Adrenal Incidentalomas: Risk of Adrenocortical Carcinoma and Clinical Outcomes

作者:O'Neill Christine J; Spence Andrew; Logan Barney; Suliburk James W; Soon Patsy S; Learoyd Diana L; Sidhu Stan B; Sywak Mark S*
来源:Journal of Surgical Oncology, 2010, 102(5): 450-453.
DOI:10.1002/jso.21553

摘要

Introduction: The number of incidentally discovered adrenal lesions is increasing due to the widespread use of abdominal immune Although most incidentalomas are benign. larger suspicious lesions will require adrenalectomy The aim of this study is to determine the risk of malignancy in patients undergoing surgery for adrenal incidentaloma, and to compare clinical outcomes in those with adrenocortical carcinoma (ACC) based on the mode of presentation Methods: A retrospective study of consecutive patients who underwent adrenalectomy between 1995 and 2008 was performed Data were retrieved from a prospectively maintained adrenal tumor database Those with adrenal incidentaloma were selected and histopathology reviewed All patients with ACC (presenting with symptoms or incidentally) during the same time period were identified and clinical outcomes compared Results: Adrenalectomy was performed in 274 patients of whom 73 (27%) were characterized pre-operatively as incidentaloma Benign. non-functioning adrenocortical adenoma was the most common histopathological finding (46 patients. 63%) There was a trend (P = 0 08) towards increased survival amongst the seven patients with ACC presenting incidentally compared to the nine patients with symptomatic ACC Conclusions: Adrenal incidentalomas have a small but important risk of malignancy ACC presenting as incidentaloma appear to have a more favorable prognosis than symptomatic or functioning ACC J Surg Oncol 2010.102.