{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:17:42Z","timestamp":1792210662119,"version":"4.4.0"},"reference-count":21,"publisher":"Bioscientifica","issue":"2","content-domain":{"domain":["erc.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12,18]]},"abstract":"<jats:p>\n                    Adrenal lesions (ALs) are often detected in patients with multiple endocrine neoplasia type 1 (MEN1). However, they are not well described in MEN1, making their clinical management unclear. This study examined the prevalence and outcomes of ALs found in MEN1. We performed a retrospective chart review of patients diagnosed with MEN1 from 1990 to 2021. ALs were diagnosed using abdominal or thoracic imaging and classified as being unilateral or bilateral, having single or multiple nodules, and as having diffuse enlargement or not. Measurable nodular lesions were analyzed for their size and growth over time. Patients\u2019 clinical and radiographic characteristics were collected. We identified 382 patients with MEN1, 89 (23.3%) of whom had ALs. The mean age at detection was 47 \u00b1 11.9 years. We documented 101 measurable nodular lesions (mean size, 17.5 mm; range, 3\u2013123 mm). Twenty-seven nodules (26.7%) were smaller than 1 cm. Watchful waiting was indicated in 79 (78.2%) patients, of whom 28 (35.4%) had growing lesions. Functional lesions were diagnosed in 6 (15.8%) of 38 that had functional work-up (diagnoses: pheochromocytoma (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092), adrenocorticotropic hormone-dependent hypercortisolism (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092), hyperandrogenism (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091), hyperaldosteronism (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091)); surgery was indicated for 5 (83.3%;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200912 nodules), 2 of whom had bilateral, diffuse adrenal enlargement. Two patients were diagnosed with adrenocortical carcinoma and two with neoplasms of uncertain malignant potential. Radiographic or clinical progression of ALs is uncommon. Malignancy should be suspected on the basis of a lesion\u2019s growth rate and size. A baseline hormonal work-up is recommended, and no further biochemical work-up is suggested when the initial assessment shows nonfunctioning lesions.\n                  <\/jats:p>","DOI":"10.1530\/erc-23-0162","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T10:19:16Z","timestamp":1702894756000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-8","source":"Crossref","is-referenced-by-count":7,"title":["Beyond the three P\u2019s: adrenal involvement in MEN1"],"prefix":"10.1530","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1591-7845","authenticated-orcid":true,"given":"Uriel","family":"Clemente-Gutierrez","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina R C","family":"Pieterman","sequence":"additional","affiliation":[{"name":"Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Szabo","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Tame-Elorduy","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernice L","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8132-3391","authenticated-orcid":true,"given":"Aditya S","family":"Shirali","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek J","family":"Erstad","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey E","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah B","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul H","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth G","family":"Grubbs","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven G","family":"Waguespack","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaan S","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5933-1005","authenticated-orcid":true,"given":"Nancy","family":"Perrier","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"564","article-title":"Aldosterone-secreting adrenal adenoma as part of multiple endocrine neoplasia type 1 (MEN1): loss of heterozygosity for polymorphic chromosome 11 deoxyribonucleic acid markers, including the MEN1 locus","volume":"75","author":"Beckers","year":"1992","unstructured":"Beckers AAbs RWillems PJvan der Auwera BKovacs KReznik M & Stevenaert A1992Aldosterone-secreting adrenal adenoma as part of multiple endocrine neoplasia type 1 (MEN1): loss of heterozygosity for polymorphic chromosome 11 deoxyribonucleic acid markers, including the MEN1 locus. 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(https:\/\/doi.org\/10.2214\/AJR.10.5540)"},{"key":"bib3","series-title":"International Journal of Surgical Pathology","first-page":"231","article-title":"Adrenocortical oncocytic tumors: report of 10 cases and review of the literature","volume":"12","author":"Bisceglia","year":"2019","unstructured":"Bisceglia MLudovico ODi Mattia ABen-Dor DSandbank JPasquinelli GLau SK & Weiss LM2019Adrenocortical oncocytic tumors: report of 10 cases and review of the literature. International Journal of Surgical Pathology12231\u2013243. (https:\/\/doi.org\/10.1177\/106689690401200304)"},{"key":"bib4","series-title":"American Journal of Surgical Pathology","first-page":"396","article-title":"Myxoid neoplasms of the adrenal cortex: a rare histologic variant","volume":"24","author":"Brown","year":"2000","unstructured":"Brown FMGaffey TAWold LE & Lloyd RV2000Myxoid neoplasms of the adrenal cortex: a rare histologic variant. American Journal of Surgical Pathology24396\u2013401. 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(https:\/\/doi.org\/10.1159\/000345141)"},{"key":"bib9","series-title":"Surgical Case Reports","first-page":"84","article-title":"Concomitant existence of pheochromocytoma in a patient with multiple endocrine neoplasia type 1","volume":"2","author":"Okada","year":"2016","unstructured":"Okada RShimura TTsukida SAndo JKofunato YMomma TYashima RKoyama YSuzuki S & Takenoshita S2016Concomitant existence of pheochromocytoma in a patient with multiple endocrine neoplasia type 1. Surgical Case Reports284. (https:\/\/doi.org\/10.1186\/s40792-016-0214-x)"},{"key":"bib10","series-title":"American Journal of Surgical Pathology","first-page":"973","article-title":"Adrenocortical tumors with myxoid features: a distinct morphologic and phenotypical variant exhibiting malignant behavior","volume":"34","author":"Papotti","year":"2010","unstructured":"Papotti MVolante MDuregon EDelsedime LTerzolo MBerruti A & Rosai J2010Adrenocortical tumors with myxoid features: a distinct morphologic and phenotypical variant exhibiting malignant behavior. American Journal of Surgical Pathology34973\u2013983. (https:\/\/doi.org\/10.1097\/PAS.0b013e3181e2b726)"},{"key":"bib11","series-title":"European Journal of Endocrinology","first-page":"699","article-title":"Natural course of small adrenal lesions in multiple endocrine neoplasia type 1: an endoscopic ultrasound imaging study","volume":"158","author":"Schaefer","year":"2008","unstructured":"Schaefer SShipotko MMeyer SIvan DKlose KJWaldmann JLanger P & Kann PH2008Natural course of small adrenal lesions in multiple endocrine neoplasia type 1: an endoscopic ultrasound imaging study. European Journal of Endocrinology158699\u2013704. (https:\/\/doi.org\/10.1530\/EJE-07-0635)"},{"key":"bib12","series-title":"CA","first-page":"369","article-title":"It's not a mystery, it's in the history: multidisciplinary management of multiple endocrine neoplasia type 1","volume":"71","author":"Shirali","year":"2021","unstructured":"Shirali ASPieterman CRCLewis MAHyde SMMakawita SDasari AThosani NIkoma NMcCutcheon IEWaguespack SG, et al.2021It's not a mystery, it's in the history: multidisciplinary management of multiple endocrine neoplasia type 1. CA71369\u2013380. (https:\/\/doi.org\/10.3322\/caac.21673)"},{"key":"bib13","series-title":"Clinical Endocrinology","first-page":"379","article-title":"Cushing's syndrome in multiple endocrine neoplasia type 1","volume":"76","author":"Simonds","year":"2012","unstructured":"Simonds WFVarghese SMarx SJ & Nieman LK2012Cushing's syndrome in multiple endocrine neoplasia type 1. Clinical Endocrinology76379\u2013386. (https:\/\/doi.org\/10.1111\/j.1365-2265.2011.04220.x)"},{"key":"bib14","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"76","article-title":"Clinical and genetic features of adrenocortical lesions in multiple endocrine neoplasia type 1","volume":"75","author":"Skogseid","year":"1992","unstructured":"Skogseid BLarsson CLindgren PGKvanta ERastad JTheodorsson EWide LWilander E & Oberg K1992Clinical and genetic features of adrenocortical lesions in multiple endocrine neoplasia type 1. Journal of Clinical Endocrinology and Metabolism7576\u201381. (https:\/\/doi.org\/10.1210\/jcem.75.1.1352309)"},{"key":"bib15","series-title":"Surgery","first-page":"1077","article-title":"Adrenal lesion in multiple endocrine neoplasia type 1","volume":"118","author":"Skogseid","year":"1995","unstructured":"Skogseid BRastad JGobl ALarsson CBacklin KJuhlin CAkerstr\u00f6m G & Oberg K1995Adrenal lesion in multiple endocrine neoplasia type 1. Surgery1181077\u20131082. 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(https:\/\/doi.org\/10.1210\/jc.2012-1230)"},{"key":"bib17","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"e1014","article-title":"The management of neuroendocrine tumors of the lung in MEN1: results from the Dutch MEN1 study group","volume":"106","author":"van den Broek","year":"2021","unstructured":"van den Broek MFMde Laat JMvan Leeuwaarde RSvan de Ven ACde Herder WWDekkers OMDrent MLKerstens MNBisschop PHHavekes B, et al.2021The management of neuroendocrine tumors of the lung in MEN1: results from the Dutch MEN1 study group. Journal of Clinical Endocrinology and Metabolism106e1014\u2013e1027. (https:\/\/doi.org\/10.1210\/clinem\/dgaa800)"},{"key":"bib18","series-title":"Archives of Endocrinology and Metabolism","first-page":"516","article-title":"Outcome and long-term follow-up of adrenal lesions in multiple endocrine neoplasia type 1","volume":"63","author":"Ventura","year":"2019","unstructured":"Ventura MMelo M & Carrilho F2019Outcome and long-term follow-up of adrenal lesions in multiple endocrine neoplasia type 1. Archives of Endocrinology and Metabolism63516\u2013523. (https:\/\/doi.org\/10.20945\/2359-3997000000170)"},{"key":"bib19","series-title":"Journal of the European Academy of Dermatology and Venereology","first-page":"835","article-title":"Cutaneous lesions associated to multiple endocrine neoplasia syndrome type 1","volume":"22","author":"Vidal","year":"2008","unstructured":"Vidal AIglesias MJFern\u00e1ndez BFonseca E & Cordido F2008Cutaneous lesions associated to multiple endocrine neoplasia syndrome type 1. 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(https:\/\/doi.org\/10.1007\/s00423-006-0124-7)"},{"key":"bib21","series-title":"Human Pathology","first-page":"489","article-title":"Oncocytic adrenocortical neoplasms\u2014a clinicopathologic study of 13 new cases emphasizing the importance of their recognition","volume":"42","author":"Wong","year":"2011","unstructured":"Wong DDSpagnolo DVBisceglia MHavlat MMcCallum D & Platten MA2011Oncocytic adrenocortical neoplasms\u2014a clinicopathologic study of 13 new cases emphasizing the importance of their recognition. Human Pathology42489\u2013499. (https:\/\/doi.org\/10.1016\/j.humpath.2010.08.010)"}],"container-title":["Endocrine-Related Cancer"],"original-title":[],"link":[{"URL":"https:\/\/erc.bioscientifica.com\/view\/journals\/erc\/31\/2\/ERC-23-0162.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/erc.bioscientifica.com\/downloadpdf\/journals\/erc\/31\/2\/ERC-23-0162.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/erc.bioscientifica.com\/downloadpdf\/journals\/erc\/31\/2\/ERC-23-0162.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:56:39Z","timestamp":1784555799000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/erc\/article\/25804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,18]]},"references-count":21,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.1530\/erc-23-0162","relation":{},"ISSN":["1351-0088","1479-6821"],"issn-type":[{"value":"1351-0088","type":"print"},{"value":"1479-6821","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,18]]}}}