{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:02:38Z","timestamp":1792425758790,"version":"4.5.0"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T00:00:00Z","timestamp":1537315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T00:00:00Z","timestamp":1537315200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2019,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Management of patients with bilateral adrenal masses and ACTH\u2010independent Cushing\u2019s syndrome (AICS) is challenging, as bilateral adrenalectomy can lead to steroid dependence and lifelong risk of adrenal crisis. Adrenal venous sampling (AVS) has been previously reported to facilitate lateralization for guiding adrenalectomy. The aim of the current study was to investigate the utility of AVS using protocol from study by Young et al. in the management of patients with bilateral adrenal masses and AICS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and design<\/jats:title><jats:p>A retrospective review of all patients with bilateral adrenal masses and AICS who underwent AVS from 2008 to 2016 was performed. AVS for cortisol and epinephrine was performed with dexamethasone suppression. The adrenal vein to peripheral vein cortisol ratios and side\u2010to\u2010side cortisol lateralization ratios were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>AVS was successful in 8 of 9 patients. All 8 patients had AVS results indicating bilateral cortisol hypersecretion. Six patients underwent adrenalectomy: 3 had unilateral adrenalectomy of the larger size mass, 2 had bilateral adrenalectomy (both sides &gt;4\u00a0cm.) and 1 had stepwise bilateral adrenalectomy. Final pathology revealed macronodular adrenal hyperplasia in all 6 patients that underwent surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>AVS was useful in excluding a unilateral adenoma as the source of AICS in this study of patients with bilateral adrenal masses and AICS. However, adrenal mass size influenced surgical decision making more than AVS results. More data are needed before AVS can be advocated as essential for management of patients with bilateral adrenal masses and AICS.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4788-2","type":"journal-article","created":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T16:09:19Z","timestamp":1537373359000},"page":"527-533","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Outcomes of Adrenal Venous Sampling in Patients with Bilateral Adrenal Masses and ACTH\u2010Independent Cushing\u2019s Syndrome"],"prefix":"10.1002","volume":"43","author":[{"given":"Runa","family":"Acharya","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism SUNY Upstate Medical University Syracuse NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mashaal","family":"Dhir","sequence":"additional","affiliation":[{"name":"Department of Surgery SUNY Upstate Medical University Syracuse NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupal","family":"Bandi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Interventional Radiology University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linwah","family":"Yip","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Endocrine Surgery University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Challinor","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,19]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp065470"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102265.2011.04253.x"},{"key":"e_1_2_6_4_2","first-page":"460","article-title":"Incidentally discovered adrenal masses","volume":"16","author":"Kloos RT","year":"1995","journal-title":"Endocrine Review"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31819a47d2"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011\u20100085"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010007\u20109332\u20108"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem\u201045\u20102\u2010353"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010015\u20103242\u2010y"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010007\u20109408\u20105"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015\u20102662"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008\u20100125"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-018-4788-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-018-4788-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-018-4788-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-018-4788-2","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T15:28:35Z","timestamp":1704900515000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-018-4788-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,19]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2,15]]}},"alternative-id":["10.1007\/s00268-018-4788-2"],"URL":"https:\/\/doi.org\/10.1007\/s00268-018-4788-2","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,19]]},"assertion":[{"value":"19 September 2018","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}