Skip to main content

Advertisement

SpringerLink
Log in

1,161 patients with adrenal incidentalomas: indications for surgery

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background and aims

The aim of this study is to analyze the clinical data and criteria for surgery in a group of over 1,100 patients with adrenal incidentalomas (AI) observed at the Department of Endocrinology.

Patients and methods

The material consisted of 1,161 patients (842 women and 319 men, 10–87 years old) with AI ranging in size from 1.0 to 23.0 cm. The methods included clinical examination, imaging studies, hormonal determinations in the blood and in the urine as well as histological and immunocytochemical investigations in 390 patients treated by surgery.

Results

Basing on these studies, we diagnosed 112 patients with primary malignant adrenal tumors (100 with carcinoma), 45 with metastatic infiltrations, and 1,004 with probable benign AI. Imaging phenotypes (especially high density on computed tomography, CT) were characteristic of malignant and chromaffin tumors. Subclinical adrenal hyperactivity was found in 8% of the patients with pre-Cushing’s syndrome as the most frequent form (6.5%). Chromaffin tumors were detected in 3%.

Conclusions

(1) Indications for surgery include malignant tumors (both primary and metastatic), tumors with subclinical hyperfunction, and chromaffin tumors. High density on CT, >20 HU, appeared to be an important indication for surgery. (2) A slight prevalence of oncological indications over endocrinological indications (14 vs. 11%) was found.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Kasperlik-Załuska AA, Migdalska B, Jeske W, Tołłoczko T, Szamowska R, Leowska E, Słowińska-Srzednicka J, Rosłonowska E, Misiorowski W (1992) Incidentally found adrenal tumors: Results of investigation of the pituitary–adrenal axis. Endokr Pol 43:322–329

    PubMed  Google Scholar 

  2. Kasperlik-Załuska AA, Rosłonowska E, Słowińska-Srzednicka J, Migdalska B, Jeske W, Makowska A, Snochowska H (1997) Incidentally discovered adrenal mass (incidentaloma): investigation and management of 208 patients. Clin Endocrinol 46:29–37

    Article  Google Scholar 

  3. Angeli A, Osella G, Ali A, Terzolo M (1997) An overview of clinical and epidemiological data from the National Italian Study Group. Horm Res 47:279–283

    Article  PubMed  CAS  Google Scholar 

  4. Kievit J, Haak HR (2000) Diagnosis and treatment of adrenal incidentaloma: a cost-effectiveness analysis. Endocrinol Metab Clin North Am 29:69–90

    Article  PubMed  CAS  Google Scholar 

  5. Schteingart DE (2000) Management approaches to adrenal incidentalomas: a view from Ann Arbor, Michigan. Endocrinol Metab Clin North Am 29:127–139

    Article  PubMed  CAS  Google Scholar 

  6. Mantero F, Terzolo M, Arnaldi G, Osella G, Masini AM, Ali A, Giovagnetti M, Opocher G, Angeli A (2000) A survey on adrenal incidentaloma in Italy. J Clin Endocrinol Metab 85:637–644

    Article  PubMed  CAS  Google Scholar 

  7. Ambrosi B, Peverelli S, Passini E, Re T, Ferrario R, Colombo P, Sartorio A, Faglia G (1995) Abnormalities of endocrine function in patients with clinically “silent” adrenal masses. Eur J Endocrinol 132:422–428

    PubMed  CAS  Google Scholar 

  8. Young WF Jr (2004) Adrenal incidentaloma MTP. ENDO, New Orleans, pp. 7–15

  9. Young WF Jr (2000) Management approaches to adrenal incidentalomas: a view from Rochester, Minnesota. Endocrinol Metab Clin North Am 29:159–185

    Article  PubMed  Google Scholar 

  10. Bernini G, Moretti A, Argenio G, Salvetti A (2002) Primary aldosteronism in normokalemic patients with adrenal incidentalomas. Eur J Endocrinol 146:523–529

    Article  PubMed  CAS  Google Scholar 

  11. Kasperlik-Zaluska AA, Slowinska-Srzednicka J (2000) Adrenal response to glucocorticoid treatment. Lancet 355:1458–1459

    Google Scholar 

  12. Schteingart DE, Doherty GM, Gauger PG, Giordano TJ, Hammer GD, Korobkin M, Worden FP (2005) Management of patients with adrenal cancer: recommendations of an international consensus conference. Endocr Relat Cancer 12:667–680

    Article  PubMed  CAS  Google Scholar 

  13. Kasperlik-Zaluska AA, Cichocki A (2005) Clinical role of determination of plasma mitotane and its metabolites levels in patients with adrenal cancer: results of a long-term follow-up. J Experim Therap Oncol 5:125–132

    CAS  Google Scholar 

  14. Dobbie JW (1969) Adrenocortical nodular hyperplasia: the ageing adrenal. J Pathol 99:1–18

    Article  PubMed  CAS  Google Scholar 

  15. Griffing GT (1994) A-I-D-S: the new endocrine epidemic. J Clin Endocrinol Metab 79:1530–1531

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrinology, Center for Postgraduate Medical Education, 01-809, Warsaw, Poland

    A. A. Kasperlik-Załuska, E. Rosłonowska, J. Słowinska-Srzednicka, W. Zgliczyński, W. Jeske & L. Papierska

  2. Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Banacha 1, 02-097, Warsaw, Poland

    M. Otto & T. Tołłoczko

  3. Department of Surgery, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Wawelska 15, 00-973, Warsaw, Poland

    A. Cichocki

  4. Department of Surgery, Warsaw University of Medicine, Stepinska 19/25, 00-739, Warsaw, Poland

    J. Polański

  5. Department of Imaging, Warsaw University of Medicine, Kondratowicza 8, 03-242, Warsaw, Poland

    R. Słapa

Authors
  1. A. A. Kasperlik-Załuska
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Otto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Cichocki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Rosłonowska
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Słowinska-Srzednicka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. W. Zgliczyński
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. W. Jeske
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. L. Papierska
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. T. Tołłoczko
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. J. Polański
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. R. Słapa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. A. Kasperlik-Załuska.

Additional information

Supported by a 501-2-2-07-45/01 and 501-1-1-07-16/06 CMKP Grant.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kasperlik-Załuska, A.A., Otto, M., Cichocki, A. et al. 1,161 patients with adrenal incidentalomas: indications for surgery. Langenbecks Arch Surg 393, 121–126 (2008). https://doi.org/10.1007/s00423-007-0238-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-007-0238-6

Keywords

Search

Navigation