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

The characterisation of adrenal lesions is a common radiological dilemma. Incidental adrenal lesions are commonly detected with computed tomography (CT), and lesion characterisation is critical. The prevalence of incidental adrenal lesions has been reported to be 2.3% at autopsy and 0.5-2% with abdominal CT. Such lesions are likely to be seen with increasing frequency given the expanding use of radiological imaging in clinical practice. Although the majority of adrenal lesions are benign, in patients with an extra-adrenal primary cancer the probability of an adrenal mass being a metastasis is 52%. Unfortunately, there may be significant overlap between the imaging appearances of benign lesions such as lipid-poor adenomas and malignant lesions, particularly metastases and small adrenal carcinomas. This review highlights recent advances in radiological imaging of adrenal lesions and we discuss the relative merits of CT and magnetic resonance imaging to aid the identification of benign and malignant adrenal lesions and their roles, in combination with biochemical and clinical data, in recognizing common pathologies such as adrenal adenoma, phaeochromocytoma, carcinoma and metastases. We also discuss the radiological characteristics of rarer adrenal lesions including lymphoma, neuroblastic tumours (neuroblastoma, ganglioneuroblastoma, and ganglioneuroma), lipomatous tumours (myelolipoma, angiolipoma, teratoma, lipoma and liposarcoma), in addition to hemangioma, hemangiosarcoma and leiomyosarcoma.
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PMID:Radiological localizing techniques in adrenal tumors. 1947 Dec 40

The incidental discovery of adrenal masses during modern diagnostic imaging is a common occurrence. These masses form part of a long differential diagnostic list; most often, they are benign adrenal adenomas, but their discovery requires a clinical evaluation that is sufficiently broad to exclude clinically silent endocrine disease, metastases to the adrenal gland in patients with suspected or known malignancies, and rare adrenocortical carcinomas. CT, MRI and nuclear medicine approaches have all been used to evaluate incidentally discovered adrenal masses. Each technology provides information that contributes to the noninvasive characterization of the majority of these neoplasms. Understanding of the modalities used to assess an unanticipated adrenal mass allows for more rapid diagnosis and cost avoidance in a condition that has been referred to as a 'disease' of modern imaging technology.
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PMID:Contemporary imaging of incidentally discovered adrenal masses. 1950 82

The adrenal gland is a common site of disease, with an abnormality prevalence as high as 9% in autopsy series. With the increasing use of CT, adrenal lesions are frequently found in the daily practice of radiology and are diagnosed in up to 5% of CT examinations performed for varied reasons. Imaging features on CT can establish a specific diagnosis of many of these lesions, including myelolipoma, hematoma and cysts. Once a diagnostic dilemma, now adenomas can be accurately diagnosed using unenhanced CT, chemical shift magnetic resonance imaging and CT contrast washout analysis. Because the adrenal gland is also a frequent site of metastasis, recent literature has focused on imaging characterization of adrenal masses for differentiation of adenomas from metastases. In patients without known malignancy, most adrenal lesions are benign and a specific diagnosis can now be made on the basis of imaging features. It is important to understand the prevalence of adrenal abnormalities because the gland is a common site of disorders, and the increased use of cross-sectional imaging has increased the frequency of detection of adrenal lesions. The prevalence of disease is important in predicting the risk of malignancy when an adrenal mass is discovered in a patient without known cancer. Detection of adrenal gland diseases has increased substantially with the advent and widespread use of imaging techniques. Although several imaging modalities can be used, CT has a central role in both detection and differential diagnosis of an adrenal lesion. The aim of this article is to review the CT findings of adrenal gland diseases.
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PMID:Computed tomography findings in diseases of the adrenal gland. 1962 94

Adrenal metastases usually occur in prostate cancer patients with widespread bone and visceral disease. Autopsy studies have shown that adrenal metastases may be found in up to 23% of these patients. However, the finding of an isolated adrenal metastasis without the involvement of other organs in a patient with prostate cancer is exceedingly rare. Thus, it may cause a diagnostic dilemma on FNA cytology. We report a patient with a history of prostate cancer, status post radiation, and hormonal therapy 4 years before, who presented with a new, single adrenal mass on abdominal imaging studies. The ultrasound-guided FNA cytology of the adrenal mass revealed cytomorphological features that were suggestive of a primary adrenal cortical neoplasm, but overlapped with those of a prostate metastasis. To our knowledge, FNA findings of metastatic prostate cancer simulating an adrenal cortical neoplasm have not been previously reported in the English literature. The purpose of our study is to discuss the differential diagnosis of these entities. The accurate diagnosis is important because of different prognosis and treatment implications for the various diseases.
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PMID:Fine needle aspiration of metastatic prostate carcinoma simulating a primary adrenal cortical neoplasm: a case report and review of the literature. 1969 37

Cushing syndrome is rare in infancy and usually due to an adrenocortical tumor (ACT). We report an infant with Cushing syndrome due to adrenocortical carcinoma. The patient presented at six months of age with a three-month history of growth failure, rapid weight gain, acne, and irritability. Physical examination showed obesity, hypertension, and Cushingoid features. Biochemical evaluation showed very high serum cortisol, mildly elevated testosterone, and suppressed ACTH. Abdominal MRI revealed a heterogeneous right adrenal mass extending into the inferior vena cava. Evaluation for metastases was negative. The tumor was removed surgically en bloc. Pathologic examination demonstrated low mitotic rate, but capsular and vascular invasion. She received no adjuvant therapy. Her linear growth has improved and Cushingoid features resolved. Hormonal markers and quarterly PET scans have been negative for recurrence 24 months postoperatively. In conclusion, adrenocortical neoplasms in children are rare, but should be considered in the differential diagnosis of Cushing syndrome.
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PMID:Cushing Syndrome in a 6-Month-Old Infant due to Adrenocortical Tumor. 2004 52

The aim of this study was to assess the usefulness of integrated (18)F-FDG PET/CT in differentiating benign from metastatic malignant adrenal masses in patients with lung cancer. One hundred and ten adrenal masses (size range, 0.5 - 6.3 cm, mean size, 1.9 cm) were evaluated retrospectively in 87 lung cancer patients. Integrated PET/CT images were assessed. PET findings were interpreted as positive if the (18)F-FDG uptake of the adrenal mass was greater than or equal to that of the liver. PET findings were interpreted as negative if the 18F-FDG uptake of the adrenal mass was less than that of the liver. All studies were reviewed independently by 3 nuclear medicine physicians, and the results were then correlated with clinical follow-up or biopsy results when available. PET/CT findings were positive in 77 adrenal masses. Seventy-four of these were eventually considered to be metastatic adrenal disease. In the remaining 3, in the course of follow-up, two underwent percutaneous puncture, and one underwent surgery. In the end, histopathological examinations of the adrenal lesions demonstrated the presence of adenomas. PET/CT findings were negative in 33 adrenal masses, of which 31 eventually proved to be benign. The 2 adrenal masses that were false-negative, underwent PET/CT twice with a two-month interval. At the initial study, the size was 0.5cm, 0.9cm in diameter, respectively. However, at the follow-up study, PET/CT showed both positive result with the size of 1.6cm, and 2.3cm in diameter, respectively. Both adrenal masses were interpreted as metastasis. The sensitivity, specificity, and accuracy for detecting metastatic disease were 97 %( 74 of 76), 94 %( 31 of 34), and 95% (105 of 110), respectively. The positive predictive value was 95 %( 74 of 77), and the negative predictive value was 94% (31 of 33). Integrated (18)F-FDG PET-CT is an accurate, noninvasive technique for differentiating benign from metastatic adrenal lesions detected on CT or MRI in patients with lung cancer. It allows early detection and accurate localization of adrenal lesions and differentiation of metastatic nodules from benign lesions, thereby facilitating treatment planning.
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PMID:18F-FDG PET/CT in the evaluation of adrenal masses in lung cancer patients. 2009 76

Although renal cell carcinoma (RCC) can metastasize to almost every organ, the most common metastatic sites are the lungs, abdomen, bones and brain. We present a rare case of a 72-year-old male with a large left RCC with simultaneous bilateral adrenal metastasis. In the process of surgical treatment, he underwent left radical nephrectomy with ipsilateral adrenalectomy. Due to the poor general condition of the patient, and also to prevent adrenal insufficiency, the right adrenal mass was preserved, without imposing any hazard to the patient. Systemic immunotherapy was initiated and the patient is still alive 1 year after surgery.
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PMID:Renal Cell Carcinoma with Simultaneous Bilateral Adrenal Metastasis: Ipsilateral Radical Nephrectomy with Contralateral Adrenal Preservation. 2111 46

The patients were infant male twins born by cesarean delivery following a healthy pregnancy at 36 weeks' gestation to unrelated parents. At 4 months of age, twin 2 presented with hepatomegaly and a right suprarenal mass. Resection of an adrenal tumor and a liver tumor biopsy were performed. Twin 1 had no symptoms at 4 months of age. Screening by abdominal ultrasonography showed multiple masses in the liver but no adrenal mass. Metaiodobenzylguanidine scintigraphy showed positive findings in multiple liver masses. A laparoscopic biopsy for a liver tumor was performed. All primary tumor and liver tumor specimens from twin 2 and the liver tumor of twin 1 had the same histologic classification of neuroblastoma and nearly identical genetic aberrations, including a chromosome gain or loss using array-comparative genomic hybridization. From these clinical and pathologic findings and genetic analyses, we strongly demonstrate the transplacental metastatic spread from twin 2 to twin 1. In the literature, 9 pairs of concordant twin neuroblastomas, including the current twin, have been presented; and the clinical findings of 5 twin pairs may represent placental metastases from one twin with congenital neuroblastoma to the other twin. This study is the first report presenting the possibility of twin-to-twin metastasis in monozygotic twins with neuroblastoma based on an analysis of the clinical features and genetic aberrations.
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PMID:Concordance for neuroblastoma in monozygotic twins: case report and review of the literature. 2112 36

The objectives of this study were to review how conventional imaging for adrenocortical carcinoma has evolved over the past 100 years and to highlight the current role for computed tomography (CT) and magnetic resonance imaging (MRI). Using historical cases from the Mayo Clinic archives, the approaches to conventional imaging for adrenocortical carcinoma are described, and pertinent literature is reviewed. Limited conventional imaging options in the first 75 years of the twentieth century were supplemented with keen clinical observation and clinical intuition. With the development of CT and MRI, technologic advances in the computed image-based assessment of adrenocortical carcinoma have been truly remarkable. CT and MRI can help determine whether an adrenal mass is an adrenocortical carcinoma and can also assess for local tumor invasion and metastatic disease. CT and MRI provide the clinician and surgeon with key information to guide medical and surgical management. Three decades from now, what we currently view as conventional imaging (e.g., CT and MRI) will be the imaging equivalents to the plain abdominal roentogram and intravenous pyelogram of the mid-twentieth century.
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PMID:Conventional imaging in adrenocortical carcinoma: update and perspectives. 2199 91

Introduction. In patients with extra-adrenal malignancy, an adrenal mass necessitates investigating the possibility of metastatic tumor. Curable adrenal metastasis are considered as a rare event. Case report. A 52-year-old male suffering from lower esophageal adenocarcinoma with a solitary left adrenal metastasis is presented herein, who underwent concomitant transhiatal esophagectomy and left adrenalectomy. The patient remains disease-free 18 months later. Discussion. Adrenal metastases mostly occur in patients with lung, kidney, breast, and gastrointestinal carcinomas. Primary esophageal adenocarcinoma gives adrenal metastatic deposits according to autopsy series with an incidence of about 3%-12%. When no other evidence of metastatic disease in cancer patients exists, several authors advocate adrenalectomy with curative intent. Isolated cases of long-term survival after resection of solitary adrenal metastasis from esophageal adenocarcinoma, like in our case, have been reported only as case reports. Conclusion. This study concludes that surgical resection may result in survival benefit in selected patients with solitary adrenal metastasis from esophageal adenocarcinoma.
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PMID:Solitary adrenal metastasis from esophageal adenocarcinoma: a case report and review of the literature. 2202 24


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