MADSON QUEIROZ DE ALMEIDA

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Lattes
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/42 - Laboratório de Hormônios e Genética Molecular, Hospital das Clínicas, Faculdade de Medicina

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  • article 8 Citação(ões) na Scopus
    Amplification of the Insulin-Like Growth Factor 1 Receptor Gene Is a Rare Event in Adrenocortical Adenocarcinomas: Searching for Potential Mechanisms of Overexpression
    (2014) RIBEIRO, Tamaya Castro; JORGE, Alexander Augusto; ALMEIDA, Madson Q.; MARIANI, Beatriz Marinho de Paula; NISHI, Mirian Yumi; MENDONCA, Berenice Bilharinho; FRAGOSO, Maria Candida Barisson Villares; LATRONICO, Ana Claudia
    Context. IGF1R overexpression appears to be a prognostic biomarker of metastatic pediatric adrenocortical tumors. However, the molecular mechanisms that are implicated in its upregulation remain unknown. Aim. To investigate the potential mechanisms involved in IGF1R overexpression. Patients and Methods. We studied 64 adrenocortical tumors. IGF1R copy number variation was determined in all patients using MLPA and confirmed using real time PCR. In a subgroup of 32 patients, automatic sequencing was used to identify IGF1R allelic variants and the expression of microRNAs involved in IGF1R regulation by real time PCR. Results. IGF1R amplification was detected in an adrenocortical carcinoma that was diagnosed in a 46-year-old woman with Cushing's syndrome and virilization. IGF1R overexpression was demonstrated in this case. In addition, gene amplification of other loci was identified in this adrenocortical malignant tumor, but no IGF1R copy number variation was evidenced in the remaining cases. Automatic sequencing revealed three known polymorphisms but they did not correlate with its expression. Expression of miR-100, miR-145, miR-375, and miR-126 did not correlate with IGF1R expression. Conclusion. We demonstrated amplification and overexpression of IGF1R gene in only one adrenocortical carcinoma, suggesting that these combined events are uncommon. In addition, IGF1R polymorphisms and abnormal microRNA expression did not correlate with IGF1R upregulation in adrenocortical tumors.
  • article 1 Citação(ões) na Scopus
    Retrospective Analysis of Prognostic Factors in Pediatric Patients with Adrenocortical Tumor from Unique Tertiary Center with Long-Term Follow-Up
    (2022) BACHEGA, Fernanda S.; V, Caio Suartz; ALMEIDA, Madson Q.; BRONDANI, Vania B.; CHARCHAR, Helaine L. S.; LACOMBE, Amanda M. F.; MARTINS-FILHO, Sebastiao N.; SOARES, Ibere C.; ZERBINI, Maria Claudia N.; DENES, Francisco T.; MENDONCA, Berenice; I, Roberto Lopes; LATRONICO, Ana Claudia; V, Maria Candida B. Fragoso
    Pediatric adrenocortical tumors (PACTs) represent rare causes of malignancies. However, the south/southeast regions of Brazil are known to have a high incidence of PACTs because of the founder effect associated with a germline pathogenic variant of tumor suppressor gene TP53. We aimed to retrospectively analyze the types of variables among hormone production, radiological imaging, tumor staging, histological and genetic features that were associated with the occurrence of malignancy in 95 patients (71% females) with PACTs from a unique center. The worst prognosis was associated with those aged > 3 years (p < 0.05), high serum levels of 11-desoxicortisol (p < 0.001), tumor weight >= 200 g (p < 0.001), tumor size >= 5 cm (p < 0.05), Weiss score >= 5 (p < 0.05), Wieneke index >= 3 (p < 0.001) and Ki67 >= 15% (p < 0.05). Furthermore, patients with MacFarlane stage IV had an overall survival rate almost two times shorter than patients with other stages (p < 0.001). Additionally, the subtractions of BUB1B-PINK1 (<6.95) expression (p < 0.05) and IGF-IR overexpression (p = 0.0001) were associated with malignant behavior. These results helped identify patients who are likely to have an aggressive course; further multicenter prospective studies are required to confirm our results. In conclusion, PACTs with these patterns of prognostic factors could be treated using an adjuvant approach that may improve the overall survival in such patients.
  • article 26 Citação(ões) na Scopus
    PROP1 and CTNNB1 expression in adamantinomatous craniopharyngiomas with or without beta-catenin mutations
    (2011) CANI, Carolina M. G.; MATUSHITA, Hamilton; CARVALHO, Luciani R. S.; SOARES, Ibere C.; BRITO, Luciana P.; ALMEIDA, Madson Q.; MENDONCA, Berenice B.
    INTRODUCTION: Activating mutations in exon 3 of the beta-catenin gene are involved in the pathogenesis of adamantinomatous craniopharyngiomas. Recently, the interaction between beta-catenin and PROP1 has been shown to be responsible for pituitary cell lineage determination. We hypothesized that dysregulated PROP1 expression could also be involved in the pathogenesis of craniopharyngiomas. OBJECTIVES: To determine whether dysregulated gene expression was responsible for tumor pathogenesis in adamantinomatous craniopharyngiomas, the beta-catenin gene was screened for mutations, and the expression of the beta-catenin gene and PROP1 was evaluated. METHODS: The beta-catenin gene was amplified and sequenced from 14 samples of adamantinomatous craniopharyngiomas. PROP1 and beta-catenin gene expression was assessed by real-time RT-PCR from 12 samples, and beta-catenin immunohistochemistry was performed on 11 samples. RESULTS: Mutations in the beta-catenin gene were identified in 64% of the adamantinomatous craniopharyngiomas samples. Evidence of beta-catenin gene overexpression was found in 71% of the tumors with beta-catenin mutations and in 40% of the tumors without mutations, and beta-catenin immunohistochemistry revealed a nuclear staining pattern for each of the analyzed samples. PROP1 expression was undetectable in all of the tumor samples. CONCLUSION: We found evidence of beta-catenin gene overexpression in the majority of adamantinomatous craniopharyngiomas, and we also detected a nuclear beta-catenin staining pattern regardless of the presence of a beta-catenin gene mutation. These results suggest that WNT signaling activation plays an important role in the pathogenesis of adamantinomatous craniopharyngiomas. Additionally, this study was the first to evaluate PROP1 expression in adamantinomatous craniopharyngiomas, and the absence of PROP1 expression indicates that this gene is not involved in the pathogenesis of this tumor, at least in this cohort.
  • article 10 Citação(ões) na Scopus
    Perioperative Management of Pheochromocytomas and Sympathetic Paragangliomas
    (2022) FAGUNDES, Gustavo F. C.; ALMEIDA, Madson Q.
    Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors arising from chromaffin cells of the adrenal medulla or extra-adrenal paraganglia, respectively. PPGLs have the highest degree of heritability among endocrine tumors. Currently, similar to 40% of individuals with PPGLs have a genetic germline and there are at least 12 different genetic syndromes related to these tumors. Metastatic PPGLs are defined by the presence of distant metastases at sites where chromaffin cells are physiologically absent. Approximately 10% of pheochromocytomas and similar to 40% of sympathetic paragangliomas are linked to metastases, explaining why complete surgical resection is the first-choice treatment for all PPGL patients. The surgical approach is a high-risk procedure requiring perioperative management by a specialized multidisciplinary team in centers with broad expertise. In this review, we summarize and discuss the most relevant aspects of perioperative management in patients with pheochromocytomas and sympathetic paragangliomas.
  • article 82 Citação(ões) na Scopus
    Comparison of Pheochromocytoma-Specific Morbidity and Mortality Among Adults With Bilateral Pheochromocytomas Undergoing Total Adrenalectomy vs Cortical-Sparing Adrenalectomy
    (2019) NEUMANN, Hartmut P. H.; TSOY, Uliana; BANCOS, Irina; AMODRU, Vincent; WALZ, Martin K.; TIROSH, Amit; KAUR, Ravinder Jeet; MCKENZIE, Travis; QI, Xiaoping; BANDGAR, Tushar; PETROV, Roman; YUKINA, Marina Y.; ROSLYAKOVA, Anna; HORST-SCHRIVERS, Anouk N. A. van der; BERENDS, Annika M. A.; HOFF, Ana O.; CASTRONEVES, Luciana Audi; FERRARA, Alfonso Massimiliano; RIZZATI, Silvia; MIAN, Caterina; DVORAKOVA, Sarka; HASSE-LAZAR, Kornelia; KVACHENYUK, Andrey; PECZKOWSKA, Mariola; LOLI, Paola; ERENLER, Feyza; KRAUSS, Tobias; ALMEIDA, Madson Q.; LIU, Longfei; ZHU, Feizhou; RECASENS, Monica; WOHLLK, Nelson; CORSSMIT, Eleonora P. M.; SHAFIGULLINA, Zulfiya; CALISSENDORFF, Jan; GROZINSKY-GLASBERG, Simona; KUNAVISARUT, Tada; SCHALIN-JANTTI, Camilla; CASTINETTI, Frederic; VLCEK, Petr; BELTSEVICH, Dmitry; I, Viacheslav Egorov; SCHIAVI, Francesca; LINKS, Thera P.; LECHAN, Ronald M.; BAUSCH, Birke; YOUNG JR., William F.; ENG, Charis; JAISWAL, Sanjeet Kumar; ZSCHIEDRICH, Stefan; V, Maria C. B. Fragoso; PEREIRA, Maria A. A.; LI, Minghao; COSTA, Josefina Biarnes; JUHLIN, Carl Christofer; GROSS, David; VIOLANTE, Alice H. D.; KOCJAN, Tomaz; NGEOW, Joanne; YOEL, Uri; FRAENKEL, Merav; SIMSIR, Ilgin Yildirim; UGURLU, M. Umit; ZIAGAKI, Athanasia; DIAZ, Luis Robles; KUDLAI, Inna Stepanovna; GIMM, Oliver; SCHERBAUM, Christina Rebecca; ABEBE-CAMPINO, Gadi; BARBON, Giovanni; TASCHIN, Elisa; MALINOC, Angelica; KHUDIAKOVA, Natalia Valeryevna; V, Nikita Ivanov; PFEIFER, Marija; ZOVATO, Stefania; PLOECKINGER, Ursula; MAKAY, Ozer; GRINEVA, Elena; JARZAB, Barbara; JANUSZEWICZ, Andrzej; SHAH, Nalini; SEUFERT, Jochen; OPOCHER, Giuseppe; LARSSON, Catharina
    IMPORTANCE Large studies investigating long-term outcomes of patients with bilateral pheochromocytomas treated with either total or cortical-sparing adrenalectomies are needed to inform clinical management. OBJECTIVE To determine the association of total vs cortical-sparing adrenalectomy with pheochromocytoma-specific mortality, the burden of primary adrenal insufficiency after bilateral adrenalectomy, and the risk of pheochromocytoma recurrence. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from a multicenter consortium-based registry for 625 patients treated for bilateral pheochromocytomas between 1950 and 2018. Data were analyzed from September 1, 2018, to June 1, 2019. EXPOSURES Total or cortical-sparing adrenalectomy. MAIN OUTCOMES AND MEASURES Primary adrenal insufficiency, recurrent pheochromocytoma, and mortality. RESULTS Of 625 patients (300 [48%] female) with a median (interquartile range [IQR]) age of 30 (22-40) years at diagnosis, 401 (64%) were diagnosed with synchronous bilateral pheochromocytomas and 224 (36%) were diagnosed with metachronous pheochromocytomas (median [IQR] interval to second adrenalectomy, 6 [1-13] years). In 505 of 526 tested patients (96%), germline mutationswere detected in the genes RET (282 patients [54%]), VHL (184 patients [35%]), and other genes (39 patients [7%]). Of 849 adrenalectomies performed in 625 patients, 324 (52%) were planned as cortical sparing and were successful in 248 of 324 patients (76.5%). Primary adrenal insufficiency occurred in all patients treated with total adrenalectomy but only in 23.5% of patients treated with attempted cortical-sparing adrenalectomy. A third of patients with adrenal insufficiency developed complications, such as adrenal crisis or iatrogenic Cushing syndrome. Of 377 patients who became steroid dependent, 67 (18%) developed at least 1 adrenal crisis and 50 (13%) developed iatrogenic Cushing syndrome during median (IQR) follow-up of 8 (3-25) years. Two patients developed recurrent pheochromocytoma in the adrenal bed despite total adrenalectomy. In contrast, 33 patients (13%) treated with successful cortical-sparing adrenalectomy developed another pheochromocytoma within the remnant adrenal after a median (IQR) of 8 (4-13) years, all of which were successfully treated with another surgery. Cortical-sparing surgery was not associated with survival. Overall survivalwas associated with comorbidities unrelated to pheochromocytoma: of 63 patients who died, only 3 (5%) died of metastatic pheochromocytoma. CONCLUSIONS AND RELEVANCE Patients undergoing cortical-sparing adrenalectomy did not demonstrate decreased survival, despite development of recurrent pheochromocytoma in 13%. Cortical-sparing adrenalectomy should be considered in all patients with hereditary pheochromocytoma.
  • article 0 Citação(ões) na Scopus
    Editorial: A year in review: discussions in cancer endocrinology
    (2023) ALMEIDA, Madson; SHARIFI-RAD, Javad; VELLA, Veronica
  • article 36 Citação(ões) na Scopus
    XAF1 as a modifier of p53 function and cancer susceptibility
    (2020) PINTO, Emilia M.; FIGUEIREDO, Bonald C.; CHEN, Wenan; GALVAO, Henrique C. R.; FORMIGA, Maria Nirvana; V, Maria Candida B. Fragoso; ASHTON-PROLLA, Patricia; RIBEIRO, Enilze M. S. F.; FELIX, Gabriela; COSTA, Tatiana E. B.; SAVAGE, Sharon A.; YEAGER, Meredith; I, Edenir Palmero; VOLC, Sahlua; SALVADOR, Hector; FUSTER-SOLER, Jose Luis; LAVARINO, Cinzia; CHANTADA, Guillermo; VAUR, Dominique; ODONE-FILHO, Vicente; BRUGIERES, Laurence; ELSE, Tobias; STOFFEL, Elena M.; MAXWELL, Kara N.; ACHATZ, Maria Isabel; KOWALSKI, Luis; ANDRADE, Kelvin C. de; PAPPO, Alberto; LETOUZE, Eric; LATRONICO, Ana Claudia; MENDONCA, Berenice B.; ALMEIDA, Madson Q.; BRONDANI, Vania B.; BITTAR, Camila M.; SOARES, Emerson W. S.; MATHIAS, Carolina; RAMOS, Cintia R. N.; MACHADO, Moara; ZHOU, Weiyin; JONES, Kristine; VOGT, Aurelie; KLINCHA, Payal P.; SANTIAGO, Karina M.; KOMECHEN, Heloisa; PARAIZO, Mariana M.; PARISE, Ivy Z. S.; V, Kayla Hamilton; WANG, Jinling; RAMPERSAUD, Evadnie; CLAY, Michael R.; MURPHY, Andrew J.; LALLI, Enzo; NICHOLS, Kim E.; RIBEIRO, Raul C.; RODRIGUEZ-GALINDO, Carlos; KORBONITS, Marta; ZHANG, Jinghui; THOMAS, Mark G.; CONNELLY, Jon P.; PRUETT-MILLER, Shondra; DIEKMANN, Yoan; NEALE, Geoffrey; WU, Gang; ZAMBETTI, Gerard P.
    Cancer risk is highly variable in carriers of the common TP53-R337H founder allele, possibly due to the influence of modifier genes. Whole-genome sequencing identified a variant in the tumor suppressor XAF1 (E134*/Glu134Ter/rs146752602) in a subset of R337H carriers. Haplotype-defining variants were verified in 203 patients with cancer, 582 relatives, and 42,438 newborns. The compound mutant haplotype was enriched in patients with cancer, conferring risk for sarcoma (P = 0.003) and subsequent malignancies (P = 0.006). Functional analyses demonstrated that wild-type XAF1 enhances transactivation of wild-type and hypomorphic TP53 variants, whereas XAF1-E134* is markedly attenuated in this activity. We propose that cosegregation of XAF1-E134* and TP53-R337H mutations leads to a more aggressive cancer phenotype than TP53-R337H alone, with implications for genetic counseling and clinical management of hypomorphic TP53 mutant carriers.
  • article 49 Citação(ões) na Scopus
    Diagnosis and management of primary aldosteronism
    (2017) VILELA, Leticia A. P.; ALMEIDA, Madson Q.
    ABSTRACT Primary aldosteronism (PA) is the most common form of secondary hypertension (HTN), with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Patients with PA have higher cardiovascular morbidity and mortality than age- and sex-matched patients with essential HTN and the same degree of blood pressure elevation. PA is characterized by an autonomous aldosterone production causing sodium retention, plasma renin supression, HTN, cardiovascular damage, and increased potassium excretion, leading to variable degrees of hypokalemia. Aldosterone-producing adenomas (APAs) account for around 40% and idiopathic hyperaldosteronism for around 60% of PA cases. The aldosterone-to-renin ratio is the most sensitive screening test for PA. There are several confirmatory tests and the current literature does not identify a “gold standard” confirmatory test for PA. In our institution, we recommend starting case confirmation with the furosemide test. After case confirmation, all patients with PA should undergo adrenal CT as the initial study in subtype testing to exclude adrenocortical carcinoma. Bilateral adrenal vein sampling (AVS) is the gold standard method to define the PA subtype, but it is not indicated in all cases. An experienced radiologist must perform AVS. Unilateral laparoscopic adrenalectomy is the preferential treatment for patients with APAs, and bilateral hyperplasia should be treated with mineralocorticoid antagonist (spironolactone or eplerenone). Cardiovascular morbidity caused by aldosterone excess can be decreased by either unilateral adrenalectomy or mineralocorticoid antagonist. In this review, we address the most relevant issues regarding PA screening, case confirmation, subtype classification, and treatment.
  • article 5 Citação(ões) na Scopus
    Predictors of complication after adrenalectomy
    (2019) SROUGI, Victor; BARBOSA, Joao A. B.; MASSAUD, Isaac; CAVALCANTE, Isadora P.; TANNO, Fabio Y.; ALMEIDA, Madson Q.; SROUGI, Miguel; FRAGOSO, Maria C.; CHAMBO, Jose L.
    Purpose: To investigate risk factors for complications in patients undergoing adrenalectomy. Materials and Methods: A retrospective search of our institutional database was performed of patients who underwent adrenalectomy, between 2014 and 2018. Clinical parameters and adrenal disorder characteristics were assessed and correlated to intra and post-operative course. Complications were analyzed within 30-days after surgery. A logistic regression was performed in order to identify independent predictors of morbidity in patients after adrenalectomy. Results: The files of 154 patients were reviewed. Median age and Body Mass Index (BMI) were 52-years and 27.8kg/m(2), respectively. Mean tumor size was 4.9 +/- 4cm. Median surgery duration and estimated blood loss were 140min and 50mL, respectively. There were six conversions to open surgery. Minor and major post-operative complications occurred in 17.5% and 8.4% of the patients. Intra-operative complications occurred in 26.6% of the patients. Four patients died. Mean hospitalization duration was 4-days (Interquartile Range: 3-8). Patients age (p=0.004), comorbidities (p=0.003) and pathological diagnosis (p=0.003) were independent predictors of post-operative complications. Tumor size (p<0.001) and BMI (p=0.009) were independent predictors of intra-operative complications. Pathological diagnosis (p<0.001) and Charlson score (p=0.013) were independent predictors of death. Conclusion: Diligent care is needed with older patients, with multiple comorbidities and harboring unfavorable adrenal disorders (adrenocortical carcinoma and pheocromocytoma), who have greater risk of post-operative complications. Patients with elevated BMI and larger tumors have higher risk of intra, but not of post-operative complications.
  • article 6 Citação(ões) na Scopus
    Pathogenesis of Primary Aldosteronism: Impact on Clinical Outcome
    (2022) SANTANA, Lucas S.; GUIMARAES, Augusto G.; ALMEIDA, Madson Q.
    Primary aldosteronism (PA) is the most common form of secondary arterial hypertension, with a prevalence of approximately 20% in patients with resistant hypertension. In the last decade, somatic pathogenic variants in KCNJ5, CACNA1D, ATP1A1 and ATP2B3 genes, which are involved in maintaining intracellular ionic homeostasis and cell membrane potential, were described in aldosterone-producing adenomas (aldosteronomas). All variants in these genes lead to the activation of calcium signaling, the major trigger for aldosterone production. Genetic causes of familial hyperaldosteronism have been expanded through the report of germline pathogenic variants in KCNJ5, CACNA1H and CLCN2 genes. Moreover, PDE2A and PDE3B variants were associated with bilateral PA and increased the spectrum of genetic etiologies of PA. Of great importance, the genetic investigation of adrenal lesions guided by the CYP11B2 staining strongly changed the landscape of somatic genetic findings of PA. Furthermore, CYP11B2 staining allowed the better characterization of the aldosterone-producing adrenal lesions in unilateral PA. Aldosterone production may occur from multiple sources, such as solitary aldosteronoma or aldosterone-producing nodule (classical histopathology) or clusters of autonomous aldosterone-producing cells without apparent neoplasia denominated aldosterone-producing micronodules (non-classical histopathology). Interestingly, KCNJ5 mutational status and classical histopathology of unilateral PA (aldosteronoma) have emerged as relevant predictors of clinical and biochemical outcome, respectively. In this review, we summarize the most recent advances in the pathogenesis of PA and discuss their impact on clinical outcome.