Avaliação por ressonância magnética dos tumores de adrenal com correlação histológica

Abstract

Magnetic resonance imaging is an important tool for the detection and characterization of adrenal tumors. The knowledge about the different presentations of primary and secondary adrenal tumors at magnetic resonance imaging and their correlation with histological data are essential for the establishment of a correct diagnosis. The present study reviews magnetic resonance imaging aspects which may narrow the differential diagnosis of adrenal tumors, emphasizing the histological correlation of the most frequent ones.A ressonância magnética é ferramenta importante para a detecção e caracterização dos tumores adrenais. O conhecimento das diferentes apresentações dos tumores primários e secundários à ressonância magnética e sua correlação com dados da histologia são essenciais para o correto raciocínio diagnóstico. Este artigo revisa os aspectos que podem estreitar o diagnóstico diferencial dos tumores adrenais, dando ênfase à correlação histológica daqueles mais comuns. Unitermos: Imagem por ressonância magnética; Glândulas supra-renais; Neoplasias retroperitoneais; Neoplasias urogenitais; Diagnóstico por imagem. AbstractResumo

Hemorrhagic adrenal cyst

“…Traditionally, these lesions are classified as pseudocysts or endothelial, epithelial, and parasitic cysts. Pseudocysts are the most common and comprise a heterogeneous group, in which a specific type of apparent vascular origin, characterized by well-defined histological and immunohistochemical findings (3) is the so-called vascular hemorrhagic adrenal pseudocyst.…”

“…Those of unknown cause are called idiopathic. However, these pseudocysts are very seldom found in association with cortical neoplasm (carcinoma or adenoma) and pheochromocytoma (1,3) . Laparoscopic adrenalectomy is considered the surgical method of choice to treat benign functioning or nonfunctioning adrenal lesions.…”

“…Besides the improved cosmetics, the technique leads to less bleeding in the intraoperative period, decreased pain in the postoperative period (less use of painkillers), decreased length of hospital stay and lower morbidly rates. Although these papers only comment on the use of laparoscopy for limited-size benign solid tumors, videolaparoscopy increasingly has gradually been used to treat larger lesions including malignant tumors (1,3,4) . Small cystic adrenal lesions can be managed conservatively by laparoscopic decortication and marsupialization, but larger cysts should be treated by partial or total adrenalectomy.…”