Pseudoglandular myxoid adrenal cortical adenoma and secondary hyperaldosteronism

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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Adrenal Cortical Adenoma With Adrenalin-Type Neurosecretory Granules Clinically Mimicking a Pheochromocytoma

Archives of Pathology & Laboratory Medicine ◽

10.5858/2002-126-1530-acawat ◽

2002 ◽

Vol 126 (12) ◽

pp. 1530-1533 ◽

Cited By ~ 2

Author(s):

Tomislav Ivsic ◽

Richard A. Komorowski ◽

Gary S. Sudakoff ◽

Stuart D. Wilson ◽

Milton W. Datta

Keyword(s):

Electron Microscopy ◽

Clinical Outcome ◽

Tumor Cells ◽

Clinical Features ◽

Adrenal Tumor ◽

Histologic Examination ◽

Adrenal Tumors ◽

Neurosecretory Granules ◽

Adrenal Cortical Adenoma ◽

Pathologic Features

Abstract Adrenal tumors often present with clinical features that are specific and unique to their endocrine metabolism. When these features are in conflict with the pathologic appearance of the tumor, there can be great consternation for both the pathologist and the surgeon. In the case reported herein, an adrenalectomy was performed for clinical features of pheochromocytoma that on gross and histologic examination had the pathologic features of an adrenal cortical adenoma. Electron microscopy subsequently revealed that the tumor cells contained adrenalin-type granules, explaining the clinical outcome. It is crucial for both the surgeon and the surgical pathologist to be aware of this possibility when the clinical and pathologic features of an adrenal tumor are not congruent.

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Spontaneous Hemorrhage of an Adrenal Cortical Adenoma Causing Cushing’s Syndrome

Urologia Internationalis ◽

10.1159/000282821 ◽

1996 ◽

Vol 56 (2) ◽

pp. 105-106 ◽

Cited By ~ 6

Author(s):

Toshihiro Saito ◽

Shigenori Kurumada ◽

Yoshiaki Kawakami ◽

Hideto Go ◽

Takeshi Uchiyama ◽

...

Keyword(s):

Cushing’S Syndrome ◽

Cushing's Syndrome ◽

Spontaneous Hemorrhage ◽

Adrenal Cortical Adenoma

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Clinical and pathological analysis of 116 cases of adult adrenal cortical adenoma and literature review

OncoTargets and Therapy ◽

10.2147/ott.s81831 ◽

2015 ◽

pp. 1251 ◽

Cited By ~ 6

Author(s):

Ai-Hua Jia ◽

Hong-Quan Du ◽

Min-Hua Fan ◽

Yu-Hong Li ◽

Jun-Long Xu ◽

...

Keyword(s):

Literature Review ◽

Pathological Analysis ◽

Adrenal Cortical Adenoma

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Effects of eplerenone on resistance to antihypertensive medication in patients with primary or secondary hyperaldosteronism

Journal of Translational Internal Medicine ◽

10.1515/jtim-2017-0020 ◽

2017 ◽

Vol 5 (2) ◽

pp. 93-99 ◽

Cited By ~ 1

Author(s):

J. David Spence ◽

Chrysi Bogiatzi ◽

Mariya Kuk ◽

George K. Dresser ◽

Daniel G. Hackam

Keyword(s):

Blood Pressure ◽

Resistant Hypertension ◽

Concomitant Medication ◽

Antihypertensive Medication ◽

Pressure Control ◽

Blinded Study ◽

History Of ◽

Secondary Hyperaldosteronism ◽

One Year ◽

Resistance Score

Abstract Background and Objectives Resistant hypertension is an important problem; nearly half of diagnosed hypertensives are not controlled to target blood pressure levels, and approximately 90% of strokes occur among patients with resistant hypertension. Primary aldosteronism accounts for approximately 20% of resistant hypertension, but the role of secondary hyperaldosteronism in resistant hypertension is seldom considered. We assessed the effects of eplerenone in patients with hypertension and either primary or secondary hyperaldosteronism. Methods Patients with a history of resistant hypertension and a supine plasma aldosterone level ≥ 360 pmol/L were randomized to eplerenone versus placebo in a fully blinded study for one year. A medication intensity score was developed to assess the resistance of hypertension to medication (blood pressure × medication intensity). We assessed the effects of eplerenone on blood pressure and on resistance to concomitant medication. Results Final results were available in 37 patients (19 on eplerenone and 18 on placebo). Resistance to medication, as assessed by the intensity of concomitant medication required to maintain blood pressure control, was markedly reduced by eplerenone: medication intensity scores declined by –0.50 ± 1.04 (SD) on placebo versus –2.11 ± 1.45 with eplerenone (P = 0.0001), the Systolic Resistance Score declined by –80.00 ± 122.93 on placebo versus –334.05 ± 21.73 on eplerenone (P = 0.0001), and the Diastolic Resistance Score increased by 1.28 ± 31.65 on placebo and declined by –40.74 ± 57.08 on eplerenone (P = 0.009). Conclusions Eplerenone significantly reduced resistance to concomitant antihypertensive medication in both primary and secondary hyperaldosteronism.

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