Demographic and Clinicopthologic Properties of Patients Operated for Adrenal Masses

Abstract

Background:The prevalence of adrenal incidentaloma is nearly 4 to 10% and increases with age. Most adrenal masses are nonfunctioning adrenocortical adenomas and found as an adrenal incidentaloma in 80% of cases, but also be conditions requiring therapeutic intervention. We presented our patients with adrenal masses and their management. Patients and methods:We documented age and gender of patients, and also size, clinical and histopathologic diagnoses of the adrenal masses; diagnostic dilemmas and preferred operation techniques in case series between 01 January; 2015 and 31 December; 2019. Results:We performed 59 operations on 41 women and 18 men patients with median age of 52.67 years; 25 open and 34 laparoscopic adrenalectomies. Histopathologic analysis revealed 28 adrenocortical adenoma, 5 pheochromocytoma, 7 myelolipoma and one pseudocyst, endothelial cyst and adrenal medullar hemorrhage. Malign ones are 5 adrenocortical carcinoma, 5 metastases from non-squamous lung cancer, 2 from renal cell carcinomas and one from colon adenocarcinoma metastases, and one follicular dendritic cell sarcoma and one lymphoma. Two of non-squamous lung cancer metastases were rarely seen poorly differentiated carcinoma showing enteric differentiation and pleomorphic carcinoma. In addition, one renal cell carcinoma was metastases to contralateral adrenal. One of adrenal mass was operated with a miss diagnosis of adrenocortical carcinoma but reported as a follicular dentritic cell sarcoma after histopathologic analysis.Discussion: Atypical sarcomas, unexpected tumor metastases and also skip to other adrenal site metastases can be found as an adrenal mass. Adrenalectomy should be performed if hormonal activity or malignancy present. Laparoscopic surgery is feasible in benign lesions and also in some malignant lesions.

A nonspecific clinical picture and the course of Conn syndrome — current findings in the screening program for hypertensive patients

“…The prevalence of adrenal cancer is approximately 4% to 10% and increases with age, with most adrenal glands showing no hormonal activity. However, when adrenal lesion hormonal activity is detected, it usually leads to a diagnosis of Cushing's syndrome, pheochromocytoma, or Conn's syndrome [2]. In a single center study, the prevalence of Conn syndrome was reported to be 2.6% of patients in primary care [3].…”