Cystic Adrenal Lesions - Analysis of Indications and Results of Treatment

Abstract

Cysts are a rare pathology of adrenal glands. As the development of new diagnostic techniques takes place, the occurrence of adrenal cystic lesions has been rapidly increasing. The majority of them are solid adrenal lesions, but localized fluid collections are also more frequently diagnosed. In case of solid adrenal lesions, there are straight indications for surgery, but on the other hand there are no clear guidelines and recommendations in case of adrenal cysts. the aim of the study was to analyze surgical methods and evaluate treatment effects in patients who were qualified for laparoscopic adrenalectomy due to adrenal cystic lesions. metarial and methods. Identical criteria were used to qualify patients with solid and cystic lesions of the adrenal gland for surgery. out of the whole number of 345 patients who underwent laparoscopic surgery for adrenal tumors, 28 had adrenal cysts. 16 of them (57%) were women and 12 (43%) men. The average age of the studied group was 46.4 years (25-62 years). The average cyst diameter in CT was 5.32 cm (1.1-10 cm). Most of the lesions were hormonally inactive (22 patients), but in 6 cases increased level of adrenal hormones was observed. Results. Pathological analysis revealed 4 (14%) pheochromocytomas and 2 (7%) dermoid cysts. In case of 22 (79%) patients, the postoperative material was profiled by pathologists as insignificant according to potential neoplasmatic transformation risk: 5 (17.5%) -endothelial vascular cysts, 3 (11%) endothelial lymphatic cysts, 7 (25.5%) pseudocysts, 3 (11%) simple cysts, 2 (7%) bronchogenic cysts, 1 (3.5%) -cortical adenoma and 1 (3.5%) cyst was of myelolipoma type. conclusions. Based on the performed research and previous experience in treating patients with adrenal lesions we can conclude that application of the same evaluating algorithm for both cystic and solid lesions is valid.

Laparoscopic Transperitoneal Lateral Adrenalectomy for Large Adrenal Tumors

“…According to the older literature, the upper size limit of lesions eligible for laparoscopy was 6 cm, while larger diameters constituted a relative contraindication to the procedure [3,4]. The indications gradually extended to larger lesions; therefore, it has quickly become the gold standard for the treatment of all benign adrenal tumors [5,6,7,8,9,10]. Although this procedure is considered relatively safe, outcomes vary depending on different factors; among them tumor size is frequently listed.…”

A giant left adrenal pseudocyst presented as abdominal discomfort and laparoscopic adrenalectomy performed

“…In a previous study (Major et al, 2012), out of the whole number of 345 patients who underwent laparoscopic surgery for adrenal tumors, 28 had adrenal cysts. 16 of them (57%) were women.…”

Leczenie laparoskopowe torbieli nadnerczy — materiał własny i przegląd piśmiennictwa

“…There are 600 cases accounted for in the publicly available literature until 2010. As our centre specialises in endocrine surgery, in the last 18 months we operated on as many as six patients with said pathology, which constitutes 8.2% of all patients who underwent surgical interventions due to adrenal [11]. Others observed adrenal cysts in 5 to 6 % of the population treated due to adrenal pathologies [3,8].…”