Adrenal Disorders. 100 Cases from the Adrenal Clinic

INCIDENTALLY DISCOVERED ADRENAL MASS

1 Adrenal mass in a patient with active extra-adrenal malignancy: role of imaging (IB)

2 Adrenal mass in a patient with active extra-adrenal malignancy: role of biopsy (IB)

3 Non-functioning lipid rich adrenal adenoma: role of follow up (IB)

4 Adrenal mass with abnormal dexamethasone suppression test: role of adrenalectomy (IB)

5 Lipid poor adrenal mass: role for surgical management (WFY)

PRIMARY ALDOSTERONISM

6 Primary aldosteronism - marked in young adult - when AVS is not needed (WFY)

7 Primary aldosteronism in a patient with a unilateral adenoma: Role of adrenal vein sampling (IB)

8 Primary aldosteronism in a patient nodular adrenals on CT, but with bilateral idiopathic hyperplasia based on AVS: Typical findings on AVS (WFY)

9 Primary aldosteronism in a patient with unilateral hyperplasia: Findings on AVS and long term BP follow-up (WFY)

10 Primary aldosteronism and ACTH independent CS in a patient with bilateral macronodular hyperplasia (IB)

11 Primary aldosteronism and cortisol co-secreting adenoma - when AVS not needed (WFY)

12 Adrenal venous sampling variants - duplication of right adrenal vein (WFY)

13 Adrenal venous sampling variants - retro-aortic left renal vein (WFY)

14 Adrenal venous sampling variants - overshooting right APA (WFY)

ACTH-INDEPENDENT CUSHING SYNDROME

15 ACTH-independent CS in a patient with bilateral adenomas: role of adrenal vein sampling (IB)

16 Unilateral benign adenoma: Post-adrenalectomy glucocorticoid withdrawal in a patient with unilateral adenoma and ACTH-independent CS (IB)

17 PPNAD and Carney Complex: ACTH-independent CS in a patient with normal adrenal imaging: uncovering Carney complex due to novel PRKAR1A mutation. (IB)

18 BMAH: ACTH-independent CS in a patient with bilateral macronodular hyperplasia: treatment with bilateral adrenalectomy (IB)

19 Cortisol-secreting adenoma with lipomatous metaplasia: ACTH-independent CS in a patient with a large myelolipoma-like adrenal mass: (IB)

20 Adrenocortical carcinoma and CS - role for surgical debulking (WFY)

ADRENAL CORTICAL CARCINOMA AND ONCOCYTIC NEOPLASM

21 Oncocytic neoplasm: presenting with a combined hormonal excess (IB)

22 Adrenal cortical carcinoma: in a young woman with a 5 year history of incidentally discovered small adrenal mass (IB)

23 Mitotane therapy in a patient with ENSAT stage 2 adrenal cortical carcinoma (IB)

24 Adrenal cortical carcinoma and severe ACTH independent CS - highlight different aspects of presentation/management (compare to topic #20) (IB)

25 Metastatic adrenal cortical carcinoma in a patient with a long standing primary aldosteronism of 20 years (IB)

26 Adrenal cortical carcinoma associated with Lynch Syndrome (IB)

27 Adrenal cortical carcinoma associated with MEN-1 (WFY)

28 Adrenal cortical carcinoma with IVC thrombus: prognostic implications (IB)

29 Adrenal cortical carcinoma with large postoperative abdominal recurrence (IB)

30 Diagnostic value of steroid profiling in patient with adrenal cortical carcinoma (IB)

31 Pure aldosterone-secreting ACC (WFY)

PHEOCHROMOCYTOMA AND PARAGANGLIOMAS

32 Growing pheochromocytoma over time: serial imaging demonstrates growth rate of adrenal pheo (WFY)

33 Massive adrenal pheo: despite huge size, no recurrence over time (WFY)

34 Pheochromocytoma in Neurofibromatosis type 1: importance of case detection strategy (IB)

35 Bilateral pheochromocytomas in MEN2A: primary hyperparathyroidism and medullary thyroid cancer: new diagnosis of MEN 2A in a 39 year-old man (IB)

36 New diagnosis of VHL in a patient with bilateral pheochromocytomas and noradrenergic catecholamine excess (IB)

37 Bilateral pheochromocytomas in patient with MAX mutation (IB)

38 Nearly totally cystic pheochromocytoma with vascular rind (WFY)

39 Skull base and neck paragangliomas in SDHD (WFY)

40 Chest and cardiac paragangliomas in SDHD (WFY)

41 Multiple abdominal paragangliomas in SDHB (WFY)

42 Role for FDG-PET in metastatic SDHB PPGL (WFY)

43 Role for Ga68-DOTATATE PET-CT in PPGL (WFY)

44 Carney Triad with paraganglioma (WFY)

45 Role for CVD chemotherapy in metastatic PPGL (WFY)

46 Metastatic pheochromocytoma treated with ablative therapy (IB)

47 Metastatic pheochromocytoma followed conservatively for 50 years (IB)

ACTH-DEPENDENT CUSHING SYNDROME

48 Discovery of pituitary Cushing disease in a young woman diagnosed with polycystic ovarian syndrome: need for high level of suspicion and proper differential diagnostic work up (IB)

49 Pituitary CS with negative MRI - role for IPSS (WFY)

50 Pituitary CS in woman with pituitary microadenoma on MRI - no need for IPSS (WFY)

51 Severe CS due to ACTH-secreting pituitary macroadenoma (WFY)

52 Ectopic ACTH CS and pheochromocytoma in patient with metastatic medullary thyroid carcinoma and MEN 2B (IB)

53 Curative ablation therapy in patient with ectopic CS due to a bronchial carcinoid tumor (IB)

54 Cyclical severe ectopic CS in a patient pancreatic neuroendocrine tumor (IB)

55 Long standing mild ectopic CS in a young patient with chronic pneumonitis (IB)

56 Severe ectopic CS due to metastatic prostate cancer - presentation with low renin hypertension (IB)

57 Ectopic ACTH CS due to ACTH-secreting pheochromocytoma (WFY)

58 MEN 1 and Cushing syndrome: discussion of pituitary, ectopic, primary adrenal (WFY)

OTHER COMMON AND UNCOMMON BENIGN AND MALIGNANT ADRENAL MASSES

59 Myelolipoma - unilateral and large causing secondary hyperaldosteronism due to compression and torqueing of the kidney (WFY)

60 Angiomyolipoma (WFY)

61 Unilateral adrenal hemorrhage due to trauma (WFY)

62 Unilateral adrenal hemorrhage into a tumor (WFY)

63 Bilateral adrenal hemorrhage (WFY)

64 Adrenal stone - flat plate and CT (WFY)

65 Adrenal simple cyst (WFY)

66 Lymphangioma

67 Hemangioma

68 Ganglioneuroma - typical imaging phenotype and gross pathology (WFY)

69 Composite tumor: pheochromocytoma/adenoma

70 Adrenal leiomyosarcoma (WFY)

71 Lymphoma - bilateral presenting with adrenal insufficiency - highlight CT and FDG-PET findings (WFY)

72 Neuroblastoma

73 Bilateral enlarging tumors in a patient with a remote history of melanoma (IB)

74 Bilateral metastases in a patient presenting with primary adrenal insufficiency (IB)

75 Edher Chester disease causing primary adrenal insufficiency

76 Appearance of untreated congenital adrenal hyperplasia on CT - with bilateral cortical hyperplasia and myelolipomas. (WFY)

77 Adrenal histoplasmosis (WFY)

78 Adrenal hyperplasia in MEN-1 (WFY)

79 Examples of pseudo-adrenal masses (WFY)

ANDROGEN EXCESS

80 Severe androgen excess in a postmenopausal woman and an adrenal adenoma: importance of adrenal and ovarian vein sampling (IB)

81 ACC with primary androgen excess (WFY)

ADRENAL DISORDERS AND PREGNANCY

82 Pregnancy in patient with metastatic pheochromocytoma (WFY)

83 Pregnancy in a patient with paraganglioma (WFY)

84 Pregnancy in patient with adrenal pheochromocytoma (WFY)

85 Pregnancy in patient with Cushing Syndrome

86 Pregnancy in patient with primary adrenal insufficiency

87 Pregnancy in patient with primary aldosteronism (WFY)