Management of Isolated Adrenal Lesions in Cancer Patients

McLean, Karen; Lilienfeld, Howard; Caracciolo, Jamie T.; Hoffe, Sarah E.; Tourtelot, John B.; Carter, W. Bradford

doi:10.1177/107327481101800206

Cited by 21 publications

(28 citation statements)

References 78 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study found that approximately 40% of patients with primary cancer did not have a malignant adrenal lesion, similar to previous reports [26]. Moreover, adrenal lesions in patients without primary cancer were all benign or owing to hyperplasia, consistent with the low frequency (approximately 10%) of primary adrenal tumours [26]. Of the patients without known primary cancer, 8.4% had an unenhanced attenuation of .10 HU and 3.1% had an SUV max ratio of .2.5.…”

Section: Discussionsupporting

confidence: 81%

“…Our study found that PET/CT was efficient in differentiating between benign and malignant adrenal lesions. Our study found that approximately 40% of patients with primary cancer did not have a malignant adrenal lesion, similar to previous reports [26]. Moreover, adrenal lesions in patients without primary cancer were all benign or owing to hyperplasia, consistent with the low frequency (approximately 10%) of primary adrenal tumours [26].…”

Section: Discussionsupporting

confidence: 78%

See 1 more Smart Citation

Utilisation of combined¹⁸F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

Kim

Kim²,

Lee³

et al. 2013

BJR

View full text Add to dashboard Cite

Objective: To assess the properties of adrenal lesions with and without known primary cancer and investigate predictors for differential diagnosis between benign and malignant adrenal enlargement. Methods: This retrospective study used fluorine-18 fludeoxyglucose positron emission tomography (PET)/CT in 325 patients with adrenal lesions (229 with known primary cancer and 96 without primary cancer). Age, sex, the presence of right and left masses, nodules or hyperplasia, unenhanced attenuation, maximum standardised uptake value (SUV max ) ratio, and the presence of metastasis in other body parts and locations of the primary cancer were assessed. Univariate and multivariate analyses were used to assess variables associated with risk of adrenal metastasis. Results: Patients with adrenal metastasis vs those without had a higher frequency of primary lung cancer (52.3% vs 30.7%) but a lower frequency of gastrointestinal cancer (7.9% vs 16.6%). The frequency of other abnormalities, including adenoma and hyperplasia, was similar between patients with and without known primary cancer. A higher proportion of patients with adrenal metastasis regardless of primary cancer site were younger, had a nodule or a mass, had an unenhanced attenuation of .10 HU, had an SUV max ratio of .2.5, and had metastasis in other body parts. Analysis found independent associations of age, unenhanced attenuation of .10 HU, SUV max ratio of .2.5 and the presence of metastasis in other body parts with adrenal metastasis. The combination of the four variables was strongly associated with adrenal metastasis. Conclusion: PET/CT was useful in characterising adrenal lesions as benign or malignant and helpful in identifying adrenal metastasis and cancer severity. Advances in knowledge: PET/CT can help in the differential diagnosis between benign and malignant adrenal enlargement.The adrenal gland is a common site of metastasis in patients with cancer. Up to 50% of adrenal lesions in patients with known primary non-adrenal cancers are malignant disease [1-4]. The most common malignant lesions that metastasise to the adrenal gland include lung, liver, colon, lymphoma, melanoma, breast, kidney, oesophagus, pancreas and stomach cancer [4][5][6]. However, diagnosis of an adrenal lesion as malignant or benign can be problematic. Characterisation of these adrenal lesions is therefore critical to stage the primary disease, direct therapy and predict prognosis. Although CT and MRI are typically used to characterise a lesion, a small but important number of adrenal lesions are found to be indeterminate on crosssectional images [7][8][9].Several reports have documented the effectiveness of standalone fluorine-18 fludeoxyglucose ( 18 F-FDG) positron emission tomography (PET) to differentiate benign from malignant adrenal lesions [8][9][10]. Interest has focused on the ability of integrated in-line PET/CT to definitively characterise these lesions given that this technique combines the anatomical and densitometrical applications of CT and the functional and metabol...

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 78%

Utilisation of combined¹⁸F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

Kim

Kim²,

Lee³

et al. 2013

BJR

View full text Add to dashboard Cite

show abstract

“…Previous studies indicate that a history of malignancy increases the likelihood of an adrenal lesion being malignant [4,21]. In the present study, previous malignancy was found to be associated with an increased risk of malignancy in univariate analysis, but not in multivariate logistic regression.…”

Section: Discussioncontrasting

confidence: 65%

Determinants for malignancy in surgically treated adrenal lesions

Wright

Nordenström

Almquist

2011

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…adrenocortical carcinoma, pheochromocytoma) because it is rarely informative and potentially hazardous. 16 In this setting is preferred to biopsy other lesion which involves the same stage disease. If the adrenal mass is the lesion with the highest stage disease, it is mandatory to perform an appropriate workup prior to performing an EUS-FNA to rule out primary adrenal tumors.…”

Section: Prioritizing Lesions Samplingmentioning

confidence: 99%

How to improve the success of endoscopic ultrasound guided fine needle aspiration cytology in the diagnosis of pancreatic lesions

Gimeno–García¹,

Elwassief²

2012

jig

View full text Add to dashboard Cite

Key words: endoscopic ultrasound guided fine needle aspiration cytology, pancreatic lesions, diagnosis Abbreviations: EUS, endoscopic ultrasonography; EUS-FNA, EUS-guided fine needle aspiration cytology Endoscopic ultrasonography (EUS) is highly accurate for assessing the pancreatic parenchyma and ductal system. Currently, it is the most sensitive imaging procedure for detecting small solid pancreatic masses. EUS-guided fine needle aspiration cytology (EUS-FNA) is a safe and highly accurate tool for the diagnosis of pancreatic malignancy. Prior to perform an EUS-FNA one should wonder whether the benefits outweigh the potential risks of the procedure. Therefore, it is important to take into account whether the procedure will influence patient management. The diagnostic yield and success rate of EUS-FNA in pancreatic lesions varies greatly depending on many factors including: the characteristics of the lesion itself (location of the mass and consistency of the lesion), technical factors (type of needle size, use of stylet, use of suction and number of needle passes performed) and the availability of immediate cytological assessment of the specimen. The aim of this review is to analyze all these factors for optimizing specimen collection and diagnostic efficiency in dealing with solid pancreatic masses.

show abstract

Management of Isolated Adrenal Lesions in Cancer Patients

Abstract: Background: Adrenal lesions are commonly identifi ed in patients with extra-adrenal cancer. When lesions are present, it is important to identify if the lesion is a metastasis of the

Cited by 21 publications

References 78 publications

Utilisation of combined¹⁸F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

Utilisation of combined¹⁸F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

Determinants for malignancy in surgically treated adrenal lesions

How to improve the success of endoscopic ultrasound guided fine needle aspiration cytology in the diagnosis of pancreatic lesions

Contact Info

Product

Resources

About

Management of Isolated Adrenal Lesions in Cancer Patients

Abstract: Background: Adrenal lesions are commonly identifi ed in patients with extra-adrenal cancer. When lesions are present, it is important to identify if the lesion is a metastasis of the

Cited by 21 publications

References 78 publications

Utilisation of combined18F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

Utilisation of combined18F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

Determinants for malignancy in surgically treated adrenal lesions

How to improve the success of endoscopic ultrasound guided fine needle aspiration cytology in the diagnosis of pancreatic lesions

Contact Info

Product

Resources

About

Utilisation of combined¹⁸F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

Utilisation of combined¹⁸F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement