Adrenal metastases: Difference between revisions

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==[[Adrenal metastases overview|Overview]]==


== Overview ==
==[[Adrenal metastases historical perspective|Historical Perspective]]==
Newer imaging technologies such as CT and MRI now indicate that the adrenal is a common site of [[metastases]], and that adrenal [[metastases]] occur much more frequently than realized.


== Epidemiology and Demographics ==
==[[Adrenal metastases classification|Classification]]==
The primary tumor is a major determinant of the frequency of adrenal metastases. Primary tumors that frequently metasticize to the adrenal include:
#50% of melanomas metastasize to the adrenals
#30-40% of breast and lung cancers
#10-20% of renal and gastrointestinal tumors


The most common sites for a primary tumor to metastasize to are
==[[Adrenal metastases pathophysiology|Pathophysiology]]==
#Lung
#Liver
#Bone
#Adrenal gland


== Screening ==
==[[Adrenal metastases causes|Causes]]==
If adrenal metastases are present on an initial imaging survey, then this indicates that stage IV disease is present. This is critical, because the presence of adrenal metastases changes the choice of treatment in most case. The only except is ipsilateral renal cancer.


== Pathophysiology & Etiology==
==[[Adrenal metastases differential diagnosis|Differentiating Adrenal metastases from Other Diseases]]==
Metastases are non calcified, vary in size and may be unilateral or bilateral.  One complication of adrenal  metastases is central necrosis with [[adrenal hemorrhage]].


== Diagnosis ==  
==[[Adrenal metastases epidemiology and demographics|Epidemiology and Demographics]]==


=== History and Symptoms ===
==[[Adrenal metastases risk factors|Risk Factors]]==
Adrenal metastases are most often asymptomatic. In the event of extensive bilateral metastatic disease, signs and symptoms of adrenal insufficiency may be present which include:


[[Dizziness]]
==[[Adrenal metastases screening|Screening]]==


[[Faintness]]
==[[Adrenal metastases natural history|Natural History, Complications and Prognosis]]==


[[Fatigue]]
==Diagnosis==
[[Adrenal metastases history and symptoms|History and Symptoms]] | [[Adrenal metastases physical examination|Physical Examination]] | [[Adrenal metastases staging|Staging]] | [[Adrenal metastases laboratory findings|Laboratory Findings]] | [[Adrenal metastases electrocardiogram|Electrocardiogram]]  | [[Adrenal metastases chest x ray|Chest X Ray]] | [[Adrenal metastases CT|CT]] | [[Adrenal metastases MRI|MRI]] | [[Adrenal metastases echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Adrenal metastases other imaging findings|Other Imaging Findings]] | [[Adrenal metastases other diagnostic studies|Other Diagnostic Studies]]


[[Weakness]]
==Treatment==
[[Adrenal metastases medical therapy|Medical Therapy]] | [[Adrenal metastases surgery|Surgery]] | [[Adrenal metastases primary prevention|Primary Prevention]]  | [[Adrenal metastases secondary prevention|Secondary Prevention]] | [[Adrenal metastases cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Adrenal metastases future or investigational therapies|Future or Investigational Therapies]]


[[Weight loss]]
=== Physical Examination ===
Usually non-revealing
==== MRI and CT ====
CT is first line imaging tool to screen the adrenal glands if a primary malignancy with a high for adrenal metastases (melanoma, lung cancer, and breast cancer) is present.
MRI and ultrasound are of limited use in the first line screening and evaluation of adrenal metastases.
====PET====
Positron emission tomography (PET) may demonstrate lower metabolic activity in an incidental adrenal adenoma vs a metastasis which may be more metabolically active.
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Revision as of 16:28, 18 September 2012

Template:Adrenal metastases Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Adrenal metastases from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Staging | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies


Template:WS

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