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Determinants for malignancy in surgically treated adrenal lesions

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Abstract

Purpose

It is difficult to definitively rule out or establish malignancy pre-operatively in patients with adrenal lesions referred for adrenal surgery. The aim of this study was to identify risk factors for a malignant diagnosis in patients treated with adrenalectomy.

Methods

Consecutive adrenalectomies at the Department of Surgery, Lund University Hospital between 2000 and 2009 were identified. Pre-operative clinical, radiological and biochemical data, as well as details on the operation and histology, were retrieved from patients’ medical records.

Results

There were 175 adrenal operations in 172 patients (98 female and 77 male). There were 28 malignancies. Malignant tumours were larger than in benign cases (p = 0.003), had radiological signs of malignancy more often (p = 0.001) and the patients were more likely to have a history of malignancy (p = 0.001). There were no differences regarding age, gender, body mass index or mode of detection (incidental vs. clinical) between patients with benign and malignant diagnoses. A unilateral uptake on fluorine-18 deoxyglucose positron emission tomography was more frequent in malignant cases than in benign; however, this association did not reach statistical significance.

Conclusions

Size of adrenal lesion, suspicious radiological findings and history of malignancy were factors associated with malignancy.

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Abbreviations

ACC:

Adrenocortical carcinoma

BMI:

Body mass index

18-FDG-PET:

Fluorine-18 deoxyglucose positron emission tomography

FNAB:

Fine needle aspiration biopsy

DHEAS:

Dehydroepiandrosterone sulphate

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Acknowledgements

We are grateful to Secretary Annette Käll for assistance in obtaining medical records.

Conflicts of interest

None.

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Authors and Affiliations

  1. Lund University, Lund, Sweden

    Lucie Wright, Erik Nordenström & Martin Almquist

  2. Department of Surgery, Lund University Hospital, 221 85, Lund, Sweden

    Lucie Wright, Erik Nordenström & Martin Almquist

Authors
  1. Lucie Wright
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  2. Erik Nordenström
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  3. Martin Almquist
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Corresponding author

Correspondence to Martin Almquist.

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Wright, L., Nordenström, E. & Almquist, M. Determinants for malignancy in surgically treated adrenal lesions. Langenbecks Arch Surg 397, 217–223 (2012). https://doi.org/10.1007/s00423-011-0849-9

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  • DOI: https://doi.org/10.1007/s00423-011-0849-9

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