Radiology of the adrenal incidentalomas. Review of the literature

Farrugia, F. A.; Martikos, Georgios; Surgeon, Consultant Ent; Tzanetis, Panagiotis; Misiakos, Evangelos P.; Zavras, Nick; Charalampopoulos, Anestis

doi:10.1515/enr-2017-0005

Cited by 18 publications

(21 citation statements)

References 127 publications

(159 reference statements)

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“…In that context, although these primary adrenal malignancies represent a small proportion of incidentalomas, appropriate early evaluation is critical to early intervention . Diagnosis encompasses an evaluation of the functional status of the adrenal mass with appropriate blood and urine testing, as well as very specific radiographic testing …”

Section: Discussionmentioning

confidence: 99%

The who, when, and why of primary adrenal malignancies: Insights into the epidemiology of a rare clinical entity

Chandrasekar

Goldberg

Klaassen

et al. 2018

Cancer

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BACKGROUND: Primary malignancies of the adrenal glands are rare. Epidemiologic assessment of primary adrenal malignancies is lacking and has been limited to case reports and series. Population-level data can provide a better understanding of the incidence, distribution, and prognostic factors associated with these rare malignancies. METHODS: The Surveillance, Epidemiology, and End Results database was queried for all patients who were diagnosed with primary adrenal malignancies, categorized in 5 histologic groups: adrenocortical carcinoma (ACC), pheochromocytoma and paraganglioma (PH), neuroblastoma (NE), non-Hodgkin lymphoma (NHL), and sarcoma (SA). Age-adjusted incidence, distribution trends, and cancer-specific survival (CSS) for each group were analyzed. RESULTS: In total, 4695 patients with primary adrenal malignancies were identified, including 2057 with ACC, 512 with PH, 1863 with NE, 202 with NHL, and 61 with SA. The age-adjusted incidence of all 5 histologic subtypes was rising. Age at presentation differed substantially by histologic group: NE was the most prevalent during the first decade of life, whereas ACC predominated after age 30 years, and NHL outnumbered PH after age 70 years. Patient-specific factors were not associated with advanced disease at the time of presentation. The 5-year CSS rate for each histologic subtype was 38% for ACC, 69% for PH, 64% for NE, 38% for NHL, and 42% for SA. Survival outcomes for patients with ACC, NHL, PH and SA remained unchanged over the 40-year study period. Multimodal therapy was associated with higher CSS in patients with NE. CONCLUSIONS: This first populationlevel analysis of all primary adrenal malignancies provides important initial data regarding presentation and clinical outcomes. Notably, except for patients with NE, the survival of patients with these rare cancers has not improved over the past 40 years.

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Section: Discussionmentioning

confidence: 99%

The who, when, and why of primary adrenal malignancies: Insights into the epidemiology of a rare clinical entity

Chandrasekar

Goldberg

Klaassen

et al. 2018

Cancer

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“…The detection of an adrenal tumour based on ultrasound depends on real time examination pa-rameters and the diameters of the mass [9,10]. Our patient did not have the diagnosis established 3 years before the current evaluation; it is difficult to appreciate if the tumour was positive at that time knowing the age-related incidence.…”

Section: Discussionmentioning

confidence: 75%

“…Our patient did not have the diagnosis established 3 years before the current evaluation; it is difficult to appreciate if the tumour was positive at that time knowing the age-related incidence. When it comes to growth rate, this is most probably a slow speed parameter so a dramatic increase of an adrenal incidentaloma is hardly expected [9,10]. Another observation is related to the response after dexamethasone suppression test that was near the recommended cut-off, a formerly called subclinical Cushing's syndrome [2,6].…”

Section: Discussionmentioning

confidence: 99%

Adrenal ultrasound

Păun¹,

Cârșote²,

Valea³

et al. 2019

Ro J Med Pract.

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Ultrasound is the first step to detect an abdominal tumour at the level of adrenal. The most common scenario is related to the pelvic and abdominal ultrasound. This kind of tumour is more frequently seen in menopausal women than in premenopausal ones. We introduce a case of a menopausal woman accidentally detected at ultrasound with an adrenal mass starting from a routine gynaecological control. The use of ultrasound on adrenal masses is related to their detection and follow-up in cases when surgery is not necessary.

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“…In cases like this, a continuous monitoring of hormone levels and imaging follow-up is justified to assess the straightforward development of adrenal hemorrhage as soon as possible and enable prompt steroid replacement therapy [14] .…”

Section: Discussionmentioning

confidence: 99%

Nontraumatic adrenal hemorrhage: the adrenal stress

Serafino

Severino

Coppola

et al. 2017

Radiology Case Reports

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Bilateral adrenal hemorrhage is a rare condition, which is burdened by potentially life-threatening consequences related to the development of acute adrenal insufficiency. Despite treatment with stress-dose glucocorticoids, a mortality rate of 15% has been reported, which varies according to the severity of underlying predisposing illness and could be much more higher if the adrenal insufficiency is not promptly recognized. An early diagnosis is crucial, though, because of nonspecific clinical and laboratory findings, adrenal hemorrhage is rarely suspected. Therefore, imaging has a pivotal role for the diagnosis of this uncommon condition but, despite adrenal hematomas characteristically appear round or oval with peripheral fat stranding, their initial presentation could be ambiguous. The authors describe a case of postoperative bilateral adrenal hemorrhage initially presenting at computed tomography scan as thickening of both glands surrounded by fat stranding, which led to close monitoring of adrenal function before unequivocal hemorrhage developed.

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Radiology of the adrenal incidentalomas. Review of the literature

Cited by 18 publications

References 127 publications

The who, when, and why of primary adrenal malignancies: Insights into the epidemiology of a rare clinical entity

The who, when, and why of primary adrenal malignancies: Insights into the epidemiology of a rare clinical entity

Adrenal ultrasound

Nontraumatic adrenal hemorrhage: the adrenal stress

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