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J Med Case Rep 2021 May 12;15(1):265. Epub 2021 May 12.

Department of Cardiothoracic Surgery, Affiliated Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210000, Jiangsu, China.

Background: Primary lung cancer is one of the most frequently diagnosed cancers. The common metastatic sites are the liver, bones, brain, adrenal glands and central nervous system. However, gastrointestinal metastases, particularly esophageal metastases, from lung cancer are rare. Read More

Int J Surg Case Rep 2021 Apr 27;82:105912. Epub 2021 Apr 27.

Department of Surgery, King Fahad Specialist Hospital-Dammam, Saudi Arabia.

Introduction And Importance: Colorectal cancer is one of the most common cancers both nationally and internationally. It commonly metastases to local lymph nodes, liver and lungs, with few reported cases of rare sites of metastasis such as adrenal glands, breast and skin.

Case Presentation: We report a 55-year-old-female admitted as case of large bowel obstruction and unintentional weight loss. Read More

Case Rep Endocrinol 2021 14;2021:5584198. Epub 2021 Apr 14.

Division of Endocrinology and Metabolism, Japanese Red Cross Musashino Hospital, Tokyo, Japan.

Background: Adrenocortical carcinoma (ACC) is a rare and highly aggressive malignancy. ACCs often secrete adrenal steroid hormones including cortisol and androgens; however, aldosterone-producing ACC is very rare. Although adrenal production of aldosterone is assessed by adrenal venous sampling, the use of sampling from the relevant vein to assess aldosterone production from a tumor arising from ACC metastasis has not been previously reported. Read More

Am J Surg Pathol 2021 Jun;45(6):854-867

Genetics Unit, Department of Tumor Biology.

VGLL2-rearranged rhabdomyosarcomas (RMS) are rare low-grade tumors with only favorable outcomes reported to date. We describe 4 patients with VGLL2-rearranged RMS confirmed by molecular studies, who experienced local progression and distant metastases, including 2 with fatal outcomes. Tumors were diagnosed at birth (n=3) or at 12 months of age (n=1), and were all localized at initial diagnosis, but unresectable and therefore managed with chemotherapy and surveillance. Read More

Exp Ther Med 2021 Jun 14;21(6):605. Epub 2021 Apr 14.

Department of Oncology, 'Gr. T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.

Checkpoint inhibitors represent the first therapeutic class to replace chemotherapy lines for the treatment of metastatic non-small cell lung cancer (NSCLC), due to improved overall survival and tolerability. Nivolumab, a fully human anti-programmed cell death-1 immunoglobulin G4 monoclonal antibody, is the first immune checkpoint inhibitor approved by the US Food and Drug Administration in 2014 for cases of metastatic melanoma and in 2015 for cases of squamous cell lung cancer and kidney cell cancer. The present study aimed to identify predictive markers (favorable or unfavorable) for time to treatment discontinuation using nivolumab in the second or subsequent line of therapy of metastatic NSCLC cases. Read More

Cancers (Basel) 2021 Apr 9;13(8). Epub 2021 Apr 9.

First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece.

Adrenocortical carcinoma is a rare malignancy with aggressive behavior, with up to 40% of patients presenting with metastases at the time of diagnosis. Both conventional chemotherapeutic regimens and novel immunotherapeutic agents, many of which are currently being tested in ongoing clinical trials, have yielded modest results so far, bringing the need for a deeper understanding of adrenal cancer behavior to the forefront. In the recent years, the tumor microenvironment has emerged as a major determinant of cancer response to immunotherapy and an increasing number of studies on other solid tumors have focused on manipulating the microenvironment in the favor of the host and discovering new potential target molecules. Read More

In Vivo 2021 May-Jun;35(3):1805-1810

Department of Oncology-Radiotherapy, "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Background/aim: Kidney cancers account for about 2% of human malignancies. In recent decades, the incidence of this cancer type has gradually increased, mainly due to advances in imaging. The metastatic potential of these cancers is significant: a quarter of patients will immediately present with metastases and more than one third of patients treated with nephrectomy for a localized disease will develop metastases during their course. Read More

Hum Pathol 2021 Apr 24. Epub 2021 Apr 24.

Department of Pathology, Yale School of Medicine, New Haven, CT. Electronic address:

Studies comparing the histomorphologic features and phenotypic heterogeneity between primary and its corresponding metastatic hepatocellular carcinoma (HCC) are lacking. The aim of this study was to assess and compare the histomorphologic features and heterogeneity between primary and metastatic HCC. A total of 39 cases with both primary and metastatic tissues were identified from pathology archives (2000-2019). Read More

J Bone Miner Res 2021 Apr 26. Epub 2021 Apr 26.

Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan.

Bone metastasis is a complication of prostate cancer in up to 90% of men afflicted with advanced disease. Therapies that reduce androgen exposure remain at the forefront of treatment. However, most prostate cancers transition to a state whereby reducing testicular androgen action becomes ineffective. Read More

Clin Nucl Med 2021 Apr 21. Epub 2021 Apr 21.

From the Clinic of Nuclear Medicine Clinic of Pathology, Istanbul Training and Research Hospital, Istanbul, Turkey.

Abstract: Bilateral adrenal metastases from bladder carcinoma have been reported rarely. We report an 86-year-old man with urothelial bladder carcinoma who had received chemotherapy and radiotherapy. Bilateral synchronous adrenal gland metastases were observed on 18F-FDG PET/CT. Read More

Int J Radiat Oncol Biol Phys 2021 May;110(1):217-226

Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.

Purpose: Stereotactic body radiation therapy (SBRT) in the management of adrenal metastases is emerging as a well-tolerated, effective method of treatment for patients with limited metastatic disease. SBRT planning and treatment utilization are widely variable, and publications report heterogeneous radiation dose fractionation schemes and treatment outcomes. The objective of this analysis was to review the current literature on SBRT for adrenal metastases and to develop treatment guidelines and a model for tumor control probability of SBRT for adrenal metastases based on these publications. Read More

BMJ Case Rep 2021 Apr 12;14(4). Epub 2021 Apr 12.

The Cancer Centre, Oncology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, Birmingham, UK

Malignant mesotheliomas (MMs) are malignancies of the mesothelium, with primary deposits originating in the pleura, peritoneum, pericardium and the tunica vaginalis (ie, testicular). Metastatic spread is commonly reported to affect the liver, adrenal glands, kidney and contralateral lung (in cases of malignant pleural mesothelioma). Metastases to distant sites are uncommon. 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

Am J Clin Exp Urol 2021 15;9(1):65-72. Epub 2021 Feb 15.

N.N. Blokhin National Medical Research Center for Oncology Moscow, Russian Federation.

Background: There is the evidence of the role of the fibroblast growth factor and its receptors (FGF/FGFR) signaling pathway in tumorogenesis of renal cell carcinoma (RCC). We conducted a study aimed at evaluating of FGF2, FGFR1, and FGFR2 expression in primary tumor cells and assessing of these molecules expression levels effect on the characteristics of the tumor process and prognosis of patients with RCC.

Methods: Expression of FGF2, FGFR1, and FGFR2 was investigated in 65 primary RCC specimens by immuhistochemical staining using the appropriate antibodies. Read More

J Pers Med 2021 Mar 15;11(3). Epub 2021 Mar 15.

First Department of Propaedeutic Internal Medicine, Laiko Hospital, National & Kapodistrian University of Athens, 11527 Athens, Greece.

Adrenal cortical carcinoma (ACC) is a rare cancer with poor prognosis that needs to be distinguished from adrenocortical adenomas (ACAs). Although, the recently developed transcriptome analysis seems to be a reliable tool for the differential diagnosis of adrenocortical neoplasms, it is not widely available in clinical practice. We aim to evaluate histological and immunohistochemical markers for the distinction of ACCs from ACAs along with assessing their prognostic role. Read More

Eur J Radiol 2021 May 18;138:109664. Epub 2021 Mar 18.

Department of Radiology Aarhus University Hospital, Skejby, Denmark. Electronic address:

Introduction: Distant metastases are found in the many of patients with lung cancer at time of diagnosis. Several diagnostic tools are available to distinguish between metastatic spread and benign lesions in the adrenal gland. However, all require additional diagnostic steps after the initial CT. Read More

Anticancer Res 2021 Mar;41(3):1539-1545

Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.

Background/aim: Nivolumab monotherapy for advanced/metastatic renal cell carcinoma (RCC) shows a survival benefit. The purpose of this study was to evaluate tumor responses to nivolumab in various metastatic and primary sites in patients with RCC.

Patients And Methods: We retrospectively reviewed 68 patients who underwent nivolumab monotherapy after one or more regimens of targeted therapy for advanced/metastatic RCC. Read More

Radiol Imaging Cancer 2020 11 30;2(6):e200011. Epub 2020 Oct 30.

Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, 1053 Carling Ave, C1 Radiology, Ottawa, ON, Canada K1Y 4E9 (W.T., J.A.G., A.U., N.S.); and Department of Radiology and Medical Imaging, King Saud University Medical City, King Khalid University Hospital, Riyadh, Saudi Arabia (A.A.).

Purpose: To evaluate T2-weighted MRI features to differentiate adrenal metastases from lipid-poor adenomas.

Materials And Methods: With institutional review board approval, this study retrospectively compared 40 consecutive patients (mean age, 66 years ± 10 [standard deviation]) with metastases to 23 patients (mean age, 60 years ± 15) with lipid-poor adenomas at 1.5- and 3-T MRI between June 2016 and March 2019. Read More

J Clin Pathol 2021 Mar 25. Epub 2021 Mar 25.

Univ Rennes, Inserm, EHESP, Irset - UMR_S1085, F-35000, Rennes 1 University, Rennes, Bretagne, France.

The dynamics of metastatic evolution in clear cell renal cell carcinoma (ccRCC) are complex. We report a case study where tumour heterogeneity resulting from clonal evolution is a frequent feature and could play a role in metastatic dissemination.We used an integrative multiomics strategy combining genomic and transcriptomic data to classify fourteen specimens from spatially different areas of a kidney tumour and three non-primary sites including a vein thrombus and two adrenal metastases. Read More

Palliat Med 2021 May 24;35(5):972-976. Epub 2021 Mar 24.

Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia.

Background: Immunotherapy is increasingly used in the management of early and advanced malignancy. There is limited data regarding the associations between immunotherapy, malignancy, pain and haemophagocytic lymphohistiocytosis.

Case: A 40-year-old woman was diagnosed with advanced melanoma, with metastases to her brain, liver, lung, adrenal glands and bone. Read More

Int J Surg Case Rep 2021 Apr 12;81:105759. Epub 2021 Mar 12.

Instructor at General Surgery Department, Aleppo University Hospital, Aleppo University, Faculty of Medicine, Aleppo, Syria. Electronic address:

Introduction And Importance: Although primary breast cancer is the most common tumor in women, breast metastases are rare findings. We report the first case in English literature with CRC metastases to the breast and adrenal gland concurrently.

Case Presentation: A 42-year-old Caucasian female complained of abdominal pain over the last 3 days. Read More

Curr Opin Endocrinol Diabetes Obes 2021 Jun;28(3):291-302

Adrenal Research Laboratory, The Discipline of Pharmacology and Therapeutics, Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Ireland.

Purpose Of Review: To summarise the emerging role of thermal ablation as a therapeutic modality in the management of functioning adrenal tumours and metastases to the adrenal gland.

Recent Findings: Observational evidence has demonstrated the benefit of thermal ablation in (i) resolving adrenal endocrinopathy arising from benign adenomas, (ii) treating solitary metastases to the adrenal and (iii) controlling metastatic adrenocortical carcinoma and phaeochromocytoma/paraganglioma.

Summary: Microwave thermal ablation offers a promising, minimally invasive therapeutic modality for the management of functioning adrenocortical adenomas and adrenal metastases. Read More

Br J Neurosurg 2021 Mar 19:1-9. Epub 2021 Mar 19.

Department of Neurosurgery, Cork University Hospital, Cork, Ireland.

Aim: Primary paragangliomas (PGs) are extra-adrenal neuroendocrine tumours that are extremely rare. Multiple lesions in the central nervous system raise suspicion of a metastatic process. Lack of consensus on their management warrants the categorization of existing literature to evaluate management options. Read More

Abdom Radiol (NY) 2021 Mar 18. Epub 2021 Mar 18.

Department of Radiology, Hacettepe University School of Medicine, Ankara, 06100, Turkey.

The detection rates of adrenal masses are increasing with the common and widespread use of cross-sectional imaging. Adrenal adenomas, myelolipomas, metastases, pheochromocytomas, and adrenocortical tumors are well-known and relatively common adrenal tumors. However, there are many less-known neoplastic and nonneoplastic adrenal diseases that might affect the adrenal glands in addition to these common lesions. Read More

Cureus 2021 Mar 13;13(3):e13867. Epub 2021 Mar 13.

Third Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.

Lung carcinoma is the leading cause of death worldwide, with almost 50% of the patients presenting with distant metastases at the moment of diagnosis. The most common metastases sites are the lymph nodes, the liver, the adrenal glands, the bones, and the brain. The gastrointestinal tract was considered an unusual site for lung metastases, and due to the asymptomatic progress of the disease, they are usually diagnosed at a late stage. Read More

Magn Reson Imaging 2021 Jun 13;79:52-58. Epub 2021 Mar 13.

Department of Advanced Biomedical Sciences, University of Naples "Federico II", Italy.

Purpose: To assess a radiomic machine learning (ML) model in classifying solid adrenal lesions (ALs) without fat signal drop on chemical shift (CS) as benign or malignant.

Method: 55 indeterminate ALs (21 lipid poor adenomas, 15 benign pheocromocytomas, 1 oncocytoma, 12 metastases, 6 primary tumors) showing no fat signal drop on CS were retrospectively included. Manual 3D segmentation on T2-weighted and CS images was performed for subsequent radiomic feature extraction. Read More

Medicine (Baltimore) 2021 Mar;100(10):e24010

Department of Urology, Tongji Hospital Affiliated Tongji Medical College of Huazhong University of Science and Technology (HUST), 1095 Jiefang Avenue, Wuhan, China.

Rationale: Renal-occupying lesions positive for urine fluorescence in situ hybridization (FISH) are usually considered urothelial carcinomas. Here, we describe 2 cases of renal metastases with chromosome duplications in urine exfoliated cells.

Patient Symptoms: Patient 1, a 56-year-old male with a history of esophageal cancer, was admitted to our hospital on May 2017 after presenting with right back pain with microscopic hematuria for 1 month. Read More

Int J Surg Case Rep 2021 Apr 5;81:105729. Epub 2021 Mar 5.

Department of Surgery, Shiga General Hospital, Moriyama, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan. Electronic address:

Introduction And Importance: Definitive diagnosis of functioning neuroendocrine neoplasms (NENs) in the pancreas is challenging. Adrenocorticotropic hormone (ACTH) regulates adrenal cortisol production. Ectopic ACTH secretion by functioning NENs may cause hypercortisolism. Read More

Int J Cancer 2021 Mar 8. Epub 2021 Mar 8.

Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany.

To report outcome (freedom from local progression [FFLP], overall survival [OS] and toxicity) after stereotactic, palliative or highly conformal fractionated (>12) radiotherapy (SBRT, Pall-RT, 3DCRT/IMRT) for adrenal metastases in a retrospective multicenter cohort within the framework of the German Society for Radiation Oncology (DEGRO). Adrenal metastases treated with SBRT (≤12 fractions, biologically effective dose [BED10] ≥ 50 Gy), 3DCRT/IMRT (>12 fractions, BED10 ≥ 50 Gy) or Pall-RT (BED10 < 50 Gy) were eligible for this analysis. In addition to unadjusted FFLP (Kaplan-Meier/log-rank), we calculated the competing-risk-adjusted local recurrence rate (CRA-LRR). Read More

J UOEH 2021 ;43(1):97-102

The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.

The patient was a 34-year-old woman. Surgical resection and chemotherapy had been performed on diagnosis of malignant melanoma in year X-9. Chronic thyroiditis was diagnosed in year X-8, but her thyroid function was normal. Read More