Subtotal adrenalectomy in the treatment of benign adrenal neoplasms

ABSTRACT A third episode of Cushing's syndrome developed in an adult male who had undergone subtotal adrenalectomy and then complete hypophysectomy in temporarily successful treatment of two earlier episodes. Judging from necropsy findings, this final recurrence was not the result of incomplete pituitary ablation or regeneration of pituitary remnants. Extrasellar pituitary or other ACTH secreting tissue could not be identified, but the patient's marked melanosis suggested its presence with consequent excesses of ACTH or MSH. However, irrespective of whether such excesses did or did not exist, it is clear that the third episode of Cushing's syndrome resulted from hyperfunction of the small adrenal remnant.

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BILATERAL SUBTOTAL ADRENALECTOMY FOR CUSHING'S SYNDROME

Acta Endocrinologica ◽

10.1530/acta.0.0160309 ◽

1954 ◽

Vol 16 (4) ◽

pp. 309-314 ◽

Cited By ~ 5

Author(s):

Carl A. Hernberg

Keyword(s):

Cushing’S Syndrome ◽

Cushing's Syndrome ◽

Subtotal Adrenalectomy

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CT-Guided Percutaneous Chemical Ablation of Adrenal Neoplasms

American Journal of Roentgenology ◽

10.2214/ajr.07.2145 ◽

2008 ◽

Vol 190 (1) ◽

pp. 105-110 ◽

Cited By ~ 45

Author(s):

Yue-Yong Xiao ◽

Jin-Lin Tian ◽

Jia-Kai Li ◽

Li Yang ◽

Jin-Shan Zhang

Keyword(s):

Ct Guided ◽

Adrenal Neoplasms ◽

Chemical Ablation

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Expression of Glucose Metabolism-Related Proteins in Adrenal Neoplasms

Pathobiology ◽

10.1159/000518208 ◽

2021 ◽

pp. 1-10

Author(s):

Eun Kyung Kim ◽

Hye Min Kim ◽

Ja Seung Koo

Keyword(s):

Prognostic Factors ◽

Glucose Metabolism ◽

Expression Patterns ◽

Univariate Analysis ◽

Hexokinase Ii ◽

Expression Levels ◽

Adrenal Cortical Adenoma ◽

Adrenal Neoplasms ◽

Cox Analysis ◽

Related Proteins

Purpose: The aim of this study was to investigate the expression patterns of glucose metabolism-related proteins and their clinicopathologic implications in adrenal cortical neoplasms (ACN) and pheochromocytoma (PCC). Methods: Immunohistochemical staining was performed to evaluate glucose metabolism-related proteins (GLUT1, CAIX, hexokinase II, G6PDH, PHGDH, and SHMT1) in 132 ACN cases (115 adrenal cortical adenoma [ACA] and 17 adrenal cortical carcinoma [ACC]) and 189 PCC cases. Results: Expression levels of GLUT1 in tumor cells ([T]; p < 0.001), GLUT1 in stromal cells ([S]; p < 0.001), G6PDH (p < 0.001), and SHMT1 (p = 0.002) were higher in ACN than in PCC. GLUT1 (T; p = 0.045) and PHGDH (p = 0.043) levels were higher in ACC than in ACA. In a univariate analysis of ACN, GLUT1 (T; p = 0.017), CAIX (S; p = 0.003), and PHGDH (p = 0.009) levels were correlated with a shorter overall survival (OS). GLUT1 (T; p = 0.001) and PHGDH (p < 0.001) were related to a shorter OS in PCC. GLUT1 (T) positivity (p = 0.043) in ACN predicted a poor OS in a multivariate Cox analysis. In PCC, high GAPP score (p = 0.026), GLUT1 (T; p = 0.002), and PHGDH (p < 0.001) were independent prognostic factors for poor OS. Conclusions: The adrenal gland tumors ACN and PCC had different expression patterns of glucose metabolism-related proteins (GLUT1, G6PDH, and SHMT1), with higher expression levels in ACN than in PCC. GLUT1 and PHGDH were significant prognostic factors in these adrenal neoplasms.

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Perioperative morbidity and mortality in dogs with invasive adrenal neoplasms treated by adrenalectomy and cavotomy

Veterinary Surgery ◽

10.1111/vsu.13221 ◽

2019 ◽

Vol 48 (5) ◽

pp. 742-750 ◽

Cited By ~ 2

Author(s):

Philipp D. Mayhew ◽

Sarah E. Boston ◽

Allison L. Zwingenberger ◽

Michelle A. Giuffrida ◽

Jeffrey J. Runge ◽

...

Keyword(s):

Morbidity And Mortality ◽

Perioperative Morbidity ◽

Adrenal Neoplasms

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Miscellaneous Adrenal Neoplasms (Cysts, Myelolipoma, Hemangioma, Lymphangioma)

Adrenal Glands ◽

10.1007/3-540-26861-8_22 ◽

2005 ◽

pp. 223-229

Author(s):

Melanie L. Richards

Keyword(s):

Adrenal Neoplasms

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SUN-937 A Case of Two Pathologies: Primary Hyperaldosteronism with a History of Pheochromocytoma

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.177 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Chukwuka Akamnonu ◽

Sahil Parikh ◽

Fredric Edward Wondisford

Keyword(s):

Renal Cysts ◽

Plasma Renin ◽

Persistent Atrial Fibrillation ◽

Normal Serum ◽

Primary Hyperaldosteronism ◽

Normal Range ◽

Refractory Hypertension ◽

Von Hippel Lindau ◽

Subtotal Adrenalectomy ◽

History Of

Abstract Background: In patients with system based diseases, multiple pathologies coexisting in the same organ can go undiagnosed. We present a case of a patient with long standing hypertension recently diagnosed with Primary hyperaldosteronism in the setting of known Pheochromocytoma. Case: A 43 year old male with a history of Von Hippel Lindau (VHL), Pheochromocytoma status post right subtotal adrenalectomy 18 years ago, renal cell carcinoma, prediabetes, bilateral renal cysts, and hypertension presented to the clinic for evaluation of suspected hyperaldosteronism. The patient had a history of medication refractory hypertension associated with hypokalemia requiring potassium supplementation. The patient’s VHL disease involved the pancreas, adrenal, brain and spine which required surgery to remove tumors in these areas. His Pheochromocytoma resolved status post subtotal adrenalectomy. Recent imaging and laboratory work up showed a stable left adrenal nodule (unchanged over the years), unremarkable right adrenal status post subtotal adrenalectomy with normal serum and urine metanephrines. In September 2019 he was seen by his Cardiologist for persistent Atrial Fibrillation and subsequent workup for suspected hyperaldosteronism showed a morning plasma aldosterone of 44.4ng/dL (normal range 4–21 ng/dL), plasma renin activity of <0.6 ng/ml/hr (normal range 0.6–4.3 ng/mL), 24 hour urine aldosterone of 21mcg/24hr (normal range 3–20 mcg/24hr), Urine sodium excretion of 236 mmol/24hr (normal range 40-217mmol/24hr), and potassium of 3.5mmol/L (normal range 3.6–5.0 mmol/L). The diagnosis of Primary hyperaldosteronism was confirmed and the patient was subsequently scheduled for adrenal venous sampling. Conclusion: This case demonstrates how multiple adrenal pathologies can present in the same individual. There is paucity of data in the literature as to the existence of both Pheochromocytoma and primary hyperaldosteronism in the same individual or the pathophysiological connection between them. When the diagnosis of a disease affecting a specific organ has already been made, the discovery of a secondary pathologic process affecting such organ may end up getting delayed. Clinicians should be aware of this possibility.

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