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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the presence of a solid intrarenal mass, ultrasound scans should not be limited to the mass itself. Modern commercial gray scale equipment is capable of demonstrating both tumor extension into the inferior vena cava and the metastatic disease to the liver. The presence of multiple solid intrarenal masses favors the diagnosis of metastatic disease to the kidney or multiple angiomyolipomas. Retroperitoneal lymphadenopathy or an adrenal mass coincidental with an intrarenal mass suggests metastatic disease. These possibilities can be detected by echography if prone scans are performed over the suprarenal region and the contralateral kidney, and supine scans are performed for evaluation of the inferior vena cava, liver, and retroperitoneum.
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PMID:The complete echographic evaluation of solid renal masses. 10 19

Benign adrenocortical masses often contain lipid; metastases and pheochromocytomas do not. Standard and lipid-sensitive (chemical shift) magnetic resonance (MR) images of the adrenal glands in 31 patients with 45 adrenal masses were reviewed to determine if simple visual analysis of these images would increase diagnostic specificity. Lipid was considered present if signal intensity of the adrenal mass relative to other tissues decreased on chemical shift images relative to comparable standard images. Both myelolipomas and 26 of 27 benign cortical masses displayed a loss of signal intensity on at least one chemical shift image; all 12 metastases, the three hemorrhages, and a cyst did not. Opposed-phase images were slightly more sensitive than fat-suppressed images in depicting lipid within benign cortical masses. All masses had higher signal intensity than that of the liver on standard T2-weighted MR images. Chemical shift MR imaging can demonstrate lipid within benign adrenocortical masses and thus increase specificity, potentially obviating biopsy and aggressive follow-up.
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PMID:Benign adrenocortical masses: diagnosis with chemical shift MR imaging. 835 69

Ultrasound has become an important diagnostic modality in the staging of patients with lung cancer. Between 1980 and 1990, 410 patients with histologically proved lung cancer were evaluated. In 44 patients (11%) an adrenal mass was discovered on ultrasound; in 13 patients it was isolated, and in 31 further evidence of abdominal disease was shown. Sonographic follow-up examinations of adrenal masses showed changes of size in all but 2 patients, and were therefore found to be adrenal metastases. In the 2 patients with isolated and stable adrenal disease, fine-needle biopsy revealed adenomas. Adrenal masses in patients with lung cancer are more likely to be metastatic than benign. The existence of neoplastic adrenal disease can be retrospectively confirmed by changes of size during sonographic follow-up examinations in almost all patients. Histologically verification would only appear necessary in stable adrenal disease and in cases with isolated adrenal disease in which prompt diagnosis affects treatment decision.
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PMID:Adrenal masses in lung cancer: sonographic diagnosis and follow-up. 151 57

Adrenocortical carcinoma (ACC) in childhood is a rare tumor with high fatality rate. Available reports provide event free survival rates ranging between 10 to 50%. Optimal treatment has not yet been established; surgery plays a major role, and the value of adjuvant chemotherapy needs to be evaluated further, especially in children who develop recurrent disease and those with metastases at diagnosis. Optimal therapy of ACC has not been established. Surgery has been curative after complete tumor resection. Children with inoperable, recurrent and metastatic ACC have been treated with O,P'DDD, with response rates ranging from 10 to 60% in different series [7,11-20]. Radiotherapy [21] and other anti-cancer drugs have been used [4-22] but their efficacy has not been established. Combination chemotherapy containing oncovin, cisPlatinum, epipodophyllotoxin and cyclophosphamide (OPEC) produced regression of metastatic ACC in a 5-year-old male [23]. We report one girl with relapsed disseminated ACC who showed good, even if temporary, control of the disease, with disappearance of lung, liver and spleen metastases, and marked reduction of the adrenal mass, following combined chemotherapy according to the "eight-drugs-in-one-day" protocol.
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PMID:Partial response after intensive chemotherapy for adrenal cortical carcinoma in a child. 157 38

The purpose of this report was to suggest the ability to differentiate adrenal masses by out-of-phase FLASH imaging. The images were obtained with breath-holding at TR/TE 100/12 ms, flip angle 20 degrees. The material included adrenal adenoma (n = 16), nodular hyperplasia (n = 1), pheochromocytoma (n = 5), and adrenal metastatic tumors (n = 7). The signal intensity ratios of the adrenal mass/the diaphragmatic crus, back muscle, and renal cortex were obtained. The mean values of the ratios of adenomas or nodular hyperplasia were significantly different from pheochromocytomas or metastases. Although the number of adrenal masses was fairly small, the ratios of adrenal mass/diaphragmatic crus could distinguish them with no overlapping case. All 17 masses with the ratio of 1.16 or less were adenomas or nodular hyperplasia, whereas all 12 masses with a ratio greater than 1.23 were pheochromocytomas or metastases. This result suggests the ability of out-of-phase FLASH imaging to differentiate adrenal masses.
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PMID:Differential diagnosis of adrenal masses using out-of-phase FLASH imaging. A preliminary report. 159 Nov 31

Although adrenal metastases are frequently noted with non-small-cell lung cancer (NSCLC) at autopsy, their incidence in patients with operable NSCLC is unclear. We prospectively assessed consecutive patients with otherwise operable NSCLC for the incidence and histology of unilateral adrenal masses. Assessment included blood chemistries, lung function tests, bronchoscopy, chest x-ray, bone scan, and computed tomography (CT) of the head, chest, and upper abdomen. Of 246 patients with otherwise operable NSCLC, 10 (4.1%) had a unilateral adrenal mass. Unilateral adrenal masses were needle-aspirated under CT control. If cytology was nondiagnostic, adrenalectomy was performed. Four (40%) of 10 patients had adrenal metastases proven by needle aspiration. Of the six (60%) patients with benign unilateral adrenal masses, one was demonstrated by needle aspiration. In the other five patients, a nondiagnostic needle aspiration led to adrenalectomy, which yielded two adenomas, two hyperplastic nodules, and one hemorrhagic cyst. There was no significant difference between the patients with benign and metastatic unilateral adrenal masses with respect to patient age or stage and size of adrenal mass. Patients with benign unilateral adrenal masses underwent curative resection of their NSCLC and had significantly prolonged survival compared with patients with metastatic unilateral adrenal masses treated with chemotherapy (P = .037). Median survival of patients with benign and metastatic unilateral adrenal masses was greater than 30 months and 9 months, respectively. In conclusion, the presence of unilateral adrenal masses in patients with otherwise operable NSCLC should not preclude thoracotomy without pathologic proof of metastatic disease.
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PMID:Prospective evaluation of unilateral adrenal masses in patients with operable non-small-cell lung cancer. 164 68

Fine-needle aspiration of an adrenal mass was performed to rule out metastatic disease in a patient with a bronchogenic carcinoma. The aspiration was misinterpreted as metastatic small cell anaplastic carcinoma. Review of the aspirate by the authors revealed the atypical small cells to be aggregates of bare nuclei of benign adrenocortical cells. Interpretation of these bare nuclei in isolation and unfamiliarity with the aspiration cytology of the adrenal gland led to the initial misdiagnosis.
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PMID:Adrenal cortical cells mimicking small cell anaplastic carcinoma in a fine-needle aspirate. 166 97

The Authors report a case of left adrenal mass incidentally discovered by upper abdominal echogram in a 40 year old man. Physical examination showed no signs of hypercortisolism and plasma cortisol and ACTH levels were in the normal range as well as urinary free cortisol. After adrenalectomy, 4 and 8 month follow-up was performed, without clinical, hormonal and TC evolution. Thirteen months later the patient was referred to our department for widespread oedema, hypertension, hypokalemia and alkalosis. These symptoms were associated with dramatically elevated concentrations of plasmatic and free urinary cortisol. TC showed a large mass in the same adrenal region and diffuse hepatic metastases. In spite of mitotane and ketoconazole therapy the patient died few weeks later.
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PMID:[Unusual endocrine behavior in adrenal carcinoma. A case study]. 181 20

Adrenal hemorrhage secondary to metastases is uncommon. We have encountered four such cases that presented as large adrenal masses. In all cases the CT findings were of an inhomogeneous mixed-density adrenal mass with extensive perirenal changes suggestive of perirenal hemorrhage or mass. When such a lesion is seen, hemorrhagic adrenal metastases should be considered. Fluid may be of high density, suggestive of hemorrhage. However, as the adrenal is in the perinephric space, hemorrhage from any cause (trauma, metastases, or anticoagulant) in the adrenal gland will gravitate into the perinephric space.
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PMID:Hemorrhagic adrenal metastases: CT findings. 253 51

A 49-year-old woman was admitted to our hospital with complaints of edema and abnormal shadow in right pulmonary area. CT scan and abdominal aortography showed left adrenal mass. Moreover, the lung metastasis measured 60 x 65 mm and bony metastases were suspected in three areas on bone scanning. Under diagnosis of left non-functioning adrenal tumor with pulmonary and bony metastases, left adrenalectomy was performed. Histological diagnosis was left adrenal cortical carcinoma without lymph node metastasis. Treatment consisted of 3 g o,p-DDD and 400 mg carmofur per day after surgery. At present, pulmonary metastasis has decreased in size and bony metastases decreased in uptake on bone scan 12 months postoperatively.
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PMID:[A case of non-functioning adrenal cortical carcinoma with pulmonary and bony metastases]. 261 88


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