ArticleHeliyon2019
Adrenal insufficiency due to bilateral adrenal metastases - A systematic review and meta-analysis.
Article in Heliyon, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 43 citations in OpenAlex.
- Primary Bilateral Adrenal Lymphoma Revealed by Adrenal Insufficiency: From Constitutional Symptoms to Crisis.Cureus · 2026Article
- Survival outcomes and prognostic predictors after adrenalectomy for renal cell carcinoma adrenal metastasis.Discover oncology · 2025Article
- Adrenal lesions in patients with abdominal multitrauma.Endocrine · 2025Article
- Adrenal crisis as a reversible etiology of heart failure with preserved ejection fraction: insights from a case series.Frontiers in cardiovascular medicine · 2025Article
- Unilateral adrenal metastases as an unusual primary presentation of hepatocellular carcinoma: a case report and literature review.Annals of medicine and surgery (2012) · 2024Article
- Adrenal Insufficiency following Stereotactic Ablative Radiotherapy (SAbR) of Adrenal Gland Metastases.Cancers · 2024Article
- Adrenal tumours in patients with pathogenic APC mutations: a retrospective study.Hereditary cancer in clinical practice · 2024Article
- Adrenal tumors in patients with neuroendocrine neoplasms.Endocrine · 2024Article
- Impact of low sodium values on survival outcomes of patients with cancer receiving immune checkpoint inhibitors.Immunotherapy · 2024Article
- Adrenal Abscesses: A Systematic Review of the Literature.Journal of clinical medicine · 2023Review
- Adrenal insufficiency after curative-intent gastric cancer treatment: a case report.Journal of medical case reports · 2023Article
- Tuberculosis of Adrenal Glands-A Population-based Case-control Study.Journal of the Endocrine Society · 2023Article
- Metastatic Renal Cell Carcinoma and Unforeseen Adrenal Insufficiency: A Case Report and Literature Review.Cureus · 2023Article
- Adrenal trauma experience at a major tertiary centre in Sweden: Clinical and radiological findings.Clinical endocrinology · 2022Article
- Adrenal crises in adolescents and young adults.Endocrine · 2022Review
- Educational Case: Adrenocortical insufficiency-Causes and pathogenesis.Academic pathology · 2022Article
- Characteristics and Challenges of Primary Adrenal Insufficiency in Africa: A Review of the Literature.International journal of endocrinology · 2022Review
- The epidemiology of primary and secondary adrenal malignancies and associated adrenal insufficiency in hospitalised patients: an analysis of hospital admission data, NSW, Australia.BMC endocrine disorders · 2021Article
- [Adrenal imaging: anatomy and pathology (literature review)].Problemy endokrinologii · 2021Review
- Masked Diabetes Insipidus Hidden by Severe Hyponatremia: A Case of Pituitary Metastasis of Lung Adenocarcinoma.The American journal of case reports · 2020Article
Corrections and comments
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveBilateral adrenal metastases may cause adrenal insufficiency (AI) but it is unclear if screening for AI in patients with bilateral adrenal metastases is justified, despite the potential for adrenal crises.
methodA search using PubMed/Medline, ScienceDirect and Cochrane Reviews was performed to collect all original research articles and all case reports from the past 50 years that describe AI in bilateral adrenal metastases.
resultsTwenty studies were included with 6 original research articles, 13 case reports and one case series. The quality was generally poor. The prevalence of AI was 3-8%. Of all cases of AI (n = 25) the mean pooled baseline cortisol was 318 ± 237 nmol/L and stimulated 423 ± 238 nmol/L. Hypotension was present in 69%, hyponatremia in 9% and hyperkalemia in 100%. Lung cancer was the cause in 35%, colorectal 20%, breast cancer 15% and lymphoma 10%. The size of the adrenal metastases was 5.5 ± 2.8 cm (left) and 5.5 ± 3.1 cm (right), respectively. There was no correlation between basal cortisol, stimulated cortisol concentration or ACTH with the size of adrenal metastases. The median time to death was 5.0 months (IQR 0.6-6.5). However, two cases were alive after 12-24 months.
conclusionThe prevalence of AI in patients with bilateral adrenal metastases was low. Prognosis was very poor. Due to the low prevalence of AI, screening is likely only indicated in patients with symptoms and signs suggestive of hypocortisolism.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.