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Xavier Bertagna - One of the best experts on this subject based on the ideXlab platform.
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Collision/Composite Tumors of the Adrenal Gland: A Pitfall of Scintigraphy Imaging and Hormone Assays in the Detection of Adrenal Metastasis
The Journal of clinical endocrinology and metabolism, 2005Co-Authors: Adeline Thorin-savouré, Xavier Bertagna, Jérôme Bertherat, Laurence Guignat, Anne Pellerin, Frédérique Tissier-rible, Hervé LefebvreAbstract:Context: In patients with a history of extraadrenal tumor, incidental discovery of an adrenal mass necessitates excluding the possibility of metastatic malignancy. Detection of the malignant tissue is a difficult challenge when metastasis occurs in an adrenal adenoma, forming a collision/composite tumor. Objective, Design, and Setting: We report two patients with adrenal collision/composite tumors referred to two French university hospitals. Patients and Results: Two patients with histories of mammary and sigmoid carcinomas, respectively, presented with adrenal mass discovered 8 and 3 yr after surgical removal of the primary tumor. In the two cases, computerized tomographic scan showed that the adrenal tumor contained two components with low and high attenuation values, respectively. Uptake of Iodocholesterol by the adrenal tumor in case 1 and elevated plasma ACTH-stimulated 17-hydroxyprogesterone values in case 2 strongly argued for the diagnosis of primary adrenocortical tumors. Enlargement of the adren...
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Urological Survey ADRENAL AND RENAL PHYSIOLOGY, AND MEDICAL RENAL DISEASE 18 F-Fluorodeoxyglucose Positron Emission Tomography as a Diagnostic Tool for Malignancy of Adrenocortical Tumours? Preliminary Results in 13 Consecutive Patients
2005Co-Authors: Florence Tenenbaum, B Richard, Xavier BertagnaAbstract:Design: This study is a preliminary report on 18 F-fluorodeoxyglucose ( 18 F-FDG) uptake for the characterization of hypersecretory or non-hypersecretory adrenocortical masses in patients without known neoplastic disease, thereby minimizing the presence of adrenal metastases, and without phacochromocytoma, in comparison with computed tomography (CT) scanning and with Iodocholesterol scintigraphy. Methods: Thirteen consecutive patients with an adrenal mass scheduled to have surgery, underwent hormonal exploration, a CT scan for tumour size measurement and an 18 F-FDG positron emission tomography scan. Eleven of these patients also had unenhanced density measurement at CT scan and Iodocholesterol scintigraphy.
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CLINICAL CASE SEMINAR Collision/Composite Tumors of the Adrenal Gland: A Pitfall of Scintigraphy Imaging and Hormone Assays in the Detection of Adrenal Metastasis
2005Co-Authors: Adeline Thorin-savouré, Laurence Guignat, Anne Pellerin, Xavier BertagnaAbstract:Patients and Results: Two patients with histories of mammary and sigmoid carcinomas, respectively, presented with adrenal mass discovered 8 and 3 yr after surgical removal of the primary tumor. In the two cases, computerized tomographic scan showed that the adrenal tumor contained two components with low and high attenuation values, respectively. Uptake of Iodocholesterol by the adrenal tumor in case 1 and elevated plasma ACTH-stimulated 17-hydroxyprogesterone values in case 2 strongly argued for the diagnosis of primary adrenocortical tumors. Enlargement of the adrenal mass during follow-up in case 1 and association of the adrenal lesion with a hepatic mass in case 2 led to adrenalectomy. In both cases, histological examination of the tumor demonstrated the presence of metastatic carcinoma tissue in an adrenocortical adenoma, allowing classification of the neoplasia as a collision/composite tumor. Conclusion: These observations show that collision/composite tumors of the adrenal gland formed by carcinoma metastasis in benign adenomas are a pitfall of Iodocholesterol scintigraphy and/or plasma steroid assays to exclude the diagnosis of adrenal metastasis. Conversely, computerized tomographic scan is a useful tool for the distinction between the benign and malignant tissues in adrenal collision/composite tumors. (J Clin Endocrinol Metab 90: 4924–4929, 2005)
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18F-fluorodeoxyglucose positron emission tomography as a diagnostic tool for malignancy of adrenocortical tumours? Preliminary results in 13 consecutive patients.
European journal of endocrinology, 2004Co-Authors: Florence Tenenbaum, Lionel Groussin, Bertrand Dousset, Paul Legmann, B Richard, Hervé Foehrenbach, Frédérique Tissier, Hervé Gouya, Jérôme Bertherat, Xavier BertagnaAbstract:Design: This study is a preliminary report on 18 F-fluorodeoxyglucose ( 18 F-FDG) uptake for the characterization of hypersecretory or non-hypersecretory adrenocortical masses in patients without known neoplastic disease, thereby minimizing the presence of adrenal metastases. and without phaeochromocytoma, in comparison with computed tomography (CT) scanning and with Iodocholesterol scintigraphy. Methods: Thirteen consecutive patients with an adrenal mass scheduled to have surgery, underwent hormonal exploration, a CT scan for tumour size measurement and an 18 F-FDG positron emission tomography scan. Eleven of these patients also had unenhanced density measurement at CT scan and Iodocholesterol scintigraphy. Results: CT-scanned adrenal masses ranged in size from 2.2 to 10 cm; attenuation value was 10 HU in nine. All benign lesions demonstrated Iodocholesterol uptake. In the case of malignant tumours, results were non-homogeneous: no uptake, uptake and non-informative scintigraphy. All patients with an adrenocortical carcinoma had positive adrenal 18 F-FDG uptake (n = 3), one had a liver metastasis with positive 18 F-FDG uptake, one showed 18 F- FDG uptake in an adrenal metastasis from an unknown primary kidney tumour. All patients with a benign adrenocortical lesion had negative 18 F-FDG uptake (n = 9). Patients' lesions were hypersecretory (n = 5), or non-hypersecretory (n = 8), regardless of the pathology. Conclusion: This short preliminary study indicates that 18 F-FDG gave a correct classification of tissue characterization with accurate identification of malignant lesions, as well as the disease stage (metastasis or primary). These promising preliminary results on adrenocortical lesions, seldom studied with 18 F-FDG, are to be confirmed in larger series.
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diagnostic tool for malignancy of adrenocortical tumours? Preliminary results in 13 consecutive patients
2004Co-Authors: Clinical S Tudy, Florence Tenenbaum, Lionel Groussin, Bertrand Dousset, Paul Legmann, B Richard, Xavier BertagnaAbstract:Design: This study is a preliminary report on 18 F-fluorodeoxyglucose ( 18 F-FDG) uptake for the characterization of hypersecretory or non-hypersecretory adrenocortical masses in patients without known neoplastic disease, thereby minimizing the presence of adrenal metastases, and without phaeochromocytoma, in comparison with computed tomography (CT) scanning and with Iodocholesterol scintigraphy. Methods: Thirteen consecutive patients with an adrenal mass scheduled to have surgery, underwent hormonal exploration, a CT scan for tumour size measurement and an 18 F-FDG positron emission tomography scan. Eleven of these patients also had unenhanced density measurement at CT scan and Iodocholesterol scintigraphy. Results: CT-scanned adrenal masses ranged in size from 2.2 to 10 cm; attenuation value was , 10 Hounsfield units (HUs) in two cases and . 10 HU in nine. All benign lesions demonstrated Iodocholesterol uptake. In the case of malignant tumours, results were non-homogeneous: no uptake, uptake and non-informative scintigraphy. All patients with an adrenocortical carcinoma had positive adrenal
Douglas L. Fraker - One of the best experts on this subject based on the ideXlab platform.
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Atlas of Iodocholesterol scintigraphy (NP-59) in Cushing's syndrome with CT and MR correlation.
Clinical nuclear medicine, 1996Co-Authors: Douglas L. Fraker, Harvey A. ZiessmanAbstract:An atlas of I-131 Iodocholesterol scintigraphy, each with correlative CT or MRI illustrates the findings in 12 patients with biochemically proven Cushing's syndrome and ultimate surgical cure. Included are patients with both ACTH dependent and independent disease, as well as patients with postoperative functional adrenal remnants. Emphasis will be on the concordance or discordance of the anatomical and functional imaging modalities.
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Role of preoperative Iodocholesterol scintiscanning in patients undergoing adrenalectomy for Cushing's syndrome.
Surgery, 1995Co-Authors: H. Richard Alexander, Harvey A. Ziessman, Jeffrey A. Norton, John L. Doppman, Joseph F. Buell, Lynnette K. Nieman, Gordon B. Cutler, George P. Chrousos, Douglas L. FrakerAbstract:Background. Iodocholesterol scintiscanning (IS) is a noninvasive, functional diagnostic test. We report our experience with IS as an adjunct for adrenal surgery for Cushing's syndrome. Methods. Between April 1983 and October 1994, 23 patients with Cushing's syndrome from benign primary adrenal disease underwent IS and computed tomography (CT) and/or magnetic resonance imaging (MRI). Twelve patients had unilateral adrenal involvement with a solitary adenoma (n=11) or unilateral multinodular disease (n=1), and 11 patients had bilateral adrenal disease. Results. In patients with Cushing's syndrome caused by unilateral adrenal disease, IS was 100% specific and 100% sensitive, whereas in two cases CT/MRI incorrectly showed bilateral disease. In patients with Cushing's syndrome with bilateral adrenal involvement, IS had one false-negative result with nonvisualization. CT/MRI showed unilateral disease in four cases and no abnormalities in two. All patients in this series were cured of Cushing's syndrome after unilateral adrenalectomy in 11 cases and bilateral adrenalectomy in 12 cases. Conclusions. IS is a highly sensitive and specific imaging modality and is an essential adjunct to biochemical testing in planning adrenal resections for Cushing's syndrome caused by primary adrenal disease.
Harvey A. Ziessman - One of the best experts on this subject based on the ideXlab platform.
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Atlas of Iodocholesterol scintigraphy (NP-59) in Cushing's syndrome with CT and MR correlation.
Clinical nuclear medicine, 1996Co-Authors: Douglas L. Fraker, Harvey A. ZiessmanAbstract:An atlas of I-131 Iodocholesterol scintigraphy, each with correlative CT or MRI illustrates the findings in 12 patients with biochemically proven Cushing's syndrome and ultimate surgical cure. Included are patients with both ACTH dependent and independent disease, as well as patients with postoperative functional adrenal remnants. Emphasis will be on the concordance or discordance of the anatomical and functional imaging modalities.
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Role of preoperative Iodocholesterol scintiscanning in patients undergoing adrenalectomy for Cushing's syndrome.
Surgery, 1995Co-Authors: H. Richard Alexander, Harvey A. Ziessman, Jeffrey A. Norton, John L. Doppman, Joseph F. Buell, Lynnette K. Nieman, Gordon B. Cutler, George P. Chrousos, Douglas L. FrakerAbstract:Background. Iodocholesterol scintiscanning (IS) is a noninvasive, functional diagnostic test. We report our experience with IS as an adjunct for adrenal surgery for Cushing's syndrome. Methods. Between April 1983 and October 1994, 23 patients with Cushing's syndrome from benign primary adrenal disease underwent IS and computed tomography (CT) and/or magnetic resonance imaging (MRI). Twelve patients had unilateral adrenal involvement with a solitary adenoma (n=11) or unilateral multinodular disease (n=1), and 11 patients had bilateral adrenal disease. Results. In patients with Cushing's syndrome caused by unilateral adrenal disease, IS was 100% specific and 100% sensitive, whereas in two cases CT/MRI incorrectly showed bilateral disease. In patients with Cushing's syndrome with bilateral adrenal involvement, IS had one false-negative result with nonvisualization. CT/MRI showed unilateral disease in four cases and no abnormalities in two. All patients in this series were cured of Cushing's syndrome after unilateral adrenalectomy in 11 cases and bilateral adrenalectomy in 12 cases. Conclusions. IS is a highly sensitive and specific imaging modality and is an essential adjunct to biochemical testing in planning adrenal resections for Cushing's syndrome caused by primary adrenal disease.
Jérôme Bertherat - One of the best experts on this subject based on the ideXlab platform.
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Collision/Composite Tumors of the Adrenal Gland: A Pitfall of Scintigraphy Imaging and Hormone Assays in the Detection of Adrenal Metastasis
The Journal of clinical endocrinology and metabolism, 2005Co-Authors: Adeline Thorin-savouré, Xavier Bertagna, Jérôme Bertherat, Laurence Guignat, Anne Pellerin, Frédérique Tissier-rible, Hervé LefebvreAbstract:Context: In patients with a history of extraadrenal tumor, incidental discovery of an adrenal mass necessitates excluding the possibility of metastatic malignancy. Detection of the malignant tissue is a difficult challenge when metastasis occurs in an adrenal adenoma, forming a collision/composite tumor. Objective, Design, and Setting: We report two patients with adrenal collision/composite tumors referred to two French university hospitals. Patients and Results: Two patients with histories of mammary and sigmoid carcinomas, respectively, presented with adrenal mass discovered 8 and 3 yr after surgical removal of the primary tumor. In the two cases, computerized tomographic scan showed that the adrenal tumor contained two components with low and high attenuation values, respectively. Uptake of Iodocholesterol by the adrenal tumor in case 1 and elevated plasma ACTH-stimulated 17-hydroxyprogesterone values in case 2 strongly argued for the diagnosis of primary adrenocortical tumors. Enlargement of the adren...
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18F-fluorodeoxyglucose positron emission tomography as a diagnostic tool for malignancy of adrenocortical tumours? Preliminary results in 13 consecutive patients.
European journal of endocrinology, 2004Co-Authors: Florence Tenenbaum, Lionel Groussin, Bertrand Dousset, Paul Legmann, B Richard, Hervé Foehrenbach, Frédérique Tissier, Hervé Gouya, Jérôme Bertherat, Xavier BertagnaAbstract:Design: This study is a preliminary report on 18 F-fluorodeoxyglucose ( 18 F-FDG) uptake for the characterization of hypersecretory or non-hypersecretory adrenocortical masses in patients without known neoplastic disease, thereby minimizing the presence of adrenal metastases. and without phaeochromocytoma, in comparison with computed tomography (CT) scanning and with Iodocholesterol scintigraphy. Methods: Thirteen consecutive patients with an adrenal mass scheduled to have surgery, underwent hormonal exploration, a CT scan for tumour size measurement and an 18 F-FDG positron emission tomography scan. Eleven of these patients also had unenhanced density measurement at CT scan and Iodocholesterol scintigraphy. Results: CT-scanned adrenal masses ranged in size from 2.2 to 10 cm; attenuation value was 10 HU in nine. All benign lesions demonstrated Iodocholesterol uptake. In the case of malignant tumours, results were non-homogeneous: no uptake, uptake and non-informative scintigraphy. All patients with an adrenocortical carcinoma had positive adrenal 18 F-FDG uptake (n = 3), one had a liver metastasis with positive 18 F-FDG uptake, one showed 18 F- FDG uptake in an adrenal metastasis from an unknown primary kidney tumour. All patients with a benign adrenocortical lesion had negative 18 F-FDG uptake (n = 9). Patients' lesions were hypersecretory (n = 5), or non-hypersecretory (n = 8), regardless of the pathology. Conclusion: This short preliminary study indicates that 18 F-FDG gave a correct classification of tissue characterization with accurate identification of malignant lesions, as well as the disease stage (metastasis or primary). These promising preliminary results on adrenocortical lesions, seldom studied with 18 F-FDG, are to be confirmed in larger series.
Florence Tenenbaum - One of the best experts on this subject based on the ideXlab platform.
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Urological Survey ADRENAL AND RENAL PHYSIOLOGY, AND MEDICAL RENAL DISEASE 18 F-Fluorodeoxyglucose Positron Emission Tomography as a Diagnostic Tool for Malignancy of Adrenocortical Tumours? Preliminary Results in 13 Consecutive Patients
2005Co-Authors: Florence Tenenbaum, B Richard, Xavier BertagnaAbstract:Design: This study is a preliminary report on 18 F-fluorodeoxyglucose ( 18 F-FDG) uptake for the characterization of hypersecretory or non-hypersecretory adrenocortical masses in patients without known neoplastic disease, thereby minimizing the presence of adrenal metastases, and without phacochromocytoma, in comparison with computed tomography (CT) scanning and with Iodocholesterol scintigraphy. Methods: Thirteen consecutive patients with an adrenal mass scheduled to have surgery, underwent hormonal exploration, a CT scan for tumour size measurement and an 18 F-FDG positron emission tomography scan. Eleven of these patients also had unenhanced density measurement at CT scan and Iodocholesterol scintigraphy.
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18F-fluorodeoxyglucose positron emission tomography as a diagnostic tool for malignancy of adrenocortical tumours? Preliminary results in 13 consecutive patients.
European journal of endocrinology, 2004Co-Authors: Florence Tenenbaum, Lionel Groussin, Bertrand Dousset, Paul Legmann, B Richard, Hervé Foehrenbach, Frédérique Tissier, Hervé Gouya, Jérôme Bertherat, Xavier BertagnaAbstract:Design: This study is a preliminary report on 18 F-fluorodeoxyglucose ( 18 F-FDG) uptake for the characterization of hypersecretory or non-hypersecretory adrenocortical masses in patients without known neoplastic disease, thereby minimizing the presence of adrenal metastases. and without phaeochromocytoma, in comparison with computed tomography (CT) scanning and with Iodocholesterol scintigraphy. Methods: Thirteen consecutive patients with an adrenal mass scheduled to have surgery, underwent hormonal exploration, a CT scan for tumour size measurement and an 18 F-FDG positron emission tomography scan. Eleven of these patients also had unenhanced density measurement at CT scan and Iodocholesterol scintigraphy. Results: CT-scanned adrenal masses ranged in size from 2.2 to 10 cm; attenuation value was 10 HU in nine. All benign lesions demonstrated Iodocholesterol uptake. In the case of malignant tumours, results were non-homogeneous: no uptake, uptake and non-informative scintigraphy. All patients with an adrenocortical carcinoma had positive adrenal 18 F-FDG uptake (n = 3), one had a liver metastasis with positive 18 F-FDG uptake, one showed 18 F- FDG uptake in an adrenal metastasis from an unknown primary kidney tumour. All patients with a benign adrenocortical lesion had negative 18 F-FDG uptake (n = 9). Patients' lesions were hypersecretory (n = 5), or non-hypersecretory (n = 8), regardless of the pathology. Conclusion: This short preliminary study indicates that 18 F-FDG gave a correct classification of tissue characterization with accurate identification of malignant lesions, as well as the disease stage (metastasis or primary). These promising preliminary results on adrenocortical lesions, seldom studied with 18 F-FDG, are to be confirmed in larger series.
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diagnostic tool for malignancy of adrenocortical tumours? Preliminary results in 13 consecutive patients
2004Co-Authors: Clinical S Tudy, Florence Tenenbaum, Lionel Groussin, Bertrand Dousset, Paul Legmann, B Richard, Xavier BertagnaAbstract:Design: This study is a preliminary report on 18 F-fluorodeoxyglucose ( 18 F-FDG) uptake for the characterization of hypersecretory or non-hypersecretory adrenocortical masses in patients without known neoplastic disease, thereby minimizing the presence of adrenal metastases, and without phaeochromocytoma, in comparison with computed tomography (CT) scanning and with Iodocholesterol scintigraphy. Methods: Thirteen consecutive patients with an adrenal mass scheduled to have surgery, underwent hormonal exploration, a CT scan for tumour size measurement and an 18 F-FDG positron emission tomography scan. Eleven of these patients also had unenhanced density measurement at CT scan and Iodocholesterol scintigraphy. Results: CT-scanned adrenal masses ranged in size from 2.2 to 10 cm; attenuation value was , 10 Hounsfield units (HUs) in two cases and . 10 HU in nine. All benign lesions demonstrated Iodocholesterol uptake. In the case of malignant tumours, results were non-homogeneous: no uptake, uptake and non-informative scintigraphy. All patients with an adrenocortical carcinoma had positive adrenal
