The human adrenal cortex: growth control and disorders

This review summarizes key knowledge regarding the development, growth, and growth disorders of the adrenal cortex from a molecular perspective. The adrenal gland consists of two distinct regions: the cortex and the medulla. During embryological development and transition to the adult adrenal gland, the adrenal cortex acquires three different structural and functional zones. Significant progress has been made in understanding the signaling and molecules involved during adrenal cortex zonation. Equally significant is the knowledge obtained regarding the action of peptide factors involved in the maintenance of zonation of the adrenal cortex, such as peptides derived from proopiomelanocortin processing, adrenocorticotropin and N-terminal proopiomelanocortin. Findings regarding the development, maintenance and growth of the adrenal cortex and the molecular factors involved has improved the scientific understanding of disorders that affect adrenal cortex growth. Hypoplasia, hyperplasia and adrenocortical tumors, including adult and pediatric adrenocortical adenomas and carcinomas, are described together with findings regarding molecular and pathway alterations. Comprehensive genomic analyses of adrenocortical tumors have shown gene expression profiles associated with malignancy as well as methylation alterations and the involvement of miRNAs. These findings provide a new perspective on the diagnosis, therapeutic possibilities and prognosis of adrenocortical disorders.

Incidentaloma suprarrenal: a propósito de un caso / Adrenal incidentaloma. apropos of a case

El hallazgo de masas suprarrenales descubiertas de forma accidental ante la utilización de técnicas de imagen abdominales para el estudiode otras patologías es un problema cada vez màs frecuente.Se presenta el caso de una mujer de 44 años de edad a la que se descubrió una masa en la glándula suprarrenal derecha de formaaccidental. Su aparición requiere un estudio de funcionalidad hormonal y estudios con técnicas de imagen para determinar su naturaleza,tamaño y tratamiento...

Abdominal masses discovered accidentally during abdominal imaging perfomed for other reasons, are a common problem. We report a case of a 44 years old woman with a right adrenal masse incidentally discovered, this study requires the exclusion of hypersecreting lesions and imaging studies to determine its nature, size and treatment.

Un caso de síndrome de Cushing por hiperplasia nodular pigmentaria primaria / A case of primary pigmented nodular edrenocortical disease

La hiperplasia nodular pigmentaria primaria es una causa rara de síndrome de Cushing, con predilección en adultos jóvenes del género femenino. En el laboratorio está caracterizada por un hipercortisolismo independiente de ACTH; en el estudio histopatológico por múltiples nódulos corticales pequeños y obscuros, de células grandes, citoplasma con eosinofilia y lipofuscina que le dan una particularidad distintiva; además puede encontrarse una atrofia internodular el tratamiento de elección es la adrenalectomía bilateral. En este reporte damos a conocer el caso de una mujer de 32 años de edad con hiperplasia nodular pigmentaria primaria; además presentamos una revisión de la literatura