Management of adrenal incidentaloma: the role of adrenalectomy may be underesti
PUBLISHED: 2015-11-30  199 total views, 1 today

Yunlin Ye, Zike Qin

Urology, Sun Yat-sen University Cancer Center

 


Objective:As the development of imaging technology,the incidence of adrenal incidentaloma is increasing. Adrenalectomy isrecommended for patients with potential malignant or hypersecretory lesions,and surveillance is for non-functioning small tumor. But the evaluation ofmalignant lesions is undefined and the distribution of incidentaloma type iscontroversial. This study is to demonstrate clinical characters of adrenalincidentaloma in South China and explore the management of it. Method: Theclinical data of patients with adrenal neoplasm from Jan 1998 to Dec 2012 wereanalyzed retrospectively. Patients with suspicions of adrenal abnormalities ordetected in staging procedure of other cancer, were excluded. Most patientswith adrenal incidentaloma performed adrenalectomy, and some chose surveillance.Relationships between clinical features were analyzed with chi-square test andrank sum test. Result: Six hundred and thirty four patients with adrenalincidentaloma were recorded. They were 17 to 85 years old, with a median age of50 years. Of 478 cases with pathological results, adenoma was the most commontumor (233/478). Cases of pheochromocytoma and adrenocortical carcinoma were 84and 36, respectively. For tumor size≤100px, >95% tumors were benign, and 33%were malignant for those >150px. For patients with tumor size≤100px, 249/376cases were performed adrenalectomy. Conclusion: Pheochromocytoma andadrenocortical carcinoma were not rare tumor of adrenal incidentaloma. 100px is agood cutoff for diagnosis. Laparoscopic adrenalectomy may be a trend for managementof small adrenal incidentaloma other than surveillance.

 


Key Words: Adrenal tumor, Incidentaloma, Adrenalectomy


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