Adrenal masses (diagnosis and differential diagnosis)

Молашенко, Н В; Юкина, М. Ю.; Soldatova, T V; Rogal, E A

doi:10.14341/probl201056148-56

Cited by 7 publications

(3 citation statements)

References 15 publications

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“…In many publications, the results of ultrasound scans for the detection of focal pathology of the adrenal glands are estimated to be reliably high, and in some cases, its sensitivity and specificity reach 100 % [3]. It allows estimating the size of tumors greater than 1 cm.…”

Section: Introductionmentioning

confidence: 99%

Laboratory Diagnostics of Primary Hyperaldosteronism and its Peculiarities (Literature Review)

et al. 2019

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The final stage of the diagnostic of primary hyperaldosteronism is to identify the causes of excessive secretion of aldosterone and determination of its variants. Based on the analysis of literature data, the diagnostic value, sensitivity and specificity of the methods of radiation diagnostics for primary hyperaldosteronism were assessed: ultrasound, computed tomography, magnetic resonance imaging, photon emission tomography, magnetic resonance spectroscopy, scintigraphy with iodine radiopharmaceuticals. The causes of false-positive and false-negative evaluations of changes in adrenal glands in the application of these diagnostics have been analyzed. There are many genetic and morphological studies when searching the literature data on the principles and methods of distinguishing the nosological forms of primary hyperaldosteronism based on the results of the aldosterone level estimation in the separated blood from the central veins of both adrenal glands or segmental veins of one gland with subsequent determination of the concentration gradient. It was noted that topical diagnostics and, especially, the determination of nosological forms of primary hyperaldosteronism are complex and expensive, but their results allow choosing an appropriate treatment approach for each particular case.

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Section: Introductionmentioning

confidence: 99%

Laboratory Diagnostics of Primary Hyperaldosteronism and its Peculiarities (Literature Review)

et al. 2019

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“…За последние годы активное развитие современных технологий позволило значительно увеличить выявляемость опухолей различных локализаций, в том числе и опухолей надпочечников. Возможности современной визуализирующей аппаратуры позволяют выявлять образования размером менее 1 см, которые могут клинически ничем не проявляться [2][3][4].…”

Section: Introductionunclassified

“…Гормональная активность таких образований является абсолютным показанием к операции. В случае же если опухоль гормонально не активна, показания к оперативному лечению ставятся при наличии косвенных признаков злокачественности образования, таких как большой размер образования, быст рый рост, высокая нативная плотность по данным КТ (более 15-20 HU), скорость вымывания контраста (менее 50% через 10 мин после введения), нечеткость контуров [2][3][4].…”

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Comparison of adrenal tumor treatment results by different volume of surgical interventions.

Semenov

Юрьевич²,

Панкова

et al. 2016

Endo Serg

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Results. Performing the organ-sparing operations doesn't increase the risk of intraoperative complications. In all patients with hormone-active tumors we found decline of pathologically increased hormone levels and trend to regress of clinical manifestations of the disease in early postoperative period. We found no difference in local recurrences in both groups, and its occurrence did not exceed 3.33%. Refractory postoperative adrenal insufficiency was observed only in corticosteroma patients in spite of surgery volume. In case of both side adrenal tumors there was no need in replacement therapy after total adrenalectomy from there one side and resection from the other. Conclusions. In cases of adrenal tumor performing organ-sparing operations is advisable, if there are no preoperative sings of malignancy.

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Diagnostic value of ct in examination of patients with adrenal cancer

Rusakov

Shcherbakov

Чинчук

et al. 2022

Probl Endokrinol (Mosk)

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BACKGROUND: In most cases adrenal tumours are detected by accident while performing medical imaging tests for other diseases. These findings are treated as adrenal incidentaloma. Prevalence of incidentalomas detected on CT scans is up to 4%. According to different authors, 4–12% of all adrenal tumours are adrenocortical carcinomas. As for today, the most significant medical imaging technique is CT scan with bolus IV injection of contrast agent and assessment of tumour’s density. The analysis of the results of CT imaging in 67 patients with ACC was carried out according to a single protocol. The main signs characteristic of this disease are described. It is very important to evaluate typical signs of ACC on CT scans for risk assessment of ACC before surgical treatment. If malignant tumour is suspected during preoperative examination, it is extremely important to choose the right surgical treatment strategy.AIM: To evaluate the significance of CT as the main method of preoperative diagnosis in patients with malignant tumors of the adrenal cortex. Studying CT semiotics of adrenocortical cancer in a large group of patients using a single standard imaging protocol. Find the main radiological symptoms characteristic of adrenocortical cancerMATERIALS AND METHODS: Here are the results of retrospective study of CT scans performed on 67 patients with adrenocortical carcinoma who received treatment in the Department of Endocrine Surgery of Saint-Petersburg State University N.I. Pirogov Clinic of High Medical Technologies during 2012–2020. The diagnostic significance of CT in patients with ACC was assessed.RESULTS: The most common features of ACC: tumour heterogeneity (84.3%), tumour’s size 3–9 cm (75%), signs of invasion into surrounding structures (10%), pre-contrast density above +30 HU (75%), absolute contrast washout less than 60% (68.8%), relative contrast washout less than 40% (64.6%)CONCLUSION: CT scan with IV contrast was not able to show any definitive pathognomonic signs of ACC. Nevertheless, CT scan should be performed in all patients with suspected (or confirmed using other medical imaging technique) adrenal tumour according to standard protocol. Bolus injection of contrast agent should be performed in all patients with tumour’s pre-contrast density above +5 HU.

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Adrenal masses (diagnosis and differential diagnosis)

Cited by 7 publications

References 15 publications

Laboratory Diagnostics of Primary Hyperaldosteronism and its Peculiarities (Literature Review)

Laboratory Diagnostics of Primary Hyperaldosteronism and its Peculiarities (Literature Review)

Comparison of adrenal tumor treatment results by different volume of surgical interventions.

Diagnostic value of ct in examination of patients with adrenal cancer

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