[en] Computed tomography was used for diagnosing primary or recurrent adrenal gland tumors, being positive in all nine cases and later confirmed at surgery. The tumors are adenocarcinoma (6 cases); pheochromocytoma (2); aldostenoma (1) an cyst(u). Comparison of selective arteriography, ultrasonography, scintigraphy and computed tomography has shown the later to be most accurate. (Author)

No abstract available

[en] Adrenalectomy is the standard of care for management of many adrenal tumor types and, in the United States alone, approximately 6000 adrenal surgeries are performed annually. Two general approaches to adrenalectomy have been described; (1) the open approach, in which a diseased adrenal is removed through a large (10–20 cm) abdominal wall incision, and (2) the minimally invasive approach, in which laparoscopy is used to excise the gland through incisions generally no longer than 1–2 cm. Given these disparate technique options, clear preoperative characterization of those specific disease features that inform selection of adrenalectomy approach is critically important to the surgeon. Because most of these features are directly assessed via preoperative abdominal imaging, in particular computed tomography (CT) scanning, a clear mutual understanding among surgeons and radiologists of those adrenal tumor features impacting operative approach selection is vital for planning adrenal surgery. In this context, we review the preoperative CT imaging features that specifically inform adrenalectomy approach selection, provide illustrative examples from our institution’s imaging and surgical archives, and provide a stepwise guide to both the open and laparoscopic adrenalectomy approaches.

[en] Adrenal metastasis is considered a rare hematogenous metastasis that develops after gastric cancer surgery. The chances of curative surgery are very low. It is usually unresectable. We aim to present a case of isolated adrenal metastasis that developed in a patient, who underwent a total gastrectomy with the diagnosis of gastric cancer approximately 26 months back. Left adrenalectomy was planned with curative intent. R0 resection was performed. The patient was followed up for one year after surgery. The option of surgical treatment is recommended for isolated metachronous adrenal metastases. Curative surgical resection may positively impact the prognosis of patients in selected cases. (author)

[en] A postmenopausal woman presented with hirsutism and elevated serum testosterone levels. A 1-cm adrenal adenoma was noted on computed tomography. Combined adrenal and ovarian venous sampling was performed to localize an androgen producing tumor to the left ovary. The patient underwent a bilateral salpingo-oophrectomy and was spared an unnecessary adrenalectomy.

No abstract available

[en] Adrenal vein sampling (AVS) is the key test for subtyping patients with primary aldosteronism (PA) before referring those with unilateral disease for laparoscopic unilateral adrenalectomy. However, it is still not systematically used, despite guidelines recommendations, because it is still considered as an invasive, risky, and challenging procedure. Simultaneous bilateral catheterization is believed to add technical difficulties inherent with attempting to catheterize both adrenal veins at the same time, but can be useful to minimize differences between the sides due to timing. We herein report on the protocol for routine clinical use. Tips for preparation of the patient as well as optimal catheterization of adrenal veins and sampling are provided to propose a protocol that is easy, safe, and reliable.

Key Points

• Adrenal vein sampling is the reference standard in the case of primary aldosteronism to detect the hyper-functioning side and allow subsequent treatment.

• Simultaneous bilateral adrenal vein sampling avoids bias related to sampling timing.

• Some technical suggestions concerning patient preparation and catheterization are proposed to make simultaneous adrenal vein sampling easier and safer

[en] The prognosis of patients with adrenal metastases from hepatocellular carcinoma (HCC) has been poor, and aggressive treatment of these tumors is mandatory to improve patients' survival. Since adrenalectomy may be difficult to perform after previous surgery of the right liver lobe, other approaches are required to treat the adrenal mass. This report aims at demonstrating the feasibility of CT-guided transhepatic radiofrequency ablation of right adrenal HCC metastases pretreated with chemoembolization in patients unable to undergo surgical resection.

[en] Methodology: Data of 83 patients operated for adrenal lesions was collected retrospectively. Patients were categorized into two groups based on the size of the adrenal gland as <5 cm and ≥5 cm. The groups were compared in terms of perioperative outcomes. Results: The median age of the patients was 51 (41-60) years, with a female-to-male ratio of 27/56. The median follow-up period was 27 (11.5-91) months. Of 83 adrenal masses, 60 (72.3%) were in the <5 cm group and 23 (27.7%) were in the ≥5 cm group. Fifteen (18.1%) patients underwent adrenalectomy for lung cancer metastasis, whereas three (3.6%) for renal cell carcinoma metastasis. The overall rate of post-operative complications was 10.8%. Post-operative complication rates were similar in each group (p=0.433). Operation time was found to be significantly higher in patients with large adrenal masses (p=0.003). Conclusion: Minimally invasive surgical techniques have the same perioperative results in the group with adrenal lesions ≥5 cm compared to <5 cm and may be safely employed in this group of patients. (author)

[en] Highlights: • Daily variations in systemic anaphylaxis differed among inbred mouse strains. • The daily variations differed with anaphylaxis-inducing substances. • Glucocorticoid-dependent and -independent mechanisms regulated the variations. A time-of-day-dependent variation in IgE-mediated passive systemic anaphylaxis was previously reported in ICR mice. In the present study, we investigated time-of-day-dependent variations in IgE-, histamine-, and platelet-activating factor (PAF)-mediated systemic anaphylaxis in C57BL/6, BALB/c, and NC/Nga mice at 9:00 h and 21:00 h, and evaluated the potential influence of glucocorticoids (GCs) on these variations. We found significant time-of-day-dependent variations in IgE-mediated systemic anaphylaxis in C57BL/6 mice, and in histamine- and PAF-mediated systemic anaphylaxis in BALB/c mice. Significant daily variations in IgE-, histamine-, and PAF-mediated systemic anaphylaxis were not observed in NC/Nga mice. Pretreatment with dexamethasone and adrenalectomy abolished the daily variations in IgE-mediated systemic anaphylaxis in C57BL/6 mice and in PAF-mediated systemic anaphylaxis in BALB/c mice, suggesting that GCs from adrenal glands are pivotal in regulating these variations. In contrast, pretreatment with dexamethasone and adrenalectomy did not abolish the daily variation in histamine-mediated systemic anaphylaxis in BALB/c mice, suggesting that GC-independent and adrenal gland-independent mechanisms are important for the variation. The present study demonstrated that time-of-day-dependent variations in systemic anaphylaxis differed among inbred mouse strains and with anaphylaxis-inducing substances. Thus, mouse strains, time of experiment, and anaphylaxis-inducing substances used must be considered to obtain appropriate experimental results.