World Journal of Surgery

, Volume 25, Issue 7, pp 905–913 | Cite as

Adrenal locidentaloma

  • L. Michael Brunt
  • Jeffrey F. Moley
World Progress In Surgery: Adrenal Tumors

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.

Keywords

Adenoma Primary Aldosteronism Adrenal Tumor Adrenal Mass Laparoscopic Adrenalectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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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Copyright information

© Société Internationale de Chirurgie 2001

Authors and Affiliations

  • L. Michael Brunt
    • 1
  • Jeffrey F. Moley
    • 1
  1. 1.Department of Surgery, Section of Endocrine and Oncologic SurgeryWashington University School of MedicineSt. LouisUSA

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