Scintigraphic patterns of adrenocortical carcinoma: morpho-functional correlates

Barzon, Luisa; Zucchetta, Pietro; Boscaro, Marco; Marzola, Maria Cristina; Bui, Franco; Fallo, Francesco

doi:10.1530/eje.0.1450743

Cited by 20 publications

(5 citation statements)

References 19 publications

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“…Uptake of radiocholesterol was present in 33.3% of patients; consequently, absence of uptake at adrenocortical scintigraphy was not a helpful marker of malignancy of the adrenal mass in our population. Similar findings have recently been described by Barzon et al [31], who reported increased tracer uptake in 30% of hypersecreting AC, regardless of the biochemical and histological features of the tumor.…”

Section: Discussionsupporting

confidence: 91%

Andrenocortical Carcinomas: Twelve‐year Prospective Experience

et al. 2004

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Adrenocortical carcinoma (AC) is a rare tumor with poor prognosis. Twenty-two patients (14 F, 8 M; age 22 to 59 years; median, 43 years) with AC were evaluated prospectively in a single center: tumor stage was I-II in 12 cases and III-IV in 10. The overall survival in our cohort was 41.6 +/- 42 months; 16 subjects are still alive. Curative surgery was followed by longer survival than debulking or no surgery (p < 0.0001). The first relapse was highly predictive for further recurrences. Recurrent ACs were progressively more aggressive, and they occurred with variable but ever shorter intervals. At diagnosis, 14 patients (63.5%) presented with features of clear adrenocortical hyperactivity. Despite the absence of clinical signs of hormonal excess, all other patients presented some abnormalities of steroid secretion. The most common clinical finding was a recent diagnosis of moderate-to-severe hypertension (68%), poorly controlled by pharmacological treatment, often associated with multiple cardiovascular risk factors. High mitotic rate and undifferentiated polymorph cellular pattern were associated with worse prognosis. Response to treatments other than surgery (mitotane chemotherapy) was better in patients treated early after the first surgery. In conclusion, curative surgery was the most effective treatment. Monitoring arterial pressure, endocrine parameters, and metabolic parameters can be helpful for the early detection of AC recurrences.

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Section: Discussionsupporting

confidence: 91%

Andrenocortical Carcinomas: Twelve‐year Prospective Experience

et al. 2004

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“…83,88,92 Typically, benign hypersecreting tumors, such as cortisol-, ALD-and androgen-secreting adenomas and non-hypersecreting adenomas, show radiocholesterol uptake, whereas primary and secondary adrenal malignancies appear as 'cold' masses, providing an overall sensitivity of 71-100% and specificity of 50-100%. 83,88,92,93,[95][96][97][98][99][100][101] A large study of 229 patients with abnormal adrenal anatomy depicted by CT who were evaluated by injecting 131 I-NP-59 concluded that in the absence of hormonal dysfunction, the presence of concordant CT and 131 I-NP-59 scans is characteristic of functioning, but not hypersecretory, benign adrenocortical adenomas. Discordant CT and 131 I-NP-59 scans are suggestive of nonfunctioning, space-occupying, adrenal lesions.…”

Section: Functional Imaging Modalitiesmentioning

confidence: 99%

Adrenal incidentaloma: a diagnostic challenge

Anagnostis¹,

Karagiannis²,

Τζιόμαλος³

et al. 2009

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The widespread application of abdominal imaging procedures has resulted in an increased frequency of clinically silent adrenal masses. Adrenal incidentaloma (AI) is a term applied to an accidentally discovered adrenal mass on imaging performed for the investigation of an unrelated complaint. Adrenal incidentalomas (AIs) are a cluster of different pathologies, the majority of which are benign and non-functioning adrenal adenomas. However, mild hormonal alterations as well as metabolic abnormalities may be present in patients with AIs. Thus, a multidisciplinary approach with biochemical and radiologic evaluation is needed to characterize these lesions and identify patients who are at high risk for hormonal or malignant evolution. Significant new information has helped resolve controversies regarding the most reliable approach to this clinical problem. The present review considers the prevalence, pathology and natural history of AIs. We also discuss the reliability of available screening methods and localization techniques and consider optimal management and follow-up strategies.

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“…Radiocholesterol scintigraphy can have an important role in diagnosing adrenocortical carcinomas, but in the present case the poor differentiation of the mass did not lead to tracer uptake. Moreover, this technique is used to identify nonviewable lesions but this was not the case and the risk of hemorrhage of the adrenal lesion prompted surgical resection 8,9 .…”

Section: Discussionmentioning

confidence: 99%

Primary adrenal gland carcinosarcoma associated with metastatic rectal cancer: A hitherto unreported collision tumor

Bertolini

Rossi

Fiocchi

et al. 2011

Tumori

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In this report we describe the case of a young woman with familial adenomatous polyposis who developed metastatic rectal cancer during pregnancy. At diagnosis, we decided to perform a transabdominal laparoscopic adrenalectomy, because of the high risk of bowel obstruction, and to define the origin of the adrenal gland lesion, suspected to be primary on the basis of imaging results. The histological specimen showed a collision tumor between an adrenal metastasis of a rectal tumor and a primary adrenal gland carcinosarcoma. The peculiarity of the case is due not only to its clinical presentation during pregnancy, but also to the presence of this uncommon adrenal collision tumor. A particular challenge for the clinician is to define the priority between these two tumors: the presence of two distinct and colliding aggressive neoplasms poses a problem in the choice of the best therapeutic approach, also given the impossibility to biopsy all metastatic sites. However, we decided to treat the patient as having a metastatic rectal cancer, because we had a solid histological confirmation of metastases.

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Scintigraphic patterns of adrenocortical carcinoma: morpho-functional correlates

Cited by 20 publications

References 19 publications

Andrenocortical Carcinomas: Twelve‐year Prospective Experience

Andrenocortical Carcinomas: Twelve‐year Prospective Experience

Adrenal incidentaloma: a diagnostic challenge

Primary adrenal gland carcinosarcoma associated with metastatic rectal cancer: A hitherto unreported collision tumor

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