Adrenal masses in oncologic patients: functional and morphologic evaluation.

Abstract

The role of adrenocortical scintigraphy in the evaluation of unilateral adrenal masses detected with computed tomography (CT) in 28 oncologic patients with normal adrenal function was studied prospectively with the use of NP-59 (iodine-131-6-iodomethyl-19-norcholesterol). The diagnosis was proved by means of percutaneous fine-needle aspiration cytologic examination in 20 patients, surgical biopsy in one, and clinical and CT follow-up in seven. In 14 of the 28 patients, there was increased uptake of the NP-59 on the side of the adrenal mass detected at CT (concordant uptake). Thirteen of the 14 masses with concordant uptake were greater than 2 cm in diameter, and one was 1.5 cm; all were found to be adenomas. In 11 of 28 patients there was decreased uptake on the side of the mass detected at CT (discordant uptake). None of these 11 masses were adenomas; nine were metastases and two were adrenal cysts. Uptake was indeterminate (symmetric) in three patients, two of whom had adrenal adenomas and one an adrenal metastasis; each mass with indeterminate uptake was less than 2 cm in diameter.

Adrenal Metastasis from Rectal Cancer: Report of a Case

“…[2][3][4][5][6][8][9][10] However, reports of a very low incidence could be attributed to adrenal metastasis being mistaken for lymph node metastasis adjacent to the aorta. The rate of detecting clinically silent adrenal masses has increased due to the widespread use of abdominal imaging modalities, 11,12 including ultrasonography, CT, 13 and MRI. 14 In fact, "adrenal incidentaloma" is defined as adrenal masses that are detected during abdominal imaging done for unrelated reasons.…”

The role of adrenocortical scintigraphy in the evaluation of unilateral incidentally discovered adrenal and juxtaadrenal masses

“…The remaining 11 masses should be silent or nonhyperfunctioning cortical adenomas. [15][16][17]22 Two patients with cortisol-producing carcinoma had a complete defect and an inhomogenous uptake with nonvisualization of the opposite adrenal, respectively. A diffuse decrease and a partial or complete defect were observed in benign noncortical massive lesions including 2 solid masses, 3 cysts, 2 myelolipomas, 2 ganglioneuromas, 2 pheochromocytomas and one calcified adrenal and 5 malignant tumors including 2 primary carcinomas and 3 metastases.…”

“…3 The scintigraphic approach, which uses the uptake of the cholesterol analog, 131 1-6-beta-iodomethyl-19-norcholesterol(NCL-6-131111 or NP-5912) into adrenocortical tissues can provide unique functional information about adrenocortical steroid hormone secretion 13,14 and visualize the differential functional status of the adrenal cortex in patients with euadrenal masses. [15][16][17] In this paper, we reviewed the scintigraphic findings of incidentally discovered unilateral adrenal and juxtaadrenal masses to study the role of adrenocortical scintigraphy in the evaluation of these masses initially discovered with CT, US or abdominal X-ray examination.…”

Charakterisierung von Nebennierenraumforderungen

“…Lee et al [12] konnten 1991 in einer Studie mit 66 Raumforderungen der Nebennieren die durchschnittliche Dichte von die Nebennieren, wobei in Autopsiestudien in 25-72% Metastasen gefunden werden konnten [4][5][6].…”

“…[30]. Nachteile dieser Methode sind, daß sie eine geringe Sensitivität [5,31] aufweist und eines großen Zeitaufwands bedarf, wobei sich die Patienten am 3., 5. und 7. Tag nach Tracerapplikation einer Szinitigraphie zu unterziehen haben.…”