PRECISION MEDICINE IN ADRENAL DISORDERS: THE NEXT GENERATION.
OBJECTIVE
Discuss exciting new research in the area of adrenal disorders that has emerged in the last few years. Advances in genetics, biochemical diagnosis, and imaging modalities that have set new standards for diagnosis and treatment are described.


METHODS
A literature review was conducted on adrenal disorders using PubMed.


RESULTS
We highlight new developments in adrenal diseases from new genes discovered in aldosterone-producing adenomas, cortisol-producing tumors to pheochromocytomas/paragangliomas. In addition, we discuss new information regarding the question of whether nonfunctional adrenal adenomas are really functional or not. In congenital adrenal hyperplasia, emerging steroids that might be helpful in the near future for diagnostic purposes are discussed. New types of imaging are now available to identify endocrine neoplasms to help clinicians find lesions after biochemical confirmation.


CONCLUSIONS
The tremendous knowledge gained thus far in adrenal diseases sets the stage for not only new precision treatment modalities for individualized care but also for prevention.


BACKGROUND
ACC = adrenal cortical carcinoma; APA = aldosterone-producing adenoma; APCC = aldosterone-producing cell cluster; CAH = congenital adrenal hyperplasia; CT = computed tomography; DOTATATE = [68Ga]-DOTA(0)-Tyr(3)-octreotate; FDG = fluorodeoxyglucose; FH = fumarate hydratase; MR = miner-alocorticoid; MDH2 = malate dehydrogenase 2; PCC = pheochromocytoma; PET = positron emission tomography; PGL = paraganglioma; SCS = subclinical cortisol-secreting; SDHB = succinate dehydrogenase subunit B; TCGA = The Cancer Genome Atlas.
Hans K
HK
Ghayee
Aaron I
AI
Vinik
Karel
K
Pacak
D000306:Adrenal Cortex Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy; D000307:Adrenal Gland Diseases / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy*; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy; D000312:Adrenal Hyperplasia, Congenital / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy; D018268:Adrenocortical Carcinoma / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy; D006801:Humans; D006929:Hyperaldosteronism / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy; D010235:Paraganglioma / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy; D010673:Pheochromocytoma / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy; D057285:Precision Medicine