Adrenal Incidentaloma: The Influence of a Decision-Making Algorithm on the Short-Term Outcome of Laparoscopy

Abstract

Our study shows that laparoscopy is feasible and safe for AIs, regardless of the preoperative probability of malignancy. The size of the AI was the only determinant for choosing a laparotomy. Further long-term studies are necessary to confirm the laparoscopic efficacy in terms of oncologic safety.

Bilateral Primary Adrenal Non-Hodgkin's Lymphoma and Primary Adrenocortical Carcinoma - Review of the Literature Preoperative Differentiation of Adrenal Tumors

“…In general, surgery of adrenal tumors should be considered in patients with functioning cortical tumors and clinical symptoms [4,[37][38][39]. Regarding nonfunctioning tumors, recommendations for treatment mainly refer to the tumor size.…”

“…Regarding nonfunctioning tumors, recommendations for treatment mainly refer to the tumor size. In general, clinically inapparent lesions smaller than 3 cm without any criteria of malignancy are not resected and should be followed up closely by CT or MR scan every 6 or 12 months [4,[37][38][39]. Both, a close follow-up or adrenalectomy are reasonable treatment options for intermediate sized tumours between 3 and 6 cm.…”

“…Both, a close follow-up or adrenalectomy are reasonable treatment options for intermediate sized tumours between 3 and 6 cm. In these cases, imaging should be repeated every 3 to 6 months to avoid misclassification of a small ACC as benign neoplasia [4,[37][38][39]. For lesions that do not increase in size, there are no data to support further radiological examination.…”

“…In case of increase in tumor size or suspicion of malignancy, adrenalectomy should be strongly considered. Hitherto, adrenal lesion larger than 6 cm have been generally associated with a higher risk of malignancy and should have been removed [4,17,[37][38][39], as performed in the cases presented.…”

“…Many retrospective studies demonstrate its association with less intraoperative blood loss, lower postoperative morbidity, a shorter hospital stay, greater patients satisfaction and fewer incisional hernia [37][38][39][40][41][42][43][44][45][46][47][48]. At the moment still controversy exsits about the appropriate surgical approach for tumors larger than 6 cm.…”