Interventional radiology of the adrenal glands: current status

Ierardi, Anna Maria; Petrillo, Mario; Patella, Francesca; Biondetti, Pierpaolo; Fumarola, Enrico Maria; Angileri, Salvatore Alessio; Pesapane, Filippo; Pinto, Antonio; Dionigi, Gianlorenzo; Carrafiello, Gianpaolo

doi:10.21037/gs.2018.01.04

Cited by 25 publications

(17 citation statements)

References 165 publications

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“…The number of adrenal biopsies has significantly reduced in recent years due to improvements in noninvasive imaging techniques, which can increasingly accurately diagnose benign adrenal lesions. There are a number of reasons not to perform a biopsy on an adrenal lesion which includes the risk of seeding of adrenal cancer after biopsy ( 329 ), the adverse hemodynamic effects of performing a biopsy on an undiagnosed pheochromocytoma or paraganglioma, and most importantly of all it is frequently not possible to distinguish between an adrenal adenoma and an adrenal cortical carcinoma on the sample which is obtained and therefore it often does not help the clinical decision-making process.…”

Section: Special Circumstancesmentioning

confidence: 99%

Adrenal Incidentaloma

et al. 2020

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An adrenal incidentaloma is now established as a common endocrine diagnosis that requires a multidisciplinary approach for effective management. The majority of patients can be reassured and discharged, but a personalized approach based upon image analysis, endocrine workup and clinical symptoms and signs are required in every case. ACC remains a real concern but is restricted to <2% of all cases. Functional AI lesions are commoner (but still probably <10% of total) and the greatest challenge remains the diagnosis and optimum management of autonomous cortisol secretion. Modern-day surgery has improved outcomes and novel radiological and urinary biomarkers will improve early detection and patient stratification in future years to come.

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Section: Special Circumstancesmentioning

confidence: 99%

Adrenal Incidentaloma

et al. 2020

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“…If the basal density is > 10 HU, a contrast media washout will be helpful in differentiating a benign lesion from ACC; an absolute washout > 50% suggests a benign lesion. [11][12][13][14] If CT imaging cannot adequately characterize the adrenal mass, three major characteristics of an MRI will be helpful in diagnosing ACC: the presence of isointense to hypointense signal on T1-weighted images, a hyperintense signal on T2-weighted images and a heterogeneous signal drop on chemical shift. 15 Although a percutaneous adrenal biopsy was widely used in the past, with the advances in imaging modalities and the associated complications with biopsy, it is less frequently used at present.…”

Section: Components Of Stagingmentioning

confidence: 99%

The Spectrum of Large Adrenal Masses: A Case Series

Cooke-Barber¹,

Hatef²,

McGreal³

et al. 2020

HCA Healthcare Journal of Medicine

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Background Adrenocortical carcinoma (ACC) is a rare malignancy that is challenging to diagnose and has important implications for surgeons who approach this disease. Despite its rarity, it must always be in the differential diagnosis when investigating and treating large adrenal masses. We aim to demonstrate the complexities of this disease through a review of five recent patients at a single tertiary care center. Methods A series of five patients are described, each of whom presented to a single institution as referrals for "large adrenal mass" in the past sixteen months. Their pre-operative diagnosis, radiographic findings, the operative approach and the pathology results were examined. Results The first patient had a 12 cm high grade adrenocortical carcinoma. The second patient had pathology consistent with a 9 cm, high grade ACC. The third had a liposarcoma. The fourth patient had a myelolipoma. The fifth was diagnosed with a benign process. Conclusion Although adrenocortical carcinoma is an uncommon cancer, it has significant implications for the patient's prognosis and ultimately, their treatment algorithm. Therefore, when evaluating large adrenal masses, surgeons must remain vigilant of the possibility of adrenocortical carcinoma.

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“…Adrenal traumatic hemorrhages management through transcatheter angiographic embolization, both in adult and in pediatric patients are reported in the literature (19,47). Transcatheter embolization is often a chance in a hemodynamically unstable patient to rapidly solve an active source of bleeding (48). Isolated adrenal injuries are not fatal and do not require surgery, and thus they should be managed conservatively.…”

Section: Treatment and Prognosismentioning

confidence: 99%

Multi-detector computed tomography in the diagnosis and characterization of adrenal gland traumatic injuries

et al. 2019

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Adrenal gland injuries after a blunt abdominal trauma are rare events and represent important indicators for severe trauma. Multidetector CT evolution with high volumetric resolution and fast acquisition with the use of multiplanar reformatted (MPR) visualization allows for an accurate and fast diagnosis of the adrenal gland for post-traumatic pathologies. While, before its introduction the diagnosis was made mainly postmortem or during surgery. Adrenal injuries are unilateral up to 90% of the cases involving most commonly the right gland; thoracoabdominal organs injuries are often also associated. Bilateral adrenal lesions are asymptomatic, potentially leading to the development of acute adrenal insufficiency. The purpose of the present review was to determine the prevalence, the mechanism of injury and the different CT appearances of adrenal trauma. Prognosis and management of adrenal injury will also be reviewed.

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Interventional radiology of the adrenal glands: current status

Cited by 25 publications

References 165 publications

Adrenal Incidentaloma

Adrenal Incidentaloma

The Spectrum of Large Adrenal Masses: A Case Series

Multi-detector computed tomography in the diagnosis and characterization of adrenal gland traumatic injuries

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