Change in adrenal mass size as a predictor of a malignant tumor.

Objective: To assess the value of adrenal mass absolute growth, growth rate, and percentage growth rate on serial imaging for distinguishing benign from malignant adrenal masses.

Methods: We retrospectively reviewed the Cleveland Clinic medical record data on 136 adrenalectomies or biopsies in 132 patients with 2 imaging studies performed more than 2 months apart (during 1997 to 2008).

Results: There were 111 benign (81.

Lipid-induced insulin resistance is associated with increased monocyte expression of scavenger receptor CD36 and internalization of oxidized LDL.

Elevated free fatty acids (FFAs) contribute to the development of insulin resistance, type 2 diabetes mellitus (T2DM), and may be atherogenic. We tested the relationship among lipid-induced insulin resistance, endothelial dysfunction, and monocyte capacity to form foam cells through scavenger receptor A (SRA) and CD36. Ten healthy subjects underwent 24-h infusion of Intralipid/heparin and saline (0.

Recurrent acute suppurative thyroiditis attributable to a piriform sinus fistula in an adult.

Objective: To report a case of recurrent acute suppurative thyroiditis (AST) caused by a piriform sinus fistula (PSF).

Methods: We review the related literature and describe the clinical presentation, diagnostic evaluation, and management of a patient with recurrent AST due to PSF.

Results: A 50-year-old woman presented with recurrent episodes of pain and swelling in the left anterior neck area and odynophagia.

Symptomatic pituitary metastases from renal cell carcinoma.

Symptomatic metastases to the pituitary (MP) from renal cell carcinoma (RCC) are rare. In this largest case series reported, we describe the clinical features, treatment and outcome of 5 patients. Over a 6-year period (2000-2006), we treated 5 patients (3 males; mean age 61 years) with large sellar masses and RCC.

Evaluating and managing adrenal incidentalomas.

Adrenal masses that are found incidentally should be evaluated with both imaging and hormonal studies. The attenuation coefficient on noncontrast computed tomography (CT), expressed in Hounsfield units (HU), is better than tumor size in differentiating adrenal adenomas and hyperplastic lesions from nonadenomas. All patients should undergo hormonal evaluation for Cushing syndrome and pheochromocytoma.

Oncogenic osteomalacia cured by removal of an organized hematoma.

Objective: To describe a patient with oncogenic osteomalacia whose symptoms were rapidly resolved after surgical removal of an organized hematoma of the hip.

Methods: A case report is presented, including clinical and laboratory findings. The relevant literature is reviewed, and the current understanding of oncogenic osteomalacia is summarized.