Guidelines for the management of the incidentally discovered adrenal mass

Kapoor, Anil; Morris, Topher

doi:10.5489/cuaj.657

Cited by 20 publications

(44 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hypokalemia will maintain the metabolic alkalosis through its effects in the proximal tubule and will also lead to chloriuresis by decreasing chloride reabsorption. Treatment of this disorder involves blockade of the mineralocorticoid effect or surgical removal of an adrenal adenoma [52,53] .…”

Section: Nonhypochloremic Metabolic Alkalosismentioning

confidence: 99%

Disorders of Acid-Base Balance: New Perspectives

Seifter

Chang

2016

Kidney Dis

View full text Add to dashboard Cite

Background: Disorders of acid-base involve the complex interplay of many organ systems including brain, lungs, kidney, and liver. Compensations for acid-base disturbances within the brain are more complete, while limitations of compensations are more apparent for most systemic disorders. However, some of the limitations on compensations are necessary to survival, in that preservation of oxygenation, energy balance, cognition, electrolyte, and fluid balance are connected mechanistically. Summary: This review aims to give new and comprehensive perspective on understanding acid-base balance and identifying associated disorders. All metabolic acid-base disorders can be approached in the context of the relative losses or gains of electrolytes or a change in the anion gap in body fluids. Acid-base and electrolyte balance are connected not only at the cellular level but also in daily clinical practice. Urine chemistry is essential to understanding electrolyte excretion and renal compensations. Key Messages: Many constructs are helpful to understand acid-base, but these models are not mutually exclusive. Electroneutrality and the close interconnection between electrolyte and acid-base balance are important concepts to apply in acid-base diagnoses. All models have complexity and shortcuts that can help in practice. There is no reason to dismiss any of the present constructs, and there is benefit in a combined approach.

show abstract

Section: Nonhypochloremic Metabolic Alkalosismentioning

confidence: 99%

Disorders of Acid-Base Balance: New Perspectives

Seifter

Chang

2016

Kidney Dis

View full text Add to dashboard Cite

show abstract

“…However, all lesions should be evaluated in terms of hormonal activity or local invasion. The detailed evaluation may reveal lesions that requires surgery such as adrenocortical carcinoma, pheochromocytoma, primary aldosteronism, and Cushing's syndrome, or benign nonfunctioning adenoma that requires clinical follow-up (3,7,8).…”

Section: Discussionmentioning

confidence: 99%

“…Although when evaluated retrospectively it has been determined that these patients had complaints due to the adrenal mass or hormonal activity, they were included in the incidentaloma group for being identified coincidentally (1,2). Most incidentaloma lesions are benign and do not require treatment (3). Further tests may reveal a non-functioning mass as well as subclinical Cushing's disease, pheochromocytoma, aldosterone-secreting adenoma and metastatic lesions (4).…”

Section: Introductionmentioning

confidence: 99%

Surgical approach in adrenal incidentalomas: Report of thirteen cases and review of the literature

Erdem

Çetinkünar

Kuyucu

et al. 2016

UCD

View full text Add to dashboard Cite

Objective: The rate of adrenal incidentalomas detected in routine diagnostic imaging techniques is approximately 4-7%. Although the lesions are generally benign, carcinoma and functional adenomas can be diagnosed with careful clinic and laboratory evaluation.Material and Methods: Data of 13 patients who underwent surgery for an adrenal mass between January 2010-June 2014 were analyzed retrospectively.Results: Seven (54%) patients were male, 6 (46%) were female, and the mean age was 38.2. The clinical diagnosis was pheochromacytoma in 5 patients (38.4%), non-functional adenoma in 5 (38.4), and metastatic lesion, Cushing syndrome, and adrenal carcinoma each in one patient (7.6%). Conventional open adrenalectomy was performed in 8 patients, while 5 patients underwent laparoscopic adrenalectomy. Conclusion:Adrenal incidentalomas should be carefully evaluated for hormonal activity even if asymptomatic, and non-functional lesions should be considered as suspicious-for-malignancy. Laparoscopic adrenalectomy has become the gold standard for patients with a mass less than 6 cm, and without infiltration to adjacent organs.

show abstract

“…Surgical indication for non-functional adrenal incidentalomas is principally guided by tumor size. Surgical excision is recommended for adrenal tumors >4 cm since most of the adrenocortical carcinomas (ACC) are usually large [6].…”

Section: Incidentalomasmentioning

confidence: 99%

Current Approaches in the Minimally Invasive Surgical Treatment of Adrenal Tumors

Cianci¹,

Fersini²,

Tartaglia³

et al. 2017

Clinical Management of Adrenal Tumors

View full text Add to dashboard Cite

The use of imaging modalities and minimally invasive surgery plays an important role in the current management of adrenal tumors. Ultrasonography frequently allows for the incidental diagnosis of adrenal masses. The most frequent adrenal pathologies encountered are hypercortisolism (Cushing's syndrome), primary hyperaldosteronism (Conn's syndrome), and pheochromocytomas. Clinical presentation of these adrenal tumors can often be non-specific, or such lesions may present as "incidentalomas" in patients who undergo imaging for clinical reasons unrelated to the adrenal glands. Adrenal malignancy is suggested by morphologic characteristics found on imaging studies: increased size, irregular borders, local invasion, and large necrotic areas. The risk of malignancy increases for larger adrenal masses. Minimally invasive surgery has become the initial choice for the treatment of adrenal tumors with retroperitoneal and transperitoneal approaches. This chapter describes the surgical indications and compares the various minimally invasive surgical approaches for the therapeutic management of adrenal masses.

show abstract

Guidelines for the management of the incidentally discovered adrenal mass

Cited by 20 publications

References 18 publications

Disorders of Acid-Base Balance: New Perspectives

Disorders of Acid-Base Balance: New Perspectives

Surgical approach in adrenal incidentalomas: Report of thirteen cases and review of the literature

Current Approaches in the Minimally Invasive Surgical Treatment of Adrenal Tumors

Contact Info

Product

Resources

About