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Urine steroid profile as a new promising tool for the evaluation of adrenal tumors. Literature review

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Abstract

Purpose

To review the literature assessing the diagnostic performance of urinary steroid profiling (USP) by high-performance liquid chromatography (LC–MS) or gas chromatography (GC) coupled to mass spectrometry (MS) in the evaluation of adrenal lesions, both in terms of functionality and malignancy.

Results

The evaluation of adrenal incidentalomas (AI) aims to rule out malignancy and hormone excess. Current diagnostic protocols have several limitations and include time consuming and relatively complicated multi-step processes in most cases. On the contrary, USP by LC–MS/MS or LC-GC/MS offer an easy, comprehensive and non-invasive assessment of adrenal steroid secretion. USP complements current workups used in the evaluation of AIs by improving our ability to identify malignancy and/or autonomous hormone secretion.

Conclusions

Urine steroid profiling by LC–MS/MS and GC–MS allows a thorough, non-invasive, assessment of adrenal steroidogenesis as a whole which complement the current evaluation of AIs, and holds a promising role in the diagnosis of autonomous cortisol secretion, primary aldosteronism, and adrenal malignancy.

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Funding

Supported by Grants “BECA SENDIMAD de Ayuda a la Investigación en Endocrinología, Nutrición y Diabetes 2019”, Sociedad de Endocrinología, Nutrición y Diabetes de Madrid, Madrid, Spain, and “Convocatoria intramural de ayudas a proyectos de investigación de investigadores noveles, investigadores clínicos asociados y/o grupos emergentes del Hospital Universitario Ramón y Cajal”, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.

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Authors and Affiliations

  1. Department of Endocrinology & Metabolism, Hospital Universitario Ramón y Cajal, Madrid, Spain

    Marta Araujo-Castro, Pablo Valderrábano & Héctor F. Escobar-Morreale

  2. Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain

    Marta Araujo-Castro, Pablo Valderrábano & Héctor F. Escobar-Morreale

  3. Universidad de Alcalá, Madrid, Spain

    Héctor F. Escobar-Morreale

  4. Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain

    Héctor F. Escobar-Morreale

  5. Department of Endocrinology & Metabolism, Hospital Clinic, Barcelona, Spain

    Felicia A. Hanzu

  6. Department of Biochemistry and Molecular Genetics, Hospital Clinic, IDIBAPS, Barcelona, Spain

    Gregori Casals

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Araujo-Castro, M., Valderrábano, P., Escobar-Morreale, H.F. et al. Urine steroid profile as a new promising tool for the evaluation of adrenal tumors. Literature review. Endocrine 72, 40–48 (2021). https://doi.org/10.1007/s12020-020-02544-6

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