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Eur J Endocrinol 2021 May 1. Epub 2021 May 1.

K Yokote, Department of Endocrinology, Hematology and Gerontology, Chiba University, Chiba, Japan.

Introduction: Although 18F-FDG PET was originally developed to evaluate benign and malignant tumors, the frequency of detection of benign adrenocortical adenomas showing FDG-PET accumulation has increased. However, the details of FDG-PET-accumulated benign adrenocortical adenomas have not been elucidated.

Methods: To elucidate the pathophysiology of FDG-PET-positive cortisol-producing adrenal tumors, we performed clinicopathological and genetic analyses of adrenocortical adenomas examing FDG-PET in 30 operated patients with unilateral cortisol-producing adrenal tumors (26 adrenal adenomas and 4 adrenal cancers). Read More

CVIR Endovasc 2021 Apr 1;4(1):38. Epub 2021 Apr 1.

Department of Radiology, Division of Interventional Radiology, University of Utah, 50 North Medical Drive, Salt Lake City, UT, 84132, USA.

Primary aldosteronism is the leading cause of secondary hypertension worldwide. Its deleterious effects outstrip those due to blood pressure elevation alone. An essential part of the work-up of a patient with primary aldosteronism is determining if aldosterone production is unilateral or bilateral. Read More

Radiol Case Rep 2021 Jun 10;16(6):1443-1446. Epub 2021 Apr 10.

Department of Radiology, Nerima Hikarigaoka hospital, Tokyo, 179-0072, Japan.

This report presents a case of left adrenal aldosterone-producing adenoma (APA) diagnosed by segmental adrenal venous sampling in a patient with primary aldosteronism and a rare venous anomaly in which the left inferior phrenic vein (LIPV) and adrenal central vein entered the left renal vein separately. The outflow of tumor blood into the LIPV and the specimen from the LIPV that showed much higher aldosterone level than that from the adrenal central vein and tributaries were useful for proving the aldosterone hypersecretion from the APA. Sampling from the LIPV could be of diagnostic value for left APA. Read More

J Formos Med Assoc 2021 Apr 24. Epub 2021 Apr 24.

TAIPAI, Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taiwan.

The aim of this study was to update the information on internationally acceptable standards and clinical practice recommendations for the management of patients with primary aldosteronism (PA). The Taiwan Society of Aldosteronism (TSA) Task Force acknowledged the novel issues of PA and reached a group consensus on PA in Taiwan by collecting the best available evidence and conducting one group meeting, several conference calls, and multiple e-mail communications. Unilateral adrenalectomy is the preferred treatment for patients with aldosterone-producing adenoma (APA). Read More

Harefuah 2021 Apr;160(4):221-225

Nephrology and Hypertension Institute, "Samson" Assuta University Hospital, Ashdod, Israel.

Introduction: This is a case study of a thirty-five year old woman with a past medical history of anxiety disorder and hypertension which has been elevated up to 180/100 mmHg during the previous year. She had no cardiovascular risk factors or family history of hypertension. Her high blood pressure was initially attributed to emotional stress, however, she was later referred for additional evaluation for secondary causes of hypertension. Read More

Ann Palliat Med 2021 Apr 16. Epub 2021 Apr 16.

Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Branch of National Clinical Research Center for Metabolic Disease, Wuhan, China.

The clinical and aetiological characteristics of family-clustered primary aldosteronism (PA) are not fully understood and need further exploration. Our study reported a PA case with a family history accompanied by unusual concomitant disease and explored the genetic background of the affected family members, thus providing more evidence of the manifestation and pathogenesis of family-clustered PA. We studied a family with PA in which the proband and her maternal aunt were diagnosed with aldosteroneproducing adenoma (APA) and primary adrenal hyperplasia (PAH), respectively. Read More

Rare Tumors 2021 9;13:20363613211007792. Epub 2021 Apr 9.

Cardiology, Scripps Health, San Diego, CA, USA.

A case of pheochromocytoma producing vasoactive intestinal peptide (VIP) and left ventricular thrombus in the absence of cardiomyopathy or wall motion abnormalities on echocardiogram is presented along with a review of the relevant literature. A 30-year-old female of Afghani descent with past medical history of panic attacks presented with fever, cough, sore throat, vomiting, and was found to have an 11 cm adrenal mass consistent with primary adrenocortical adenoma versus carcinoma. Her tumor elicited catechols and vasoactive intestinal peptide. Read More

N Engl J Med 2021 Apr;384(16):1542-1551

From the Division of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA.

Eur Rev Med Pharmacol Sci 2021 Apr;25(7):3028-3037

Endocrinology, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Derince/Kocaeli, Turkey.

Objective: Few studies have used electrocardiography (ECG) to examine nonfunctional adrenal adenomas (NFAAs). No study has investigated the QRS-T angle in NFAA patients. We analyzed the frontal QRS-T angle of patients with incidentally discovered NFAAs. Read More

Radiol Case Rep 2021 Jun 28;16(6):1294-1299. Epub 2021 Mar 28.

Department of Urology, St. Marianna University School of Medicine Yokohama City Seibu Hospital, 1197-1 Yasashicho Asahi Ward, Yokohama, Kanagawa 241-0811, Japan.

We report a patient with sigmoid colon cancer who revealed a unique collision of hemorrhagic vascular adrenal cyst and adrenocortical adenoma with myelolipomatous changes. Two months before referral to our hospital, anticoagulant therapy was started for acute myocardial infarction. The components of the adrenocortical adenoma demonstrated a typical signal drop in opposed-phase magnetic resonance (MR) images although macroscopic fat was also depicted both on CT and MR images. Read More

AACE Clin Case Rep 2021 Jan-Feb;7(1):61-64. Epub 2020 Dec 28.

Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, Louisiana.

Objective: In an adult endocrine clinic, the majority of patients referred for evaluation of an incidentally discovered adrenal mass are aged more than 30 years, for which many national and international societies have developed management guidelines. However, adrenal incidentalomas in children and young adults are uncommon. We report the case of an 18-year-old woman with an incidentally discovered right-sided adrenal mass. Read More

BMJ Case Rep 2021 Apr 13;14(4). Epub 2021 Apr 13.

Division of Endocrinology and Metabolism, Jewish General Hospital, McGill University, Montreal, Québec, Canada

A 39-year-old woman was referred to the cancer genetics outpatient clinic for a clinical diagnosis of Carney complex (CNC) in her deceased brother. The patient had some characteristic clinical features such as periorbital lentigines and coarse facial features, suggestive of CNC; however, she did not meet major diagnostic criteria for CNC. Previous extensive investigations revealed a mild insulin-like growth factor 1 elevation, a stable left adrenal gland adenoma and a slightly enlarged pituitary gland. Read More

Br J Surg 2021 Apr 11. Epub 2021 Apr 11.

Department of Surgery, Skåne University Hospital, Lund, Sweden.

Background: Contemporary patients with primary hyperparathyroidism are often diagnosed with mildly raised serum calcium levels. Previous studies have reported increased mortality in patients with primary hyperparathyroidism. This retrospective cohort study aimed to examine whether contemporary patients operated for primary hyperparathyroidism have higher mortality than the general population, and whether mortality in these patients is associated with serum calcium concentration, adenoma weight or multiglandular disease. Read More

Pituitary 2021 Apr 9. Epub 2021 Apr 9.

Neuroendocrine Unit, Massachusetts General Hospital and Department of Medicine, Harvard Medical School, 100 Blossom Street, Cox140, Boston, MA, 02114, USA.

Purpose: To examine the clinical presentation and longitudinal outcome of Pituitary Apoplexy (PA) after gonadotropin-releasing hormone agonist (GnRHa) in a series of patients and compare to prior reports.

Methods: A retrospective chart review was performed on seven patients receiving GnRHa who developed PA. Prior reported cases were analyzed. Read More

Folia Histochem Cytobiol 2021 Apr 9. Epub 2021 Apr 9.

Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland.

Introduction: Ghrelin, originally isolated from the endocrine cells of the gastric mucosa, is also expressed in many peripheral tissues, including normal adrenals and adrenocortical tumors. It was shown that ghrelin stimulates proliferation and inhibits apoptosis of adrenocortical cells. In the current study, we compared ghrelin expression at the protein level in various adrenal tumors. Read More

Abdom Radiol (NY) 2021 Apr 8. Epub 2021 Apr 8.

Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA, 02114-2696, USA.

Purpose: To investigate the diagnostic performance of dual-layer dual-energy CT (dlDECT) in the evaluation of adrenal nodules.

Methods: In this retrospective study, 66 patients with triphasic dlDECT (unenhanced, venous phase (VP), delayed phase (DP)) for suspected adrenal lesions were included. Virtual unenhanced images (VUE) were derived from VP acquisitions. Read More

Neurology 2021 Apr 7. Epub 2021 Apr 7.

Department of Neurology

Biomedicines 2021 Mar 17;9(3). Epub 2021 Mar 17.

Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.

For the last seven decades, primary aldosteronism (PA) has been gradually recognized as a leading cause of secondary hypertension harboring increased risks of cardiovascular incidents compared to essential hypertension. Clinically, PA consists of two major subtypes, surgically curable and uncurable phenotypes, determined as unilateral or bilateral PA by adrenal venous sampling. In order to further optimize the treatment, surgery or medications, diagnostic procedures from screening to subtype differentiation is indispensable, while in the general clinical practice, the work-up rate is extremely low even in the patients with refractory hypertension because of the time-consuming and labor-intensive nature of the procedures. Read More

Front Endocrinol (Lausanne) 2021 16;12:645488. Epub 2021 Mar 16.

Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama, Japan.

The hypothalamus-pituitary-adrenal (HPA) axis plays an important role in primary aldosteronism. Aldosterone biosynthesis is regulated not only by angiotensin II in the renin-angiotensin-aldosterone system, but also by adrenocorticotropic hormone (ACTH), one of the key components of the HPA axis. Although previous studies have reported cortisol cosecretion in primary aldosteronism, particularly aldosterone-producing adenoma (APA), the clinical relevance of such aldosterone and cortisol cosecretion from APA and hypertension or other metabolic disorders has not been fully established. Read More

J Hum Hypertens 2021 Mar 30. Epub 2021 Mar 30.

Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.

Although the aldosterone/renin ratio (ARR) is the preferred screening test for primary aldosteronism (PA), patients with non-suppressed renin and a falsely negative ARR on non-interfering medications have occasionally been reported. This report describes the clinical characteristics and outcomes of seven patients with proven aldosterone-producing adenoma (APA) and non-suppressed renin.Chart review of seven PA patients with an APA and a non-suppressed plasma renin concentration (PRC > 8. Read More

Front Endocrinol (Lausanne) 2021 12;12:632543. Epub 2021 Mar 12.

Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States.

The genetic alterations that cause the development of glucocorticoid and/or mineralocorticoid producing benign adrenocortical tumors and hyperplasias have largely been elucidated over the past two decades through advances in genomics. In benign aldosterone-producing adrenocortical tumors and hyperplasias, alteration of intracellular calcium signaling has been found to be significant in aldosterone hypersecretion, with causative defects including those in , and In benign cortisol-producing adrenocortical tumors and hyperplasias abnormal cyclic adenosine monophosphate-protein kinase A signaling has been found to play a central role in tumorigenesis, with pathogenic variants in , and being implicated. The role of this signaling pathway in the development of Cushing's syndrome and adrenocortical tumors was initially discovered through the study of the underlying genetic defects causing the rare multiple endocrine neoplasia syndromes McCune-Albright syndrome and Carney complex with subsequent identification of defects in genes affecting the cyclic adenosine monophosphate-protein kinase A pathway in sporadic tumors. Read More

EBioMedicine 2021 Apr 25;66:103294. Epub 2021 Mar 25.

Departments of Medicine, David Geffen School of Medicine, University of California, Los Angeles, United States; Departments of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, United States. Electronic address:

Background: Cushing disease (CD), although rare, is a life-threatening disorder caused by an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma, which leads to excess adrenal-derived cortisol. Efficacious and safe medical therapies that control both hormonal hypersecretion and pituitary corticotroph tumor growth remain an unmet need in the management of CD. Translational research in pituitary tumors has been significantly hampered by limited quantities of surgically resected tissue for ex vivo studies, and unavailability of human pituitary tumor cell models. Read More

J Am Coll Surg 2021 Mar 22. Epub 2021 Mar 22.

Yale School of Medicine, New Haven, CT.

Background: As the incidence of adrenalectomy increases steadily, so does the use of minimally invasive approaches like posterior retroperitoneoscopic adrenalectomy (PRA). To date, the largest studies of PRA have been from abroad, and we sought to provide a contemporary US update on the outcomes after PRA.

Methods: A retrospective chart review was conducted on all PRAs performed at a single tertiary care institution between 2013 and 2020. Read More

Best Pract Res Clin Endocrinol Metab 2021 Mar 15:101521. Epub 2021 Mar 15.

Institute of Metabolism and System Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Centre of Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom. Electronic address:

Endogenous Cushing's syndrome (CS) is a rare endocrine disorder characterised by excess cortisol secretion due to either ACTH-dependent conditions [commonly an ACTH-producing pituitary adenoma (Cushing's disease)] or ACTH-independent causes (with most common aetiology being a benign adrenal adenoma). Overall, the annual incidence of CS ranges between 1.8 and 3. Read More

Hormones (Athens) 2021 Mar 23. Epub 2021 Mar 23.

Department of Endocrinology and Diabetes Center, General Hospital of Athens "G. Gennimatas", Athens, Greece.

Purpose: Primary aldosteronism (PA) is the most frequent type of endocrine hypertension. In our previous studies, we introduced two modified diagnostic tests for PA, the post-dexamethasone saline infusion test (DSIT) and the overnight dexamethasone, captopril, and valsartan test (DCVT). In this study, we aimed to validate both tests in respect to the biochemical and clinical response of a cohort of hypertensive patients in pre- and post-surgical setting. Read More

JAMA 2021 03;325(12):1216-1217

Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Endokrynol Pol 2021 ;72(1):64-72

Department of Endocrinology and Diabetes Centre, G. Gennimatas General Hospital, Athens, Greece.

Cushing's syndrome (CS) causes hypogonadotropic hypogonadism and anovulatory infertility due to hypercortisolism, and it is very rare in pregnancy. CS in pregnancy is associated with important maternal-foetal morbidity and mortality, such as preeclampsia and premature delivery. A systematic search was conducted in the MEDLINE library to retrieve articles reporting cases of CS in pregnant women, during the period between 2010 and 2020. Read More

J Renin Angiotensin Aldosterone Syst 2021 Jan-Dec;22(1):14703203211003780

Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.

Normotensive patients with primary aldosteronism (PA) are relatively rare. Herein, we report two patients with normotensive PA and present a literature review to improve an understanding of the disease. Patient 1, a 56-year-old man, presented with recurrent hypokalemia that lasted for more than 2 years. Read More

World J Clin Cases 2021 Mar;9(8):1916-1922

Department of Urology, Dalian Municipal Central Hospital Affiliated of Dalian Medical University, Dalian 116033, Liaoning Province, China.

Background: The standard treatment of transitional cell carcinoma of the upper urinary tract consists of radical nephroureterectomy with bladder cuff removal, which can be performed either in open or laparoscopy or robot-assisted laparoscopy. Treatment of chronic renal insufficiency patients with upper urothelial tumor is in a dilemma. Urologists weigh and consider the balance between tumor control and effective renal function preservation. Read More