Diagnosis of a malignant adrenal mass: the role of urinary steroid metabolite profiling
Author(s)
Bancos, Irina
Arlt, Wiebke
Type
Journal Article
Abstract
Purpose of review
Adrenal masses are highly prevalent, found in 5% of the population. Differentiation of benign adrenocortical adenoma from adrenocortical carcinoma is currently hampered by the poor specificity and limited evidence base of imaging tests. This review summarizes the results of studies published to date on urine steroid metabolite profiling for distinguishing benign from malignant adrenal masses.
Recent findings
Three studies have described cohorts of at least 100 patients with adrenal tumors showing significant differences between urinary steroid metabolite excretions according to the nature of the underlying lesion, suggesting significant value of steroid metabolite profiling as a highly accurate diagnostic test.
Summary
Steroid profiling is emerging as a powerful novel diagnostic tool with a significant potential for improving the management for patients with adrenal tumors. Although the current studies use gas chromatography–mass spectrometry for proof of concept, widespread use of the method in routine clinical care will depend on transferring the approach to high-throughput tandem mass spectrometry platforms. The use of computational data analysis in conjunction with urine steroid metabolite profiling, that is, steroid metabolomics, adds accuracy and precision.
Adrenal masses are highly prevalent, found in 5% of the population. Differentiation of benign adrenocortical adenoma from adrenocortical carcinoma is currently hampered by the poor specificity and limited evidence base of imaging tests. This review summarizes the results of studies published to date on urine steroid metabolite profiling for distinguishing benign from malignant adrenal masses.
Recent findings
Three studies have described cohorts of at least 100 patients with adrenal tumors showing significant differences between urinary steroid metabolite excretions according to the nature of the underlying lesion, suggesting significant value of steroid metabolite profiling as a highly accurate diagnostic test.
Summary
Steroid profiling is emerging as a powerful novel diagnostic tool with a significant potential for improving the management for patients with adrenal tumors. Although the current studies use gas chromatography–mass spectrometry for proof of concept, widespread use of the method in routine clinical care will depend on transferring the approach to high-throughput tandem mass spectrometry platforms. The use of computational data analysis in conjunction with urine steroid metabolite profiling, that is, steroid metabolomics, adds accuracy and precision.
Date Issued
2017-06-01
Date Acceptance
2017-02-01
Citation
Current Opinion in Endocrinology, Diabetes and Obesity, 2017, 24 (3), pp.200-207
ISSN
1752-296X
Publisher
Lippincott, Williams & Wilkins
Start Page
200
End Page
207
Journal / Book Title
Current Opinion in Endocrinology, Diabetes and Obesity
Volume
24
Issue
3
Copyright Statement
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/28234802
Subjects
adrenal tumor
adrenocortical carcinoma
ADRENOCORTICAL CARCINOMA
BIOPSY
diagnostic test
Endocrinology & Metabolism
GUIDELINES
INCIDENTALOMA
Life Sciences & Biomedicine
MANAGEMENT
mass spectrometry
METAANALYSIS
PERFORMANCE
PREVALENCE
Science & Technology
steroid metabolomics
steroid profiling
TOOL
TUMORS
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2027-02-27