Vol 68, No 4 (2017)
Original paper
Published online: 2017-06-07

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Adrenal tumour bigger than 5 cm — what could it be? An analysis of 139 cases

Andrzej Cichocki1, Radosław Samsel, Lucyna Papierska, Katarzyna Roszkowska-Purska, Karolina Nowak, Zbigniew Jodkiewicz, Anna Kasperlik-Załuska
Pubmed: 28604945
Endokrynol Pol 2017;68(4):411-415.

Abstract

Introduction: There is an increasing number of adrenal being tumours discovered incidentally during imaging examinations performed for many different indications. Radiological findings suggesting adrenal pathology may be caused by true adrenal tumours or by other retroperitoneal masses. Generally, the larger the tumour, the higher the possibility of adrenal cancer.

Material and methods: Analysis of our data — 139 operations performed over 11 years (2004–2014) in patients with tumours in the adrenal area larger than 5 cm.

Results: The most common finding was adrenal cancer (25.2%), benign adenoma (24.5%), pheochromocytoma (12.9%), and metastatic cancer (10.1%). In total, there were 19 various histopathological diagnoses in this group.

Conclusion: Although adrenal cancer is the most likely diagnosis in large adrenal tumours, a broad spectrum of various adrenal and retroperitoneal tumours with size more than 5 cm can be found in such patients.

References

  1. Bovio S, Cataldi A, Reimondo G, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest. 2006; 29(4): 298–302.
  2. Young WF. Management approaches to adrenal incidentalomas: a view from Rochester, Minnesota. Endocrinol Metab Clin North Am. 2009; 29: 159–85.
  3. Kloos RT, Gross MD, Francis IR, et al. Incidentally discovered adrenal masses. Endocr Rev. 1995; 16(4): 460–484.
  4. Lee J, El-Tamer M, Schifftner T, et al. Open and laparoscopic adrenalectomy: analysis of the National Surgical Quality Improvement Program. J Am Coll Surg. 2008; 206(5): 953–959.
  5. Bittner JG, Brunt LM. Evaluation and management of adrenal incidentaloma. J Surg Oncol. 2012; 106(5): 557–564.
  6. Taskin HE, Berber E. Retroperitoneal tumors that may be confused as adrenal pathologies. J Surg Oncol. 2012; 106(5): 600–603.
  7. Henneman D, Chang Y, Hodin RA, et al. Effect of laparoscopy on the indications for adrenalectomy. Arch Surg. 2009; 144(3): 255–259.
  8. McCauley LR, Nguyen MM. Laparoscopic radical adrenalectomy for cancer: long-term outcomes. Curr Opin Urol. 2008; 18(2): 134–138.
  9. Porpiglia F, Fiori C, Daffara F, et al. Retrospective evaluation of the outcome of open versus laparoscopic adrenalectomy for stage I and II adrenocortical cancer. Eur Urol. 2010; 57(5): 873–878.
  10. NIH. State-of-the-science statement on management of the clinically inapparent adrenal mass( “incidentaloma”) NIH Consens Staate Sci Statements. 2004; 19: 1–23.
  11. Kapoor A, Morris T, Rebello R. Guidelines for the management of the incidentally discovered adrenal mass. Can Urol Assoc J. 2011; 5(4): 241–247.
  12. Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016; 175(2): G1–G34.
  13. Birsen O, Akyuz M, Dural C, et al. A new risk stratification algorithm for the management of patients with adrenal incidentalomas. Surgery. 2014; 156(4): 959–965.
  14. Shenoy VG, Thota A, Shankar R, et al. Adrenal myelolipoma: Controversies in its management. Indian J Urol. 2015; 31(2): 94–101.
  15. Zeiger MA, Thompson GB, Duh QY, et al. American Association of Clinical Endocrinologists, American Association of Endocrine Surgeons. The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas. Endocr Pract. 2009; 15 Suppl 1: 1–20.
  16. Bednarczuk T, Bolanowski M, Sworczak K, et al. Adrenal incidentaloma in adults - management recommendations by the Polish Society of Endocrinology. Endokrynol Pol. 2016; 67(2): 234–258.
  17. Kasperlik-Załuska AA, Otto M, Cichocki A, et al. 1,161 patients with adrenal incidentalomas: indications for surgery. Langenbecks Arch Surg. 2008; 393(2): 121–126.
  18. Zhou Y, Tang Y, Tang J, et al. Primary adrenal leiomyosarcoma: a case report and review of literature. Int J Clin Exp Pathol. 2015; 8(4): 4258–4263.
  19. Tonyali S, Atac F, Eroglu U, et al. The Pathologic Point of View of Laparoscopic Adrenalectomy in the Era of Radiologic Imaging: A Multicenter Retrospective Study. Urol Int. 2016; 97(2): 173–178.
  20. Morelli V, Palmieri S, Salcuni AS, et al. Bilateral and unilateral adrenal incidentalomas: biochemical and clinical characteristics. Eur J Endocrinol. 2013; 168(2): 235–241.
  21. Kasperlik-Załuska AA, Słowińska-Srzednicka J, Rosłonowska E, et al. Bilateral, incidentally found adrenal tumours — results of observation of 1790 patients registered at a single endocrinological centre. Endocrynol Pol. 2010; 61(1): 69–73.
  22. Young WF. The Incidentally Discovered Adrenal Mas. N Engl J Med. 2007; 356: 601–10.
  23. Vassiliadi DA, Ntali G, Vicha E, et al. High prevalence of subclinical hypercortisolism in patients with bilateral adrenal incidentalomas: a challenge to management. Clin Endocrinol (Oxf). 2011; 74(4): 438–444.
  24. Lutz A, Stojkovic M, Schmidt M, et al. Adrenocortical function in patients with macrometastases of the adrenal gland. Eur J Endocrinol. 2000; 143(1): 91–97.