Adrenal metastases
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Overview
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
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
- Lung
- Liver
- Bone
- Adrenal gland
Screening
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
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
History and Symptoms
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:
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.
WikiDoc Research Resources for Adrenal metastases | |
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| Articles on Adrenal metastases | Most recent articles on Adrenal metastases • Most cited articles on Adrenal metastases • Review articles on Adrenal metastases • Articles on Adrenal metastases in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Adrenal metastases | Powerpoint slides on Adrenal metastases • Images of Adrenal metastases • Photos of Adrenal metastases • Podcasts & MP3s on Adrenal metastases • Videos on Adrenal metastases |
| Evidence Based Medicine Regarding Adrenal metastases | AND (Cochrane Database Syst Rev[http://worldselectshop.com/?id=9361 Cochrane Collaboration on Adrenal metastases • Bandolier on Adrenal metastases • TRIP on Adrenal metastases |
| Cost Effectiveness of Adrenal metastases | AND (Cost effectiveness) |
| group5 = Clinical Trials Involving Adrenal metastases | list5 = Ongoing Trials on Adrenal metastases at Clinical Trials.gov • Trial results on Adrenal metastases • Clinical Trials on Adrenal metastases at Google
| group6 = Guidelines / Policies / Government Resources (FDA/CDC) Regarding Adrenal metastases
| list6 = US National Guidelines Clearinghouse on Adrenal metastases • NICE Guidance on Adrenal metastases • NHS PRODIGY Guidance • FDA on Adrenal metastases • CDC on Adrenal metastases
| group7 = Textbook Information on Adrenal metastases
| list7 = Books and Textbook Information on Adrenal metastases
| group8 = Pharmacology Resources on Adrenal metastases
| list8 =
AND (Dose)}} Dosing of Adrenal metastases • AND (drug interactions)}} Drug interactions with Adrenal metastases • AND (side effects)}} Side effects of Adrenal metastases • AND (Allergy)}} Allergic reactions to Adrenal metastases • AND (overdose)}} Overdose information on Adrenal metastases • AND (carcinogenicity)}} Carcinogenicity information on Adrenal metastases • AND (pregnancy)}} Adrenal metastases in pregnancy • AND (pharmacokinetics)}} Pharmacokinetics of Adrenal metastases •
| group9 = Genetics, Pharmacogenomics, and Proteinomics of Adrenal metastases
| list9 =
AND (pharmacogenomics)}} Genetics of Adrenal metastases • AND (pharmacogenomics)}} Pharmacogenomics of Adrenal metastases • AND (proteomics)}} Proteomics of Adrenal metastases
| group10 = Newstories on Adrenal metastases
| list10 = Adrenal metastases in the news • Be alerted to news on Adrenal metastases • News trends on Adrenal metastases</small>
| group11 = Commentary on Adrenal metastases
| list11 =
Blogs on Adrenal metastases
| group12 = Patient Resources on Adrenal metastases | list12 = Patient resources on Adrenal metastases • Discussion groups on Adrenal metastases • Patient Handouts on Adrenal metastases • Directions to Hospitals Treating Adrenal metastases • Risk calculators and risk factors for Adrenal metastases
| group13 = Healthcare Provider Resources on Adrenal metastases
| list13 =
Symptoms of Adrenal metastases • Causes & Risk Factors for Adrenal metastases • Diagnostic studies for Adrenal metastases • Treatment of Adrenal metastases
| group14 = Continuing Medical Education (CME) Programs on Adrenal metastases | list14 = CME Programs on Adrenal metastases
| group15 = International Resources on Adrenal metastases | list15 = Adrenal metastases en Espanol • Adrenal metastases en Francais
| group16 = Business Resources on Adrenal metastases | list16 = Adrenal metastases in the Marketplace • Patents on Adrenal metastases
| group17 = Informatics Resources on Adrenal metastases | list17 = List of terms related to Adrenal metastases
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