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An Evidence-Based, Multidisciplinary Approach to the Clinical Considerations, Management, and Surveillance of Adrenal Lesions in Familial Adenomatous Polyposis: Report of Three Cases

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Diseases of the Colon & Rectum

Abstract

Adrenal masses are commonly discovered incidentally in patients with familial adenomatous polyposis, and adrenal malignancies have been rarely reported. Individuals with familial adenomatous polyposis frequently undergo abdominal CT-scan examinations for surveillance or symptoms. Adrenal lesions often are detected unexpectedly and are thus becoming a common clinical problem in this population. Adrenal lesions encompass a heterogeneous spectrum of pathologic entities, including primary adrenocortical and medullary tumors, benign or malignant lesions, hormonally active or inactive lesions, metastases, and infections. When an adrenal mass is detected, the clinician needs to address two crucial questions: 1) is the mass malignant? and 2) is it hormonally active? This article presents three new cases of incidental adrenal lesions in familial adenomatous polyposis, reviews the medical literature for this setting, and provides an overview of the diagnostic clinical approach and management of the adrenal findings in familial adenomatous polyposis patients.

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Authors and Affiliations

  1. Department of Outreach and Prevention, Huntsman Cancer Institute, Salt Lake City, Utah, USA

    Angel Ferrández M.D., Lana Pho M.S., Cindy Solomon M.S. & Randal W. Burt M.D.

  2. Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA

    Wade S. Samowitz M.D.

  3. Division of Gastroenterology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA

    Scott K. Kuwada M.D.

  4. Division of Endocrinology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA

    Thomas P. Knecht M.D., Ph.D.

  5. Division of Radiology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA

    Maryellyn Gilfeather M.D.

  6. Servicio de Aparato Digestivo, Avenida San Juan Bosco 15, 50009, Zaragoza, Spain

    Angel Ferrández M.D.

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  1. Angel Ferrández M.D.
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Correspondence to Angel Ferrández M.D..

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Supported (Dr. Ferrández) by a grant from the University oz Zaragoza Spain, and the grant “Professor Díaz Rubio” from the Spanish Society of Digestive Diseases (SEPD), and a grant RC 03/02 from the National Institute of Research Carlos III.

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Ferrández, A., Pho, L., Solomon, C. et al. An Evidence-Based, Multidisciplinary Approach to the Clinical Considerations, Management, and Surveillance of Adrenal Lesions in Familial Adenomatous Polyposis: Report of Three Cases. Dis Colon Rectum 49, 1781–1790 (2006). https://doi.org/10.1007/s10350-006-0716-x

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