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Adrenal locidentaloma

  • World Progress In Surgery: Adrenal Tumors
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Abstract

Because of the frequent use of computed tomography and other abdominal imaging modalities, clinicians more frequently see the incidentally discovered, clinically silent adrenal mass. Most adrenal incidentalomas should be evaluated for hormonal activity and assessed for their risk of malignancy. Adrenalectomy is indicated for hyperfunctioning tumors and for any potential primary malignant adrenal lesion. Nonfunctioning cortical adenomas<4 to 5 cm in size should be followed clinically and radiographically. Laparoscopic adrenalectomy has been used increasingly as the preferred approach in patients who require surgical resection whereas open adrenalectomy is reserved for patients with large, malignant tumors. The indications for adrenalectomy in patients with nonfunctioning adrenal tumors should not be liberalized because of the laparoscopic approach.

Résumé

En raison de l’utilisation fréquente de tomodensitométric et d’autres modalités d’imagerie, on découvre de plus en plus souvent des masses de la surrénale cliniquement silencieuses (dites «incidentalomes»). La plupart des incidentalomes surrénaliens méritent d’être explorées au plan hormonal, mais il faut également éliminer une tumeur maligne. La surrénalectomie est indiquée pour toute tumeur hyperfonctionnelle et pour toute lésion potentiellement maligne. Les adénomes non fonctionnels de la corticosurrénale inférieurs à 4–5 cm doivent être suivis cliniquement et du point de vue radiographique. La surrénalectomie laparoscopique est employée de plus en plus souvent comme voie d’approche préférée chez les patients qui nécessitent une résection chirurgicale alors que la voie traditionnelle est préférée en cas de tumeur volumineuse et/ou malignes. Les indications de surrénalectomie chez le patient ayant une tumeur non fonctionnelle ne doit pas être étendues sous seule prétexte de la laparoscopic.

Resumen

El descubrimiento incidental de masas suprarrenales asintomáticas se hace cada día más común, en la medida que se incrementa el uso de la tomografia computadorizada y de otras modalidades imagenológicas. La mayoría de los incidentalomas suprarrenales debe ser evaluada en cuanto a actividad hormonal y al riesgo de malignidad. La adrenalectomía está indicada en tumores hiperfuncionantes y en los casos de lesiones primarias potencialmente malignas. Los adenomas corticales no funcionantes de tamaño <4–5 cm deben ser observados por métodos clínicos y radiológicos. La adrenalectomía laparoscópica viene siendo utilizada como el método preferencial en pacientes que deban ser sometidos a resección, reservando la adrenalectomía abierta para pacientes con grandes tumores malignos. El hecho de disponer del método laparoscópico no significa que se deban liberalizar las indicaciones para adrenalectomía en los pacientes con tumores adrenales no funcionantes.

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References

  1. Griffing, G.T.: Editorial: A-I-D-S: The new endocrine epidemic. J. Clin. Endocrinol. Metab. 79:1530, 1994

    Article  PubMed  CAS  Google Scholar 

  2. Abecassis, M., McLoughlin, M.J., Langer, B., Kudlow, J.E.: Serendipitous adrenal mass: prevalence, significance, and management. Amer. J. Surg. 149:183, 1985

    Google Scholar 

  3. Hedeland, H., Osterberg, G., Hokfelt, B.: On the prevalence of adrenocortical adenomas in an autopsy material in relation to hypertension and diabetes. Acta. Med. Scand. 184:211, 1968

    PubMed  CAS  Google Scholar 

  4. Glazer, H.S., Weyman, P.J., Sagel, S.S., McLennan, B.L, Nonfunctioning adrenal masses: Incidental discovery on computed tomography. A.J.R. 139:81, 1982

    CAS  Google Scholar 

  5. Prinz R.A., Brooks M.H., Churchill R., Graner J.L., Lawrence A.M., Paloyan E., Sparagana M. Incidental asymptomatic adrenal masses detected by computed tomographic scanning: is operation required? J.A.M.A. 248, 701. 82

  6. Belledgrun, A., Hussain, S., Seltzer, S.E., Loughlin, K.R., Gittes, R.F., Richie, J.P.: Incidentally discovered mass of the adrenal gland. Surg. Gynecol. Obstet. 163:203, 1986

    Google Scholar 

  7. Kiev H.K., Wagner H., Jaresh S. (1990) Endokrin inaktiv nebennierentumoren. Moderne diagnostik und therapeutische Strategien bei nebennierentumoren. Allolio, B. and Schulte, H.M. New York, Schattauer; pp.189–197

    Google Scholar 

  8. Herrera, M.M.F., Grant, C.S., van Heerden, J.A., Sheedy, P.F., Ilstrup, D.M.: Incidentally discovered adrenal tumors: An institutional perspective. Surgery 110:1014, 1991

    PubMed  CAS  Google Scholar 

  9. Kloos, R.T., Gross, M.D., Francis, I.R., Korobkin, M., Shapiro, B.: Incidentally discovered adrenal masses. Endocr. Rev. 16:460, 1995

    PubMed  CAS  Google Scholar 

  10. Bitter, D.A., Ross, D.S.: Incidentally discovered adrenal masses. Amer. J. Surg. 158:159, 1989

    Article  PubMed  CAS  Google Scholar 

  11. Hubbard, M.M., Husami, T.W., Abumrad, N.N.: Nonfunctioning adrenal tumors: Dilemmas in management. Amer. Surg. 55:516, 1989

    CAS  Google Scholar 

  12. Katz, R.L., Shirkoda, A.: Diagnostic approach to adrenal nodules in the cancer patient. Results of a clinical, radiologic, and fine needle aspiration study. Cancer. 55:1995, 1985

    Article  PubMed  CAS  Google Scholar 

  13. Gross M.D., Shapiro B., Francis I.R., Glazer G.M., Bree I.L., Arcomano M.A., Schneitgart D.E., McLeod M.K., Sanfield JA., Thompson N.W. (1994) Scintigraphic evaluation of clinically silent adrenal masses [see comments]. J. Nucl. Med. 35

  14. Berland, L.L., Koslin, D.B., Kenney, P.L., Stanley, R.J., Lee, J.Y.: Differentiation between small benign and malignant adrenal masses with dynamic incremented CT. A.J.R. 151:95, 1988

    CAS  Google Scholar 

  15. Wood, D.E., Delbridge, L., Reeve, T.S.: Surgery for adrenal tumors: Is operation for the small incidental tumor appropriate? Aust. N.Z.J. Surg. 57:739, 1987

    Article  PubMed  CAS  Google Scholar 

  16. Oliver, T.W., Jr., Bernardino, M.E., Miller, J.I., Mansour, K., Greene, D., Davis, W.A.: Isolated adrenal masses in non small-cell bronchogenic carcinoma. Radiology 153:217, 1984

    PubMed  Google Scholar 

  17. Francis, I.R., Smid, A., Gross, M.D., Shapiro, B., Naylor, B., Glazer, G.M.: Adrenal masses in oncologic patients: Functional and morphologic evaluation. Radiology 166:353, 1988

    PubMed  CAS  Google Scholar 

  18. Silverman, S.G., Mueller, P.R., Pinkney, L.P., Koenker, R.M., Seltzer, S.E.: Predictive value of image-guided adrenal biopsy: Analysis of results of 101 biopsies. Radiology 187:715, 1993

    PubMed  CAS  Google Scholar 

  19. Geelhoed, G.W., Druy, E.M.: Management of the adrenal “incidentaloma”. Surgery 92:866, 1982

    PubMed  CAS  Google Scholar 

  20. Seddon, J.M., Baranetsky, N., Van Boxel, P.J.: Adrenal “incidentalomas”. Need for surgery. Urology 25:1, 1985

    Article  PubMed  CAS  Google Scholar 

  21. Siren, J.E., Haapiainen, R.K., Huikuri, K.T., Sivula, A.H.: Incidentalomas of the adrenal gland: 36 operated patients and review of literature. World J. Surg. 17:634, 1993

    Article  PubMed  CAS  Google Scholar 

  22. Guerrero, L.A.: Diagnostic and therapeutic approach to incidental adrenal mass. Urology. 26:435, 1985

    Article  PubMed  CAS  Google Scholar 

  23. Ross, N.S., Aron, D.C.,: Hormonal evaluation of the patient with an incidentally discovered adrenal mass. N. Engl. J. Med. 323:1401, 1990

    PubMed  CAS  Google Scholar 

  24. Terzolo, M., Ali, A., Osella, G., Mazza, E.: Prevalence of adrenal carcinoma among incidentally discovered adrenal masses: A retrospective study from 1989–1994. Arch. Surg. 132:914, 1997

    PubMed  CAS  Google Scholar 

  25. Angeli, A., Osella, G., Ali, A., Terzolo, M.: Adrenal incidentaloma: An overview of clinical and epidemiological data from the National Italian Study Group. Horm. Res. 47:219, 1997

    Article  Google Scholar 

  26. Kasperlik-Zaluska, A.A., Roslonowska, E., Slowinska-Srzednicka, J., Migdalska, B., Jeske, W., Makowska, A., Snochowska, H.: Incidentally discovered adrenal mass (incidentaloma): Investigation and management of 208 patients. Clin. Endocrinol. 46:29, 1997

    Article  Google Scholar 

  27. Korobkin, M., Lombardi, T.J., Aisen, A.M., Francis, I.R., Quint, L.E., Dunnick, N.R., Londy, F., Shapiro, B., Gross, M.D., Thompson, N.W.: Characterization of adrenal masses with chemical shift and gadolinium-enhanced MR imaging. Radiology 197:411, 1995

    PubMed  CAS  Google Scholar 

  28. Melby, J.C.: Diagnosis and treatment of primary aldosteronism and isolated hypoaldosteronism. Clin. Endocrinol. Metab. 14:977, 1985

    PubMed  CAS  Google Scholar 

  29. Young, W.F.: Pheochromocytoma and primary aldosteronism: Diagnostic approaches. Endocrinol. Metab. Clin. No. Amer. 26:801, 1997

    Article  Google Scholar 

  30. Gordon, R.D., Stowasser, M., Tunny, T.J., Klemm, S.A., Rutherford, J.C.: High incidence of primary aldosteronism in 199 patients referred with hypertension. Clin. Exp. Pharmacol. Physiol. 21:315, 1994

    Article  PubMed  CAS  Google Scholar 

  31. Gangulv, A.: Primary aldosteronism. N. End. J. Med. 339:1828, 1998

    Article  Google Scholar 

  32. Weinberger, My.H., Grim, C.E., Holifield, J.W., Kern, D.C., Ganguly, A., Kramer, N.J., Yune, H.Y., Wellman, H., Donohue, J.P.: Primary aldosteronism: Diagnosis, localization, and treatment. Ann. Intern. Med. 90:386, 1979

    PubMed  CAS  Google Scholar 

  33. Melby, J.C., Azar, S.T.: Adrenal steroids and hypertension: New-aspects. The Endocrinologist 3:344, 1993

    Article  Google Scholar 

  34. Young, W.F., Hogan, M.J., Klee, G.G., Grant, C.S., van Heerden, J.A.: Primarv aldosteronism: Diagnosis and treatment. Mavo Clin. Proc. 65:96, 1990

    Google Scholar 

  35. Bornstein, S.R., Stratakis, C.A., Chrousos, G.P.: Adrenocortical tumors: Recent advances in basic concepts and clinical management. Ann. Intern. Med. 130:759, 1999

    PubMed  CAS  Google Scholar 

  36. Young, W.F., Stanson, A.W., Grant, C.S., Thompson, G.B., van Heerden, J.A.: Primary aldosteronism: Adrenal venous sampling. Surgery 120:913, 1996

    Article  PubMed  Google Scholar 

  37. Zeiger, M.A., Nieman, L.K., Cutler, G.B., Chrousos, G.P., Doppman, J.L., Travis, W.D., Norton, J.A.: Primary bilateral adrenal causes of Cushing’s syndrome. Surgery 110:1106, 1991

    PubMed  CAS  Google Scholar 

  38. Reincke M. (1997) Subclinical Cushing’s syndrome: Clinical and laboratory suspicion. International Conference on the Management of “Nonfunctioning” Adrenal Tumors. Vouliagmeni, Greece, September 1997

    Google Scholar 

  39. Osella, G., Terzolo, M., Borreta, G., Magro, G., Ali, A., Piovesan, A., Paccotti, P., Angeli, A.: Endocrine evaluation of incidentally discovered adrenal masses (incidentalomas). J. Clin. Endocrinol. Metab. 79:1532, 1994

    Article  PubMed  CAS  Google Scholar 

  40. Mantero, F., Masini, A.M., Opocher, G., Giovagnetti, M., Arnaldi, G.: Adrenal incidentaloma: An overview of hormonal data from the National Italian Study Group. Horm. Res. 47:284, 1997

    Article  PubMed  CAS  Google Scholar 

  41. Reincke, M., Nieke, J., Krestin, G.P., Saeger, W., Allolio, B., Winkelmann, W.: Preclinical Cushing’s syndrome in adrenal “incidentalomas”: Comparison with adrenal Cushing’s syndrome. J. Clin. Endocrinol. Metab. 75:826, 1992

    Article  PubMed  CAS  Google Scholar 

  42. McLeod, M., Thompson, N.W., Gross, M., Bondeson, A., Bondeson, L.: Sub-clinical Cushing’s syndrome in patients with adrenal gland incidentalomas. Pitfalls in diagnosis and management. Amer. Surg. 56:398, 1990

    CAS  Google Scholar 

  43. Barzon, L., Scaroni, C., Sonino, N., Fallo, F., Paoletta, A., Boscaro, M.: Risk factors and long-term follow-up of adrenal incidentalomas. J. Clin. Endocrinol. Metab. 84:520, 1999

    Article  PubMed  CAS  Google Scholar 

  44. Copeland, P.: The incidentally discovered adrenal mass. Ann. Intern. Med. 98:940, 1983

    PubMed  CAS  Google Scholar 

  45. Harrison, L.E., Gaudin, P.B., Brennan, M.F.: Pathologic features of prognostic significance for adrenocortical carcinoma after curative resection. Arch. Surg. 134:181, 1999

    Article  PubMed  CAS  Google Scholar 

  46. Icard, P., Chapuis, Y., Andreassian, B., Bernard, A., Prove, C.: Adrenocortical carcinoma in surgically treated patients: A retrospective study on 156 cases by the French Association of Endocrine Surgery. Surgery 112:972, 1992

    PubMed  CAS  Google Scholar 

  47. Fishman, E.K., Deutch, B.M., Hartman, D.S., Goldman, S.M., Zerhouni, E.A., Siegelman, S.S.: Primary adrenocortical carcinoma: CT evaluation with clinical correlation. AJ.R. 148:531, 1987

    CAS  Google Scholar 

  48. Latronico, A.C., Chrousos, G.P.: Extensive personal experience: Adrenocortical tumors. J. Clin. Endocrinol. Metab. 82:1317, 1997

    Article  PubMed  CAS  Google Scholar 

  49. Terzolo, M., Osella, G., Ali, A., Borreta, G., Magro, G.P., Termine, A., Paccotti, P., Angeli, A.: Different patterns of steroid secretion in patients with adrenal incidentaloma. J. Clin. Endocrinol. Metab. 81:740, 1996

    Article  PubMed  CAS  Google Scholar 

  50. Sutton, M.G., Sheps, S.G., Lie, J.T.: Prevalence of clinically unsuspected pheochromocytoma. Review of a 50 year autopsv series. Mavo Clin. Proc. 56:354, 1981

    CAS  Google Scholar 

  51. Siekavizza J.L., Bernardino M.E., Samaan N.A. (1981) Suprarenal mass and its differential diagnosis. Urology 18:625

    Article  PubMed  CAS  Google Scholar 

  52. Abrams, H.L., Spiro, R., Goldstein, N.: Metastases in carcinoma: Analysis of 1000 autopsied cases. Cancer 3:74, 1950

    Article  PubMed  CAS  Google Scholar 

  53. Hussain, S., Belledgrun, A., Seltzer, S.E., Richie, J.P., Gittes, R.F., Abrams, H.L.: Differentiation of malignant from benign adrenal masses: Predictive indices on computed tomography. AJ.R. 144:61, 1985

    CAS  Google Scholar 

  54. Candel, A., Gattuso, P., Reyes, C.V., Prinz, R.A., Castelli, M.J.: Fine-needle aspiration biopsy of adrenal masses in patients with extraadrenal malignancy. Surgery 114:1132, 1993

    PubMed  CAS  Google Scholar 

  55. Wade, T.P., Longo, W.E., Virgo, K.S., Johnson, F.E.: A comparison of adrenalectomy with other resections for metastatic cancers. Amer. J. Surg. 775:183 1998

    Article  Google Scholar 

  56. Peplinski G.R., Norton J.A. (1998) The adrenal glands. In: Maingot’s Abdominal Operations, 10th edition, Zinner, M.J., Schwartz, S.I., Ellis, H., editors, Stamford, CT, Appleton & Lange, p.723

    Google Scholar 

  57. Hofle, G., Gasser, R.W., Lhotta, K., Janetschek, G., Kreczy, A., Finkenstedt, G.: Adrenocortical carcinoma evolving after diagnosis of preclinical Cushing’s syndrome in an adrenal incidentaloma. Horm. Res. 50:237, 1998

    Article  PubMed  CAS  Google Scholar 

  58. Gross, M.D., Shapiro, B., Francis, I.R., Bree, R.L., Korobkin, M., McLeod, M.K., Thompson, N.W., Sanfield J.A.,: Incidentally discovered bilateral adrenal masses. Eur. J. Nucl. Med. 22:315, 1995

    Article  PubMed  CAS  Google Scholar 

  59. Van Erkel, A.R., van Gils, A.P., Lequin, M., Kruitwagen, C., Bloem, J.L., Falke, T.H.: CT and MR distinction of adenomas and nonadenomas of the adrenal gland. J. Comp. Assist. Tomog. 18:432, 1994

    Article  Google Scholar 

  60. Linos, D.A., Stylopoulos, N., Raptis, S.: Fifty-seven cases of adrenaloma. World J. Surg. 20:788, 1996

    Article  PubMed  CAS  Google Scholar 

  61. Staren, E.D., Prinz, R.A.: Selection of patients with adrenal incidentalomas for operation. Surg. Clin. No. Amer. 75:499, 1995

    CAS  Google Scholar 

  62. Dunnick, N.R., Korobkin, M., Francis, I.: Adrenal radiology: Distinguishing benign from malignant adrenal masses. AJ.R. 167:861, 1996

    CAS  Google Scholar 

  63. Gross, M.D., Shapiro, B.: Clinically silent adrenal masses. J. Clin. Endocrinol. Metab. 77:885, 1993

    Article  PubMed  CAS  Google Scholar 

  64. Francis, I.R., Gross, M.D., Shapiro, B., Korobkin, M., Quint, LE.: Integrated imaging of adrenal disease. Radiology 184:1, 1992

    PubMed  CAS  Google Scholar 

  65. Paivansalo, M., Lahde, S., Merikanto, J., Kaliionen, M.: Computed tomography in primary and secondary adrenal tumours. Acta Radiol. 29:519, 1988

    PubMed  CAS  Google Scholar 

  66. Lee, M.J., Hahn, P.F., Papanicolaou, N., Egglin, T.K., Saini, S., Mueller, P.R., Simeone, J.F.: Benign and malignant adrenal masses: CT distinction with attenuation coefficients, size, and observer analysis. Radiology 179:415, 1991

    PubMed  CAS  Google Scholar 

  67. Schteingart D.E. (1997) Significance of size in the evaluation of incidentally discovered non-functioning adrenal masses. International Conference on the Management of “Nonfunctioning” Adrenal Tumors. Vouliagmeni, Greece, September, 1997

    Google Scholar 

  68. Shady, K.L., Brown, J.J.: MR imaging of the adrenal glands. MRI Clin. No. Amer. 3:73, 1995

    CAS  Google Scholar 

  69. Mitchell, D.G., Crovello, M., Matteuci, T., Petersen, R.O., Mietiinen, M.M.: Benign adrenocortical masses: Diagnosis with chemical shift MR imaging [see comments]. Radiology 185:2345, 1992

    Google Scholar 

  70. Outwater, E.K., Siegelman, E.S., Radecki, P.D., Piccoli, C.W., Mitchell, D.G.: Distinction between benign and malignant adrenal masses: Value of Tl weighted chemical-shift MR imaging. AJ.R. 165:579, 1995

    CAS  Google Scholar 

  71. Mayo-Smith, W.W., Lee, M.J., McNicholas, M.M., Hahn, P.F., Boland, G.W., Saini, S.: Characterization of adrenal masses <5cm by use of chemical shift MR imaging: Observer performance versus quantitative measures. A.J.R. 165:91, 1995

    CAS  Google Scholar 

  72. Gross, M.D., Wilton, G.P., Shapiro, B., Cho, K., Samuels, B.I., Bouffard, J.A., Glazer, G., Grekin, R.J., Brady, T.: Functional and scintigraphic evaluation of the silent adrenal mass. J. Nucl. Med. 28:1401, 1987

    PubMed  CAS  Google Scholar 

  73. Gross, M.D., Shapiro, B.: Scintigraphic studies in adrenal hypertension. Sem. Nucl. Med. 19:122, 1989

    Article  CAS  Google Scholar 

  74. Bardet, S., Rohmer, V., Murat, A., Guillemot, C., Marechaud, R., Chupin, M., Lecomte, P., Simon, D., Delemer, B., Schneebelli, S., Beutter, D., Jacquin, V., Peltier, P., Charbonnel, B.: West France Study Group on Incidentalomas. 131I-6B-Iodomethylnorcholesterol scintigraphy: An assessment of its role in the investigation of adrenocortical incidentalomas. Clin. Endocrinol. 44:587, 1996

    Article  CAS  Google Scholar 

  75. Gross, M.D., Shapiro, B., Bouffard, A.J.A., Glazer, G.M., Francis, I.R., Wilton, G.P., Khafagi, F., Sonda, L.P.: Distinguishing benign from malignant euadrenal masses. Ann. Intern. Med. 109:613, 1988

    PubMed  CAS  Google Scholar 

  76. Gagner, M., Lacroix, A., Boite, E., Pomp, A.: Laparoscopic adrenalectomy: The importance of a flank approach in the lateral decubitus position. Surg. Enclose. 8:135, 1994

    Article  CAS  Google Scholar 

  77. Miccoli, P., Iacconi, P., Conte, M., Goletti, O., Buccianti, P.: Laparoscopic adrenalectomy. J. Laproendosc. Surg. 5:221, 1995

    CAS  Google Scholar 

  78. Brunt, L.M., Doherty, G.M., Norton, J.A., Soper, N.J., Quasebarth, M.A., Moley, J.F.: Laparoscopic compared to open adre-nalecotmy for benign adrenal neoplasms. J. Amer. Coll. Surg. 183:1, 1996

    CAS  Google Scholar 

  79. Duh, Q-Y., Siperstein, A.E., Clark, O.H., Schecter, W.P., Horn, J.K., Harrison, M.R., Hunt, T.K., Way, L.W.: Laparoscopic adrenalectomy: Comparison of the lateral and posterior approaches. Arch. Surg. 131:870, 1996

    PubMed  CAS  Google Scholar 

  80. Staren, E.D., Prinz, R.A.: Adrenalectomy in the era of laparoscopv. Surgery 120:706, 1996

    Article  PubMed  CAS  Google Scholar 

  81. Marescauz, J., Mutter, D., Wheeler, M.H.: Laparoscopic right and left adrenalectomies. Surg. Endosc. 10:912, 1996

    Article  Google Scholar 

  82. Rutherford, J.C., Stowasser, M., Tunny, T.J., Klemm Shelley, A., Gordon, R.D.: Laparoscopic adrenalectomy. World J. Surg. 20:758, 1996

    Article  PubMed  CAS  Google Scholar 

  83. Walz, M.K., Peitgen, K., Hoermann, R., Giebler, R.M., Mann, K., Eigler, F.W.: Posterior retroperitoneoscopy as a new minimally invasive approach for adrenalectomy: Results of 30 adrenalectomies in 27 patients. World J. Surg. 20:769, 1996

    Article  PubMed  CAS  Google Scholar 

  84. Gagner, M., Pomp, A., Heniford, B.T., Pharand, D., Lacroix, A.: Laparoscopic adrenalectomy: Lessons learned from 100 consecutive procedures. Ann. Surg. 226:238, 1997

    Article  PubMed  CAS  Google Scholar 

  85. Filliponi, S., Guerrieri, M., Arnaldi, G.G.M., Masini, A.M., Lezoche, E., Mantero, F.,: Laparoscopic adrenalectomy: A report on 50 operations. Eur. J. Endocrinol. 138:548, 1998

    Article  Google Scholar 

  86. Fernandez-Cruz, L., Saenz, A., Taura, P., Benarroch, G., Astudillo, E., Sabater, L.: Retroperitoneal approach in laparoscopic adrenalectomy? Is it advantageous? Surg. Endosc. 13:86, 1999

    Article  PubMed  CAS  Google Scholar 

  87. Thompson, G.B., Grant, C.S., van Heerden, J.A., Schlinkert, R.T., Young, W.F., Farley, D.R., Ilstrup, D.M.: Laparoscopic versus open posterior adrenalectomy: A case-control study of 100 patients. Surgery 122:1132, 1997

    Article  PubMed  CAS  Google Scholar 

  88. Prinz, R.A.: A comparison of lapaorscopic and open adrenalectomies. Arch. Surg. 130:489, 1995

    PubMed  CAS  Google Scholar 

  89. MacGillivray, D.C., Shichman, S.J., Ferrer, F.A., Malchoff, CD.: A comparison of laparoscopic vs open adrenalectomy. Surg. Endosc. 10:987, 1996

    Article  PubMed  CAS  Google Scholar 

  90. Linos, D.A., Stylopoulos, N., Boukis, M., Souvatzoglou, A., Raptis, S., Papadimitriou, J.: Anterior, posterior, or laparoscopic approach for the management of adrenal diseases? Amer. J. Surg. 173:120, 1997

    Article  PubMed  CAS  Google Scholar 

  91. Jacobs, J.K., Goldstein, R.E., Geer, R.J.: Laparoscopic adrenalectomy: A new standard of care. Ann. Surg. 225:495, 1997

    Article  PubMed  CAS  Google Scholar 

  92. Imai, T., Kikumori, T., Ohiwa, M., Mase, T., Funahashi, H.: A case-controlled study of laparoscopic compared with open lateral adrenalectomy. Amer. J. Surg. 178:50, 1999

    Article  PubMed  CAS  Google Scholar 

  93. de Canniere, L., Michel, L., Hamoir, E., Hubens, G., Meurisse, M., Squifflet,: Multicentric experience of the Belgian Group for Endoscopic Surgery (BGES) with endoscopic adrenalectomy. Surg. Endosc. 11:1065, 1997

    Article  PubMed  Google Scholar 

  94. Ushiyama, T., Suzuki, K., Kageyama, S., Fujita, K., Oki, Y., Yoshimi, T.: A case of Cushing’s syndrome due to adrenocortical carcinoma with recurrence 19 months after laparoscopic adrenalectomy. J. Urol. 157:2239, 1997

    Article  PubMed  CAS  Google Scholar 

  95. Foxius, A., Ramboux, A., Lefebvre, Y., Broze, B., Hamels, J., Squifflet, J-P.: Hazards of laparoscopic adrenalectomy for Conn’s adenoma: When enthusiasm turns to tragedy. Surg. Endosc. 13:715, 1999

    Article  PubMed  CAS  Google Scholar 

  96. Iacconi, P., Bendinelli, C., Miccoli, P., Bernini, G.P.: Re: A case of Cushing’s syndrome due to adrenocortical carcinoma with recurrence 19 months after laparoscopic adrenalectomy. J. Urol. 161:1580, 1999

    Article  PubMed  CAS  Google Scholar 

  97. Heniford, B.T., Ianniti, D.A., Hale, J., Gagner, M.: The role of intraoperative ultrasonography during laparoscopic adrenalectomy. Surgery 122:1068, 1997

    Article  PubMed  CAS  Google Scholar 

  98. Brunt L.M., Bennett H.F., Teefey S.A., Moley J.F., Middleton W.D. (1999) Laparoscopic ultrasound imaging of adrenal tumors during laparoscopic adrenalectomy. Amer. J. Surg.

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  1. Department of Surgery, Section of Endocrine and Oncologic Surgery, Washington University School of Medicine, 6605 Euclid Ave., Campus Box 8109, 63110, St. Louis, Missouri, USA

    L. Michael Brunt M.D. & Jeffrey F. Moley M.D.

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  1. L. Michael Brunt M.D.
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  2. Jeffrey F. Moley M.D.
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Published Online: June 27, 2001

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Brunt, L.M., Moley, J.F. Adrenal locidentaloma. World J. Surg. 25, 905–913 (2001). https://doi.org/10.1007/s00268-001-0029-0

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