Virilization of a Young Girl Caused by Concomitant Ectopic and Intra-Adrenal Adenomas of the Adrenal Cortex

Choukair, Daniela; Beuschlein, Felix; Zwermann, Oliver; Wudy, Stefan A.; Haufe, Sabine; Holland‐Cunz, Stefan; Bettendorf, Markus

doi:10.1159/000350244

Cited by 5 publications

(2 citation statements)

References 40 publications

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“…Although early 75 Se-selenomethyl-19-norcholesterol studies showed promising results, scintadren is currently no longer available for clinical studies and has been replaced by 131 I-iodomethyl-norcholesterol (NP-59) [25]. In a declining number of cases, NP-59 continues to be used to investigate the secretory status of adrenal adenomas and aid lesion lateralization [26,27,28,29,30,31]. However, these techniques have significant shortcomings including delivery of a relatively high radiation dose to the adrenal glands, time-consuming acquisition protocols, a requirement for the patient to take a 7–10 day course of high-dose glucocorticoids to suppress non-autonomous hormone synthesis and low sensitivity with poor spatial resolution (traditionally only allowing reliable detection of lesions >2 cm in diameter, although single photon emission computed tomography (SPECT) may afford improved resolution).…”

Section: Norcholesterol Scintigraphy—historical Perspectivementioning

confidence: 99%

Targeted Molecular Imaging in Adrenal Disease—An Emerging Role for Metomidate PET-CT

et al. 2016

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Adrenal lesions present a significant diagnostic burden for both radiologists and endocrinologists, especially with the increasing number of adrenal ‘incidentalomas’ detected on modern computed tomography (CT) or magnetic resonance imaging (MRI). A key objective is the reliable distinction of benign disease from either primary adrenal malignancy (e.g., adrenocortical carcinoma or malignant forms of pheochromocytoma/paraganglioma (PPGL)) or metastases (e.g., bronchial, renal). Benign lesions may still be associated with adverse sequelae through autonomous hormone hypersecretion (e.g., primary aldosteronism, Cushing’s syndrome, phaeochromocytoma). Here, identifying a causative lesion, or lateralising the disease to a single adrenal gland, is key to effective management, as unilateral adrenalectomy may offer the potential for curing conditions that are typically associated with significant excess morbidity and mortality. This review considers the evolving role of positron emission tomography (PET) imaging in addressing the limitations of traditional cross-sectional imaging and adjunctive techniques, such as venous sampling, in the management of adrenal disorders. We review the development of targeted molecular imaging to the adrenocortical enzymes CYP11B1 and CYP11B2 with different radiolabeled metomidate compounds. Particular consideration is given to iodo-metomidate PET tracers for the diagnosis and management of adrenocortical carcinoma, and the increasingly recognized utility of 11C-metomidate PET-CT in primary aldosteronism.

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Section: Norcholesterol Scintigraphy—historical Perspectivementioning

confidence: 99%

Targeted Molecular Imaging in Adrenal Disease—An Emerging Role for Metomidate PET-CT

et al. 2016

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“…All signs indicated the benign tendency of this mass. Recently, some molecular markers have been used to differentiate adrenal carcinoma from benign tumors [ 7 ]. These new markers may help to distinguish the nature of tumor in the future.…”

Section: Discussionmentioning

confidence: 99%

An ectopic adreocortical adenoma of the renal sinus: a case report and literature review

et al. 2016

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BackgroundEctopic adrenal tumors are very rare, especially in the renal sinus in adults. An unusual case of ectopic adrenal cortical adenoma in the right renal sinus is reported here.Case presentationThis patient was a 37-year-old woman. She was admitted to our hospital for hypertension and bilateral limb weakness. Computed tomography (CT) revealed a mass in right renal sinus. It was initially considered a tumor of the renal pelvis. Further computed tomographic angiography (CTA) showed the mass to be located outside the renal pelvis. After adequate preoperative preparation (blood pressure control and serum potassium supplement), the patient underwent laparoscopic resection of retroperitoneal tumor. During the procedure, a soft tissue tumor 3.4*3.0 cm2 in size with a golden color was found in the right renal sinus. The final immunohistochemistry examination showed an ectopic adreocortical adenoma.ConclusionEctopic adrenal tumors are rare in the renal sinus and difficult to diagnose and treat. Large and functional tumors should be treated with complete resection. The procedure is sometimes difficult for tumors located deep in the renal sinus. The decision to perform an open or minimally invasive surgery should be made according to the surgeon’s experience.

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Ectopia of the adrenal

Saeger

2018

Pathologe

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Ectopia of nodular adrenocortical tissue is very frequently found in the periadrenal region. It corresponds to accessory adrenal tissue and is a normal variant. Ectopia in more distant regions are found in inner male or female genitalia. Strong long-lasting hyperstimultions induce hyperplasia and simulate true tumors ("adrenal rest tumors"). Real autonomic tumors from ectopic adrenal tissue with or without hyperfunction are rare. Ectopia of adrenomedullary tissue are nearly exclusively found in the surroundings of normal medulla. Ectopia in the adrenals corresponds almost exclusively with thyroid tissue. Ectopic secretion of hormones, mostly ACTH, can be found in pheochromocytomas and induces hyperfunction (Cushing's syndrome).

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Virilization of a Young Girl Caused by Concomitant Ectopic and Intra-Adrenal Adenomas of the Adrenal Cortex

Cited by 5 publications

References 40 publications

Targeted Molecular Imaging in Adrenal Disease—An Emerging Role for Metomidate PET-CT

Targeted Molecular Imaging in Adrenal Disease—An Emerging Role for Metomidate PET-CT

An ectopic adreocortical adenoma of the renal sinus: a case report and literature review

Ectopia of the adrenal

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