Current concepts in the management of adrenal incidentalomas

Kanagarajah, Prashanth; Ayyathurai, Rajinikanth; Manoharan, Murugesan; Narayanan, Govindarajan; Kava, Bruce R.

doi:10.4103/0974-7796.102657

Cited by 18 publications

(24 citation statements)

References 40 publications

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“…Abdominal ultrasonography (USG) can detect adrenal masses more than 2cm in size, but characterization of * the lesion is limited (16). In our patient, USG revealed round, multiechoic solid mass in the right suprarenal area, 12.5x11cm in diameters and according to this finding, adrenal tumor was suspected.…”

Section: Discussionmentioning

confidence: 83%

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Clinically “silent” giant pheochromocytoma. case report

Radojkovic¹

2013

Acta Endo (Buc)

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Context.Clinically "silent" pheochromocytomas are tumors of special interest due to potential complications.Objective. We present a patient with incidentally discovered, asymptomatic benign pheochromocytoma and discuss its presentation and management.Conclusion. Considering the increasing incidence of adrenal incidentalomas and, therefore, pheochromocytomas too, every incidentally found adrenal mass has to be carefully examined.

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Section: Discussionmentioning

confidence: 83%

“…Even though it is still widely used because of its inexpensiveness, easy performing and acceptable specificity (95%), it is not recommended for pheochromocytoma screening, because it has low sensitivity (64%) (16,26).…”

Section: Measurementsmentioning

confidence: 99%

Clinically “silent” giant pheochromocytoma. case report

Radojkovic¹

2013

Acta Endo (Buc)

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“…Unfortunately, no single imaging modality has proven ideal for the comprehensive evaluation of incidental adrenal lesions [3][4][5][6][7]. Further complicating this topic is the difficulty establishing a simple universally accepted diagnostic algorithm because these adrenal lesions are initially detected over a variety of modalities (and variety of protocols/techniques within each modality) due to their incidental nature.…”

Section: Introductionmentioning

confidence: 97%

“…For the remaining nonfunctioning adrenal lesions, a variety of imaging modalities can be utilized to attempt to predict the histopathology [4][5][6]. Diagnostic strategies have classically focused on distinguishing between adrenocortical adenoma and adrenal metastasis [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

et al. 2014

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PET/CT with (18)F-fluorodeoxyglucose (FDG) or using different radiocompounds has proven accuracy for detection of adrenal metastases in patients undergoing cancer staging. It can assist the diagnostic work-up in oncology patients by identifying distant metastases to the adrenal(s) and defining oligometastatic disease that may benefit from targeted intervention. In patients with incidentally discovered adrenal nodules, so-called adrenal "incidentaloma" FDG PET/CT is emerging as a useful test to distinguish benign from malignant etiology. Current published evidence suggests a role for FDG PET/CT in assessing the malignant potential of an adrenal lesion that has been 'indeterminately' categorized with unenhanced CT, adrenal protocol contrast-enhanced CT, or chemical-shift MRI. FDG PET/CT could be used to stratify patients with higher risk of malignancy for surgical intervention, while recommending surveillance for adrenal masses with low malignant potential. There are caveats for interpretation of the metabolic activity of an adrenal nodule on PET/CT that may lead to false-positive and false-negative interpretation. Adrenal lesions represent a wide spectrum of etiologies, and the typical appearances on PET/CT are still being described, therefore our goal was to summarize the current diagnostic strategies for evaluation of adrenal lesions and present metabolic and anatomic appearances of common and uncommon adrenal lesions. In spite of the emerging role of PET/CT to differentiate benign from malignant adrenal mass, especially in difficult cases, it should be emphasized that PET/CT is not needed for most patients and that many diagnostic problems can be resolved by CT and/or MR imaging.

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“…Current guidelines recommend adrenalectomy for active hormone producing masses greater than 4 cm in diameter. [10,11] However, diverse opinions about approach to smaller mass lesions are available in the literature. Bulow et al [12] followed up 229 patients with adrenal masses for 30 months, and observed development of hormonal activity only in 3% of these patients.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic transperitoneal adrenalectomy: Our initial results

Özgör

Binbay

Akbulut

et al. 2014

Turkish Journal of Urology

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Objective: To present the first 24 laparoscopic adrenalectomies performed in our clinic because of an adrenal mass. Material and methods:The medical files of 24 patients who underwent laparoscopic adrenalectomy between December 2008 and March 2013 at Haseki Teaching and Research Hospital were analyzed retrospectively. The demographic characteristics of the patients were recorded. Lateral transperitoneal laparoscopic adrenalectomy was performed in all patients. The operation time was defined as the interval between the first incision of the skin and closure of the skin. Intraoperative complications, estimated blood loss and hospital stays of the patients were evaluated. Final pathologies were recorded. Results:The mean age of the patients was 44.2±8.58 years (range: 29-66 years). Nine patients were female and 15 were male. A total of 24 masses were identified in the right (n=11), and left (n=13) adrenal glands masses were identified., Eighteen patients (75%) had no symptoms, and the masses were identified incidentally. The mean operation time was 144±46.1 minutes (range: 90-320 minutes), and the mean blood loss was 74±12.3 mL (range: 50-130 mL). None of the patients required a blood transfusion. In one patient, liver injury was identified intraoperatively due to traction. The mean duration of hospitalization was 2.9±1.1 days (range: 2-5 days). Adrenocortical adenoma and pheochromocytoma were the most common pathologies. Conclusion:Laparoscopic adrenalectomy is a safe and effective method for the treatment of adrenal masses with low complication rates.

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Current concepts in the management of adrenal incidentalomas

Cited by 18 publications

References 40 publications

Clinically “silent” giant pheochromocytoma. case report

Clinically “silent” giant pheochromocytoma. case report

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

Laparoscopic transperitoneal adrenalectomy: Our initial results

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