3,510 results match your criteria bilateral adrenalectomy


Nelson Syndrome: A Case Report and Literature Review.

AACE Clin Case Rep 2021 Mar-Apr;7(2):141-144. Epub 2020 Dec 28.

Endocrinology and Metabolism Department, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico.

Objective: Nelson syndrome (NS) is a rare clinical disorder that can occur after total bilateral adrenalectomy (TBA), performed as a treatment for Cushing disease. NS is defined as the accelerated growth of an adrenocorticotropic hormone-producing pituitary adenoma. Our objective is to describe a case of NS and discuss it based on existing knowledge of this syndrome. Read More

View Article and Full-Text PDF
December 2020

Therapeutic Outcomes with Surgical and Medical Management of Primary Aldosteronism.

Curr Cardiol Rep 2021 Jun 3;23(7):89. Epub 2021 Jun 3.

Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein Pavilion, Philadelphia, PA, 19104, USA.

Purpose Of Review: Primary aldosteronism (PA) is the most common cause of secondary hypertension and is significantly under-diagnosed. Delays in diagnosis and treatment can lead to cardiovascular morbidity and mortality. The goal of this study is to review the management of PA, with a focus on medical and surgical treatment outcomes. Read More

View Article and Full-Text PDF

The importance of adrenal venous sampling in ACTH-independent Cushing syndrome: A case report and literature review.

Exp Ther Med 2021 Jul 18;22(1):772. Epub 2021 May 18.

Discipline of Pediatric Surgery, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Independent Cushing's adrenocorticotropic hormone (ACTH) syndrome can have several causes, including adrenal carcinoma or simple adrenal hyperplasia. Although the distinction between malignant and benign can be effectively made through imaging investigations, in the situation where there are bilateral formations, their hormonal activity is impossible to appreciate via non-invasive techniques. The present study includes the presentation of a clinical case on the basis of which a literature review was made. Read More

View Article and Full-Text PDF

Malignant pheochromocytoma: A diagnostic and therapeutic dilemma.

Int J Surg Case Rep 2021 May 24;83:106009. Epub 2021 May 24.

Ibn Rochd University Hospital Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Morocco.

Introduction: Malignant pheochromocytomas are rare endocrine tumors that develop within chromaffin tissue. The diagnosis of malignancy is based on neoplastic recurrence or the presence of metastasis in organs that lack chromaffin tissue. We report a series of four cases because of their diagnostic and therapeutic particularities. Read More

View Article and Full-Text PDF

Characteristics and outcomes of the Finnish ectopic ACTH syndrome cohort.

Endocrine 2021 May 25. Epub 2021 May 25.

Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Purpose: Ectopic ACTH syndrome (EAS) is rare. We established a national cohort to increase awareness and address unmet needs.

Methods: The Finnish national EAS cohort includes 60 patients diagnosed in 1997-2016. Read More

View Article and Full-Text PDF

Prevalence of Nelson's syndrome after bilateral adrenalectomy in patients with cushing's disease: a systematic review and meta-analysis.

Pituitary 2021 May 25. Epub 2021 May 25.

Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden.

Purpose: Bilateral adrenalectomy (BA) still plays an important role in the management of Cushing's disease (CD). Nelson's syndrome (NS) is a severe complication of BA, but conflicting data on its prevalence and predicting factors have been reported. The aim of this study was to determine the prevalence of NS, and identify factors associated with its development. Read More

View Article and Full-Text PDF

Laparoscopic adrenal-sparing approach for children with bilateral Pheochromocytoma in Von Hippel-Lindau disease.

J Pediatr Surg 2021 Apr 20. Epub 2021 Apr 20.

Section of Pediatric Surgery, Department of Surgery, Michigan Medicine, Ann Arbor 48109 MI, USA. Electronic address:

Introduction: Von Hippel-Lindau disease (VHL) is a rare cause of hereditary bilateral Pheochromocytomas (PHEO). Traditionally, treatment has been total adrenalectomy due to a lifetime risk of developing new tumors. Limited data exists on the surgical management of bilateral PHEO in children with VHL. Read More

View Article and Full-Text PDF

Inadequate Diagnostic Utility of Partially Successful Adrenal Vein Sampling for Primary Aldosteronism Subtyping.

Endokrynol Pol 2021 May 19. Epub 2021 May 19.

Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloska 7, 1525 Ljubljana, Slovenia.

Introduction: Failure of adrenal vein sampling (AVS) due to difficult cannulation of the right adrenal vein (AV) frequently precludes subtyping of patients with primary aldosteronism (PA) before adrenalectomy. According to a recent study, lateralized PA could be accurately predicted from partial AVS data based on the gradient of the aldosterone-to-cortisol ratios (ACR) between left AV and inferior vena cava (IVC) (LAV/IVC index). We aimed to validate the diagnostic utility of this index for PA subtyping in our cohort. Read More

View Article and Full-Text PDF

NP-59 Adrenal Scintigraphy as an Imaging Biomarker to Predict Mutation in Primary Aldosteronism Patients.

Front Endocrinol (Lausanne) 2021 28;12:644927. Epub 2021 Apr 28.

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

Purpose: Somatic mutation occurs in half of unilateral primary aldosteronism (PA) and is associated with more severe phenotype. Mutation status can only be identified by tissue sample from adrenalectomy. NP-59 adrenal scintigraphy is a noninvasive functional study for disease activity assessment. Read More

View Article and Full-Text PDF

Bronchogenic Cyst in the Cervical Region: A Rare Entity - A Case Report and Review of the Literature.

Cureus 2021 Apr 11;13(4):e14413. Epub 2021 Apr 11.

Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.

Bronchogenic cysts originate from the tracheobronchial bud, which arises from the embryonic foregut. Congenital bronchogenic cysts in the cervical region, especially in the thyroid or perithyroidal area, are extremely rare. Moreover, distinguishing them from other cervical cystic lesions such as thyroglossal duct and branchial cleft cysts and metastatic cervical lymph nodes is difficult preoperatively. Read More

View Article and Full-Text PDF

Clinical impacts of endothelium-dependent flow-mediated vasodilation assessment on primary aldosteronism.

Endocr Connect 2021 Jun 8;10(6):578-587. Epub 2021 Jun 8.

Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

Objective: Primary aldosteronism (PA) is divided into two major subtypes, aldosterone-producing adenoma (APA) and bilateral idiopathic hyperplasia (IHA) and is associated with a higher risk of cardiovascular events. However, the nature of vascular function in PA patients remains to be determined. The aim of this study was to determine the vascular function and investigate the implications of vascular function assessments in the patients. Read More

View Article and Full-Text PDF

A novel nonsense mutation in ARMC5 causes primary bilateral macronodular adrenocortical hyperplasia.

BMC Med Genomics 2021 May 10;14(1):126. Epub 2021 May 10.

Branch of National Clinical Research Center for Metabolic Disease, Hubei, Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

Background: Primary bilateral macronodular adrenocortical hyperplasia (PBMAH) is a rare form of adrenal Cushing's syndrome. The slowly progressing expansion of bilateral adrenal tissues usually persists for dozens of years, leading to delayed onset with severe conditions due to chronic mild hypercortisolism. About 20-50% cases were found to be caused by inactivating mutation of armadillo repeat-containing protein 5 (ARMC5) gene. Read More

View Article and Full-Text PDF

Should Adrenal Venous Sampling Be Performed in PA Patients Without Apparent Adrenal Tumors?

Front Endocrinol (Lausanne) 2021 12;12:645395. Epub 2021 Apr 12.

Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

Introduction: Some aldosterone-producing micro-adenomas cannot be detected through image inspection. Therefore, adrenal venous sampling (AVS) is often performed, even in primary aldosteronism (PA) patients who have no apparent adrenal tumors (ATs) on imaging. In most of these cases, however, the PA is bilateral. Read More

View Article and Full-Text PDF

Etiology-, Sex-, and Tumor Size-Based Differences in Adrenocorticotropin-Dependent Cushing Syndrome.

Endocr Pract 2021 May 15;27(5):471-477. Epub 2020 Dec 15.

Department of Histopathology, PGIMER, Chandigarh, India.

Objective: To examine demographic, clinical, and biochemical differences in patients with adrenocorticotropin (ACTH)-dependent Cushing syndrome (CS) based on etiology, sex, and tumor size.

Methods: This was a single-center study of 211 patients with ACTH-dependent CS followed for 35 years. Patients were stratified into 3 groups based on etiology: Cushing disease (CD)/transsphenoidal surgery, Cushing disease/total bilateral adrenalectomy (CD/TBA), and ectopic ACTH secretion (EAS). Read More

View Article and Full-Text PDF

Bilateral pheochromocytoma revealed by acute abdominal pain in a child. A case report.

Pediatr Endocrinol Diabetes Metab 2021 Apr 15. Epub 2021 Apr 15.

Department of Pediatrics, University Hospital Farhat Hached, Sousse, Tunisia.

Pheochromocytoma is a rare tumor during childhood, originating from the chromafine tissue. The clinical presentation can be variable and assembling many other diseases. This tumor submits specific care problems. Read More

View Article and Full-Text PDF

Nonseminomatous Germ-Cell Tumor Presenting as Bilateral Adrenal Masses.

AACE Clin Case Rep 2021 Jan-Feb;7(1):43-46. Epub 2020 Dec 28.

Department of Endocrinology, Medstar Washington Hospital Center, Washington, District of Columbia.

Objective: Many tumors can metastasize to the adrenal glands, making the diagnosis of adrenal masses challenging. Awareness that rare primary tumors can metastasize to the adrenals and consideration of biopsy for their diagnosis, sometimes at extra-adrenal sites, is essential to prevent unnecessary adrenalectomies and facilitate the right treatment. We report a rare case of bilateral adrenal masses due to metastasis from a nonseminomatous germ-cell tumor of a retroperitoneal lymph node origin. Read More

View Article and Full-Text PDF
December 2020

Estrogen-secreting adrenocortical tumor in a postmenopausal woman: a challenging diagnosis.

Endocrinol Diabetes Metab Case Rep 2021 Mar 15;2021. Epub 2021 Mar 15.

Department of Internal MedicineHematology and Oncology, University of Sao Paulo Faculty of Medicine of Ribeirao Preto, Ribeirao Preto, São Paulo, Brazil.

Summary: Adrenocortical carcinoma (ACC) is a malignant disorder with rapid evolution and severe prognosis in adults and most produce cortisol and androgen. Estrogen-secreting adrenocortical carcinomas are extremely rare, especially in women, tend to be larger and have worse prognosis compared with other types of ACCs. We report the case of a 58-year-old woman who presented with bilateral breast enlargement and postmenopausal genital bleeding. Read More

View Article and Full-Text PDF

Case Report: Pheochromocytoma and Synchronous Neuroblastoma in a Family With Hereditary Pheochromocytoma Associated With a MAX Deleterious Variant.

Front Endocrinol (Lausanne) 2021 17;12:609263. Epub 2021 Mar 17.

Department of Endocrinology, Centro Hospitalar Universitário do Porto (CHUP), Porto, Portugal.

Introduction: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumours arising from chromaffin cells of the adrenal medulla or extra-adrenal sympathetic paraganglia. Recent studies have indicated that up to 40% of pheochromocytomas could be attributable to an inherited germline variant in an increasing list of susceptibility genes. Germline variants of the MYC-associated factor () gene have been associated with familial pheochromocytomas and paragangliomas with an autosomal dominant pattern of inheritance, a median age at onset of 33 years and an overall frequency estimated at 1. Read More

View Article and Full-Text PDF

Updates in the outcomes of radiation therapy for Cushing's disease.

Best Pract Res Clin Endocrinol Metab 2021 Mar 10;35(2):101514. Epub 2021 Mar 10.

University of Medicine and Pharmacy Carol Davila, Bucharest, Romania; National Institute of Endocrinology C.I. Parhon, Bucharest, Romania. Electronic address:

External radiation therapy (RT) directed to the pituitary gland is generally recommended in patients with Cushing's disease (CD) as adjuvant to transsphenoidal surgery, among other second-line therapies offered to patients with residual or recurrent hypercortisolism (i.e., medical treatment, repeat surgery or bilateral adrenalectomy). Read More

View Article and Full-Text PDF

Primary Aldosteronism with Parathyroid Hormone Elevation: A Single-center Retrospective Study.

Intern Med 2021 1;60(7):993-998. Epub 2021 Apr 1.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan.

Objective Primary aldosteronism (PA) is a major cause of secondary hypertension. The association between PA and other hormone disorders is unclear. The present study aimed to evaluate whether the parathyroid hormone (PTH) value is associated with PA subtypes or specific treatments. Read More

View Article and Full-Text PDF

[Primary aldosteronism: from diagnosis to therapy in clinical practice].

G Ital Cardiol (Rome) 2021 Apr;22(4):319-326

U.O.C. Cardiologia, Ospedale "Garibaldi Nesima", Catania.

Primary aldosteronism (PA) is the single most common cause of secondary hypertension and is associated with increased target organ injury. It can be can either surgically cured or treated with targeted pharmacotherapy. PA is frequently undiagnosed and untreated, leading to aldosterone-specific cardiovascular morbidity and nephrotoxicity. Read More

View Article and Full-Text PDF

"Double-Down" Adrenal Vein Sampling Results in Patients with Apparent Bilateral Aldosterone Suppression: Utility of Repeat Sampling including Super-Selective Sampling.

J Vasc Interv Radiol 2021 05 27;32(5):656-665. Epub 2021 Mar 27.

Department of Radiology, Division of Interventional Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Purpose: To report outcomes of patients undergoing adrenal vein sampling (AVS) for primary aldosteronism with results indicating apparent bilateral adrenal suppression (ABAS), in which the adrenal aldosterone-to-cortisol ratios are decreased bilaterally ("double-down") compared to the non-adrenal sample, and evaluate repeat AVS results.

Materials And Methods: Between 2003 and 2020, 762 patients underwent AVS. Twenty patients (2. Read More

View Article and Full-Text PDF

Electrical Storm in a Case of Bilateral Pheochromocytomas.

Am J Case Rep 2021 Mar 25;22:e929507. Epub 2021 Mar 25.

Department of Cardiology, Stony Brook University Hospital, Stony Brook, NY, USA.

BACKGROUND Pheochromocytomas are catecholamine-secreting tumors that develop within the chromaffin cells of the adrenal glands. They most commonly present with hypertension, and the classic triad of symptoms is headaches, palpitations, and diaphoresis. Electrical storm (ES) is defined as at least 3 sustained episodes of ventricular tachycardia (VT), ventricular fibrillation (VF), or appropriate shocks from an implanted cardioverter-defibrillator (ICD) within 24 h. Read More

View Article and Full-Text PDF

Stereotactic radiosurgery before bilateral adrenalectomy is associated with lowered risk of Nelson's syndrome in refractory Cushing's disease patients.

Acta Neurochir (Wien) 2021 Mar 24. Epub 2021 Mar 24.

Department of Neurosurgery, University of Virginia, Charlottesville, VA, 22908, USA.

Background: Nelson's syndrome is a rare but challenging sequelae of Cushing's disease (CD) after bilateral adrenalectomy (BLA). We sought to determine if stereotactic radiosurgery (SRS) of residual pituitary adenoma performed before BLA can decrease the risk of Nelson's syndrome.

Methods: Consecutive patients with CD who underwent BLA after non-curative resection of ACTH secreting pituitary adenoma and had at least one follow-up visit after BLA were studied. Read More

View Article and Full-Text PDF

A case report of multiple bilateral breast metastases after colorectal cancer.

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

View Article and Full-Text PDF

Genomic and Clinical Correlates of Adrenocortical Carcinoma in an Adult Patient with Li-Fraumeni Syndrome: A Case Report.

Curr Oncol 2020 12 31;28(1):226-232. Epub 2020 Dec 31.

Division of Medical Oncology, Department of Oncology, McMaster University, Hamilton, ON L8V 5C2, Canada.

Li-Fraumeni Syndrome (LFS) is defined by germline mutations of the p53 tumour suppressor gene. Adrenocortical carcinoma (ACC) is a rare aggressive malignancy that is commonly associated with LFS. Most LFS-linked ACC cases occur in children, and limited research has been dedicated to the clinical outcomes and genomics of adult cases with LFS-linked ACC. Read More

View Article and Full-Text PDF
December 2020

Osilodrostat for the treatment of Cushing's disease.

Expert Opin Pharmacother 2021 Mar 11:1-8. Epub 2021 Mar 11.

Division of Clinical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, IN, USA.

Introduction: The treatment of Cushing's disease (CD) has been advanced well with the introduction of treatment options like transsphenoidal surgery, radiosurgery, bilateral adrenalectomy, and various classes of medication; however, many patients still fail to achieve disease remission. Osilodrostat, an orally bioavailable adrenal steroidogenesis inhibitor, was approved in the USA and EU in 2020 for the treatment of CD.

Areas Covered: This review provides an overview of Cushing's disease and the newly FDA approved 11β-hydroxylase inhibitor, osilodrostat, for CD with a focus on pharmacodynamics, pharmacokinetics, safety and efficacy data, and phase 2 and 3 clinical trials. Read More

View Article and Full-Text PDF

Volumetric evaluation of CT images of adrenal glands in primary aldosteronism.

J Endocrinol Invest 2021 Mar 5. Epub 2021 Mar 5.

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

Objectives: To investigate whether adrenal volumetry provides better agreement with adrenal vein sampling (AVS) than conventional CT for subtyping PA. Furthermore, we evaluated whether the size of this contralateral adrenal was a prognostic factor for clinical outcome after unilateral adrenalectomy.

Methods: We retrospectively analyzed volumes of both adrenal glands of the 180 CT-scans (88/180 with unilateral and 92/180 with bilateral disease) of the patients with PA included in the SPARTACUS trial of which 85 also had undergone an AVS. Read More

View Article and Full-Text PDF

Cotrimoxazole-induced hyperkalaemia in a patient with known hypoaldosteronism.

BMJ Case Rep 2021 Mar 4;14(3). Epub 2021 Mar 4.

Department of Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta.

A70-year-old man, with established hypoadrenalism due to a previous bilateral adrenalectomy, was admitted with recurrent episodes of postural dizziness and presyncope. He had been discharged from hospital 3 weeks earlier on a 1-month course of cotrimoxazole following a diagnosis of prostatitis. His electrolytes on admission showed new onset hyponatraemia and hyperkalaemia. Read More

View Article and Full-Text PDF

The Potential of Computed Tomography Volumetry for the Surgical Treatment in Bilateral Macronodular Adrenal Hyperplasia: A Case Report.

Tohoku J Exp Med 2021 02;253(2):143-150

Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital.

Although adrenal resection is a major option to control hypercortisolemia in patients with bilateral macronodular adrenal hyperplasia, a predictive method for postoperative cortisol production has not been established. A 53-year-old man with ulcerative colitis was referred to our hospital for bilateral multiple adrenal nodules and hypertension. Physical and endocrinological examination revealed inappropriate cortisol production and suppressed secretion of adrenocorticotropic hormone with no typical signs of Cushing's syndrome. Read More

View Article and Full-Text PDF
February 2021