Urine steroid profile as a new promising tool for the evaluation of adrenal tumors. Literature review
- PDF / 843,944 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 85 Downloads / 192 Views
REVIEW
Urine steroid profile as a new promising tool for the evaluation of adrenal tumors. Literature review Marta Araujo-Castro Gregori Casals 6
1,2
●
Pablo Valderrábano1,2 Héctor F. Escobar-Morreale1,2,3,4 Felicia A. Hanzu5 ●
●
●
1234567890();,:
1234567890();,:
Received: 17 September 2020 / Accepted: 31 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To review the literature assessing the diagnostic performance of urinary steroid profiling (USP) by highperformance liquid chromatography (LC–MS) or gas chromatography (GC) coupled to mass spectrometry (MS) in the evaluation of adrenal lesions, both in terms of functionality and malignancy. Results The evaluation of adrenal incidentalomas (AI) aims to rule out malignancy and hormone excess. Current diagnostic protocols have several limitations and include time consuming and relatively complicated multi-step processes in most cases. On the contrary, USP by LC–MS/MS or LC-GC/MS offer an easy, comprehensive and non-invasive assessment of adrenal steroid secretion. USP complements current workups used in the evaluation of AIs by improving our ability to identify malignancy and/or autonomous hormone secretion. Conclusions Urine steroid profiling by LC–MS/MS and GC–MS allows a thorough, non-invasive, assessment of adrenal steroidogenesis as a whole which complement the current evaluation of AIs, and holds a promising role in the diagnosis of autonomous cortisol secretion, primary aldosteronism, and adrenal malignancy. Keywords Adrenal incidentalomas Urine steroid profile Mass spectrometry Autonomous cortisol secretion Tetrahydrocortisol Tetrahydro-11-deoxycortisol ●
●
●
●
●
Introduction
* Marta Araujo-Castro [email protected] * Gregori Casals [email protected] 1
Department of Endocrinology & Metabolism, Hospital Universitario Ramón y Cajal, Madrid, Spain
2
Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain
3
Universidad de Alcalá, Madrid, Spain
4
Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
5
Department of Endocrinology & Metabolism, Hospital Clinic, Barcelona, Spain
6
Department of Biochemistry and Molecular Genetics, Hospital Clinic, IDIBAPS, Barcelona, Spain
An adrenal incidentaloma (AI) is an adrenal mass found incidentally during an imaging technique performed for unrelated reasons [1]. Malignancy and hormonal excess— which are present in up to 12% and 20–30% of cases, respectively [1]—are the main reasons for the evaluation of AIs [2–4]. The diagnosis of malignancy presently relies on computed tomography imaging characteristics of the adrenal mass such as tumor size and attenuation. Imaging techniques, however, have limited specificity [2, 5, 6], are expensive, may require contrast agents, and some modalities expose patients to ionizing radiation [7]. Several hormones can be measured in plasma or urine to assess functionality of the adrenal lesions [2]. Overt syndromes of hormonal excess such
Data Loading...
