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Surgical therapy of adrenal tumors: guidelines from the German Association of Endocrine Surgeons (CAEK)

  • Systematic Reviews and Meta-analysis
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Abstract

Background and aims

Previous guidelines addressing surgery of adrenal tumors required actualization in adaption of developments in the area. The present guideline aims to provide practical and qualified recommendations on an evidence-based level reviewing the prevalent literature for the surgical therapy of adrenal tumors referring to patients of all age groups in operative medicine who require adrenal surgery. It primarily addresses general and visceral surgeons but offers information for all medical doctors related to conservative, ambulatory or inpatient care, rehabilitation, and general practice as well as pediatrics. It extends to interested patients to improve the knowledge and participation in the decision-making process regarding indications and methods of management of adrenal tumors. Furthermore, it provides effective medical options for the surgical treatment of adrenal lesions and balances positive and negative effects. Specific clinical questions addressed refer to indication, diagnostic procedures, effective therapeutic alternatives to surgery, type and extent of surgery, and postoperative management and follow-up regime.

Methods

A PubMed research using specific key words identified literature to be considered and was evaluated for evidence previous to a formal Delphi decision process that finalized consented recommendations in a multidisciplinary setting.

Results

Overall, 12 general and 52 specific recommendations regarding surgery for adrenal tumors were generated and complementary comments provided.

Conclusion

Effective and balanced medical options for the surgical treatment of adrenal tumors are provided on evidence-base. Specific clinical questions regarding indication, diagnostic procedures, alternatives to and type as well as extent of surgery for adrenal tumors including postoperative management are addressed.

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References

  1. awmf.org/leitlinien/detail/ll/088-008.html. Accessed 11 Jan 2018

  2. Hartel W, Röher HD, Simon D, Frilling A, Rothmund M, Wagner PK, Klempa I, Goretzki PE, Becker HD, Niederle B, Nies C, Wahl RA, Dralle H (2000) Deutsche Gesellschaft für Chirurgie, Leitlinien zur chirurgischen Therapie von Nebennierenerkrankungen. Mitteilung der Deutschen Gesellschaft für Chirurgie 4:G92

    Google Scholar 

  3. Palazzo FF, Sebag F, Sierra M, Ippolito G, Souteyrand P, Henry JF (2006) Long-term outcome following laparoscopic adrenalectomy for large solid adrenal cortex tumors. World J Surg 30:893–898

    Article  PubMed  Google Scholar 

  4. Walz MK, Petersenn S, Koch JA, Mann K, Neumann HP, Schmid KW (2005) Endoscopic treatment of large primary adrenal tumours. Br J Surg 92:719–723

    Article  CAS  PubMed  Google Scholar 

  5. Tischler AS (2008) Pheochromocytoma and extra-adrenal paraganglioma: updates. Arch Pathol Lab Med 132:1272–1284

    PubMed  Google Scholar 

  6. Walz MK (2012) Minimally invasive adrenal gland surgery. Transperitoneal or retroperitoneal approach? Chirurg 83:536–545

    Article  CAS  PubMed  Google Scholar 

  7. Asari R, Koperek O, Niederle B (2012) Endoscopic adrenalectomy in large adrenal tumors. Surgery 152:41–49

    Article  PubMed  Google Scholar 

  8. Gaujoux S, Mihai R (2017) European Society of Endocrine Surgeons (ESES) and European Network for the Study of Adrenal Tumours (ENSAT) recommendations for the surgical management of adrenocortical carcinoma. Joint working group of ESES and ENSAT. Br J Surg 104:358–376

    Article  CAS  PubMed  Google Scholar 

  9. Boland GW, Lee MJ, Gazelle GS, Halpern EF, McNicholas MM, Mueller PR (1998) Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature. Am J Roentgenol 171:201–204

    Article  CAS  Google Scholar 

  10. Israel GM, Korobkin M, Wang C, Hecht EN, Krinsky GA (2004) Comparison of unenhanced CT and chemical shift MRI in evaluating lipid-rich adrenal adenomas. AJR Am J Roentgenol 183:215–219

    Article  PubMed  Google Scholar 

  11. Brix D, Allolio B, Fenske W, Agha A, Dralle H, Jurowich C, Langer P, Mussack T, Nies C, Riedmiller H, Spahn M, Weismann D, Hahner S, Fassnacht M, German Adrenocortical Carcinoma Registry Group (2010) Laparoscopic versus open adrenalectomy for adrenocortical carcinoma: surgical and oncologic outcome in 152 patients. Eur Urol 58:609–615

    Article  Google Scholar 

  12. Lombardi CP, Raffaelli M, De Crea C, Boniardi M, De Toma G, Marzano LA, Miccoli P, Minni F, Morino M, Pelizzo MR, Pietrabissa A, Renda A, Valeri A, Bellantone R (2012) Open versus endoscopic adrenalectomy in the treatment of localized (stage I/II) adrenocortical carcinoma: results of a multiinstitutional Italian survey. Surgery 152:1158–1164

    Article  PubMed  Google Scholar 

  13. Brauckhoff M, Gimm O, Thanh PN, Bär A, Ukkat J, Brauckhoff K, Bönsch T, Dralle H (2003) Critical size of residual adrenal tissue and recovery from impaired early postoperative adrenocortical function after subtotal bilateral adrenalectomy. Surgery 134:1020–1028

    Article  PubMed  Google Scholar 

  14. Alesina PF, Hinrichs J, Meier B, Schmid KW, Neumann HP, Walz MK (2012) Minimally invasive cortical-sparing surgery for bilateral pheochromocytomas. Langenbeck's Arch Surg 397:233–238

    Article  Google Scholar 

  15. Walz MK (2009) Adrenalectomy for preservation of adrenocortical function. Indication and results. Chirurg 80:99–104

    Article  CAS  PubMed  Google Scholar 

  16. Alesina PF, Hommeltenberg S, Meier B, Petersenn S, Lahner H, Schmid KW, Mann K, Walz MK (2010) Posterior retroperitoneoscopic adrenalectomy for clinical and subclinical Cushing’s syndrome. World J Surg 34:1391–1397

    Article  PubMed  Google Scholar 

  17. Telenius-Berg M, Ponder MA, Berg B, Ponder BA, Werner S (1989) Quality of life after bilateral adrenalectomy in MEN 2. Henry Ford Hosp Med J 37:160–163

    CAS  Google Scholar 

  18. Lairmore TC, Ball DW, Baylin SB, Wells SA Jr (1993) Management of pheochromocytomas in patients with multiple endocrine neoplasia type 2 syndromes. Ann Surg 217:595–601

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Erlic Z, Rybicki L, Peczkowska M, Golcher H, Kann PH, Brauckhoff M, Mussig K, Muresan M, Schaffler A, Reisch N, Schott M, Fassnacht M, Opocher G, Klose S, Fottner C, Forrer F, Plockinger U, Petersenn S, Zabolotny D, Kollukch O, Yaremchuk S, Januszewicz A, Walz MK, Eng C, Neumann HP, European-American Pheochromocytoma Study Group (2009) Clinical predictors and algorithm for the genetic diagnosis of pheochromocytoma patients. Clin Cancer Res 15:6378–6385

    Article  CAS  PubMed  Google Scholar 

  20. Lowery AJ, Seeliger B, Alesina PF, Walz MK (2017) Posterior retroperitoneoscopic adrenal surgery for clinical and subclinical Cushing’s syndrome in patients with bilateral adrenal disease. Langenbeck's Arch Surg 402:775–785

    Article  Google Scholar 

  21. Petersenn S, Beckers A, Ferone D, Van der Lely AJ, Bollerslev J, Boscaro M, Brue T, Bruzzi P, Casanueva FF, Chanson P (2015) Therapy of endocrine disease: outcomes in patients with Cushing’s disease undergoing transsphenoidal surgery: systematic review assessing criteria used to define remission and recurrence. Eur J Endocrinol 172:R227–R239

    Article  CAS  PubMed  Google Scholar 

  22. Ritzel K, Beuschlein F, Mickisch A, Osswald A, Schneider HJ, Schopohl J, Reincke M (2013) Clinical review: outcome of bilateral adrenalectomy in Cushing’s syndrome: a systematic review. J Clin Endocrinol Metab 98:3939–3948

    Article  CAS  PubMed  Google Scholar 

  23. Sancho JJ, Triponez F, Montet X, Sitges-Serra A (2012) Surgical management of adrenal metastases. Langenbeck's Arch Surg 97:179–194

    Article  Google Scholar 

  24. Vazquez BJ, Richards ML, Lohse CM, Thompson GB, Farley DR, Grant CS, Huebner M, Moreno J (2012) Adrenalectomy improves outcomes of selected patients with metastatic carcinoma. World J Surg 36:1400–1405

    Article  PubMed  Google Scholar 

  25. Bradley CT, Strong VE (2014) Surgical management of adrenal metastases. J Surg Oncol 109:31–35

    Article  PubMed  Google Scholar 

  26. Welch BT, Callstrom MR, Carpenter PC, Wass CT, Welch TL, Boorjian SA, Nichols DA, Thompson GB, Lohse CM, Erickson D, Leibovich BC, Atwell TD (2014) A single-institution experience in image-guided thermal ablation of adrenal gland metastases. J Vasc Interv Radiol 25:593–598

    Article  Google Scholar 

  27. Hiramatsu K, Yamada T, Yukimura Y, Komiya I, Ichikawa K, Ishihara M, Nagata H, Izumiyama T (1981) A screening test to identify aldosterone-producing adenoma by measuring plasma renin activity. Arch Intern Med 141:1589–1593

    Article  CAS  PubMed  Google Scholar 

  28. Gordon RD, Stowasser M, Rutherfort JC (2001) Primary aldosteronism: are we diagnosing and operating on too few patients? World J Surg 25:941–947

    Article  CAS  PubMed  Google Scholar 

  29. Namba K, Tamanaha T, Nakao K, Kawashima ST, Usui T, Tagami T, Okuno H, Shimatsu A, Suzuki T, Naruse M (2012) Confirmatory testing in primary aldosteronism. J Clin Endocrinol Metab 97:1688–1694

    Article  CAS  Google Scholar 

  30. Funder JW, Carey RM, Fardella C, Gomez-Sanchez CE, Mantero F, Stowasser M, Young WF Jr, Montori VM (2008) Case detection, diagnosis and treatment of patients with primary aldosteronism: an Endocrine Society Clinical practise Guideline. J Clin Endocrinol Metab 93:3266–3328

    Article  CAS  Google Scholar 

  31. Waldmann J, Bartsch DK, Kann PH, Fendrich V, Rothmund M, Langer P (2007) Adrenal involvement in multiple endocrine neoplasia type 1: results of 7 years prospective screening. Langenbeck's Arch Surg 387:437–443

    Article  Google Scholar 

  32. Agha A, Hornung M, Iesalnieks I, Schreyer A, Jung EM, Haneya A, Schlitt HJ (2014) Predictors of malignancy in primary aldosteronism. Langenbeck's Arch Surg 399:93–98

    Article  Google Scholar 

  33. Rossi GP, Barisa M, Allolio B, Auchus RJ, Amar L, Cohen D, Degenhart C, Deinum J, Fischer E, Gordon R, Kickuth R, Kline G, Lacroix A, Magill S, Miotto D, Naruse M, Nishikawa T, Omura M, Pimenta E, Plouin PF, Quinkler M, Reincke M, Rossi E, Rump LC, Satoh F, Schultze Kool L, Seccia TM, Stowasser M, Tanabe A, Trerotola S, Vonend O, Widimsky J Jr, Wu KD, Wu VC, Pessina AC (2012) The adrenal vein sampling international study AVIS for identifying the major subtypes of primary aldosteronism. J Clin Endocrinol Metab 97:1606–1614

    Article  CAS  Google Scholar 

  34. Young WF, Stanson AW, Thompson GB, Grant CS, Farley DR, van Heerden JA (2004) Role for adrenal venous sampling in primary aldosteronism. Surgery 136:1227–1235

    Article  Google Scholar 

  35. Lim V, Guo Q, Grant CS, Thompson GB, Richards ML, Farley DR, Young WF Jr (2014) Accuracy of adrenal imaging an adrenal venous sampling in predicting surgical cure of primary aldosteronism. J Clin Endocrinol Metab 99:2712–2719

    Article  CAS  PubMed  Google Scholar 

  36. Tan YY, Ogilvie JB, Triponez F, Caron NR, Kebebew EK, Clark OH, Duh QY (2006) Selective use of adrenal venous sampling in the lateralization of aldosterone-producing adenomas. World J Surg 30:879–887

    Article  PubMed  Google Scholar 

  37. Oh EM, Lee KE, Yoon K, Kim SY, Kim HC, Youn YK (2012) Value of adrenal venous sampling for lesion localization in primary aldosteronism. World J Surg 36:2522–2527

    Article  PubMed  Google Scholar 

  38. Pirvu A, Naem N, Baguet JP, Thony F, Chabre O, Chaffanjon P (2014) Is adrenal venous sampling mandatory before surgical decision in case of primary hyperaldosteronism? World J Surg 38:1749–1754

    Article  PubMed  Google Scholar 

  39. Volpe C, Enberg U, Sjögren A, Wahrenberg H, Jacobsson H, Törring O, Hamberger B, Thorén M (2008) The role of adrenal scintigraphy in the preoperative management of primary aldosteronism. Scand J Surg 97:248–253

    Article  CAS  PubMed  Google Scholar 

  40. Carter Y, Roy M, Sippel RS, Chen H (2012) Persistent hypertension after adrenalectomy for an aldosteron-producing adenoma: weight as a critical prognostic factor for aldosterone’s lasting effect on the cardiac and vascular systems. J Surg Res 177:241–247

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Van der Linden P, Streichen O, Zinzindohoue F, Plouin PF (2012) Blood pressure and medication changes following adrenalectomy for unilateral aldosteronism: a follow-up study. J Hypertens 30:761–769

    Article  CAS  PubMed  Google Scholar 

  42. Wang W, Hu W, Zhang X, Wang B, Bin C, Huang H (2012) Predictors of successful outcome after adrenalectomy for primary aldosteronism. Int Surg 97:104–111

    Article  PubMed  PubMed Central  Google Scholar 

  43. Strauch B, Petrak O, Zelinka T, Wichterle D, Holaj R, Kasalicky M, Safarik L, Rosa J, Widimsky J Jr (2008) Adrenalectoy improves arterial stiffness in primary aldosteronism. Am J Hypertens 21:1086–1092

    Article  PubMed  Google Scholar 

  44. Lin YH, Wu XM, Lee HH, Lee JK, Liu YC, Chang HW, Lin CY, Wu VC, Chueh SC, Lin LC, Lo MT, Ho YL, Wu KD, TAIPAI Study Group (2012) Adrenalectomy reverses myocardial fibrosis in patients with primary aldosteronism. J Hypertens 30:1606–1613

    Article  CAS  PubMed  Google Scholar 

  45. Tsuchiya K, Yoshimoto T, Hirata Y (2009) Endothelial dysfunction is related to aldosterone excess and raised blood pressure. Endocr J 56:553–559

    Article  CAS  PubMed  Google Scholar 

  46. Magill SB, Raff H, Shaker JL, Brickner RC, Knechtges TE, Kehoe ME, Findling JW (2001) Comparison of adrenal vein sampling and computed tomography in the differentiation of primary aldosteronism. J Clin Endocrinol Metab 86:1066–1071

    CAS  PubMed  Google Scholar 

  47. Steichen O, Zinzindohoué F, Plouin PF, Amar L (2012) Outcomes of adrenalectomy in patients with unilateral primary aldosteronism: a review. Horm Metab Res 44:221–227

    Article  CAS  Google Scholar 

  48. Walz MK, Gwosdz R, Levin SL, Alesina PF, Suttorp AC, Metz KA, Wenger FA, Petersenn S, Mann K, Schmid KW (2008) Retroperitoneoscopic adrenalectomy in Conn’s syndrome caused by adrenal adenomas or nodular hyperplasia. World J Surg 32:847–853

    Article  Google Scholar 

  49. Ishidoya S, Ito A, Sakai K (2005) Laparoscopic partial versus total adrenalectomy for aldosterone producing adenoma. J Urol 174:40–43

    Article  Google Scholar 

  50. Chen SF, Chueh SC, Wang SM, Wu VC, Pu YS, Wu KD, Huang KH (2014) Clinical outcomes in patients undergoing laparoscopic adrenalectomy for unilateral aldosterone producing adenoma: partial versus total adrenalectomy. J Endourol 28:1103–1106

    Article  Google Scholar 

  51. Fu B, Zhang X, Wang GX, Lang B, Ma X, Li HZ, Wang BJ, Shi TP, Ai X, Zhou HX, Zheng T (2011) Long-term results of a prospective, randomized trial comparing retroperitoneoscopic partial versus total adrenalectomy for aldosterone producing adenoma. J Urol 185:1578–1582

    Article  Google Scholar 

  52. Nieman LK, Biller BM, Findling JW, Murad MH, Newell-Price J, Savage MO, Tabarin A. Endocrine Society (2015) Treatment of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 100:2807–2831

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Arnaldi G, Trementino L (2016) Update on hypercortisolism therapy. Front Horm Res 46:87–105

    Article  CAS  PubMed  Google Scholar 

  54. Buliman A, Tataranu LG, Paun DL, Mirica A, Dumitrache C (2016) Cushing’s disease: a multidisciplinary overview of the clinical features, diagnosis, and treatment. J Med Life 9:12–18

    CAS  PubMed  PubMed Central  Google Scholar 

  55. Young WF Jr, du Plessis H, Thompson GB, Grant CS, Farley DR, Richards ML, Erickson D, Vella A, Stanson AW, Carney JA, Abboud CF, Carpenter PC (2008) The clinical conundrum of corticotropin-independent autonomous cortisol secretion in patients with bilateral adrenal masses. World J Surg 32:856–862

    Article  PubMed  Google Scholar 

  56. Reincke M, Ritzel K, Oßwald A, Berr C, Stalla G, Hallfeldt K, Reisch N, Schopohl J, Beuschlein F (2015) A critical reappraisal of bilateral adrenalectomy for ACTH-dependent Cushing’s syndrome. Eur J Endocrinol 173:23–32

    Article  CAS  Google Scholar 

  57. Seki T, Yasuda A, Kitajima N, Oki M, Takagi A, Nakamura N, Hanai K, Terachi T, Fukagawa M (2015) Adrenal venous sampling is useful for a definitive diagnosis in Cushing’s syndrome with bilateral adrenal tumors. Tokai J Exp Clin 40:149–156

    Google Scholar 

  58. Lack EE (2007) Tumors of the adrenal glands and the extraadrenal paraganglia. AFIP Atlas of tumor pathology. American Registry of Pathology, Armed Forces Institute of Pathology, Washington, pp 1–500

    Google Scholar 

  59. Gaujoux S, Brennan MF (2012) Recommendation for standardized surgical management of primary adrenocortical carcinoma. Surgery 152:123–132

    Article  PubMed  Google Scholar 

  60. Else T, Kim AC, Sabolch A, Raymond VM, Kandathil A, Caoili EM, Jolly S, Miller BS, Giordano TJ, Hammer GD (2014) Adrenocortical carcinoma. Endocr Rev 35:282–326

    Article  CAS  PubMed  Google Scholar 

  61. Stigliano A, Chiodini I, Giordano R, Faggiano A, Canu L, Della Casa S, Loli P, Luconi M, Mantero F, Terzolo M (2016) Management of adrenocortical carcinoma: a consensus statement of the Italian Society of Endocrinology (SIE). J Endocrinol Invest 39:103–121

  62. Eisenhofer G, Keiser H, Friberg P, Mezey E, Huynh TT, Hiremagalur B, Ellingson T, Duddempudi S, Eijsbouts A, Lenders JW (1998) Plasma metanephrines are markers of pheochromocytoma produced by catechol-O methyltransferase within tumors. J Clin Endocrinol Metab 83:2175–2185

    Article  CAS  PubMed  Google Scholar 

  63. Sawka AM, Jaeschke R, Singh RJ, Young WF (2003) A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24-hour urinary metanephrines and catecholamines. J Clin Endocrinol Metab 88:553–558

    Article  CAS  PubMed  Google Scholar 

  64. Osinga TE, van der Horst-Schrivers AN, van Faassen M, Kerstens MN, Dullart RP, Pacak K, Links TP, Kema IP (2016) Mass spectrometic quantification of salivary metanephrines-a study in healthy subjects. Clin Biochem 49:983–938

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Eisenhofer G, Goldstein DS, Walther MM, Friberg P, Lenders JW, Keiser HR, Pacak K (2003) Biochemical diagnosis of pheochromocytoma:how to distinguish true- from false positive test results. J Clin Endocrinol Metab 88:2656–2666

    Article  CAS  PubMed  Google Scholar 

  66. Därr R, Lenders JW, Stange K, Kindel B, Hofbauer LC, Bornstein SR, Eisenhofer G (2013) Diagnosis of pheochromocytoma and paraganglioma: the clonidine suppression test in patients with borderline elevations of plasma free normetanephrine. Dtsch Med Wochenschr 138:76–81

    Article  PubMed  Google Scholar 

  67. Neary NM, King KS, Pacak K (2011) Drugs and pheochromocytoma—don’t be fooled by every elevated metanephrine. N Engl J Med 364:2268–2270

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Motta-Ramirez GA, Remer EM, Herts BR, Gill IS, Hamrahian AH (2005) Comparison of CT findings in symptomatic and incidentally discovered pheochromocytomas. Am J Roentgenol 185:684–688

    Article  Google Scholar 

  69. Blake MA, Krishnamoorthy SK, Boland GW, Sweeney AT, Pitman MB, Harisinghani M, Mueller PR, Hahn PF (2003) Low-density pheochromocytoma on CT: a mimicker of adrenal adenoma. Am J Roentgenol 181:1663–1668

    Article  Google Scholar 

  70. Sahdev A, Sohaib A, Monson JP, Grossman AB, Chew SL, Reznek RH (2005) CT and MR imaging of unusual locations of extra-adrenal paragangliomas (pheochromocytomas). Eur Radiol 15:85–92

    Article  PubMed  Google Scholar 

  71. Van Berkel A, Pacak K, Lenders JWM (2014) Should every patient diagnosed with a pheochromocytoma have a 123I-MIBG scintigraphy? Clin Endocrinol 81:329–333

    Article  CAS  Google Scholar 

  72. Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SK, Murad MH, Naruse M, Pacak K, Young WF (2014) Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99:1915–1942

    Article  CAS  PubMed  Google Scholar 

  73. Shulkin BL, Thompson NW, Shapiro B, Francis IR, Sisson JC (1999) Pheochromocytomas: imaging with 2-[fluorine-18]fluoro-2-deoxy-D-glucose PET. Radiology 212:35–41

    Article  CAS  PubMed  Google Scholar 

  74. Mann GN, Link JM, Pham P, Pickett CA, Byrd DR, Kinahan PE, Krohn KA, Mankoff DA (2006) [11C]metahydroxyephedrine and [18F]fluorodeoxyglucose positron emission tomography improve clinical decision making in suspected pheochromocytoma. Ann Surg Oncol 13:187–197

    Article  PubMed  Google Scholar 

  75. Timmers HJ, Eisenhofer G, Carrasquillo JA, Chen CC, Whatley M, Ling A, Adams KT, Pacak K (2009) Use of 6-[18F]-fluorodopamine positron emission tomography (PET) as first-line investigation for the diagnosis and localization of non-metastatic and metastatic phaeochromocytoma (PHEO). Clin Endocrinol 71:11–17

    Article  Google Scholar 

  76. Pacak K, Eisenhofer G, Ahlman H, Bornstein SR, Gimenez-Roqueplo AP, Grossman AB, Kimura N, Mannelli M, McNicol AM, Tischler AS (2007) Pheochromocytoma: recommendations for clinical practice from the First International Symposium. Nat Clin Pract Endocrinol Metab 3:92–102

    Article  PubMed  Google Scholar 

  77. Ellis RJ, Patel D, Prodanov T, Sadowski S, Nilubol N, Adams K, Steinberg SM, Pacak K, Kebebew E (2013) Response after surgical resection of metastatic pheochromocytoma and paraganglioma: can postoperative biochemical remission be predicted? J Am Coll Surg 217:489–496

    Article  PubMed  PubMed Central  Google Scholar 

  78. Stefanidis D, Goldfarb M, Kercher KW, Hope WW, Richardson W, Fanelli RD (2013) SAGES guidelines for minimally invasive treatment of adrenal pathology. Surg Endosc 27:3960–3980

    Article  PubMed  Google Scholar 

  79. Walz MK, Peitgen K, Neumann HP, Janssen OE, Philipp T, Mann K (2002) Endoscopic treatment of solitary, bilateral, multiple, and recurrent pheochromocytomas and paragangliomas. World J Surg 26:1005–1012

    Article  PubMed  Google Scholar 

  80. Brunt LM, Lairmore TC, Doherty GM, Quasebarth MA, DeBenedetti M, Moley JF (2002) Adrenalectomy for familial pheochromocytoma in the laparoscopic era. Ann Surg 235:713–720

    Article  PubMed  PubMed Central  Google Scholar 

  81. Yip L, Lee JE, Shapiro SE, Waguespack SG, Sherman SI, Hoff AO, Gagel RF, Arens JF, Evans DB (2004) Surgical management of hereditary pheochromocytoma. J Am Coll Surg 198:525–534

    Article  PubMed  Google Scholar 

  82. Young WF (2007) The incidentally discovered adrenal mass. N Engl J Med 356:601–610

    Article  CAS  Google Scholar 

  83. Reincke M, Slawick M Adrenal incidentalomas. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, Weickert MO (eds) Endotext [Internet]. MDText.com, Inc., South Dartmouth, pp 2000–2010

  84. Terzolo M, Stigliano A, Chiodini I, Loli P, Furlani L, Arnaldi G, Reimondo G, Pia A, Toscano V, Zini M, Borretta G, Papini E, Garofalo P, Allolio B, Dupas B, Mantero F, Tabarin A (2011) Italian Association of Clinical Endocrinologists (AME) position statement on adrenal incidentaloma. Eur J Endocrinol 164:851–870

    Article  CAS  PubMed  Google Scholar 

  85. Petersenn S, Richter PA, Broemel T, Ritter CO, Deutschbein T, Beil FU, Allolio B, Fassnacht M, German ACC Study Group (2015) Computed tomography criteria for discrimination of adrenal adenomas and adrenocortical carcinomas: analysis of the German ACC registry. Eur J Endocrinol 172:415–422

    Article  CAS  PubMed  Google Scholar 

  86. Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A, Tabarin A, Terzolo M, Tsagarakis S, Dekkers OM (2016) Management of adrenal incidentalomas: European Society of Endocrinology clinical practice guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 175:G1–G34

    Article  CAS  PubMed  Google Scholar 

  87. Kapoor A, Morrios T, Rebello R (2011) Guidelines for the managemnet of the incidentally discovered adrenal mass. Can Urol Assoc J 5:241–247

    Article  PubMed  PubMed Central  Google Scholar 

  88. Grumbach MM, Biller BM, Braunstein GD, Campbell KK, Carney JA, Godley PA, Harris EL, Lee JK, Oertel YC, Posner MC, Schlechte JA, Wieand HS (2003) Management of the clinically inapparent adrenal mass (“incidentaloma”). Ann Intern Med 138:424–429

    Article  Google Scholar 

  89. Fernández-Cruz L, Sáenz A, Benarroch G, Sabater L, Taurá P (1996) Does hormonal function of the tumor influence the outcome of laparoscopic adrenalectomy? Surg Endosc 10:1088–1091

    Article  PubMed  Google Scholar 

  90. Shen WT, Lim RC, Siperstein AE, Clark OH, Schecter WP, Hunt TK, Horn JK, Duh QY (1999) Laparoscopic vs open adrenalectomy for the treatment of primary hyperaldosteronism. Arch Surg:134628–134631

  91. Natkaniec M, Pędziwiatr M, Wierdak M (2016) Laparoscopic transperitoneal lateral adrenalectomy for large adrenal tumors. Urol Int 97:165–172

    Article  PubMed  Google Scholar 

  92. Arlt W, Biehl M, Taylor AE, Hahner S, Libé R, Hughes BA, Schneider P, Smith DJ, Stiekema H, Krone N, Porfiri E, Opocher G, Bertherat J, Mantero F, Allolio B, Terzolo M, Nightingale P, Shackleton CH, Bertagna X, Fassnacht M, Stewart PM (2011) Urine steroid metabolomics as a biomarker tool for detecting malignancy in adrenal tumors. J Clin Endocrinol Metab 96:3775–3784

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  93. Zhang HM, Perrier ND, Grubbs EG, Sircar K, Ye ZX, Lee JE, Ng CS (2012) CT features and quantification of the characteristics of adrenocortical carcinomas on unenhanced and contrast-enhanced studies. Clin Radiol 67:38–46

    Article  CAS  PubMed  Google Scholar 

  94. Young WF Jr (2011) Conventional imaging in adrenocortical carcinoma: update and perspectives. Horm Cancer 2:341–347

    Article  PubMed  Google Scholar 

  95. Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB, Reznek RH (2011) Adrenocortical carcinoma: the range of appearances on CT and MRI. Am J Roentgenol 196:706–714

    Article  Google Scholar 

  96. Berutti A, Baudin E, Gelderblum H, Haak HR, Porpiglia F, Fassnacht M, Pentheroudakis G (2012) Adrenal Cancer: ESMO Clincal Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 23(Suppl 7):131–138

    Google Scholar 

  97. Reibetanz J, Jurowich C, Erdogan I, Nies C, Rayes N, Dralle H, Behrend M, Allolio B, Fassnacht M, German ACC Study Group (2012) Impact of lymphadenectomy on the oncologic outcome of patients with adrenocortical carcinoma. Ann Surg 255:363–369

    Article  PubMed  Google Scholar 

  98. Freire DS, Siqueira SA, Zerbini MC, Wajchenberg BL, Corrêa-Giannella ML, Lucon AM, Pereira MA (2013) Development and internal validation of an adrenal cortical carcinoma prognostic score for predicting the risk of metastasis and local recurrence. Clin Endocrinol 79:468–745

    Article  Google Scholar 

  99. Gratian L, Pura J, Dinan M, Reed S, Scheri R, Roman S, Sosa JA (2014) Treatment patterns and outcomes for patients with adrenocortical carcinoma associated with hospital case volume in the United States. Ann Surg Oncol 213:509–514

    Google Scholar 

  100. Miller BS, Gauger PG, Hammer GD, Doherty GM (2012) Resection of adrenocortical carcinoma is less complete and local recurrence occurs sooner and more often after laparoscopic adrenalectomy than after open adrenalectomy. Surgery 152:1150–1157

    Article  PubMed  Google Scholar 

  101. Porpiglia F, Fiori C, Daffara FC, Zaggia B, Ardito A, Scarpa RM, Papotti M, Berruti A, Scagliotti GV, Terzolo M (2016) Does nephrectomy during radical adrenalectomy for stage II adrenocortical cancer affect patient outcome? J Endocrinol Investig 39:465–471

    Article  CAS  Google Scholar 

  102. Turbendian HK, Strong VE, Hsu M, Ghossein RA, Fahey TJ 3rd (2010) Adrenocortical carcinoma: the influence of large vessel extension. Surgery 148:1057–1064

    Article  PubMed  Google Scholar 

  103. Mihai R, Iacobone M, Makay O, Moreno P, Frilling A, Kraimps JL, Soriano A, Villar del Moral J, Barczynski M, Durán MC, Sadler GP, Niederle B, Dralle H, Harrison B, Carnaille B (2012) Outcome of operation in patients with adrenocortical cancer invading the inferior vena cava-a European Society of Endocrine Surgeons (ESES) survey. Langenbeck's Arch Surg 397:225–231

    Article  Google Scholar 

  104. Fassnacht M, Kroiss M, Allolio B (2013) Update in adrenocortical carcinoma. J Clin Endocrinol Metab 98:4551–4564

    Article  CAS  PubMed  Google Scholar 

  105. Saade N, Sadler C, Goldfarb M (2015) Impact of regional lymph node dissection on disease specific survival in adrenal cortical carcinoma. Horm Metab Res 47:820–825

    Article  CAS  PubMed  Google Scholar 

  106. Mihai R (2015) Diagnosis, treatment and outcome of adrenocortical cancer. Br J Surg 102:291–306

    Article  CAS  PubMed  Google Scholar 

  107. Nilubol N, Patel D, Kebebew E (2016) Does lymphadenectomy improve survival in patients with adrenocortical carcinoma? A population-based study. World J Surg 40:697–705

    Article  PubMed  Google Scholar 

  108. Bilimoria KY, Shen WT, Elaraj D, Bentrem DJ, Winchester DJ, Kebebew E, Sturgeon C (2008) Adrenocortical carcinoma in the United States: treatment utilization and prognostic factors. Cancer 113:3130–3136

    Article  PubMed  Google Scholar 

  109. Icard P, Goudet P, Charpenay C, Andreassian B, Carnaille B, Chapuis Y, Cougard P, Henry JF, Proye C (2001) Adrenocortical carcinomas: surgical trends and results of a 253-patient series from the French Association of Endocrine Surgeons study group. World J Surg 25:891–897

    Article  CAS  PubMed  Google Scholar 

  110. Polat B, Fassnacht M, Pfreundner L, Guckenberger M, Bratengeier K, Johanssen S, Kenn W, Hahner S, Allolio B, Flentje M (2009) Radiotherapy in adrenocortical carcinoma. Cancer 115:2816–2823

    Article  PubMed  Google Scholar 

  111. Bednarski BK, Habra MA, Phan A, Milton DR, Wood C, Vauthey N, Evans DB, Katz MH, Ng CS, Perrier ND, Lee JE, Grubbs EG (2014) Borderline resectable adrenal cortical carcinoma: a potential role for preoperative chemotherapy. World J Surg 38:1318–1327

    Article  PubMed  Google Scholar 

  112. Bellantone R, Ferrante A, Boscherini M, Lombardi CP, Crucitti P, Crucitti F, Favia G, Borrelli D, Boffi L, Capussotti L, Carbone G, Casaccia M, Cavallaro A, Del Gaudio A, Dettori G, Di Giovanni V, Mazziotti A, Marrano D, Masenti E, Miccoli P, Mosca F, Mussa A, Petronio R, Piat G, Ruberti U, Serio G, Marzano L (1997) Role of reoperation in recurrence of adrenal cortical carcinoma: results from 188 cases collected in the Italian National Registry for Adrenal Cortical Carcinoma. Surgery 122:1212–1218

    Article  CAS  PubMed  Google Scholar 

  113. Fassnacht M, Hahner S, Polat B, Koschker AC, Kenn W, Flentje M, Allolio B (2006) Efficacy of adjuvant radiotherapy of the tumor bed on local recurrence of adrenocortical carcinoma. J Clin Endocrinol Metab 91:4501–4504

    Article  CAS  PubMed  Google Scholar 

  114. Kemp CD, Ripley RT, Mathur A, Steinberg SM, Nguyen DM, Fojo T, Schrump DS (2011) Pulmonary resection for metastatic adrenocortical carcinoma: the National Cancer Institute experience. Ann Thorac Surg 92:1195–1200

    Article  PubMed  Google Scholar 

  115. Ripley RT, Kemp CD, Davis JL, Langan RC, Royal RE, Libutti SK, Steinberg SM, Wood BJ, Kammula US, Fojo T, Avital I (2011) Liver resection and ablation for metastatic adrenocortical carcinoma. Ann Surg Oncol 18:1972–1979

    Article  PubMed  PubMed Central  Google Scholar 

  116. Kerkhofs TM, Verhoeven RH, Bonjer HJ, van Dijkum EJ, Vriens MR, De Vries J, Van Eijck CH, Bonsing BA, Van de Poll-Franse LV, Haak HR, Dutch Adrenal Network (2013) Surgery for adrenocortical carcinoma in The Netherlands: analysis of the national cancer registry data. Eur J Endocrinol 169:83–89

    Article  CAS  PubMed  Google Scholar 

  117. Dy BM, Wise KB, Richards ML, Young WF, Grant CS, Bible KC, Rosedahl J, Harmsen WS, Farley DR, Thompson GB (2013) Operative intervention for recurrent adrenocortical cancer. Surgery 154:1292–1299

    Article  PubMed  Google Scholar 

  118. Erdogan I, Deutschbein T, Jurowich C, Kroiss M, Ronchi C, Quinkler M, Waldmann J, Willenberg HS, Beuschlein F, Fottner C, Klose S, Heidemeier A, Brix D, Fenske W, Hahner S, Reibetanz J, Allolio B, Fassnacht M, German Adrenocortical Carcinoma Study Group (2013) The role of surgery in the management of recurrent adrenocortical carcinoma. J Clin Endocrinol Metab 98:181–191

    Article  CAS  PubMed  Google Scholar 

  119. Schteingart DE, Doherty GM, Gauger PG, Giordano TJ, Hammer GD, Korobkin M, Worden FP (2005) Management of patients with adrenal cancer: recommendations of an international consensus conference. Endocr Relat Cancer 12:667–680

    Article  CAS  PubMed  Google Scholar 

  120. Hero B, Berthold F (2011) Neuroblastom. Leitlinie der Gesellschaft für Pädiatrische Onkologie und Hämatologie. AWMF-Register Nr. 025/008 online

  121. Shawa H, Elsayes KM, Javadi S, Morani A, Williams MD, Lee JE, Waguespack SG, Busaidy NL, Vassilopoulou-Sellin R, Jimenez C, Habra MA (2014) Adrenal ganglioneuroma: features and outcomes of 27 cases at a referral cancer centre. Clin Endocrinol 80:342–347

    Article  CAS  Google Scholar 

  122. Patel VG, Babalola OA, Fortson JK, Weaver WL (2006) Adrenal myelolipoma: a report of a case and review of the literature. Am Surg 72:649–654

    PubMed  Google Scholar 

  123. Uberoi J, Munver R (2009) Surgical management of metastases to the adrenal gland: open, laparoscopic, and ablative approaches. Curr Urol Rep 10:67–72

    Article  PubMed  Google Scholar 

  124. Lenert JT, Barnett CC Jr, Kudelka AP, Sellin RV, Gagel RF, Prieto VG, Skibber JM, Ross MI, Pisters PW, Curley SA, Evans DB, Lee JE (2001) Evaluation and surgical resection of adrenal masses in patients with a history of extra-adrenal malignancy. Surgery 130:1060–1067

    Article  CAS  PubMed  Google Scholar 

  125. Lumb G, Mackenzie DH (1959) The incidence of metastases in adrenal glands and ovaries removed for carcinoma of the breast. Cancer 12:521–526

    Article  CAS  PubMed  Google Scholar 

  126. Korobkin M, Giordano TJ, Brodeur FJ, Francis IR, Siegelman ES, Quint LE, Dunnick NR, Heiken JP, Wang HH (1996) Adrenal adenomas: relationship between histologic lipid and CT and MR findings. Radiology 200:743–747

    Article  CAS  PubMed  Google Scholar 

  127. Caoili EM, Korobkin M, Francis IR, Cohan RH, Platt JF, Dun-nick NR, Raghupathi KI (2002) Adrenal masses: characterization with combined unenhanced and delayed enhanced CT. Radiology 222:629–633

    Article  PubMed  Google Scholar 

  128. Haider MA, Ghai S, Jhaveri K, Lockwood G (2004) Chemical shift MR imaging of hyperattenuating (>10 HU) adrenal masses: does it still have a role? Radiology 231:711–716

    Article  PubMed  Google Scholar 

  129. Song JH, Chaudhry FS, Mayo-Smith WW (2008) The incidental adrenal mass on CT: prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known malignancy. Am J Roentgenol 190:1163–1168

    Article  Google Scholar 

  130. Pfannschmidt J, Schlolaut B, Muley T, Hoffmann H, Dienemann H (2005) Adrenalectomy for solitary adrenal metastases from non-small cell lung cancer. Lung Cancer 49:203–207

    Article  PubMed  Google Scholar 

  131. Mercier O, Fadel E, de Perrot M, Mussot S, Stella F, Chapelier A, Dartevelle P (2005) Surgical treatment of solitary adrenal metastasis from non-small cell lung cancer. J Thorac Cardiovasc Surg 130:136–140

    Article  PubMed  Google Scholar 

  132. Muth A, Persson F, Jansson S, Johanson V, Ahlman H, Wangberg B (2010) Prognostic factors for survival after surgery for adrenal metastasis. Eur J Surg Oncol 36:699–704

    Article  CAS  PubMed  Google Scholar 

  133. Young WF Jr (2003) Primary aldosteronism—changing concepts in diagnosis and treatment. Endocrinology 144:2208–2213

    Article  CAS  Google Scholar 

  134. Funder JW, Carey RM, Matero F, Murad MH, Reincke M, Shibata H, Stowasser M, Young WF (2016) Guidelines on primary aldosteronism. J Clin Endocrinol Metab 101:1889–1916

    Article  CAS  Google Scholar 

  135. Sawka AM, Young WF, Thompson GB, Grant CS, Farley DR, Leibson C, van Heerden JA (2001) Primary aldosteronism: factors associated with normalization of blood pressure after surgery. Ann Intern Med 135:258–226

    Article  CAS  PubMed  Google Scholar 

  136. Harris DA, Au-Yong I, Basnyat PS, Sadler GP, Wheeler MH (2003) Review of surgical management of aldosterone secreting tumours of the adrenal cortex. Eur J Surg Oncol 29:467–474

    Article  CAS  PubMed  Google Scholar 

  137. Lim PO, Young WF, MacDonald TM (2001) A review of the medical treatment of primary aldosteronism. J Hypertens 19:353–361

    Article  CAS  PubMed  Google Scholar 

  138. Montori VM, Young WF (2002) Use of plasma aldosterone concentration-to-plasma renin activity ratio as a screening test for primary aldosteronism: a systematic review of the literature. Endocrinol Metab Clin N Am 31:619–632

    Article  CAS  Google Scholar 

  139. Parthasarathy HK, Ménard J, White WB, Young WF, Williams GH, Williams B, Ruilope LM, McInnes GT, Connell JM, MacDonald TM (2011) A double-blind, randomized study comparing the antihypertensive effect of eplerenone and spironolactone in patients with hypertension and evidence of primary aldosteronism. J Hypertens 29:980–990

    Article  CAS  PubMed  Google Scholar 

  140. Karagiannis A, Tziomalos K, Papageorgiou A, Kakafika AI, Pagourelias ED, Anagnostis P, Athyros VG, Mikhailidis DP (2008) Spironolactone versus eplerenone for the treatment of idiopathic hyperaldosteronism. Expert Opin Pharmacother 9:509–515

    Article  CAS  PubMed  Google Scholar 

  141. Sood A, Majumder K, Kachroo N, Sammon JD, Abdollah F, Schmid M, Hsu L, Jeong W, Meyer CP, Hanske J, Kalu R, Menon M, Trinh QD (2016) Adverse event rates, timing of complications, and the impact of specialty on outcomes following adrenal surgery: an analysis of 30-day outcome data from the American college of surgeons national surgical quality improvement program (ACS-NSQIP). Urology 90:62–68

    Article  PubMed  Google Scholar 

  142. Niemann LK (2015) Cushing’s syndrome: update on signs, symptoms and biochemical screening. Eur J Endocrinol 173:M33–M38

    Article  CAS  Google Scholar 

  143. Gumbs AA, Gagner M (2006) Laparoscopic adrenalectomy. Best Pract Res Clin Endocrinol Metab 20:483–499

    Article  PubMed  Google Scholar 

  144. Flohr F, Seufert J (2007) Hypophysen- und Nebennierenoperationen. Internist 48:578–585

    Article  CAS  PubMed  Google Scholar 

  145. Hahner S, Allolio B (2005) Management of adrenal insufficiency in different clinical settings. Expert Opin Pharmacother 6:2407–2417

    Article  CAS  PubMed  Google Scholar 

  146. Ortiz DI, Findling JW, Carroll TB, Javorsky BR, Carr AA, Evans DB, Yen TW, Wang TS (2016) Cosyntropin stimulation testing on postoperative day 1 allows for selective glucocorticoid replacement therapy after adrenalectomy for hypercortisolism: results of a novel, multidisciplinary institutional protocol. Surgery 159:259–266

    Article  PubMed  Google Scholar 

  147. der Zee V, de Boer A (2014) Pheochromocytoma: a review on preoperative treatment with phenoxybenzamine or doxazosin. Neth J Med 72:190–201

    PubMed  Google Scholar 

  148. Shao Y, Chen R, Shen ZJ, Teng Y, Huang P, Rui WB, Xie X, Zhou WL (2011) Preoperative alpha blockade for normotensive pheochromocytoma: is it necessary. J Hypertens 29:2429–2432

    Article  CAS  PubMed  Google Scholar 

  149. Groeben H, Nottebaum BJ, Alesina PF, Traut A, Neumann HP, Walz MK (2017) Perioperative alpha-receptor blockade in pheochromocytoma surgery: an observational case series. Br J Anaesth 118:182–189

    Article  CAS  PubMed  Google Scholar 

  150. Lafont M, Fagour C, Haissaguerre M, Darancette G, Wagner T, Corcuff JB, Tabarin A (2015) Perioperative hemodynamic instability in normotensive patients with incidentally discovered pheochromocytomas. J Clin Endocrinol Metab 100:417–421

    Article  CAS  PubMed  Google Scholar 

  151. Naranjo J, Dodd S, Martin YN (2017) Perioperative management of pheochromocytoma. J Cardiothoracic Vasc Anaest 31:1427–1439. https://doi.org/10.1053/j.jvca2017.02.023

    Article  Google Scholar 

  152. Ong KR, Woodward ER, Killick P, Lim C, Macdonald F, Maher ER (2007) Genotype-phenotype correlations in von Hippel-Lindau disease. Hum Mutat 28:143–149

    Article  CAS  PubMed  Google Scholar 

  153. Gimenez-Roqueplo AP, Caumont-Prim A, Houzard C, Hignette C, Hernigou A, Halimi P, Niccoli P, Leboulleux S, Amar L, Borson-Chazot F, Cardot-Bauters C, Delemer B, Chabolle F, Coupier I, Libé R, Peitzsch M, Peyrard S, Tenenbaum F, Plouin PF, Chatellier G, Rohmer V (2013) Imaging work-up for screening of paraganglioma and pheochromocytoma in SDHx mutation carriers: a multicenter prospective study from the PGL.EVA Investigators. J Clin Endocrinol Metab 98:162–167

    Article  CAS  Google Scholar 

  154. Chrisoulidou A, Kaltsas G, Ilias I, Grossman AB (2007) The diagnosis and management of malignant phaeochromocytoma and paraganglioma. Endocr Relat Cancer 14(569):585

    Google Scholar 

  155. Amar L, Fassnacht M, Gimenez-Roqueplo AP, Januszewicz A, Prejbisz A, Timmers H, Plouin PF (2012) Long-term postoperative follow-up in patients with apparently benign pheochromocytoma and paraganglioma. Horm Metab Res 44:385–389

    Article  CAS  PubMed  Google Scholar 

  156. Favier J, Amar L, Gimenez-Roqueplo AP (2015) Pheochromocytoma and paraganglioma: from genetic to clinics. Nat Rev Endocrinol 11:101–111

    Article  CAS  PubMed  Google Scholar 

  157. Eisenhofer G, Lenders JW, Siegert G, Bornstein SR, Friberg P, Milosevic D, Mannelli M, Linehan WM, Adams K, Timmers HJ, Pacak K (2012) Plasma methoxytyramine: a novel biomarker of metastatic pheochromocytoma and paraganglioma in relation to established risk factors of tumour size, location and SDHB mutation status. Eur J Cancer 48:1739–1749

    Article  CAS  PubMed  Google Scholar 

  158. Eisenhofer G, Peitzsch M (2014) Laboratory evaluation of pheochromocytoma and paraganglioma. Clin Chem 60:1486–1499

    Article  CAS  PubMed  Google Scholar 

  159. Neumann HP, Pawlu C, Peczkowska M, Bausch B, McWhinney SR, Muresan M, Buchta M, Franke G, Klisch J, Bley TA, Hoegerle S, Boedeker CC, Opocher G, Schipper J, Januszewicz A, Eng C (2004) Distinct clinical features of paraganglioma syndromes associated with SDHB and SDHD gene mutations. J Am Ass Med 292:943–951

    Article  CAS  Google Scholar 

  160. Rufini V, Treglia G, Castaldi P, Perotti G, Giordano A (2013) Comparison of metaiodobenzyl-guanidine scintigraphy with positron emission tomography in the diagnostic work-up of pheochromocytoma and paraganglioma: a systematic review. Q J Nucl Med Mol Imaging 57:122–133

    CAS  PubMed  Google Scholar 

  161. Cascón A, Comino-Méndez I, Currás-Freixes M, de Cubas AA, Contreras L, Richter S, Peitzsch M, Mancikova V, Inglada-Pérez L, Pérez-Barrios A, Calatayud M, Azriel S, Villar-Vicente R, Aller J, Setién F, Moran S, Garcia JF, Río-Machín A, Letón R, Gómez-Graña Á, Apellániz-Ruiz M, Roncador G, Esteller M, Rodríguez-Antona C, Satrústegui J, Eisenhofer G, Urioste M, Robledo M (2015) Whole-exome sequencing identifies MDH2 as a new familial paraganglioma gene. J Natl Cancer Inst 107:5

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Universitätsklinikum Halle, Halle/Saale, Germany

    K. Lorenz

  2. Klinikum Hanau, Hanau, Germany

    P. Langer

  3. Ordination Siebenbrunnenstrasse, Wien, Austria

    B. Niederle

  4. Kliniken Essen-Mitte, Essen, Germany

    P. Alesina & M. K. Walz

  5. Universitätsklinikum Marburg, Marburg, Germany

    K. Holzer & D. K. Bartsch

  6. Marienhospital Osnabrück, Osnabrück, Germany

    Ch. Nies

  7. Universitatsklinikum Mainz, Mainz, Germany

    Th. Musholt

  8. Charité Universitätsmedizin Berlin, Berlin, Germany

    P. E. Goretzki

  9. Universitätsklinikum Leipzig, Leipzig, Germany

    N. Rayes

  10. Endokrinologiepraxis Berlin, Berlin, Germany

    M. Quinkler

  11. MIVENDO Klinik Hamburg, Hamburg, Germany

    J. Waldmann

  12. Evangelisches Krankenhaus BETHESDA Duisburg, Duisburg, Germany

    D. Simon

  13. Klinikum Starnberg, Klinikum Starnberg, Germany

    A. Trupka

  14. Ludwig-Maximilians-Universität München, München, Germany

    R. Ladurner & K. Hallfeldt

  15. Diakonie-Klinikum Stuttgart, Stuttgart, Germany

    A. Zielke

  16. Universitätsklinikum Hamburg, Hamburg, Germany

    D. Saeger

  17. Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany

    Th. Pöppel

  18. Universitätsklinikum Bonn, Bonn, Germany

    G. Kukuk

  19. Universitätsklinikum Zürich, Zürich, Switzerland

    A. Hötker

  20. RAE Ratacjzak und Partner, Sindelfingen, Germany

    P. Schabram

  21. Krankenhaus Agatharied, Hausham, Germany

    S. Schopf

  22. HELIOS Universitätsklinikum Wuppertal, Wuppertal, Germany

    C. Dotzenrath

  23. Medizinische Universität Wien, Wien, Austria

    P. Riss

  24. Deutsches Rotes Kreuz Krankenhaus Berlin, Berlin, Germany

    Th. Steinmüller

  25. AWMF, Frankfurt am Main, Germany

    I. Kopp

  26. Bürgerhospital Frankfurt, Frankfurt am Main, Germany

    C. Vorländer

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  1. K. Lorenz
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Corresponding author

Correspondence to K. Lorenz.

Ethics declarations

Conflict of interest

Lorenz K: no disclosures

Langer P: no disclosures

Niederle B: no disclosures

Alesina P: no disclosures

Holzer, K: holds Bayer shares

Nies C: no disclosures

Musholt Th: no disclosures

Goretzki P: received consultant’s + speaker’s honorarium from: Sanofi, Ipsen, Novartis GmbH

Rayes N: no disclosures

Quinkler M: received speaker’s honorarium from: Shire plc GmbH, Ipsen GmbH

Waldmann J: no disclosures

Simon D: no disclosures

Trupka A: holds Bayer shares

Ladurner R: no disclosures

Hallfeldt K: no disclosures

Zielke A: no disclosures

Saeger W: received grants from: Ipsen, Novo-Nordisk, Novartis GmbH

Pöppel Th: no disclosures

Kukuk G: no disclosures

Hötker A: no disclosures

Schabram P: no disclosures

Schopf S: holds shares from ISAR-U GmbH

Dotzenrath C: no disclosures

Riss P: no disclosures

Steinmüller Th: no disclosures

Kopp I: no disclosures

Vorländer C: received grants from:Olympus GmbH

Walz M: received speaker’s honorarium from: Karl Storz GmbH, Medtronic Co.

Bartsch DK: received speaker’s honorarium from: Novartis

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Appendix

Appendix

Guideline working group “surgical treatment of adrenal tumors” of the German Society of Endocrine Surgery (CAEK) of the German Society of General and Visceral Surgery (DGAV) (in alphabetical order)

Dr. P. Alesina, Essen

Prof. D.K. Bartsch, Marburg

Prof. C. Dotzenrath, Wuppertal

Prof. P.E. Goretzki, Berlin

Prof. K. Hallfeldt, München

Prof. K. Holzer, Marburg

PD Dr. R. Ladurner, München

Prof. P. Langer, Hanau

Prof. K. Lorenz, Halle

Prof. T.J. Musholt, Mainz

Prof. B. Niederle, Wien

Prof. Chr. Nies, Osnabrück

Prof. N. Rayes, Leipzig

RA P. Schabram, Freiburg

Prof. D. Simon, Duisburg

PD Dr. S. Schopf, Agatharied

Prof. Th. Steinmüller, Berlin

Prof. A.W. Trupka, Starnberg

Dr. C. Vorländer, Frankfurt

Prof. J. Waldmann, Hamburg

Prof. M. Walz, Essen

Prof. A. Zielke, Stuttgart

Delegates from the participating der medical societies and organizations

AWMF, moderator live consnensus conference: Prof. I. Kopp, Marburg

DGAV: represented by the guideline working group of the CAEK

German Society of Endocrinology: Prof. M. Quinkler, Berlin

German Society of Nuclear Medicine: Prof. Dr. Th.Pöppel, Essen

German Society of Pathology: Prof. Saeger, Hamburg

German Society of Radiology: PD R. Guido Kukuk, Bonn, Dr. Andreas Hötker, Zürich

German Society of Medical Oncology: Prof. Heiko Krude, Berlin

Patientent Support Group Network Pituitary and Adrenal Diseases; registered association, Ms. M. Schubert

Participants of the live consensus conference June 6, 2016 in Frankfurt/M

Prof. I. Kopp, AWMF

Dr. P. Alesina, Essen

Prof. D.K. Bartsch, Marburg

Prof. C. Dotzenrath, Wuppertal

Prof. Dr. K. Hallfeldt, München

Prof. K. Holzer, Frankfurt/M.

Prof. P. Langer, Hanau

Prof. K. Lorenz, Halle

Prof. T.J. Musholt, Mainz

Prof. B. Niederle, Wien

Prof. M. Quinkler, Berlin

Prof. N. Rayes, Leipzig

Prof. W. Saeger, Hamburg

RA P. Schabram, Freiburg

Prof. Th. Steinmüller, Berlin

Dr. C. Vorländer, Frankfurt/M.

Prof. J. Waldmann, Hamburg

Prof. M. Walz, Essen

Prof. A. Zielke, Stuttgart

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Lorenz, K., Langer, P., Niederle, B. et al. Surgical therapy of adrenal tumors: guidelines from the German Association of Endocrine Surgeons (CAEK). Langenbecks Arch Surg 404, 385–401 (2019). https://doi.org/10.1007/s00423-019-01768-z

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