Laparoscopic Adrenalectomy for Bilateral Metachronous Aldosteronomas

Rizek, Philippe; Górecki, Piotr; Lindenmayer, Aristid; Moktan, Sabita

doi:10.4293/108680811x13071180407230

Cited by 5 publications

(1 citation statement)

References 26 publications

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“…This finding indicated that different nodules might contribute jointly to abnormal aldosterone synthesis and secretion. In addition, it has been reported that aldosterone adenoma occurred simultaneously (or successively) in the same or opposite adrenal glands ( 23 , 24 ). Therefore, such multinodular lesions are obviously different from traditional “nodular hyperplasia,” and they should be distinguished from the subtype of multiple nodules (formally known as nodular hyperplasia).…”

Section: Discussionmentioning

confidence: 99%

Exploration of KCNJ5 Somatic Mutation and CYP11B1/CYP11B2 Staining in Multiple Nodules in Primary Aldosteronism

et al. 2022

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ObjectiveUnilateral primary aldosteronism (PA) includes aldosterone-producing adenoma (APA), unilateral adrenal hyperplasia, and unilateral multiple nodules. The correlation of multiple nodules, especially genotypic and pathological characteristics, remains unknown. KCNJ5 mutation accounts for 60–80% of unilateral PA, so we aimed to explore the correlation of KCNJ5 somatic mutation and CYP11B1/CYP11B2 staining in multiple nodules in unilateral PA.Design and MethodsA total of 56 microdissected nodules from 24 patients with unilateral PA were included. We assessed somatic KCNJ5 mutations, immunohistochemistry for aldosterone synthase (CYP11B2)/cortisol synthase (CYP11B1), and histological cellular composition of nodules together with adjacent adrenal cortical statements.ResultsKCNJ5 mutations were identified in 17 (17/56, 30.4%) nodules from 11 adrenals (11/24, 45.8%). All KCNJ5-mutant nodules were positive for CYP11B2 staining, 6 cases (6/11) had only one KCNJ5-mutant nodular, and the other 5 cases (5/11) had more than one KCNJ5-mutant nodules. Three cases (3/11) had different KCNJ5 mutations in individual nodules. Compared with KCNJ5-positive adrenals, the cortices adjacent to the nodules in KCNJ5-negative adrenals showed significant proliferation (p = 0.004). CYP11B2/CYP11B1 expression patterns revealed great heterogeneity in intensity and range both in KCNJ5-mutant nodules and KCNJ5-WT ones.ConclusionThere is great heterogeneity among nodules from patients with unilateral PA. Countable nodules could be considered as multiple APAs, featuring somatic KCNJ5 mutation, positive CYP11B2 staining, and lack of adjacent cortical proliferation in unilateral multiple nodules.

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Section: Discussionmentioning

confidence: 99%

Exploration of KCNJ5 Somatic Mutation and CYP11B1/CYP11B2 Staining in Multiple Nodules in Primary Aldosteronism

et al. 2022

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Bilateral Adrenal Tumors from Different Histology: Case Report and Literature Review

Zhang

Xiao

et al. 2014

Cell Biochem Biophys

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Bilateral adrenal tumors are very uncommon in clinical practice and all originate from the same histology. We presented here a case report and literature review of bilateral adrenal tumors from different histology: pheochromocytoma in one side and adrenocortical adenoma in the other side. The patient was a 37 years old female suffered from Cushing's syndrome form 3 years. One year ago she was diagnosed as ACTH-independent Cushing's syndrome and received Laparoscopic adrenalectomy for right adrenal tumor which diagnosed as a pheochromocytoma by the pathological reports. After the operation, patient's clinical manifestation was not change, then half-year later the lab test showed no improvement in the blood biochemical parameters. Finally, CT detected a mass in left adrenal gland. Thereafter, this patient received Laparoscopic adrenalectomy for left adrenal tumor. The tumor was diagnosed as adrenocortical adenoma by the pathologists. One week after operation, the blood biochemical parameters became normal. In conclusion, bilateral adrenal tumors from different histology are very rare, adrenalectomy for both side tumors and preserving the normal adrenal glands is necessary.

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Adrenal Nodularity and Somatic Mutations in Primary Aldosteronism: One Node Is the Culprit?

Dekkers¹,

Meer²,

Lenders³

et al. 2014

The Journal of Clinical Endocrinology &Amp; Metabolism

110

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Laparoscopic Adrenalectomy for Bilateral Metachronous Aldosteronomas

Abstract: Aldosterone-producing adenoma can present months to years after adrenalectomy in the contralateral adrenal gland. Laparoscopic adrenalectomy may be the procedure of choice for this pathology.

Cited by 5 publications

References 26 publications

Exploration of KCNJ5 Somatic Mutation and CYP11B1/CYP11B2 Staining in Multiple Nodules in Primary Aldosteronism

Exploration of KCNJ5 Somatic Mutation and CYP11B1/CYP11B2 Staining in Multiple Nodules in Primary Aldosteronism

Bilateral Adrenal Tumors from Different Histology: Case Report and Literature Review

Adrenal Nodularity and Somatic Mutations in Primary Aldosteronism: One Node Is the Culprit?

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