PRECISION MEDICINE IN ADRENAL DISORDERS: THE NEXT GENERATION

Endocr Pract. 2017 Jun;23(6):672-679. doi: 10.4158/EP161716.RA. Epub 2017 Mar 23.

Abstract

Objective: Discuss exciting new research in the area of adrenal disorders that has emerged in the last few years. Advances in genetics, biochemical diagnosis, and imaging modalities that have set new standards for diagnosis and treatment are described.

Methods: A literature review was conducted on adrenal disorders using PubMed.

Results: We highlight new developments in adrenal diseases from new genes discovered in aldosterone-producing adenomas, cortisol-producing tumors to pheochromocytomas/paragangliomas. In addition, we discuss new information regarding the question of whether nonfunctional adrenal adenomas are really functional or not. In congenital adrenal hyperplasia, emerging steroids that might be helpful in the near future for diagnostic purposes are discussed. New types of imaging are now available to identify endocrine neoplasms to help clinicians find lesions after biochemical confirmation.

Conclusion: The tremendous knowledge gained thus far in adrenal diseases sets the stage for not only new precision treatment modalities for individualized care but also for prevention.

Abbreviations: ACC = adrenal cortical carcinoma; APA = aldosterone-producing adenoma; APCC = aldosterone-producing cell cluster; CAH = congenital adrenal hyperplasia; CT = computed tomography; DOTATATE = [68Ga]-DOTA(0)-Tyr(3)-octreotate; FDG = fluorodeoxyglucose; FH = fumarate hydratase; MR = miner-alocorticoid; MDH2 = malate dehydrogenase 2; PCC = pheochromocytoma; PET = positron emission tomography; PGL = paraganglioma; SCS = subclinical cortisol-secreting; SDHB = succinate dehydrogenase subunit B; TCGA = The Cancer Genome Atlas.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Neoplasms / diagnostic imaging
  • Adrenal Cortex Neoplasms / genetics
  • Adrenal Cortex Neoplasms / therapy
  • Adrenal Gland Diseases / diagnostic imaging
  • Adrenal Gland Diseases / genetics
  • Adrenal Gland Diseases / therapy*
  • Adrenal Gland Neoplasms / diagnostic imaging
  • Adrenal Gland Neoplasms / genetics
  • Adrenal Gland Neoplasms / therapy
  • Adrenal Hyperplasia, Congenital / diagnostic imaging
  • Adrenal Hyperplasia, Congenital / genetics
  • Adrenal Hyperplasia, Congenital / therapy
  • Adrenocortical Carcinoma / diagnostic imaging
  • Adrenocortical Carcinoma / genetics
  • Adrenocortical Carcinoma / therapy
  • Humans
  • Hyperaldosteronism / diagnostic imaging
  • Hyperaldosteronism / genetics
  • Hyperaldosteronism / therapy
  • Paraganglioma / diagnostic imaging
  • Paraganglioma / genetics
  • Paraganglioma / therapy
  • Pheochromocytoma / diagnostic imaging
  • Pheochromocytoma / genetics
  • Pheochromocytoma / therapy
  • Precision Medicine*