Abstract | PURPOSE: To investigate clinical, biochemical and radiological features in 35 patients with adrenal incidentaloma found on CT and/or MRI and to define the management of patients with adrenal masses. MATHERIAL AND METHODS: From January 2011 and May 2013, 35 patients (19F, 16M) with an adrenal mass incidentally discovered on CT and/or MRI were enrolled in a retrospective study. Thirthy-two patients underwent MDCT and eight 1.5 MRI. RESULTS: Patients consisted in 16 males and 19 females, aged between 25 and 89 yo. Adrenal lesions were most commonly found in the sixth decade; in relation to the side of the mass, 20 were found on left side, 15 on the right. Of all the mass analyzed, 3 were <1 cm diameter, 29 between 1 and 4 cm, 3 > 4 cm. The most common finding on CT was adenoma-like appearance (19 cases in relation to size, 14 in relation to attenuation values). Hormonal analysis showed 32 cases of nonfunctional masses and 3 cases of hormone activity. Adrenalectomy was performed in ten patients having adenoma (5 cases), malignant lesions (2 cases), pheocromocitoma, cyst and myelolipoma (1 case). CONCLUSION: Diagnostic approach to adrenal incidentaloma is focused on the definition of malignancy and hormonal activity; the characterization is needs hormonal and radiological (CT and/or MRI) evaluation, even if a fine needle aspiration is needed in selected cases. Benign and/or non-hypersecreting hormone lesion with <4 cm diameter could be sent to follow-up; active adrenal tumors or >4 cm diameter lesions with malignancy suspicious or growth during follow-up could be treated with surgical adrenalectomy.
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Authors | Alfonso Reginelli, Graziella Di Grezia, Andrea Izzo, Alfredo D'andrea, Gianluca Gatta, Salvatore Cappabianca, Ettore Squillaci, Roberto Grassi |
Journal | International journal of surgery (London, England)
(Int J Surg)
Vol. 12 Suppl 1
Pg. S126-31
( 2014)
ISSN: 1743-9159 [Electronic] United States |
PMID | 24862667
(Publication Type: Journal Article)
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Copyright | Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved. |
Topics |
- Adenoma
(diagnosis, pathology, surgery)
- Adrenal Gland Neoplasms
(diagnosis, pathology, surgery)
- Adrenalectomy
- Adult
- Aged
- Biopsy, Fine-Needle
- Female
- Humans
- Incidental Findings
- Magnetic Resonance Imaging
(methods)
- Male
- Middle Aged
- Retrospective Studies
- Tomography, X-Ray Computed
(methods)
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