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  1. Article: Breast implant-associated anaplastic large cell lymphoma presenting as a breast mass: A case report and literature review.

    Galván, Joab Rafael / Cordera, Fernando / Arrangoiz, Rodrigo / Paredes, Luis / Pierzo, Jean Enrique

    International journal of surgery case reports

    2023  Volume 108, Page(s) 108482

    Abstract: Introduction: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare neoplasm most frequently associated with textured implant placement. The classic presentation consists of a persistent periprosthetic seroma. Implant removal and ...

    Abstract Introduction: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare neoplasm most frequently associated with textured implant placement. The classic presentation consists of a persistent periprosthetic seroma. Implant removal and individualized adjuvant treatment are potentially curative interventions. Most BIA-ALCL present with a seroma, not with a breast and/or axillary mass. Knowledge of this presentation and how to manage it allows an adequate diagnosis, and appropriate treatment with excellent results.
    Presentation of case: A 44-year-old woman presented with a 3-month history of a right breast mass located in the lower medial quadrant, with associated right axillary lymphadenopathy. Medical history was significant for a mastoplasty with textured implants 15 years before the onset of her symptoms. Imaging studies and histological analysis helped to confirm the diagnosis of BIA-ALCL. A bilateral capsulectomy was performed and adjuvant chemotherapy and immunotherapy were administered. With these interventions, the patient had complete resolution of her symptoms, good cosmetic results, and absence of tumor activity detectable by positron emission tomography with fluorodeoxyglucose (PET-CT FDG) at a 2.5-year follow-up.
    Discussion: This case describes an atypical presentation of BIA-ALCL as a breast mass, as well as lymph node and bone marrow involvement. Knowledge of the different presentation modalities of this pathology is necessary for a correct diagnosis and treatment. Through a multidisciplinary approach, adequate treatment was given with excellent results.
    Conclusion: Anaplastic large cell lymphoma associated with breast implants is a clinicopathological entity still little known in some medical fields. A variety of presentations must be considered, and high clinical suspicion must be maintained in patients with a history of textured breast implant placement to optimize diagnosis and avoid delays in treatment.
    Language English
    Publishing date 2023-07-07
    Publishing country Netherlands
    Document type Case Reports
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2023.108482
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Steroid receptors and their role in the biology and control of breast cancer growth.

    Cordera, Fernando / Jordan, V Craig

    Seminars in oncology

    2006  Volume 33, Issue 6, Page(s) 631–641

    Abstract: Steroid hormone receptors (estrogen receptor [ER] and progesterone receptor [PR]) play a critical role in the development of breast cancer. Most importantly, the expression of ER and/or PR by tumor cells provides important information that is critical ... ...

    Abstract Steroid hormone receptors (estrogen receptor [ER] and progesterone receptor [PR]) play a critical role in the development of breast cancer. Most importantly, the expression of ER and/or PR by tumor cells provides important information that is critical for the selection of treatment. Recent studies on ER and PR have provided new insights into the pathogenesis of breast cancer and the mechanisms of resistance to antihormonal therapy. Better understanding of steroid receptors, their ligands, and the mechanisms through which they exert their effects will allow the correct treatment to be targeted to responsive tumors.
    MeSH term(s) Antineoplastic Agents, Hormonal ; Breast Neoplasms/drug therapy ; Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Cell Proliferation ; Drug Resistance, Neoplasm ; Estrogen Receptor Modulators/therapeutic use ; Female ; Gene Expression Regulation, Neoplastic ; Histone Deacetylases/metabolism ; Humans ; Neoplasms, Hormone-Dependent/metabolism ; Neoplasms, Hormone-Dependent/pathology ; Receptors, Estrogen/physiology ; Receptors, Progesterone/physiology
    Chemical Substances Antineoplastic Agents, Hormonal ; Estrogen Receptor Modulators ; Receptors, Estrogen ; Receptors, Progesterone ; Histone Deacetylases (EC 3.5.1.98)
    Language English
    Publishing date 2006-12
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 189220-4
    ISSN 1532-8708 ; 0093-7754
    ISSN (online) 1532-8708
    ISSN 0093-7754
    DOI 10.1053/j.seminoncol.2006.08.020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Laparoscopic resection of gastric schwannoma: A case report.

    Cordera, Fernando / Salazar-Vitale, Andrea / Mejía-Sánchez, Estephany / Arrangoiz, Rodrigo / Caba-Molina, David / Muñoz-Juárez, Manuel / Luque-de-León, Enrique / Moreno-Paquentín, Eduardo

    International journal of surgery case reports

    2019  Volume 65, Page(s) 271–274

    Abstract: Introduction: Gastric schwannomas are an extremely rare presentation of mesenchymal tumors originating from Schwann cells, accounting for 0.2% of all gastric tumors. Patients are usually asymptomatic, so these tumors are frequently detected incidentally. ...

    Abstract Introduction: Gastric schwannomas are an extremely rare presentation of mesenchymal tumors originating from Schwann cells, accounting for 0.2% of all gastric tumors. Patients are usually asymptomatic, so these tumors are frequently detected incidentally.
    Presentation of case: 68-year old male patient found to have a 5 cm mass in the lesser curvature of the stomach. After a careful preoperative evaluation, complete laparoscopic resection was performed. Pathology review confirmed a completely resected gastric Schwannoma. The patient's recovery was uneventful. At a one-year follow-up he remains asymptomatic and with no evidence of disease.
    Discussion: We present the uncommon case of a gastric schwannoma that was appropriately treated with a laparoscopic approach and present a current literature review focusing on diagnostic and treatment methods of these rare tumors.
    Conclusion: Schwannomas should be included in the differential diagnosis of gastric tumors and can be appropriately treated with a laparoscopic approach.
    Language English
    Publishing date 2019-10-25
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2019.10.037
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Pulmonary extraskeletal myxoid chondrosarcoma: A case report and literature review.

    Balanzá, Ricardo / Arrangoiz, Rodrigo / Cordera, Fernando / Muñoz, Manuel / Luque-de-León, Enrique / Moreno, Eduardo / Molinar, Lourdes / Somerville, Nicole

    International journal of surgery case reports

    2016  Volume 27, Page(s) 96–101

    Abstract: Background: Extraskeletal myxoid chondrosarcoma (EMC) accounts for the 3% of all soft tissue sarcomas and it's categorized as a tumour of uncertain differentiation. This entity has shown to have the recurrent balanced chromosomal translocation t(9;22) ( ... ...

    Abstract Background: Extraskeletal myxoid chondrosarcoma (EMC) accounts for the 3% of all soft tissue sarcomas and it's categorized as a tumour of uncertain differentiation. This entity has shown to have the recurrent balanced chromosomal translocation t(9;22) (q22;q12.2), which leads to the oncogenic fusion gene EWSR1-NR4A3. This sarcoma usually presents as a slow growing, palpable mass in the extremities. EMC arising from the lung is extremely infrequent. We report one case of pulmonary extraskeletal mixoid chondrosarcoma and a review of the world literature.
    Case report: A 69-year-old male patient presented with intermittent hemoptysis for the last 6 months. A PET/CT scan showed a hypermetabolic solid mass with lobulated borders of approximately 29×26mm in the inferior right lobe. We performed a right thoracotomy with inferior lobectomy and lymphadenectomy of levels VII, VIII, X, and XI levels. The neoplasm was constituted by cords of small cells with small round nucleus and scarce cytoplasm immerse in an abundant myxoid matrix. The immunophenotype was positive for MUM-1, CDK4, MDM2, and showed focal expression for S-100 protein and CD56. The final pathology report revealed a pulmonary extraskeletal mixoid chondrosarcoma. No further surgical interventions or adjuvant therapies were needed.
    Conclusion: EMC is an intermediate-grade neoplasm, characterized by a long clinical course with high potential for local recurrence and distant metastasis. Treatment for EMC is surgical and non-surgical treatment is reserved for recurrence or metastatic disease. Pulmonary extraskeletal myxoid chondrosarcoma is a rare neoplasm with only isolated case reports found in the literature.
    Language English
    Publishing date 2016-08-26
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2016.08.025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Mammary analog secretory carcinoma of the parotid gland: A case report and literature review.

    Balanzá, Ricardo / Arrangoiz, Rodrigo / Cordera, Fernando / Muñoz, Manuel / Luque-de-León, Enrique / Moreno, Eduardo / Toledo, Carlos / González, Edgar

    International journal of surgery case reports

    2015  Volume 16, Page(s) 187–191

    Abstract: Background: Mammary analog secretory carcinoma (MASC) was first described in 2010 by Skálová et al. This entity shares morphologic and immunohistochemical features with the secretory carcinoma (SC) of the breast. MASC usually presents as an asymptomatic ...

    Abstract Background: Mammary analog secretory carcinoma (MASC) was first described in 2010 by Skálová et al. This entity shares morphologic and immunohistochemical features with the secretory carcinoma (SC) of the breast. MASC usually presents as an asymptomatic mass in the parotid gland and predominantly affects men. This tumor is considered a low-grade carcinoma but has the potential for high-grade transformation. We report one MASC case and a review of world literature.
    Case report: A 66-year-old male patient presented because he noticed a mass of approximately 3×3cm on the right pre-auricular region. Physical examination demonstrated a 3×3.5cm, firm, fixed, non-tender mass in the right pre-auricular region. An MRI of the head and neck showed an ovoid heterogeneous lesion, dependent of the right parotid gland of 27×28mm. We performed a superficial parotidectomy with identification and preservation of the facial nerve. The immunophenotype was positive for epithelial membrane antigen (EMA), CK8/18, vimentin, S-100 protein, and mammoglobin. No further surgical interventions or adjuvant therapies were needed. The patient will have a close follow up.
    Conclusion: The presence of t(12;15) (p13;q25) translocation which results in the ETV6-NTRK3 gene fusion or positive immunochemical studies for STAT5, mammoglobin and S100 protein, are necessary to confirm the diagnosis of MASC. MASC treatment should mimic the management of other low-grade malignant salivary gland neoplasms. The inhibition of ETV6-NTRK3 gene fusion could be used as treatment in the future.
    Language English
    Publishing date 2015-10-01
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2015.09.031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Estrogen receptors as therapeutic targets in breast cancer.

    Ariazi, Eric A / Ariazi, Jennifer L / Cordera, Fernando / Jordan, V Craig

    Current topics in medicinal chemistry

    2006  Volume 6, Issue 3, Page(s) 181–202

    Abstract: The estrogen receptor alpha (ERalpha) has proven to be the single most important target in breast cancer over the last 30 years. The use of the selective ER modulator (SERM) tamoxifen for the treatment and prevention of breast cancer has changed ... ...

    Abstract The estrogen receptor alpha (ERalpha) has proven to be the single most important target in breast cancer over the last 30 years. The use of the selective ER modulator (SERM) tamoxifen for the treatment and prevention of breast cancer has changed therapeutics. The SERM raloxifene, approved for the treatment of osteoporosis, lacks tamoxifen's increased risk for endometrial cancer and is being evaluated for the prevention of breast cancer. Other SERMs approved or under development for use against breast cancer or osteoporosis include toremifene, GW5638, GW7604 (the active metabolite of GW5638), idoxifene, lasofoxifene, arzoxifene, bazedoxifene, EM-800 and acolbifene (the active metabolite of EM-800). Aromatase inhibitors (AIs) have recently proven to be more efficacious than tamoxifen as first-line therapy, efficacious for second-line therapy (e.g. against tamoxifen-resistant disease), and useful for extended adjuvant therapy after tamoxifen. The AIs include the non-steroidal agents letrozole and anastrole, and the steroidal agent exemestane. The pure antiestrogen fulvestrant has proven to be just as effective as AIs. Other pure antiestrogens, ZK-703, ZK-253, RU 58668 and TAS-108 show great promise. The development of resistance to endocrine therapy remains a clinically important problem, and laboratory models based on human breast cancer cells grown as tumors in immune-compromised mice have led to important insights into this problem. Progesterone receptor-negative status of ER-positive breast cancers may reflect altered growth factor receptor signaling, and helps to explain why this subclass of tumors exhibits lower response rates to tamoxifen compared to cancers typed progesterone receptor-positive. Crosstalk among plasma membrane-localized ER, growth factor receptor signaling, and nuclear-localized ER provide further insights into antihormonal-resistant breast cancer.
    MeSH term(s) Animals ; Breast Neoplasms/drug therapy ; Drug Delivery Systems ; Estrogen Receptor alpha/agonists ; Estrogen Receptor alpha/antagonists & inhibitors ; Estrogen Receptor beta/agonists ; Estrogen Receptor beta/antagonists & inhibitors ; Female ; Humans ; Receptors, Estrogen/agonists ; Receptors, Estrogen/antagonists & inhibitors ; Selective Estrogen Receptor Modulators/pharmacology
    Chemical Substances Estrogen Receptor alpha ; Estrogen Receptor beta ; Receptors, Estrogen ; Selective Estrogen Receptor Modulators
    Language English
    Publishing date 2006
    Publishing country Netherlands
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2064823-6
    ISSN 1873-4294 ; 1568-0266
    ISSN (online) 1873-4294
    ISSN 1568-0266
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Type IV thoracoabdominal aortic aneurysm with lymphoplasmacytic aortitis and cystic medial degeneration in a 32-year-old patient with Marfan syndrome.

    Cordera, Fernando / Bowen, Juan M / Aubry, Marie-Christine / Gloviczki, Peter

    Journal of vascular surgery

    2005  Volume 42, Issue 1, Page(s) 168–171

    Abstract: Aortitis identified in approximately 12% of all thoracoabdominal aneurysms. The most common subtype of inflammatory aortitis is giant cell aortitis, followed by lymphoplasmacytic aortitis. Inflammatory aortitis may occur in isolation or as part of a ... ...

    Abstract Aortitis identified in approximately 12% of all thoracoabdominal aneurysms. The most common subtype of inflammatory aortitis is giant cell aortitis, followed by lymphoplasmacytic aortitis. Inflammatory aortitis may occur in isolation or as part of a systemic inflammatory disorder such as Takayasu arteritis, systemic lupus erythematosus, rheumatoid arthritis, and giant cell arteritis. Aortitis has not been described in patients with Marfan syndrome. We report the case of a 32-year-old man with Marfan syndrome and a strong family history of aneurysmal disease who presented with an asymptomatic Crawford type IV thoracoabdominal aneurysm. His aneurysm had no associated dissection, and surgical pathology revealed severe medial degeneration and lymphoplasmacytic aortitis. To our knowledge, this is the first report of such a finding in a patient with Marfan syndrome.
    MeSH term(s) Adult ; Aortic Aneurysm, Abdominal/complications ; Aortic Aneurysm, Abdominal/surgery ; Aortitis/complications ; Aortitis/pathology ; Blood Vessel Prosthesis Implantation ; Humans ; Male ; Marfan Syndrome/complications ; Tunica Media/pathology
    Language English
    Publishing date 2005-07
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 605700-7
    ISSN 1097-6809 ; 0741-5214
    ISSN (online) 1097-6809
    ISSN 0741-5214
    DOI 10.1016/j.jvs.2005.03.033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Unsatisfactory weight loss after vertical banded gastroplasty: is conversion to Roux-en-Y gastric bypass successful?

    Cordera, Fernando / Mai, Jane L / Thompson, Geoffrey B / Sarr, Michael G

    Surgery

    2004  Volume 136, Issue 4, Page(s) 731–737

    Abstract: Background: In 1991, the National Institutes of Health sanctioned 2 operations for treatment of morbid obesity: vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGB). Long-term results with VBG are disappointing. We wondered whether ... ...

    Abstract Background: In 1991, the National Institutes of Health sanctioned 2 operations for treatment of morbid obesity: vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGB). Long-term results with VBG are disappointing. We wondered whether patients who had "adapted" to the VBG anatomy and had regained weight would lose weight after conversion to RYGB.
    Methods: We reviewed data on patients undergoing conversion of VBG to RGYB.
    Results: Fifty-four patients (mean body mass index [BMI] of 46 kg/m2 [range, 36-66]) underwent standard (48 patients) or distal (malabsorptive) (6 patients) RYGB. There were no perioperative deaths; postoperative morbidity delaying discharge occurred in 7 patients (13%). Follow-up (complete in 51 patients, x=6.1 years) was obtained by mail questionnaires and patient contact. Mean BMI decreased to 35 kg/m 2 (range, 22-47), and 59% of the patients with >1 year follow-up had a BMI <35 kg/m2 . The number of patients requiring positive pressure oxygen for sleep apnea decreased by half; most patients discontinued or decreased the number of medications treating weight-related comorbidities. At last follow-up, 90% of patients were satisfied subjectively with the results.
    Conclusions: Conversion of VBG to RYGB is safe and provides weight loss, improved quality of life, and reversal of weight related comorbidities.
    MeSH term(s) Adult ; Aged ; Anastomosis, Roux-en-Y ; Female ; Gastric Bypass/adverse effects ; Gastric Bypass/mortality ; Gastroplasty/adverse effects ; Gastroplasty/mortality ; Humans ; Male ; Middle Aged ; Morbidity ; Obesity, Morbid/mortality ; Obesity, Morbid/surgery ; Reoperation ; Retrospective Studies ; Stomach/surgery ; Treatment Outcome ; Weight Loss
    Language English
    Publishing date 2004-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2004.05.055
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Significance of common hepatic artery lymph node metastases during pancreaticoduodenectomy for pancreatic head adenocarcinoma.

    Cordera, Fernando / Arciero, Cletus A / Li, Tianyu / Watson, James C / Hoffman, John P

    Annals of surgical oncology

    2007  Volume 14, Issue 8, Page(s) 2330–2336

    Abstract: Background: Common hepatic artery lymph nodes (CHALN) are frequently sampled during pancreaticoduodenectomy for adenocarcinomas of the head of the pancreas. In some institutions, if metastatic disease is detected intraoperatively in these lymph nodes, ... ...

    Abstract Background: Common hepatic artery lymph nodes (CHALN) are frequently sampled during pancreaticoduodenectomy for adenocarcinomas of the head of the pancreas. In some institutions, if metastatic disease is detected intraoperatively in these lymph nodes, the tumor is considered unresectable and a curative operation is not performed. No solid data exist to support this practice.
    Methods: A retrospective review of a prospectively collected database was conducted of the records of all patients who underwent a pancreaticoduodenectomy for pancreatic adenocarcinoma between September 1991 and April 2005. Clinical and pathologic factors were analyzed to determine their influence on survival.
    Results: Fifty-five of 175 patients had CHALN separately identified and evaluated; these patients constituted the study population. Thirty-eight patients (69%) had one or more lymph nodes with metastatic involvement; 10 of these had disease in CHALN. The median overall survival for patients with node-negative, node-positive (but CHALN-negative), and CHALN-positive disease were 22.9, 16.1, and 14.7 months, respectively. The 5-year overall survival rates for the respective groups were 22%, 17%, and 0%.
    Conclusions: CHALN metastases correlate with poor prognosis and no long-term survival. Further studies examining CHALN status are indicated and could lead to modifications of pancreatic cancer staging and management.
    MeSH term(s) Adenocarcinoma/pathology ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Disease-Free Survival ; Female ; Hepatic Artery/pathology ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy ; Prognosis ; Prospective Studies ; Survival Rate ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2007-08
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-006-9339-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Androgen-secreting adrenal tumors.

    Cordera, Fernando / Grant, Clive / van Heerden, Jon / Thompson, Geoffrey / Young, William

    Surgery

    2003  Volume 134, Issue 6, Page(s) 874–80; discussion 880

    Abstract: Background: Adrenal tumors that secrete androgens exclusively are extraordinarily rare. The aim of this study was to characterize patients with pure androgen-secreting adrenal tumors.: Methods: A retrospective chart review from January 1946 through ... ...

    Abstract Background: Adrenal tumors that secrete androgens exclusively are extraordinarily rare. The aim of this study was to characterize patients with pure androgen-secreting adrenal tumors.
    Methods: A retrospective chart review from January 1946 through November 2002 identified 11 female patients with pure androgen-secreting adrenal tumors.
    Results: The mean age was 23.4 years (range, 1-52). The most common presenting symptoms were hirsutism, acne, and clitoral enlargement. Elevated 17-ketosteroids were found in seven of nine tested patients. Computed tomogram, ultrasound, or both localized tumors in six of seven patients. All tumors were surgically resected, one laparoscopically, all without complications. Five of the 11 tumors were malignant. Mean weight and mean maximal diameter for benign and malignant tumors were 44 g and 4.2 cm and 232 g and 9.8 cm, respectively. Mean hospital stay was 8.5 days, with excess androgen production resolved in all patients. Recurrence and disease-related death occurred in only one patient who had pulmonary metastases at diagnosis. The remaining patients had no recurrence of tumor at mean follow-up of 11.7 years (range, 0.5-32 years).
    Conclusions: Pure androgen-producing tumors are extremely rare. Approximately 50% are benign, and surgical resection provides excellent treatment if the tumors are not metastatic at the time of diagnosis.
    MeSH term(s) Adolescent ; Adrenal Gland Neoplasms/metabolism ; Adrenal Gland Neoplasms/pathology ; Adrenal Gland Neoplasms/physiopathology ; Adrenal Gland Neoplasms/surgery ; Adrenocortical Adenoma/metabolism ; Adrenocortical Adenoma/pathology ; Adrenocortical Adenoma/physiopathology ; Adrenocortical Adenoma/surgery ; Adrenocortical Carcinoma/metabolism ; Adrenocortical Carcinoma/physiopathology ; Adrenocortical Carcinoma/secondary ; Adrenocortical Carcinoma/therapy ; Adult ; Androgens/biosynthesis ; Child, Preschool ; Female ; Humans ; Infant ; Lung Neoplasms/metabolism ; Lung Neoplasms/physiopathology ; Lung Neoplasms/secondary ; Lung Neoplasms/therapy ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Virilism/physiopathology
    Chemical Substances Androgens
    Language English
    Publishing date 2003-11-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/s0039-6060(03)00410-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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