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PubMed1980

Spontaneous adrenal tumors in the aged, ovariectomized NIH swiss mouse without enhanced retrovirus expression.

A high incidence of adrenal tumors was observed in aged female NIH Swiss mice which had been ovariectomized at 2 to 4 weeks of age but not in nonovariectomized controls. Although tumors weighing more than 1 g were not infrequent in the oldest (> 24 months) animals, adrenal glands did not appear macroscopically abnormal before the age of 18 months. Histologically, however, focal or diffuse abnormalities were found in essentially every gland examined from mice over 12 months of age, including glands of normal size. Since the NIH Swiss mouse has been shown to contain an endogenous xenotropic virus whose expression is under hormonal control, the adrenal tumors were examined in detail for evidence of abnormal viral expression. We were unable, by a variety of techniques, to demonstrate elevated expression of type C virus in these adrenal tumors.

Adrenal Gland Neoplasms↗
PubMed1995

Interventional radiology of the adrenal glands.

Interventional radiology of the adrenal glands comprises angiographic and percutaneous procedures. Vascular maneuvers have never received widespread application. Venous retrograde adrenal gland ablation fell into disuse because it induced only temporary reduction of adrenal function, caused intense long lasting pain, and was considered unsafe. Chemoembolization of cortico-adrenal carcinoma has been shown to slow tumor growth and may be employed if the patient is inoperable. Percutaneous FNB, routinely performed in large hospital centers, has a high diagnostic yield and a low complication rate. The procedure is performed in the staging of oncological cases or in patients with incidentally found adrenal lesion with no evidence of adreno-cortical or adrenal medullary hypersecretion. Abscesses and adrenal cysts are rarely encountered in clinical practice. Percutaneous drainage of such lesions is readily accomplished under radiological guidance with little hazard for the patient. Furthermore treatment failure does not compromise surgical treatment. Percutaneous ethanol injection has been recently suggested for treatment of hormone producing adreno-cortical adenomas in patients at high surgical risk. Results are promising but further trials are required to ascertain the efficacy and the safety of the procedure.

Abscess↗
PubMed1995

Cell proliferation and apoptosis in normal and pathologic human adrenal.

Cell proliferation and programmed cell death play important roles in the maintenance of tissue dynamics. The adrenal cortex has been known as a cell renewal tissue. We studied cell proliferation by Ki67 immunostaining and programmed cell death or apoptosis by a recently developed 3'-OH nick end labeling technique. Fifteen cases of normal human adrenal; 22 cases of adrenocortical adenoma including Cushing's adenoma (five cases), aldosteronoma (nine cases), and nonfunctioning adenoma (eight cases); and six cases of adrenocortical carcinoma were examined. In normal adrenal cortex, Ki67 immunoreactivity was predominantly observed in the zona fasciculata in all the cases examined, whereas cortical cells positive for nick end labeling were present in the zona reticularis in all cases and in the zona glomerulosa in five cases. These results suggest that the "cell migration" or "centripetal" theory is also applicable in cell turnover of normal human adrenal cortex, and cortical cells may move in two directions, from fasciculata to reticularis and from fasciculata to glomerulosa in some instances. CD68-positive sinusoidal lining cells, which are considered to ingest the cells undergoing apoptosis, were present throughout the cortex. In adrenocortical adenoma, Ki67 immunoreactivity was observed in all cases, and tumor cells positive for nick end labeling were observed in 12 cases (Cushing's adenoma in three cases, aldosteronoma in four cases, and nonfunctioning adenoma in five cases). In adrenocortical carcinoma, Ki67 immunoreactivity was observed in all the cases, and its labeling index was significantly higher than that of normal adrenal and adrenocortical adenoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Gland Neoplasms↗
PubMed1997

MR imaging of renal and adrenal masses in children.

A large variety of benign and malignant masses of the kidneys and adrenal glands occur in children. MR imaging is an effective technique for evaluating these lesions. It is a particularly useful problem-solving test in patients with equivocal ultrasonographic or CT results. The need for sedation of young children undergoing MR imaging is a drawback as is its relative insensitivity for detecting calcification. Advantages of MR imaging include superior soft-tissue contrast, direct acquisition of images in any plane, lack of ionizing radiation, and excellent depiction of the abdominal vasculature, bone marrow, and spinal canal.

Adolescent↗
PubMed1998

[Solitary adrenal metastasis of pulmonary cancer].

We describe the case of a 46-year-old man with lung cancer and simultaneous solitary adrenal metastases. Adrenalectomy was performed 12 weeks after lung resection through a right subcostal laparotomy. Treatment was complemented with chemotherapy. Twelve months after adrenalectomy the patient was found free of signs of disease and was in satisfactory condition. The advantages of and indications for surgical resection of suprarenal metastasis are discussed in the light of published literature. In some cases, survival may improve with exeresis and chemotherapy.

Adrenal Gland Neoplasms↗
PubMed1992

Adrenal masses in lung cancer: sonographic diagnosis and follow-up.

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.

Adrenal Gland Neoplasms↗
PubMed1979

Vertebrobasilar insufficiency due to Tumoural emboli.

A case, which is clinically characterized by a subacute vertebrobasilar syndrome, is presented. The necropsy reveals multiple infarcts in brainstem, cerebellum and left cerebral hemisphere, due to tumoural emboli of a non-detected primary tumour. It is postulated that the latter has to originate in the lungs in order to produce this unique type of cerebral arterial embolism.

Adrenal Gland Neoplasms↗
PubMed1985

Positive correlation between urinary excretion of catecholamine metabolites and tumour mass in pheochromocytoma. Results in patients with sustained and paroxysmal hypertension and multiple endocrine neoplasia.

In a series of 53 pheochromocytoma patients operated on at Sahlgren's Hospital during 1956-82, a positive linear correlation is established between the 24-hour urinary excretion of vanilmandelic acid (mumol/24 h) and tumour mass (g). A similar correlation was found between the excretion of metanephrines and tumour mass in 33 subjects. The patients were subgrouped according to their type of hypertension. A statistically significant correlation between vanilmandelic acid excretion and tumour mass persisted in groups IA (sustained hypertension without attacks), IB (sustained hypertension with attacks), and II (paroxysmal hypertension) but not in group III (miscellaneous patients). There was also a correlation between metanephrine excretion and tumour mass in groups IB (n = 8) and II (n = 12). In 10 patients with the syndrome of multiple endocrine neoplasia, a positive correlation was found between tumour mass and the excretion of vanilmandelic acid, metanephrines and adrenaline.

Adrenal Gland Neoplasms↗
PubMed1991

Prospective evaluation of unilateral adrenal masses in patients with operable non-small-cell lung cancer.

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.

Adenoma↗