Evaluation and surgical resection of adrenal masses in patients with a history of extra-adrenal malignancy. Surgery 2001 Dec;130(6):1060-7
Date
12/14/2001Pubmed ID
11742339DOI
10.1067/msy.2001.118369Scopus ID
2-s2.0-0035659665 (requires institutional sign-in at Scopus site) 123 CitationsAbstract
BACKGROUND: Adrenal abnormalities are often identified on imaging studies performed during the staging of patients presenting with a new malignancy or restaging of patients with a history of a malignancy.
METHODS: We reviewed the records of patients who underwent surgical resection of an adrenal mass identified in the setting of previously or newly diagnosed extra-adrenal malignancy.
RESULTS: Eighty-one patients with an adrenal mass and recently diagnosed malignancy (n = 24) or history of a malignancy (n = 57) underwent adrenalectomy. In 42 patients (52%) the adrenal mass was a metastasis. In 39 patients (48%) the adrenal mass was an additional primary adrenal tumor process: 19 pheochromocytomas, (14 syndrome-associated, 5 sporadic), 13 cortical adenomas, 3 adrenocortical carcinomas, 2 ganglioneuromas, and 2 cases of nodular hyperplasia.
CONCLUSIONS: In this series nearly half of the patients with cancer and an adrenal mass had adrenal pathologic condition independent of their primary malignancy. Despite the presence of a newly diagnosed malignancy or history of malignancy, all patients with an adrenal mass should undergo a standard hormone evaluation to confirm that the mass is not a functional neoplasm. An assumption that the adrenal mass is metastatic disease will be wrong in up to 50% of such patients.
Author List
Lenert JT, Barnett CC Jr, Kudelka AP, Sellin RV, Gagel RF, Prieto VG, Skibber JM, Ross MI, Pisters PW, Curley SA, Evans DB, Lee JEAuthor
Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Adrenal Gland NeoplasmsAdrenalectomy
Adult
Humans
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed