Change in Adrenal Mass Size as a Predictor of a Malignant Tumor

Pantalone, Kevin M.; Gopan, Thottathil; Remer, Erick M.; Faiman, Charles; Ioachimescu, Adriana G.; Levin, Howard S.; Siperstein, Allan; Berber, Eren; Shepardson, Laura B.; Bravo, Emmanuel L.; Hamrahian, Amir H.

doi:10.4158/ep09351.or

Cited by 62 publications

(34 citation statements)

References 27 publications

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“…The 15 patients died a mean of 28 ± 36 mo after EUS without follow imaging. Table 2 Indications for endoscopic ultrasound 1 Esophageal cancer (n = 3), gastric cancer (n = 2), breast (n = 1), jejunal adenocarcinoma (n = 1), renal cell cancer (n = 2), cholangiocarcinoma (n = 1), lung cancer (n = 16); 2 Suspected recurrence of oral cancer (n = 1), breast cancer (n = 1), hepatoma (n = 1), lung adenocarcinoma (n = 1), esophageal adenocarcinoma (n = 1); 3 Chronic pancreatitis (n = 3), abnormal upper endoscopy (n = 3), common bile duct stricture (n = 2), celiac nerve block (n = 1), suspected metastatic disease on imaging (n = 1), Barrett's esophagus with high grade dysplasia (n = 1), ectatic pancreatic duct (n = 1). EUS: Endoscopic ultrasound; PET: Positron emission tomography; CT: Computed tomography.…”

Section: Eus Findings and Cytologymentioning

confidence: 99%

“…The development of modern imaging techniques such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), has led to increased detection of adrenal masses, which are found in up to 5% of patients undergoing CT of the abdomen [1] . The incidence of an adrenal incidentaloma (detection of an otherwise unsuspected adrenal mass on imaging), ranges from 0.2%-7% as reported in autopsy series [2] .…”

Section: Introductionmentioning

confidence: 99%

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Role of endoscopic ultrasound fine-needle aspiration evaluating adrenal gland enlargement or mass

Martínez

Leblanc

Al‐Haddad

et al. 2014

WJN

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AIM:To report the clinical impact of adrenal endoscopic ultrasound fine-needle aspiration (EUS-FNA) in the evaluation of patients with adrenal gland enlargement or mass. METHODS:In a retrospective single-center caseseries, patients undergoing EUS-FNA of either adrenal gland from 1997-2011 in our tertiary care center were included. Medical records were reviewed and results of EUS, cytology, adrenal size change on follow-up imaging ≥ 6 mo after EUS and any repeat EUS or surgery were abstracted. A lesion was considered benign if: (1) EUS-FNA cytology was benign and the lesion remained < 1 cm from its original size on follow-up computed tomography (CT), magnetic resonance imaging or repeat EUS ≥ 6 mo after EUS-FNA; or (2) subsequent adrenalectomy and surgical pathology was benign. RESULTS:Ninety-four patients had left (n = 90) and/or right (n = 5) adrenal EUS-FNA without adverse events. EUS indications included: cancer staging or suspected recurrence (n = 31), pancreatic (n = 20), mediastinal (n = 10), adrenal (n = 7), lung (n = 7) mass or other indication (n = 19). Diagnoses after adrenal EUS-FNA included metastatic lung (n = 10), esophageal (n = 5), colon (n = 2), or other cancer (n = 8); benign primary adrenal mass or benign tissue (n = 60); or was non-diagnostic (n = 9). Available follow-up confirmed a benign lesion in 5/9 non-diagnostic aspirates and 32/60 benign aspirates. Four of the 60 benign aspirates were later confirmed as malignant by repeat biopsy, followup CT, or adrenalectomy. Adrenal EUS-FNA diagnosed metastatic cancer in 24, and ruled out metastasis in 10 patients. For the diagnosis of malignancy, EUS-FNA of either adrenal had sensitivity, specificity, positive predictive value and negative predictive value of 86%, 97%, 96% and 89%, respectively. CONCLUSION:Adrenal gland EUS-FNA is safe, minimally invasive and a sensitive technique with significant impact in the management of adrenal gland mass or enlargement.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Adrenal gland neoplasms/diagnosis; Adrenal glands/pathology; Adrenal gland/ultrasonography; Adrenal gland neoplasms/secondary; Endosonography; Biopsy; Fine-needle Core tip: Studies evaluating endoscopic ultrasound fine-needle aspiration (EUS-FNA) of the adrenal gland generally include patients with underlying malignancy only and most lack follow-up for benign lesions. We report the clinical utility of adrenal gland EUS-FNA in a retrospective study that included 94 patients who underwent EUS-FNA of either adrenal for various indications and provide follow-up information for those with benign EUS-FNA cytology results. For the diagnosis of malignancy, EUS-FNA of either adrenal had sensitivity, specificity, positive predictive value and negative predictive value of 86%, 97%, 96% and 89%, without

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Section: Eus Findings and Cytologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of endoscopic ultrasound fine-needle aspiration evaluating adrenal gland enlargement or mass

Martínez

Leblanc

Al‐Haddad

et al. 2014

WJN

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“…There is less data on the growth rate of adrenal metastases in part because patients die before mid-and long-term follow-up imaging is performed. However, it can be assumed that most metastatic foci will show significant growth at 6 months follow-up, while almost all adenomas will show minimal or no growth (5,119). Third, patients with metastatic disease often have the primary malignancy (Fig.…”

Section: Patients With Known Primary Malignancymentioning

confidence: 99%

Adrenal MRI: Techniques and clinical applications

Siegelman

2012

Magnetic Resonance Imaging

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“…With the development of imaging techniques such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), the detection rates of adrenal masses has remarkably increased [1,2]. Most adrenal masses are benign tumors, dividing into three types: adrenocortical adenomas or carcinoma within the adrenal cortex, neuroblastoma and pheochromocytomas within the adrenal medulla [3].…”

Section: Introductionmentioning

confidence: 99%

“…Frequently, ACCs can invade adjacent large vessels, the renal vein as well as the inferior vena cava. If an ACC is found to be functional, the tumor necessitates surgical removal, although chemotherapy, radiation therapy, and hormonal therapy may also be employed to treat ACC depending on various stage of carcinoma [1].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a large adrenal carcinoma with 3D reconstruction of computed tomography images: A case report and literature review

Liang

Zeng

et al. 2016

XST

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Abstract. Adrenocortical carcinoma (ACC) is an extremely rare disease caused by a cancerous growth in the adrenal cortex. Although most of adrenal tumors are benign, the functional ACC is malignant resulting in endocrine dysfunction and necessitates surgical removal. Retroperitoneal laparoscope adrenalectomy is often used to perform adrenal gland surgery. Here, we reported a case of huge ACC with the size of 6.8 cm × 5.2 cm. To achieve better surgical outcome, we integrated 3D reconstructed CT images into a dynamic video for preoperative planning and intraoperative guiding to resect the diseased adrenal gland completely without neighbor organ's injury and surgery complications. Moreover, we reviewed associated applications using 3D reconstructed CT imaging in surgery field. Finally, the evaluation and effect of such technology were discussed to reveal that the 3D dynamic video can help surgeon to make better preoperative assessment so as to give patients better therapy.

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Change in Adrenal Mass Size as a Predictor of a Malignant Tumor

Cited by 62 publications

References 27 publications

Role of endoscopic ultrasound fine-needle aspiration evaluating adrenal gland enlargement or mass

Role of endoscopic ultrasound fine-needle aspiration evaluating adrenal gland enlargement or mass

Adrenal MRI: Techniques and clinical applications

Evaluation of a large adrenal carcinoma with 3D reconstruction of computed tomography images: A case report and literature review

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