000			03834nam a22004697a 4500
008			210607s20212021 xxu||||| |||| 00| 0 eng d
022			_a2376-0605
024			_a10.1016/j.aace.2020.11.011 [doi]
024			_aPMC7924156 [pmc]
024			_aS2376-0605(20)31012-9 [pii]
040			_aOvid MEDLINE(R)
099			_a33851019
245			_aNonseminomatous Germ-Cell Tumor Presenting as Bilateral Adrenal Masses.
251			_aAace Clinical Case Reports. 7(1):43-46, 2021 Jan-Feb.
252			_aAACE clin. case rep.. 7(1):43-46, 2021 Jan-Feb.
253			_aAACE clinical case reports
260			_c2021
260			_fFY2021
265			_sepublish
266			_d2021-06-07
520			_aConclusion: We report a rare case of rapidly progressing adrenal masses in a young man, found to have metastasized from nonseminomatous germ-cell tumors. Histopathologic confirmation of the metastatic tumor was done, which prevented unnecessary adrenalectomy. The patient received appropriate chemotherapy. Copyright (c) 2020 AACE. Published by Elsevier Inc.
520			_aMethods: The diagnosis of the adrenal masses from the nonseminomatous germ-cell tumor of a retroperitoneal lymph node origin was based on a retroperitoneal lymph node core biopsy. An initial core biopsy of the adrenal gland revealed necrotic tissue and inflammatory cells without evidence of malignancy. Due to nondiagnostic findings, the core biopsy was repeated, which showed degenerating cells with a high mitotic index and immunohistochemical staining positive for vimentin, suggesting the possibility of a high-grade sarcoma. A retroperitoneal lymph node biopsy was performed. The patient was started on chemotherapy.
520			_aObjective: Many tumors can metastasize to the adrenal glands, making the diagnosis of adrenal masses challenging. Awareness that rare primary tumors can metastasize to the adrenals and consideration of biopsy for their diagnosis, sometimes at extra-adrenal sites, is essential to prevent unnecessary adrenalectomies and facilitate the right treatment. We report a rare case of bilateral adrenal masses due to metastasis from a nonseminomatous germ-cell tumor of a retroperitoneal lymph node origin.
520			_aResults: A 34-year-old man presented with acute left upper-abdominal pain of 2 weeks and tenderness on the left upper quadrant of the abdomen, and he was found to have bilateral adrenal masses. Laboratory results showed the following: adrenocorticotropic hormone 41 pg/mL (7-69 pg/mL), metanephrine <0.1 nmol/L (0-0.49 nmol/L), normetanephrine 0.99 nmol/L (0-0.89 nmol/L), and morning cortisol 3.1 mug/dL after a 1-mg dexamethasone-suppression test. His dehydroepiandrosterone sulfate level was 62 mug/dL (120-520 mug/dL), and 17OH progesterone level was 36 ng/dL (<138 ng/dL); androstenedione and serum estradiol levels were normal. Laboratory tests for tumor markers revealed the following: testosterone 21 ng/dL (241-827 ng/dL), prostate-specific antigen 0.57 ng/mL (0-4 ng/mL), alpha-fetoprotein 1.9 IU/mL (0.6-6 IU/ml), and beta-human chorionic gonadotropin 134 mIU/mL (0-1 mIU/mL).
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Washington Hospital Center
656			_aCardiovascular Disease Fellowship
656			_aEndocrinology Fellowship
656			_aMedicine/Endocrinology
656			_aMedicine/Nuclear Medicine
656			_aPathology
657			_aCase Reports
700			_aBaral, Neelam
700			_aBasyal, Binaya
700			_aKulkarni, Kanchan
700			_aLee, Wen
700			_aSharma, Meeta
790			_aBansal R, Baral N, Basyal B, Kantorovich V, Kulkarni K, Lee W, Sharma M
856			_uhttps://dx.doi.org/10.1016/j.aace.2020.11.011 _zhttps://dx.doi.org/10.1016/j.aace.2020.11.011
942			_cART _dArticle
999			_c6393 _d6393