-bowel metastasis of hepatocellular carcinoma by double-balloon enteroscopy.

Int J Surg Case Rep. 2012 Mar 28;3(7):263-265

Authors: Kunizaki M, Hidaka S, Isomoto H, Takeshita H, Nanashima A, Sawai T, Yasutake T, Nagayasu T

Abstract
INTRODUCTION: Hepatocellular carcinoma (HCC) is a major cause of cancer-related deaths around the world. Nearly half of patients with HCC display metastatic disease at the time of initial diagnosis, frequently involving the liver, bone, brain, lungs, and adrenal glands, but gastrointestinal involvement is rare. Melena occurring secondary to a metastatic tumor from HCC is particularly rare. Herein, we present a case of melena secondary to metastatic HCC after chemoradiation to lung and brain metastases from HCC, diagnosed preoperatively by double-balloon enteroscopy. To the best of our knowledge, this represents the first such case to be reported. PRESENTATION OF CASE: 60-Year-old man had been diagnosed with hepatitis B virus-associated hepatocellular carcinoma (HCC). He was readmitted for investigation of general fatigue and iron-deficiency anemia. Esophagogastroduodenoscopy, total colonoscopy, and CT failed to identify any cause for gastrointestinal bleeding. Double-balloon enteroscopy, however, revealed small bowel metastasis from HCC preoperatively. After 5 days of conservative management, segmental small bowel resection and end-to-end anastomosis were performed. The histological appearances were considered typical for moderately differentiated HCC. DISSCUSSION: Endoscopic findings of gastrointestinal metastasis from HCC vary, such as raised and centrally ulcerated lesions, polypoid tumors, or submucosal tumors. Immunohistochemical findings are thus key to differentiating HCC from adenocarcinoma in the diagnosis of GIT metastasis. Some patients with gastrointestinal bleeding remain undiagnosed even after upper endoscopy and total colonoscopy, and most such patients will display bleeding sites in the small bowel. Video capsule endoscopy and DBE have been introduced recently for the evaluation of the small bowel. DBE, which was developed by Yamamoto et al.,(5) allowed us to obtain biopsy specimens, circumventing one limitation of capsule endoscopy. In this case, DBE contributed significantly to diagnosis and treatment. CONCLUSION: DBE thus seems to represent a valuable method, particularly in the preoperative setting, due to the possibility of precisely identifying the tumor site and achieving preoperative diagnosis.

PMID: 22503919 [PubMed - as supplied by publisher]

Steroid biosynthesis and prostate cancer.

Fetched: April 18th, 2012, 11:00pm MDT

Steroid biosynthesis and prostate cancer.

Steroids. 2012 Apr 5;

Authors: Sharifi N, Auchus RJ

Abstract
The pathways of androgen biosynthesis in human beings have been studied for decades, and the major pathways and enzymes responsible for testosterone and dihydrotestosterone synthesis are now well described. Minor or alternate pathways, which might contribute substantially to androgen production in specific states, have also emerged. Likewise, the requirement of androgen for prostate formation and growth date back over a half-century, and the dependence of prostate cancer on androgens has been known and exploited for as long. Despite the success of testicular removal or suppression, androgen receptor antagonists, and androgen synthesis inhibitors in the treatment of prostate cancer, the sources of androgen, their routes of synthesis, and the contributions of various routes remain topics of debate, particularly in castration-resistant disease when circulating androgens are very low. Here we review the major pathways of 19-carbon steroid synthesis in the adrenal and gonad, peripheral pathways to active androgens, and recent data charting flux of androgen precursors in prostate cancer. We are far from a unified understanding of androgen generation in prostate cancer, but the similarities and differences from glandular androgen synthesis that have already emerged provide important clues to designing the next generation of treatments for this common and devastating disease.

PMID: 22503713 [PubMed - as supplied by publisher]

Adrenal lesions in patients with extra-adrenal malignancy - benign or malignant?

Fetched: April 14th, 2012, 11:00pm MDT

Adrenal lesions in patients with extra-adrenal malignancy - benign or malignant?

Acta Oncol. 2012 Feb;51(2):215-21

Authors: Hammarstedt L, Muth A, Sigurjónsdóttir HÁ, Almqvist E, Wängberg B, Hellström M,

Abstract
BACKGROUND: Adrenal lesions in patients with extra-adrenal malignancy can be part of disseminated tumour disease, but may also be incidental, benign finding. Strict characterisation is therefore crucial, and may have profound effects on patient management.
PURPOSE: To prospectively characterise and follow-up adrenal lesions in patients with extra-adrenal malignancy, stratified into those with past or concurrent malignancy, with or without metastases.
MATERIAL AND METHODS: All incidentally detected adrenal lesions identified at cross-sectional imaging during 18 months in a defined geographical region were prospectively reported. All adult oncologic patients with adrenal lesions were subjected to biochemical work-up and dedicated adrenal imaging for lesion characterisation, including a two year follow-up.
RESULTS: Benign adrenal lesions were found in 74% (29/39) of patients who had a history of extra-adrenal malignancy, in 53% (57/108) of those with concurrent extra-adrenal malignancy without metastatic disease and in 25% (27/109) in those with signs of metastatic disease.
CONCLUSION: An adrenal lesion occurring in a patient with past malignancy has a high likelihood of representing a benign lesion, and even in patients with present signs of malignant disease at least one fourth to one half of such lesions are benign. Dedicated adrenal imaging including computed tomography attenuation measurements with wash-out characteristics, in addition to biochemical testing for adrenal dysfunction, is highly recommended in these cases, especially in patients without any other signs of metastatic spread.

PMID: 21879835 [PubMed - indexed for MEDLINE]

Permalink for 'An autopsy case of left ventricular apical ballooning probably caused by pheochromocytoma with persistent ST-segment elevation.'

An autopsy case of left ventricular apical ballooning probably caused by pheochromocytoma with persistent ST-segment elevation.

Fetched: April 14th, 2012, 11:00pm MDT

An autopsy case of left ventricular apical ballooning probably caused by pheochromocytoma with persistent ST-segment elevation.

Int J Cardiol. 2011 Jun 2;149(2):e50-2

Authors: Ueda H, Hosokawa Y, Tsujii U, Miyawaki M, Mitsusada N, Yasuga Y, Hiraoka H, Nakatsuka S

Abstract
We describe the autopsy case of an 86-year-old man who experienced left ventricular (LV) apical ballooning with pheochromocytoma. During the follow-up period, his electrocardiogram (ECG) showed persistent ST-segment elevation in leads V3 to V6, and an echocardiogram revealed persistent LV dysfunction in the apical region. He died 64 days after admission. Pathological findings suggested catecholamine-induced cardiomyopathy and pheochromocytoma. This is the report of a rare autopsy case of LV apical ballooning.

PMID: 19375185 [PubMed - indexed for MEDLINE]

Metabolic, electrolytes disorders and tromboembolic risk in malignant glioma patients.

Fetched: April 14th, 2012, 11:00pm MDT

Metabolic, electrolytes disorders and tromboembolic risk in malignant glioma patients.

Neurol Sci. 2011 Nov;32 Suppl 2:S229-31

Authors: Silvani A, Gaviani P, Lamperti E, Botturi A, Ferrari D, Simonetti G, Fariselli L, Salmaggi A

Abstract
In malignant gliomas, the management of symptoms and minimization of side effects assume major importance. Corticosteroids provide transient relief from neurological symptoms. However, treatment with steroids is also commonly associated with considerable side-effects including: hyperglycemia, osteoporosis, myopathy, lymphopenia and others. Sometimes, antiepileptic drugs may contribute to clinical decline of neuro-oncological patients in stable disease not only by neuropsychological impairment but also by metabolic interations. Several studies have demonstrated a high frequency of hyponatremia among patients treated with carbamazepine and particularly with oxacarbamazepine. Venous thromboembolism is a common complication in patients with cancer and it is particularly high in malignant gliomas, occurring in approximately 20-30% of such patients. Prophylactic treatment in patients with glioblastoma is a key topic. The role of prophylaxis has not yet been established with certainty. Overall the data show a clear reduction of venous thromboembolic events in patients treated with intermittent pneumatic compression (IPC). The addition of enoxaparin dose of 6.000 UI, starting in the perioperative period, induces an increase of major bleeding events. In the absence of availability of IPC, the use of enoxaparin 4.000 UI in addition to graduated compression stockings, reduces thromboembolic events without major bleeding events.

PMID: 21993831 [PubMed - indexed for MEDLINE]

Permalink for 'A black adrenal adenoma difficult to be differentiated from a malignant adrenal tumor by CT, MRI, scintigraphy and FDG PET/CT examinations.'

A black adrenal adenoma difficult to be differentiated from a malignant adrenal tumor by CT, MRI, scintigraphy and FDG PET/CT examinations.

Fetched: April 14th, 2012, 11:00pm MDT

A black adrenal adenoma difficult to be differentiated from a malignant adrenal tumor by CT, MRI, scintigraphy and FDG PET/CT examinations.

Ann Nucl Med. 2011 Dec;25(10):812-7

Authors: Nakajo M, Nakajo M, Kajiya Y, Tani A, Tsuruta M, Sugita S, Fushitani S, Umekita Y

Abstract
Black adrenal adenoma (BAA) is an adrenal adenoma which contains lipofuscin and has a black or brown appearance. Preoperative diagnosis of BAA is difficult because it is diagnosed by pathologic findings. We report a case of an incidentally discovered non-hyperfunctioning BAA in the left adrenal gland of a 58-year-old man. It showed an oval lipid-poor mass, 3 cm × 2 cm in size on computed tomography (CT) and magnetic resonance imaging (MRI), no avid uptake of (131)I-norcholesterol and (123)I-meta-iodobenzylguanidine (MIBG) on scintigraphy, and intense avid uptake of (18)F-fluorodeoxyglucose (FDG) on positron emission tomography-CT (PET/CT). FDG PET/CT showed that it was a hypermetabolic lesion, more intense than the activity of the liver, and the maximum standardized uptake value was 5.6 on 1-h early imaging and 8.3 on 2-h delayed imaging, suggesting a malignant tumor. BAA is a clinically rare benign adrenal adenoma, but it should be kept in mind that BAA may exhibit false-positive results for malignancy or inconclusive results for benignity with modern imaging modalities including CT, MRI, adrenal scintigraphy with radiolabelled cholesterol and radiolabelled MIBG, and FDG-PET like this case.

PMID: 21918842 [PubMed - indexed for MEDLINE]

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Rare Cancer News & Clinical Trials » PubMed - Adrenal Cancer

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PubMed - Adrenal Cancer (100 unread)

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