Diagnosis and Treatment of Adrenal Tumors: A Single-Center Experience with 238 Cases

Abstract

Objective: It was the aim of this study to review and analyze clinical data on the diagnosis and management of patients with adrenal masses. Patients and Methods: Between 1976 and 2005, 238 patients admitted to our institute with adrenal masses were reviewed. Incidence, clinical features, imaging technique findings, surgical approaches, morbidity and mortality, as well as pathological diagnoses were reported. Results: The series comprised 134 males and 104 females (mean age 33.3 ± 20.3 years). Right-sided masses were more common (63.4%), with a mean size of 7.7 ± 4 cm. Pain was the most frequent presenting symptom (53.4%), while 62 (26%) had a functional tumor. Incidentaloma was diagnosed in 49 patients (20.6%). Both computed tomography and magnetic resonance imaging showed a high diagnostic yield (sensitivities of 98.9 and 100%, respectively). Open adrenalectomy was performed in 153 patients (64.3%), while a laparoscopic approach was employed in 53 patients (22.3%). The intraoperative complication rate was 14.7%, the postoperative complication rate 6.1% and perioperative mortality 1.7%. Most of the excised masses were pheochromocytomas (26.4%). Conclusions: Computed tomography is recommended as the first diagnostic modality to define and characterize adrenal masses. Laparoscopic adrenalectomy is currently replacing open surgery as the standard surgical management of adrenal masses.

Laparoscopic Treatment of Adrenal Tumors: A Single-Center Experience with 58 Patients

“…Porpiglia et al [9] reported a high frequency of neighborhood repeat or port-site seeding after laparoscopic adrenalectomy for threatening injuries. In a case series of Gomha et al [13], investigating the treatment of adrenal tumors with 238 cases, 5 masses of adrenal harm were overseen laparoscopically. Three masses were confined metastases from bladder, liver, and bosom growths while 2 were essential adrenal tumor.…”

“…Also, laparoscopic adrenalectomy has been ended up to be superior in both pediatric and morbid obese cases [16]. Gomha et al [13] uncovered an essentially shorter healing center stay with matched complication rate in the laparoscopic approach regardless of being used in smaller-sized adrenal masses. In our study, supporting and similar to the literature, the average operative time was around 80 minutes that ranged between 55 and 190 minutes.…”

Adrenocortical Carcinoma: Clinicopathological Features, Prognostic Factors and Outcome

“…Surgery remains the primary treatment modality and the only chance for cure in these patients [11,12,13]. However, the role of laparoscopic adrenalectomy (LA) in the treatment of patients with AC is controversial.…”