Diagnosis of Bilateral Adrenal Metastases Secondary to Malignant Melanoma by EUS-Guided FNA

Bang, Ji Young; Hébert‐Magee, Shantel; Varadarajulu, Shyam

doi:10.1038/ajg.2011.176

Cited by 5 publications

(2 citation statements)

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“…Recently, Uemura reported a rate of visualization of the right adrenal gland of 87.3% (n = 150) on EUS [13] . To date, there have been only a few reports of successful right adrenal gland EUS-FNA, but no large case-series [9][10][11][12]20] . The utility of EUS-FNA of right adrenal masses requires further clarification.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic ultrasound guided-fine needle aspiration (EUS-FNA) of either adrenal offers a minimally invasive and accurate method for sampling the adrenals with a low risk profile [3,[9][10][11][12] . However, studies to date have mostly included patients with underlying malignancy and the great majority lack follow-up imaging for benign lesions or include follow-up for few patients [4,12,13] .…”

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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