Adrenal

Question 1

Imaging of choice for pheochromocytoma?

Answer 1

MRI

Question 2

How should we treat adrenal incidentalomas?

Answer 2

Functioning: adrenalectomy
Size >5 cm: adrenalectomy
Size 3-5 cm: look at patient’s age, history, etc.

Question 3

Is hyperaldosteronism more common in men or women?

Answer 3

Women

Question 4

What is the saline infusion test?

Answer 4

Looks at hyperaldosteronism

Saline should normally suppress aldosterone

Question 5

What is initial imaging for looking at adrenal glands?

Answer 5

CT?

Question 6

Treatment for hyperaldosteronism?

Answer 6

Laparoscopic adrenalectomy

Question 7

Results of surgery for hyperaldosteronism?

Answer 7

30% still have HTN

Hypokalemia goes away immediately

Question 8

Treatment for pheochromocytomas?

Answer 8

1. Alpha adrenergic blockade: phenoxybenzamine
2. Volume repletion
3. Beta blockers
4. Expert anesthesia care
5. Adrenalectomy

Question 9

Treatment for malignant pheochromocytomas?

Answer 9

Complete surgical excision
Chemotherapy: cyclophosphamide, vincristine, dacarbazine
I131-MIBG scans: lights up metastases

Question 10

Treatment for adrenocortical carcinoma?

Answer 10

Wide resection: still bad prognosis
Most patients present with endocrinopathy (Cushing’s)
Mitotane for metastasis

Question 11

Treatment for malignant pheochromocytomas?

Answer 11

Complete surgical excision
Chemotherapy: cyclophosphamide, vincristine, dacarbazine
I131-MIBG scans: lights up metastases

Question 12

Treatment for adrenocortical carcinoma?

Answer 12

Wide resection: still bad prognosis
Most patients present with endocrinopathy (Cushing’s)
Mitotane for metastasis

Question 13

Treatment for malignant pheochromocytomas?

Answer 13

Complete surgical excision
Chemotherapy: cyclophosphamide, vincristine, dacarbazine
I131-MIBG scans: lights up metastases

Question 14

Treatment for adrenocortical carcinoma?

Answer 14

Wide resection: still bad prognosis
Most patients present with endocrinopathy (Cushing’s)
Mitotane for metastasis