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Inzidentalome der Nebenniere

Adrenal incidentalomas

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Zusammenfassung

Inzidentalome der Nebennieren sind Raumforderungen, die im Rahmen schnittbildgebender Diagnostik, welche nicht zur Abklärung von Nebennierenerkrankungen oder zum Staging bei Tumorerkrankungen erfolgt, auffallen. Es sind relativ häufige Befunde, welche einer strukturierten Abklärung bedürfen. In vielen Fällen ist eine Beobachtung gerechtfertigt. Bei der diagnostischen Aufarbeitung muss geklärt werden, ob es sich um einen funktionellen Nebennierentumor handelt und/oder ob es Hinweise für ein malignes Leiden gibt. Handelt es sich um einen nichtfunktionellen Tumor, der eine Größe von 4 cm nicht übersteigt, ist ein abwartendes Verhalten gerechtfertigt. Funktionelle Tumoren und jede Raumforderung größer als 6 cm müssen zur Behandlung des Hormonexzesses, bzw. zum Ausschluss eines malignen Tumors reseziert werden. Eine diagnostische Punktion des Tumors ist nur in Ausnahmefällen und dann nur nach Ausschluss eines Phäochromozytoms indiziert.

Abstract

Adrenal incidentalomas are clinically inapparent masses detected incidentally with imaging studies conducted for other reasons. They are relatively common and require structured diagnostic workup. In many cases surveillance is warranted. The diagnostic workflow has to reveal whether the mass is hormonally functioning and/or if there is evidence of malignancy. If the tumor is functionally silent and not larger than 4 cm, surveillance is warranted. Functioning tumors and masses larger than 6 cm have to be resected. Fine-needle aspiration biopsy is indicated in very rare cases, but pheochromocytoma has to be ruled out first.

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  1. Klinik für Visceral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland

    P. Langer, J. Waldmann & M. Rothmund

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  1. P. Langer
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  2. J. Waldmann
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  3. M. Rothmund
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Correspondence to P. Langer.

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Langer, P., Waldmann, J. & Rothmund, M. Inzidentalome der Nebenniere. Chirurg 78, 721–728 (2007). https://doi.org/10.1007/s00104-007-1365-x

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