The Incidentally Discovered Adrenal Mass

Division of Endocrinology, Diabetes, Metabolism, Nutrition, and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
New England Journal of Medicine (Impact Factor: 55.87). 03/2007; 356(6):601-10. DOI: 10.1056/NEJMcp065470
Source: PubMed

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    • "fine-needle aspiration biopsy of a pheochromoytoma may result in hemorrhage, tumor implantation, myocardial infarction, arrhythmia, stroke, hypertensive crisis , and death.[38,39]Therefore, the possibility of pheochromoytoma should always be ruled out through biochemical tests before a fine-needle aspiration biopsy is undertaken. Given the strong association between imaging features and pheochromoytoma, some experts advocate treatment with an γ-and β-adrenergic blockade and tumor resection in patients with an imaging phenotype of pheochromoytoma, even when the results of biochemical tests for pheochromoytoma are normal.[39,40]4. CONCLUSION Correct diagnosis and management of pheochromocytoma is clinically important because a misdiagnosis leads to high morbidity and mortality secondary to hypertensive crisis. There have been many difficulties in the diagnosis of PC. "

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    • "The adrenal gland is a relatively frequent site for metastatic disease [3]. The most common malignant lesions that metastasize to the adrenal gland include malignant melanoma, breast, lung, kidney, esophagus, pancreas , liver, stomach, and colon cancers [4] [5] [6]. In patients with a primary neoplasm, in whom an adrenal metastasis is an important consideration, most adrenal masses are benign, commonly non-hyper functioning adenomas [7]. "
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    ABSTRACT: Purpose: Our aim was to evaluate the diagnostic value of MRI using different param-eters in differentiation of adenomas versus non-adenomas adrenal lesions. Materials and methods: Forty-five patients with 48 adrenal masses (28 lipid rich adenomas, 3 lipid poor adenomas, 15 metastases and 2 lymphoma) were retrospectively evaluated with MRI. The mean diameter of adrenal mass, T2WI signal, signal drop on chemical shift imaging (CSI) and enhancement pattern were assessed separately and in various combinations. Accuracies, sensitivi-ties, specificities, PPV, NPV and P values by Chi-square test were calculated for individual and combined parameters. Results: Signal drop on CSI and enhancement pattern were the most statistically significant diag-nostic discriminators of adenomatous and non-adenomatous lesions with accuracies, specificities and sensitivities of 93.8%, 90.3%, 100% and 91.7%, 93.5%, 88.2%, respectively (P-value <0.0001). The best performance of a combination of parameters was obtained after exclusion of the size, with an accuracy of 89.6% (P-value <0.0001). Conclusion: The most specific predictors for adrenal mass characterization were CSI signal drop and Gd-DTPA enhancement characteristics. Combining the MR parameters did not prove superior (S. Emad-Eldin). Peer review under responsibility of Egyptian Society of Radiology and Nuclear Medicine.
    Full-text · Article · Jul 2014 · Egyptian Journal of Radiology and Nuclear Medicine
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    • "2) Neuroblastoma , Gangiloneuroma and pheochromocytoma which arise from medulla of the adrenal glands. Most adrenal pheochromocytomas and all adrenocortical adenomas are benign tumors, which do not metastasize, but which may still cause significant health problems by giving rise to hormonal imbalances (Young 2007). Hyperadrenocorticism (HAC) is caused by either excessive pituitary ACTH secretion, as in pituitary-dependent hyperadrenocorticism (PDH), or an autonomously functioning tumor of the adrenal cortex (AT)(Feldman et al. 1996). "

    Full-text · Article · Jun 2014
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