title: Abnormalities of endocrine function in patients with clinically "silent" adrenal masses.
abstract: Because, in recent years, patients with incidentally discovered adrenal masses have been encountered increasingly, their endocrine function was investigated in basal conditions and after dynamic tests. Thirty-two patients (23 women and 9 men, aged 28-74 years) were studied. Lesion diameter, as documented by computed tomography and/or nuclear magnetic resonance imaging, ranged between 5 and 65 mm; the tumors were localized on the right in 22 patients, on the left in 5 and bilaterally in 5 cases. In basal conditions, urinary free cortisol (UFC) excretion, plasma adrenocorticotropin (ACTH) and cortisol levels were normal, except for 4 patients who showed high UFC and ACTH levels in the low-normal range. Ovine corticotropin-releasing hormone (CRH, 1 microgram/kg iv) was given to 18 patients, inducing normal ACTH and cortisol responses in 12, blunted responses in 4 and no response in 2 cases. No reduction in ACTH and cortisol levels after suppression tests was observed in 4 of 29 patients after dexamethasone (1 mg overnight) or in 6 of 29 after loperamide. The 4 patients who were unresponsive to both tests did not show any further inhibition after high-dose dexamethasone administration, had low plasma ACTH levels and showed impaired or absent responses to the CRH test: they were diagnosed as affected with preclinical Cushing's syndrome. An exogenous ACTH test performed in 30 patients caused a normal cortisol rise. Basal mean 17-hydroxy-progesterone (17-OHP) levels were not different from those in normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Institute of Endocrine Sciences, University of Milan, Ospedale Maggiore IRCCS, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Ambrosi
authors.forename: S
authors.initials: S
authors.lastname: Peverelli
authors.forename: E
authors.initials: E
authors.lastname: Passini
authors.forename: T
authors.initials: T
authors.lastname: Re
authors.forename: R
authors.initials: R
authors.lastname: Ferrario
authors.forename: P
authors.initials: P
authors.lastname: Colombo
authors.forename: A
authors.initials: A
authors.lastname: Sartorio
authors.forename: G
authors.initials: G
authors.lastname: Faglia
mesh_terms: D019326:17-alpha-Hydroxyprogesterone; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D000311:Adrenal Glands / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D000315:Adrenalectomy; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D000735:Androstenedione / Q000097:blood; D001842:Bone and Bones / Q000378:metabolism; D003094:Collagen / Q000378:metabolism; D003346:Corticotropin-Releasing Hormone; D003480:Cushing Syndrome / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D006908:Hydroxyprogesterones / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000378:metabolism; D010446:Peptide Fragments / Q000097:blood / Q000378:metabolism; D011347:Procollagen / Q000097:blood / Q000378:metabolism; D011863:Radioimmunoassay; D014057:Tomography, X-Ray Computed
chemical_list: D006908:Hydroxyprogesterones; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide; C042813:procollagen type I carboxy terminal peptide; D015675:Osteocalcin; D000735:Androstenedione; D019326:17-alpha-Hydroxyprogesterone; D000324:Adrenocorticotropic Hormone; D003094:Collagen; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone