Diagnosis

• Classified by hormonal secretion.
  • Cushing's syndrome
  • Virilization in females
    • Increased DHEA, 17-ketosteroid, increased testosterone
  • Feminizing syndrome in men
  • Hyperaldosteronism
  • Mixed secretion (common)
  • Nonfunctional 30 percent
• Signs and Symptoms
  • Clinically apparent signs of defeminization or masculinization are typical of carcinoma. Elevated DHEA, androstenedione, or urinary I7 ketosteroids makes carcinoma likely.

Treatment

• Excision, however, the cure rate is less than 50 percent, even in patients with localized disease.

References

Blumenfeld JD, Schlusse, Sealey JE, et al: Diagnosis and treatment of primary hyperaldosteronism. Ann Intern Med, 121:877-885, 1994.

Blumenfeld JD, Vaughan ED Jr.: The adrenals. In: Campbell's Urology. 7th Ed. Philadelphia, Saunders, 1998, pp. 2915-2971.

Manger WM, Gifford RW Jr.: Pheochromocytoma. A clinical review. In: Hypertension Pathophysiology, Diagnosis, and Management. Laragh JH, Brenner BM, eds. 1995, pp. 2225-2246.

Orth DN: Cushing syndrome. N Eng J Med 332:791-795, 1995.

Ulchaker JC, Goldfarb DA, Bravo EL, Novick AC: Successful outcomes in pheochromocytoma surgery in the modern era. J Urol 161:764-767, 1999. Vaughan ED Jr.: Adrenal surgery. F. F. Marshall, Ed. In: Textbook of Operative Surgery. Philadelphia, Saunders, 1996, p 220-230.

Vaughan ED Jr., (ed): Diagnosis and treatments of adrenal disorders. World J Urol 17:1064, 1999.

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