Rak kory nadnercza (ACC) — przegląd piśmiennictwa i doświadczenia własne

Dworakowska, Dorota; Drabarek, Agata; Wenzel, Ingrid; Babińska, Anna; Świątkowska−Stodulska, Renata; Sworczak, Krzysztof

doi:10.5603/ep.2014.0069

Cited by 15 publications

(14 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The number of non-severe complications of laparoscopic adrenalectomy, reaching 10%, is acceptable. Conversions to the open method are done in 5% of all cases [13][14][15]. Similar results were found in the presented study as well as in patients with malignancies and in patients with benign tumours not hormonally active.…”

Section: Rycina 2 Nowotwór Nadnerczy -Rezonans Magnetycznysupporting

confidence: 75%

The usefulness of laparoscopic adrenalectomy in the treatment of adrenal neoplasms — a single-centre experience

Pogorzelski

Toutounchi

Krajewska

et al. 2017

Endokrynologia Polska

View full text Add to dashboard Cite

Introduction: Adrenal neoplasms comprise about 10% of all tumours affecting this organ and constitute a significant, at first diagnostic and subsequently therapeutic, problem, especially since a relatively high proportion of neoplastic lesions are asymptomatic. The number of diagnosed metastases to adrenal glands is increasing. Surgical treatment involves both open surgery as well as laparoscopy. Material and methods: There were 245 adrenalectomies performed at our centre due to various indications over the past four years. In 27 (11.5%) cases neoplasms were diagnosed in the final histopahtological examination. In 11 (40.7%) cases primary adrenal cortex tumours were diagnosed, metastases from other solid organ tumours were identified in another 12 (44.4%) patients, and rarer neoplasms were diagnosed in the remaning 4 (14.8%) subjects. Cases of malignant pheochromocytoma were not included in this report.

show abstract

Section: Rycina 2 Nowotwór Nadnerczy -Rezonans Magnetycznysupporting

confidence: 75%

The usefulness of laparoscopic adrenalectomy in the treatment of adrenal neoplasms — a single-centre experience

Pogorzelski

Toutounchi

Krajewska

et al. 2017

Endokrynologia Polska

View full text Add to dashboard Cite

show abstract

“…The presence of Cushing’s syndrome was confirmed on the basis of clinical evaluation in terms of clinical symptoms (altered fat distribution, wide purple striae, etc. ), assessment of 24-h urinary cortisol (normal range 12–330 nmol/24 h), serum cortisol levels after suppression test applying 1 mg dexamethasone (DXM) (immunofluorescent assay, concentrations > 140 nmol/L indicated hypercortisolism), and analysis of plasma ACTH levels (normal range 15–46 pg/mL) [41,42]. Fourteen patients had adrenal Cushing’s syndrome due to adrenal adenomas and two patients suffered from pituitary CS.…”

Section: Methodsmentioning

confidence: 99%

“…The activity of AIs was assessed by determining UFC in 24-h urine and serum cortisol levels after suppression test with DXM using immunofluorescent assay (concentrations < 50 nmol/L excluded hypercortisolism, intermediate cut-off point of 94 nmol/L indicated subclinical hypercortisolism), dehydroepiandrosterone sulphate (DHEA-S) in serum (normal range equal to 34–430 μg/dL), aldosterone levels in serum and urine, potassium in blood, and methoxycatecholamines in 24-h urine [22,41,42]. The immunochemical assays revealed that AIs were non-hypersecretory.…”

Section: Methodsmentioning

confidence: 99%

Metabolomic Biomarkers in Urine of Cushing’s Syndrome Patients

Kotłowska

Puzyn

Sworczak

et al. 2017

IJMS

Self Cite

View full text Add to dashboard Cite

Cushing’s syndrome (CS) is a disease which results from excessive levels of cortisol in the human body. The disorder is associated with various signs and symptoms which are also common for the general population not suffering from compound hypersecretion. Thus, more sensitive and selective methods are required for the diagnosis of CS. This follow-up study was conducted to determine which steroid metabolites could serve as potential indicators of CS and possible subclinical hypercortisolism in patients diagnosed with so called non-functioning adrenal incidentalomas (AIs). Urine samples from negative controls (n = 37), patients with CS characterized by hypercortisolism and excluding iatrogenic CS (n = 16), and patients with non-functioning AIs with possible subclinical Cushing’s syndrome (n = 25) were analyzed using gas chromatography-mass spectrometry (GC/MS) and gas chromatograph equipped with flame ionization detector (GC/FID). Statistical and multivariate methods were applied to investigate the profile differences between examined individuals. The analyses revealed hormonal differences between patients with CS and the rest of examined individuals. The concentrations of selected metabolites of cortisol, androgens, and pregnenetriol were elevated whereas the levels of tetrahydrocortisone were decreased for CS when opposed to the rest of the study population. Moreover, after analysis of potential confounding factors, it was also possible to distinguish six steroid hormones which discriminated CS patients from other study subjects. The obtained discriminant functions enabled classification of CS patients and AI group characterized by mild hypersecretion of cortisol metabolites. It can be concluded that steroid hormones selected by applying urinary profiling may serve the role of potential biomarkers of CS and can aid in its early diagnosis.

show abstract

“…patients; other causes of CS are listed in Table I [8][9][10]. Cushing's disease is more common in women, but EAS has an equal incidence in both sexes or even is more common in men.…”

Section: Szkolenie Podyplomowementioning

confidence: 99%

“…Ektopowe wydzielanie ACTH stanowi 10% chorych z CS, a inne przyczyny CS podsumowano w tabeli I [8][9][10]. Typowo choroba Cushinga dominuje u kobiet, natomiast CS w przebiegu EAS w równym stopniu lub częściej dotyczy mężczyzn.…”

Section: Epidemiologiaunclassified

Zespół Cushinga w przebiegu ektopowego wydzielania ACTH

Cieszyński

Berendt-Obołończyk

Szulc

et al. 2015

Endokrynologia Polska

Self Cite

View full text Add to dashboard Cite

Cushing's syndrome (CS) is defined as a constellation of clinical signs and symptoms occurring due to hypercortisolism. Cortisol excess may be endogenous or exogenous. The most common cause of CS is glucocorticoid therapy with supraphysiological (higher than in the case of substitution) doses used in various diseases (e.g. autoimmune). One possible CS cause is ectopic (extra-pituitary) ACTH secretion (EAS) by benign or malignant tumours. Since its first description in 1963, EAS aetiology has changed, i.e. as well as small cell lung cancer (SCLC), higher incidence in other malignancies has been reported. Ectopic ACTH secretion symptoms are usually similar to hypercortisolism symptoms due to other causes. A clinical suspicion of CS requires laboratory investigations. There is no single and specific laboratory test for making a CS diagnosis, and therefore multiple dynamic tests should be ordered. A combination of multiple laboratory noninvasive and invasive tests gives 100% sensitivity and 98% specificity for EAS diagnosis. If the EAS is caused by localised malignancy, surgery is the optimal treatment choice. Radical tumour excision may be performed in 40% of patients, and 80% of them are cured of the disease. The authors present an interesting clinical case of EAS, which is always a huge diagnostic challenge for clinicians. StreszczenieZespół objawów klinicznych: podmiotowych i przedmiotowych, które wynikają z hiperkortyzolemii określa się mianem zespołu Cushinga (CS). Nadmiar kortyzolu w organizmie może mieć źródło egzo-lub endogenne. Powszechnie uważa się, że najczęstszą przyczyną CS jest terapia glikokortykosteroidem w dawkach farmakologicznych, większych niż substytucyjne, z powodu różnych chorób, na przykład tkanki łącznej. Jedną z możliwych przyczyn CS jest ektopowe, czyli poza przysadkowe wydzielanie ACTH, przez nowotwór łagodny lub złośliwy. Od czasu pierwszego opisu w 1963 roku, etiologia ektopowego wydzielania ACTH uległa istotnej zmianie, poza drobnokomórko-wym rakiem płuca (SCLC) opisano inne nowotwory, których częstość znacząco wzrosła. Symptomatologia CS w przebiegu ektopowego wydzielania ACTH najczęściej odpowiada objawom hiperkortyzolemii spotykanym u chorych z powodu innej przyczyny. Podejrzenie kliniczne CS wymaga weryfikacji laboratoryjnej. Nie ma swoistego, pojedynczego badania, które by potwierdziło CS w przebiegu ektopowego wydzielania ACTH, z tego względu należy posiłkować się szeregiem testów. Połączenie wielu badań laboratoryjnych, w tym inwazyjnych, sprawia, że czułość rozpoznania ektopowego wydzielania ACTH sięgnąć może 100%, przy swoistości 98%. W przypadku lokalizacji ogniska pierwotnego leczenie operacyjne jest postępowaniem optymalnym. Radykalne leczenie można zastosować u 40% chorych, z czego około 80% udaje się wyleczyć. Przedstawiony przypadek ektopowego wydzielania ACTH stanowi przykład licznych trudności diagnostycznych dla lekarza praktyka.

show abstract

Rak kory nadnercza (ACC) — przegląd piśmiennictwa i doświadczenia własne

Cited by 15 publications

References 46 publications

The usefulness of laparoscopic adrenalectomy in the treatment of adrenal neoplasms — a single-centre experience

The usefulness of laparoscopic adrenalectomy in the treatment of adrenal neoplasms — a single-centre experience

Metabolomic Biomarkers in Urine of Cushing’s Syndrome Patients

Zespół Cushinga w przebiegu ektopowego wydzielania ACTH

Contact Info

Product

Resources

About