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The usefulness of determining the serum concentrations of vascular endothelial growth factor (VEGF) and its soluble receptor type 2 (sVEGF-2) in the differential diagnosis of adrenal incidentalomas.
[adrenal incidentaloma]
Angiogenesis
plays
an
important
role
in
tumour
growth
,
progression
and
invasiveness
.
Vascular
endothelial
growth
factor
(
VEGF
)
is
a
recognised
angiogenesis-stimulating
factor
.
Soluble
VEGF
receptors
(
sVEGFRs
)
have
antiangiogenic
properties
.
Recent
studies
have
indicated
that
serum
concentrations
of
these
factors
show
a
good
correlation
with
the
aggressiveness
of
these
tumours
in
various
organs
.
The
aim
of
this
study
was
to
assess
the
usefulness
of
determining
serum
concentrations
of
VEGF
and
sVEGFR-
2
in
patients
with
adrenal
incidentalomas
.
The
study
included
51
patients
:
38
women
aged
53
.
57
±
10
.
12
years
and
13
men
aged
54
.
66
±
12
.
73
years
without
a
history
of
cancer
but
with
non-functioning
adrenal
tumours
incidentally
detected
on
a
CT
scan
.
The
analysis
of
the
CT
images
included
such
morphological
features
of
the
tumour
as
:
tumour
size
,
tumour
homogenicity
,
tumour
density
before
and
after
administration
of
an
intravenous
contrast
medium
,
and
the
value
of
percentage
washout
of
the
contrast
medium
from
the
tumour
.
Based
on
the
above
criteria
,
we
identified
a
group
of
40
patients
with
adrenal
tumours
who
met
the
CT
criteria
for
benign
adenomas
(
Group
1
)
and
11
patients
whose
incidentally
discovered
tumours
did
not
meet
the
radiological
criteria
for
benign
adenomas
,
thereby
providing
grounds
for
referring
these
patients
for
surgery
(
Group
2
)
.
The
control
group
consisted
of
20
healthy
sex-
and
age-matched
individuals
.
The
mean
serum
concentrations
of
VEGF
in
the
study
and
control
groups
were
similar
,
although
patients
with
adrenal
tumours
had
significantly
higher
concentrations
of
sVEGFR-
2
than
healthy
individuals
.
There
were
no
significant
differences
in
the
mean
concentrations
of
VEGF
and
sVEGFR-
2
between
the
patients
undergoing
surgery
(
Group
2
)
and
the
patients
not
undergoing
surgery
(
Group
1
)
,
or
between
the
patients
undergoing
surgery
(
Group
2
)
and
the
control
group
.
Postoperative
histopathology
of
the
resected
adrenal
tumours
revealed
benign
adrenocortical
adenoma
in
eight
patients
and
the
following
in
the
remaining
patients
:
adrenocortical
carcinoma
in
one
patient
,
phaeochromocytoma
in
one
patient
and
ganglioneuroma
in
one
patient
.
The
adrenocortical
carcinoma
patient
had
the
highest
concentration
of
VEGF
,
while
this
patient
's
concentration
of
sVEGFR-
2
was
the
lowest
in
the
study
group
.
In
the
patients
diagnosed
with
ganglioneuroma
and
phaeochromocytoma
,
VEGF
and
sVEGFR-
2
concentrations
did
not
differ
significantly
from
their
mean
concentrations
in
the
study
group
.
There
were
also
no
relationships
between
the
serum
concentrations
of
VEGF
or
sVEGFR-
2
and
the
following
parameters
:
tumour
size
,
precontrast
and
postcontrast
tumour
densities
or
the
value
of
percentage
washout
.
Positive
correlations
were
,
however
,
identified
between
the
concentration
of
VEGF
and
the
concentrations
of
total
cholesterol
and
LDL-cholesterol
.
Determining
the
serum
concentrations
of
such
angiogenesis
markers
as
VEGF
and
sVEGFR-
2
seems
useful
in
the
evaluation
of
the
nature
of
incidentally
detected
adrenal
masses
(
incidentalomas
)
,
especially
in
the
preoperative
differential
diagnosis
of
adrenal
masses
that
do
not
meet
the
CT
criteria
for
benign
tumours
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated
