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Cir Esp 2019 Feb 15. Epub 2019 Feb 15.

Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario de Valladolid, Valladolid, España.

Am J Case Rep 2019 Feb 17;20:207-211. Epub 2019 Feb 17.

Department of Endocrinology, University of California San Francisco, San Francisco, CA, USA.

BACKGROUND Pituitary gland metastasis is rarely the initial presentation of metastatic cancer. Most cases of pituitary gland metastasis are asymptomatic with diabetes insipidus being the most common symptomatic presentation. It can rarely present with symptoms of hormone underproduction such as secondary adrenal insufficiency. Read More

Endokrynol Pol 2019 Feb 11. Epub 2019 Feb 11.

Dept. of Endocrinology, Diabetes and Isotope Therapy, Medical University Wroclaw, Pasteura 4, 50-367 Wrocłąw, Poland.

Background: Acromegaly is associated with increased growth hormone (GH) and insulin-like growth factor-I (IGF-I) secretion which may support tumor development and growth.

Case Presentation: A 68-year old woman was diagnosed with acromegaly due to typical clinical and hormonal characteristics. While a contrast-enhanced MRI at diagnosis did not reveal a pituitary adenoma, a 5 mm lesion was identified on repeat scanning 13 months later. Read More

Hypertension 2019 Feb 11:HYPERTENSIONAHA11812070. Epub 2019 Feb 11.

From the Department of Molecular and Integrative Physiology (K.N., W.E.R.), University of Michigan, Ann Arbor.

Somatic mutations have been identified in aldosterone-producing adenomas (APAs) in genes that include KCNJ5, ATP1A1, ATP2B3, and CACNA1D. Based on independent studies, there appears to be racial differences in the prevalence of somatic KCNJ5 mutations, particularly between East Asians and Europeans. Despite the high cardiovascular disease mortality of blacks, there have been no studies focusing on somatic mutations in APAs in this population. Read More

Endocrinol Diabetes Metab Case Rep 2019 Feb 7;2019. Epub 2019 Feb 7.

A 29-year-old G4A3 woman presented at 25 weeks of pregnancy with progressive signs of Cushing's syndrome (CS), gestational diabetes requiring insulin and hypertension. A 3.4 × 3. Read More

BMJ Case Rep 2019 Feb 6;12(2). Epub 2019 Feb 6.

Department of Internal Medicine, Christian Medical College, Vellore, Tamil Nadu, India.

Cushing's syndrome is known to present with a characteristic set of clinical manifestations and complications, well described in literature. However, hypercoagulability remains an under recognised entity in Cushing's syndrome. A 31-year-old woman from Southern India presented with history of fever, left upper quadrant pain and progressive breathing difficulty for 3 weeks. Read More

Am J Case Rep 2019 Feb 2;20:139-145. Epub 2019 Feb 2.

Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan.

BACKGROUND Before partial adrenalectomy for primary aldosteronism due to a primary adrenal adenoma, the aldosterone-producing tumor can be localized by segmental adrenal vein sampling (S-AVS). Cardiologists, who regularly perform percutaneous coronary intervention (PCI), or coronary angioplasty with stent, may not be familiar with the technique of S-AVS. A case of the use of S-AVS is reported in a patient who presented with primary aldosteronism and a right adrenal adenoma. Read More

Internist (Berl) 2019 Feb 1. Epub 2019 Feb 1.

Klinik für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Primary aldosteronism (PA) is a frequent cause of resistant hypertension. The clinical presentation is heterogeneous, but a suppressed or low normal renin (especially with ACE inhibitors or sartans) should raise suspicion for primary aldosteronism, even when aldosterone levels are in the normal range. Diagnosis of unilateral hormone production from an adrenal adenoma (Conn syndrome), which is curable by surgery, requires adrenal vein sampling, which should be performed in experienced centers. Read More

Indian J Pathol Microbiol 2019 Jan-Mar;62(1):132-135

Department of Radiology, Karadeniz Technical University, Trabzon, Turkey.

Ectopic adrenocortical tissue may be present in many anatomical localizations. Hyperplasia, adenoma or carcinoma can occasionally develop from the ectopic adrenal tissue. Therefore, it should be surgically excised when it is detected. Read More

Nucl Med Commun 2019 Jan 28. Epub 2019 Jan 28.

Department of Internal Medicine, Division of Endocrinology and Metabolism, College of Medicine.

Background: Primary aldosteronism (PA) is a common cause of secondary hypertension. Among the many leading causes of PA, the two most frequent are, bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenomas (APA). Since a solitary APA may be cured surgically, but BAH needs lifelong pharmacologic therapy, confirmation is mandatory before surgery. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2405-2407

Dept. of Surgery, Aomori Prefectural Central Hospital.

A 70-year-old woman had consulted a doctor at a former clinic because of bloody stool and colonoscopy revealed a type 2 tumor of the rectum. She was referred to our hospital for further examinations and treatment. Preoperative blood examination showed an elevated HbA1c level of 10. Read More

Insights Imaging 2019 Jan 25;10(1). Epub 2019 Jan 25.

Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.

The widespread use of imaging examinations has increased the detection of incidental adrenal lesions, which are mostly benign and non-functioning adenomas. The differentiation of a benign from a malignant adrenal mass can be crucial especially in oncology patients since it would greatly affect treatment and prognosis. In this setting, imaging plays a key role in the detection and characterization of adrenal lesions, with several imaging tools which can be employed by radiologists. Read More

Vitam Horm 2019 8;109:407-431. Epub 2019 Jan 8.

Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Aldosterone-producing adenomas (APA) are more common than initially anticipated. APA cause primary aldosteronism (PA), which affect 3-10% of the hypertensive population. Research during recent years has led to an increased knowledge of the background dysregulation of the increased aldosterone release, where mutation in the gene encoding the potassium channel GIRK4-KCNJ5-is the most common. Read More

Vitam Horm 2019 23;109:285-302. Epub 2018 Dec 23.

Hudson Institute of Medical Research, Clayton, VIC, Australia; Monash University, Clayton, VIC, Australia. Electronic address:

Primary aldosteronism (PA), currently recognized to be 5-10% of hypertension, has a cardiovascular risk profile double that in age-, sex-, and blood pressure-matched essential hypertensives. Screening for PA is by determining the plasma aldosterone to renin ratio (ARR), followed by one of half a dozen confirmatory/exclusion tests. Unilateral hyperaldosteronism normally reflects an aldosterone producing adenoma; bilateral disease is the more common form, and termed idiopathic hyperaldosteronism (IHA). Read More

Endocr J 2019 Jan 22. Epub 2019 Jan 22.

Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan.

Adrenal Cushing's syndrome (CS) is caused by cortisol-producing adrenal adenoma and is frequently accompanied by glucose metabolism disorders, which are characterized by increased insulin resistance and insufficient β-cell compensation. However, considering the rarity of CS, few studies have assessed whether the glucose metabolism disorders could be ameliorated by surgical treatment. In this case series, we evaluated glucose metabolism before and after surgery in 11 patients (10 women and 1 man) who underwent unilateral adrenalectomy for overt adrenal CS between 2005 and 2016. Read More

BMC Endocr Disord 2019 Jan 23;19(1):14. Epub 2019 Jan 23.

Department of Endocrinology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, 310003, Hangzhou, China.

Background: Hyperandrogenemia is more common in puberty and reproductive age, but relatively rare in postmenopausal women. Postmenopausal virilization may result from androgen-producing tumors. Androgen-secreting adrenal tumors are rare in clinical practice and are diagnosed as adrenocortical carcinoma, most of which can co-secrete androgen and cortisol. Read More

BMC Endocr Disord 2019 Jan 22;19(1):13. Epub 2019 Jan 22.

Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Background: Increased urinary free cortisol in response to the oral administration of dexamethasone is a paradoxical reaction mainly reported in patients with primary pigmented nodular adrenocortical disease. Here, we describe the first case of subclinical Cushing's syndrome represented by autonomous cortisol secretion and paradoxical response to oral dexamethasone administration, harboring an activating mutation in the α subunit of the stimulatory G protein (GNAS).

Case Presentation: A 65-year-old woman was diagnosed with subclinical Cushing's syndrome during an evaluation for bilateral adrenal masses. Read More

Scand J Surg 2019 Jan 17:1457496918822622. Epub 2019 Jan 17.

4 Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.

Background And Aims:: Primary aldosteronism is a common cause of secondary hypertension. Primary aldosteronism is caused by an aldosterone-producing adenoma or bilateral hyperplasia that in some cases is asymmetrical with one adrenal dominating aldosterone secretion. Most patients with aldosterone-producing adenoma are biochemically cured by unilateral adrenalectomy, but patients with bilateral hyperplasia have a significant risk of residual or recurrent disease. Read More

J Steroid Biochem Mol Biol 2019 Jan 14. Epub 2019 Jan 14.

Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Munich, Germany; Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy. Electronic address:

In primary aldosteronism (PA) the differentiation of unilateral aldosterone-producing adenomas (APA) from bilateral adrenal hyperplasia (BAH) is usually performed by adrenal venous sampling (AVS) and/or computed tomography (CT). CT alone often lacks the sensitivity to identify micro-APAs. Our objectives were to establish if steroid profiling could be useful for the identification of patients with micro-APAs and for the development of an online tool to differentiate micro-APAs, macro-APAs and BAH. Read More

Pituitary 2019 Jan 14. Epub 2019 Jan 14.

Department of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China.

Purpose: To explore the clinical characteristics of pituitary adenomas in patients with MEN1 and to summarize treatment strategies for MEN1 in a Chinese population.

Methods: We retrospectively analyzed 54 MEN1 patients with pituitary adenomas diagnosed at Peking Union Medical College Hospital from March 2003 to January 2017. Clinical data, laboratory testing results, treatments of involved glands and treatment responses were collected and analyzed. Read More

Neuroendocrinology 2019 Jan 13. Epub 2019 Jan 13.

Background Cushing's disease (CD) represents the principal cause of endogenous hypercortisolism. The first-line therapy of CD is surgical removal of the ACTH secreting pituitary adenoma, which is generally followed by adrenal insufficiency (AI). Objective To analyse the recovery of the AI in patients with CD after pituitary surgery in relation with recurrence and persistent remission of CD. Read More

Hypertens Res 2019 Jan 8. Epub 2019 Jan 8.

Division of Circulatory and Body Fluid Regulation, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

Adrenal venous sampling (AVS) is the gold standard test for distinguishing between unilateral and bilateral primary aldosteronism (PA); however, AVS requires advanced and time consuming technique. The needs for AVS have been increasing due to the increased utilization of screening for PA. An efficient selection of unilateral PA, such as aldosterone-producing adenoma (APA), before AVS is useful to avoid undesirable AVS in bilateral PA, such as idiopathic hyperaldosteronism. Read More

Abdom Radiol (NY) 2019 Jan 1. Epub 2019 Jan 1.

Body Imaging Section, Department of Radiology, University of Washington, Box 358081, 825 Eastlake Ave E, G2-600, Seattle, WA, 98109, USA.

Objectives: To investigate whether the histogram analysis method of characterizing adrenal nodules as adenomas is affected by increased noise with modern CT technique, and if an extension that allows for noise correction will improve diagnostic performance.

Materials And Methods: This is a HIPAA-compliant, IRB-approved retrospective study performed on 58 total patients. The first group of 29 patients had 33 adrenal lesions that were pathology-proven non-adenomas. Read More

World Neurosurg 2018 Dec 21. Epub 2018 Dec 21.

Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino-city, Japan.

Background: Intracranial pseudoaneurysm is a rare complication of endoscopic endonasal surgery. Herein, we describe two-staged stent-assisted coil embolization for posterior communicating artery pseudoaneurysm after endoscopic endonasal surgery for pituitary adenoma.

Case Description: A 68-year-old man had a history of severe adult growth hormone secretion deficiency, requiring growth hormone replacement therapy; secondary adrenocortical hypofunction; hyperthyroidism; hypertension; constipation; glaucoma; and hyperuricemia. Read More

Hypertension 2019 Feb;73(2):469-480

From the Biozentrum, University of Basel, Switzerland (M.M.S., M.C., E.D., P.J., S.M., C.P., M.N.H.), University Hospital Basel, Switzerland.

Primary aldosteronism is a disease of excessive production of adrenal steroid hormones and the most common cause of endocrine hypertension. Primary aldosteronism results mainly from bilateral adrenal hyperplasia or unilateral aldosterone-producing adenoma (APA). Primary aldosteronism cause at the molecular level is incompletely understood and a targeted treatment preventing excessive adrenal steroid production is not available. Read More

Clin Endocrinol (Oxf) 2018 Dec 21. Epub 2018 Dec 21.

Department of Endocrinology, The Adelaide and Meath Hospital, Incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.

Introduction: The aldosterone/renin ratio is the initial screening test for primary hyperaldosteronism (PHA), but little data exists regarding ethnic variations in this.

Methods: Following clinical observation of a high prevalence of abnormal aldosterone/renin ratio (ARR) in patients of African-origin, we retrospectively reviewed all ARR measurements in a single centre over 10 years. Rates of hypokalaemia, intraventricular septal thickness (IVS, by echocardiography) and adrenal imaging were recorded when available. Read More

Hypertension 2018 Dec;72(6):1345-1354

From the Department of Biochemistry (Y.S., M.S., K.N.), Keio University School of Medicine, Tokyo, Japan.

Primary aldosteronism is a secondary hypertensive disease caused by autonomous aldosterone production that often caused by an aldosterone-producing adenoma (APA). Immunohistochemistry of aldosterone synthase (CYP11B2) shows the presence of aldosterone-producing cell clusters (APCCs) even in non-primary aldosteronism adult adrenal cortex. An APCC-like structure also exists as possible APCC-to-APA transitional lesions (a speculative designation) in primary aldosteronism adrenals. Read More

Rev Med Liege 2018 Dec;73(12):603-609

Service d`Endocrinologie, CHU de Liège, Liège, Belgique.

Cushing's syndrome (CS), which is often associated with infertility, exceptionally occurs in pregnancy, and markedly increases maternal and fetal morbidity and mortality. Gestational CS may be challenging. Indeed, symptoms of hypercorticism may overlap with physiological hyperactivity of the hypothalamus-pituitary-adrenal axis in normal pregnancy. Read More

Rev Endocr Metab Disord 2018 Dec 19. Epub 2018 Dec 19.

Department of Pediatrics, Hospital Lluís Alcanyís de Xàtiva, Ctra. Xàtiva a Silla km 2, 46800, Xàtiva, Valencia, Spain.

Less than 15% of hypertension cases in children are secondary to a primary hyperaldosteronism. This is idiopathic in 60% of the cases, secondary to a unilateral adenoma in 30% and 10% remaining by primary adrenal hyperplasia, familial hyperaldosteronism, ectopic aldosterone production or adrenocortical carcinoma.To date, four types of familial hyperaldosteronism (FH I to FH IV) have been reported. Read More

BMJ Case Rep 2018 Dec 14;11(1). Epub 2018 Dec 14.

Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India.

Medicine (Baltimore) 2018 Dec;97(50):e13591

Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University and Jiangsu Province Hospital, Gulou District, Nanjing City, Jiangsu Province, PR China.

Rationale: Primary aldosteronism due to aldosteronoma is the most common form of secondary hypertension, with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Diagnosis is a clinical challenge with simultaneous occurrence of primary ectopic meningioma in the adrenal gland. To our knowledge this is the first reported case of simultaneous occurrence of aldosteronomas and ectopic meningioma in the adrenal gland based on literatures. Read More

Medicine (Baltimore) 2018 Dec;97(50):e13369

Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome.

Rationale: Catecholamine-producing tumors are rare, occurring in less than 0.2% of patients with hypertension, but can have relevant cardiovascular morbidity and mortality.

Patient Concerns: A 37-year-old woman presented with a history of dyspnea, chest pain, palpitations, and paroxysmal hypertension. Read More

Medicine (Baltimore) 2018 Dec;97(50):e13322

Department of Endocrinology, Peking University First Hospital, China.

Rationale: Ectopic adrenal tissue is the adrenal rests along the path from gonads to adrenal glands during embryogenesis. Ectopic adrenocortical adenoma is a rare disease represented with over-production of cortisol by the ectopic adrenocortical tissue.

Patient Concerns: An 18-year-old Chinese female patient was presented with weight-gain for 6 months. Read More

Hinyokika Kiyo 2018 Nov;64(11):435-438

The Department of Urology, Osaka National Hospital.

A 69-year-old woman was admitted to the previous hospital because of a right adrenal tumor detected by a medical checkup. Although the tumor was diagnosed as non-functional adrenal adenoma, abdominal computed tomography (CT) revealed a left renal mass which was suspected to be renal cell carcinoma. Chest CT seeking for metastatic lesions revealed lung cancer of the left lung. Read More

EPMA J 2018 Dec 21;9(4):421-429. Epub 2018 Sep 21.

7Department of Radiology, Keck Medical Center of USC, Los Angeles, CA USA.

Objectives: This study aims to define a radiomic signature for pre-operative differentiation between subclinical pheochromocytoma (sPHEO) and lipid-poor adrenal adenoma (LPA) in adrenal incidentaloma. The goal was to apply a predictive, preventive, and personalized medical approach to the management of adrenal tumors.

Patients And Methods: This retrospective study consisted of 265 consecutive patients (training cohort, 212 (LPA, 145; sPHEO, 67); validation cohort, 53 (LPA, 36; sPHEO, 17)). Read More

Horm Metab Res 2019 Jan 6;51(1):62-68. Epub 2018 Dec 6.

Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.

Cross-sectional studies in small and selected populations report a high prevalence of hypercortisolism in patients with type 2 diabetes (T2D), which could have therapeutic implications, if confirmed. We therefore estimated the prevalence of hypercortisolism in a large and unselected cohort of recently diagnosed T2D patients. Consecutive patients with recently diagnosed T2D first underwent an overnight dexamethasone (1 mg) suppression test (OD). Read More

Endocrinol Metab (Seoul) 2018 Dec;33(4):485-492

Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Background: Increasing evidence supports interplay between aldosterone and parathyroid hormone (PTH), which may aggravate cardiovascular complications in various heart diseases. Negative structural cardiovascular remodeling by primary aldosteronism (PA) is also suspected to be associated with changes in calcium levels. However, to date, few clinical studies have examined how changes in calcium and PTH levels influence cardiovascular outcomes in PA patients. Read More

Abdom Radiol (NY) 2018 Nov 20. Epub 2018 Nov 20.

Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 77900, Olomouc, Czech Republic.

Purpose: The aim was to determine the optimal slice thickness of CT images and the optimal threshold of negative voxels for CT histogram analysis to distinguish adrenal adenomas from non-adenomas with a mean attenuation more than 10 Hounsfield units (HU).

Methods: Volume CT histogram analysis of 83 lipid-poor adenomas and 80 non-adenomas was performed retrospectively. The volume of interest was extracted from each adrenal lesion, and the mean attenuation, standard deviation (SD), and percentage of voxels with a negative CT value were recorded using reconstructions with different slice thicknesses (5 mm, 2. Read More

Hormones (Athens) 2018 Dec 19;17(4):479-490. Epub 2018 Nov 19.

Section on Endocrinology and Genetics & Inter-Institute Endocrinology Training Program, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), NIH-Clinical Research Center, 10 Center Drive, Building 10, Room 1-3330, MSC1103, Bethesda, MD, 20892, USA.

The last 10 years have produced an amazing number of significant discoveries in the field of adrenal endocrinology. The development of the adrenal gland was linked to specific molecules. Cortisol-producing lesions were associated mostly with defects of the cyclic AMP (cAMP) signaling pathway, whereas aldosterone-producing lesions were found to be the result of defects in aldosterone biosynthesis or the potassium channel KCNJ5 and related molecules. Read More

Clin Genitourin Cancer 2019 Feb 26;17(1):e216-e220. Epub 2018 Oct 26.

Department of Diagnostic Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.

Oncocytic neoplasms are rare tumors arising in the adrenal glands and usually considered as nonfunctional and benign. We report 4 cases of adrenal oncocytic neoplasm. The paucity of literature describing this entity increases the chance for misdiagnosis. Read More

Br J Radiol 2019 Feb 28;92(1094):20180429. Epub 2018 Nov 28.

1 Department of Radiology, China-Japan Friendship Hospital , Beijing , China.

Objective:: To retrospectively evaluate the diagnostic values of absolute percentage washout ratio (APW) and relative percentage washout ratio (RPW) obtained from a short time delay triphasic enhanced CT in distinguishing adenomas from non-adenomas.

Methods:: The study population consisted of 116 patients (58 males and 58 females; mean age, 52 years; age range, 23-89 years) with 116 adrenal masses from 2010 to 2016. Absolute attenuation values in each phase of CT were measured, and then the APW and RPW were calculated. Read More

J Hypertens 2019 Mar;37(3):603-611

Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai, Japan.

: Nowadays most patients diagnosed with surgically curable primary aldosteronism have small or micro aldosterone-producing adenoma or unilateral micronodular hyperplasia, which are undetectable with available imaging technologies. Therefore, a negative imaging test by no means excludes unilateral primary aldosteronism. Moreover, about 10% of the subjects above the age of 35 years have nonfunctioning adrenal tumors, regardless of being hypertensive or not, with a prevalence that raises with aging. Read More

Exp Clin Endocrinol Diabetes 2018 Nov 14. Epub 2018 Nov 14.

Section on Endocrinology and Genetics & Endocrinology Inter-institute Training Program, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.

Carney complex is a rare, autosomal dominant, multiple endocrine neoplasia and lentiginosis syndrome, caused in most patients by defects in the gene, which encodes the regulatory subunit type 1α of protein kinase A. Inactivating defects of lead to aberrant cyclic-AMP-protein kinase A signaling. Patients may develop multiple skin abnormalities and a variety of endocrine and non-endocrine tumors. Read More

Am J Surg Pathol 2019 Feb;43(2):277-287

Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.

The aim of this work was to study small neoplasms of the epithelium of the renal tubules; kidneys from 402 unselected autopsies were sectioned at 1 to 2 mm intervals. All lesions were examined histologically. A total of 232 papillary adenomas were found in 76 patients (19%), ranging from 1 to 35 adenomas/patient (mean: 3, median: 2). Read More

Steroids 2018 Dec 7;140:179-184. Epub 2018 Nov 7.

Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Objective: Elevated midnight cortisol levels induced by non-suppressed ACTH levels may lead to false-positive results for hypercortisolism in patients with adrenal incidentaloma. We investigated whether plasma ACTH-associated high midnight serum cortisol levels are correlated with other endocrinological findings with respect to hypothalamic-pituitaryadrenal function or hypercortisolism status.

Methods: Two-hundred-forty-six patients with adrenocortical adenoma were evaluated via measurements of midnight ACTH and cortisol levels, a 1-mg dexamethasone suppression test (DST), and a cosyntropin-releasing hormone (CRH) stimulation test. Read More

Surgery 2019 Jan 7;165(1):211-218. Epub 2018 Nov 7.

Department of Surgery, Division of Endocrine and Oncologic Surgery, Hospital of the University of Pennsylvania, Philadelphia.

Background: Unilateral primary aldosteronism is surgically curable. The goal of this study was to examine outcomes based on preoperative imaging findings.

Methods: We performed a retrospective analysis of patients with primary aldosteronism who underwent adrenal vein sampling. Read More

Eur J Radiol 2018 Nov 2;108:184-188. Epub 2018 Oct 2.

Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Objective: To investigate whether lipid metabolism-related factors regulate unenhanced CT attenuation in adrenal adenoma (AA).

Materials And Methods: Thirty-six patients with surgically proven AAs were enrolled in this study. The patients' underlying diseases were the following: primary aldosteronism (n = 24), Cushing's syndrome (n = 8), subclinical Cushing's syndrome (n = 3) and non-functioning AA (n = 1). Read More

J Clin Endocrinol Metab 2019 Feb;104(2):312-318

Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, Netherlands.

Background: Up to 7% of all adrenal incidentalomas (AIs) are pheochromocytomas (PCCs). In the evaluation of AI, it is generally recommended that PCC be excluded by measurement of plasma-free or 24-hour urinary fractionated metanephrines. However, recent studies suggest that biochemical exclusion of PCC not be performed for lesions with CT characteristics of an adrenocortical adenoma (ACA). Read More

J Endocr Soc 2018 Nov 17;2(11):1236-1245. Epub 2018 Sep 17.

Department of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Context: The involvement of visceral fat in aldosterone secretion has not been reported in patients with primary aldosteronism (PA). Patients with PA are complicated by metabolic syndrome more frequently than those without PA. An excess of visceral fat has been hypothesized to cause an elevation of aldosterone secretion in patients with PA. Read More