Bilateral adrenal lesions

Gupta, Pankaj; Bhalla, Ashu Seith; Sharma, Raju

doi:10.1111/j.1754-9485.2012.02435.x

Cited by 35 publications

(30 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 Differential diagnosis of bilaterally enlarged adrenal glands include neoplastic masses (malignant and benign), infections like tuberculosis, histoplasmosis, cryptococcosi, blastomycosis, penicillosis, parasitic cysts, trauma, adrenal hemorrhage and autoimmune disease. [21][22] Ultrasound, CT or EUSguided FNAC can be used for histological diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Adrenal histoplasmosis diagnosed by endoscopic ultrasound guided fine needle aspiration: experience of 10 patients

Singh¹

2017

View full text Add to dashboard Cite

Background:There have been sporadic reports of histoplasmosis from India. Although traditionally considered a disease of immunocompromised hosts, immunocompetent patients presenting with adrenal histoplasmosis have been reported. Endoscopic ultrasound (EUS) provides easy and safe approach to adrenal glands for fine needle aspiration. Methods: We report 10 cases of adrenal histoplasmosis diagnosed by endoscopic ultrasound (EUS) guided FNA. The mean age at diagnosis was 54 ± 9 years, all were males. Eight patients were immunocompetent while two had cirrhosis; none of them was retrovirus positive. All patients presented with fever and weight loss, 8 had bilateral adrenal enlargement while 2 had isolated left adrenal enlargement. EUS features included hypoechoic (30%) or heteroechoic (70%) adrenal glands, presence of hypoechoic areas suggestive of necrosis within the gland was identified in 40% of these patients. Adrenal insufficiency was present in 1 patient (10%) which persisted even after successful treatment. Conclusion: Adrenal histoplasmosis should be considered even in immunocompetent hosts presenting with constitutional symptoms and adrenal enlargement. EUS guided FNA is a safe and accurate modality for adrenal sampling.

show abstract

Section: Discussionmentioning

confidence: 99%

Adrenal histoplasmosis diagnosed by endoscopic ultrasound guided fine needle aspiration: experience of 10 patients

Singh¹

2017

View full text Add to dashboard Cite

show abstract

“…The vast majority of these unilateral masses are benign non-functioning adrenal adenomas (1). Contrary to this, bilateral adrenal masses are uncommon, have varied clinical manifestations ranging from asymptomatic incidental findings to severe systemic clinical presentation and have varied aetiologies like bilateral adrenal hyperplasia, infiltration (infection, metastasis and lymphoma), and bilateral tumours like pheochromocytomas (2, 3, 4). Hypocortisolism is an exclusive feature to be considered in the evaluation of bilateral masses (3).…”

Section: Introductionmentioning

confidence: 98%

Bilateral adrenal masses: a single-centre experience

Lomte¹,

Bandgar²,

Khare³

et al. 2016

Endocrine Connections

View full text Add to dashboard Cite

BackgroundBilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited.AimsTo analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses.MethodsRetrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002–2015).ResultsThe most common aetiology was pheochromocytoma (40%), followed by tuberculosis (27.1%), primary adrenal lymphoma (PAL) (10%), metastases (5.7%), non-functioning adenomas (4.3%), primary bilateral macronodular adrenal hyperplasia (4.3%), and others (8.6%). Age at presentation was less in patients with pheochromocytoma (33 years) and tuberculosis (41 years) compared with PAL (48 years) and metastases (61 years) (P<0.001). The presenting symptoms for pheochromocytoma were hyperadrenergic spells (54%) and abdominal pain (29%), whereas tuberculosis presented with adrenal insufficiency (AI) (95%). The presenting symptoms for PAL were AI (57%) and abdominal pain (43%), whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm) followed by pheochromocytoma (4.8cm), metastasis (4cm) and tuberculosis (2.1cm) (P<0.001). Biochemically, most patients with pheochromocytoma (92.8%) had catecholamine excess. Hypocortisolism was common in tuberculosis (100%) and PAL (71.4%) and absent with metastases (P<0.001).ConclusionIn evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies.

show abstract

“…Due to their high fat content, they have a very characteristic appearance on imaging studies. They appear echogenic on ultrasound, low attenuated lesions on CT, and hyperintense on T1-weighted in-phase MRIs [4]. The reported incidence of adrenal myelolipoma ranges from 0.08 to 0.4% and constitutes 15% of all adrenal incidental masses.…”

Section: Discussionmentioning

confidence: 99%

Giant Bilateral Adrenal Myelolipoma with Congenital Adrenal Hyperplasia

Al-Bahri

Tariq²,

Lowentritt

et al. 2014

Case Reports in Surgery

View full text Add to dashboard Cite

Myelolipomas are rare and benign neoplasms, predominant of the adrenal glands, consisting of adipose and mature hematopoietic tissue, commonly discovered incidentally with increased use of radiologic imaging. Few cases of giant bilateral adrenal masses are reported, especially in the setting of congenital adrenal hyperplasia (CAH). We report the case of a 39-year-old male with a history of CAH secondary to 21-α hydroxylase deficiency on steroids since childhood, self-discontinued during adolescence, presenting with abdominal distension, fatigue, decreased libido, and easy bruising. Imaging revealed giant bilateral adrenal masses. He subsequently underwent bilateral adrenalectomy found to be myelolipomas measuring 30 × 25 × 20 cm on the left and weighing 4.1 kg and 25 × 20 × 13 cm on the right and weighing 2.7 kg. Adrenal myelolipomas are found to coexist with many other conditions such as Cushing's syndrome, Addison's disease, and CAH. We discuss the association with high adrenocorticotropic hormone (ACTH) states and review the studies involving ACTH as proponent leading to myelolipomas. Massive growth of these tumors, as in our case, can produce compression and hemorrhagic symptoms. We believe it is possible that self-discontinuation of steroids, in the setting of CAH, may have resulted in the growth of his adrenal masses.

show abstract

Bilateral adrenal lesions

Cited by 35 publications

References 19 publications

Adrenal histoplasmosis diagnosed by endoscopic ultrasound guided fine needle aspiration: experience of 10 patients

Adrenal histoplasmosis diagnosed by endoscopic ultrasound guided fine needle aspiration: experience of 10 patients

Bilateral adrenal masses: a single-centre experience

Giant Bilateral Adrenal Myelolipoma with Congenital Adrenal Hyperplasia

Contact Info

Product

Resources

About