Document Detail

Adrenal incidentalomas: risk of adrenocortical carcinoma and clinical outcomes.
MedLine Citation:
PMID:  20734420     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The number of incidentally discovered adrenal lesions is increasing due to the widespread use of abdominal imaging. 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.
Christine J O'Neill; Andrew Spence; Barney Logan; James W Suliburk; Patsy S Soon; Diana L Learoyd; Stan B Sidhu; Mark S Sywak
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of surgical oncology     Volume:  102     ISSN:  1096-9098     ISO Abbreviation:  J Surg Oncol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2010-10-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0222643     Medline TA:  J Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  450-3     Citation Subset:  IM    
Copyright Information:
J. Surg. Oncol. 2010;102:450-453. © 2010 Wiley-Liss, Inc.
University of Sydney Endocrine Surgical Unit, St. Leonards, New South Wales, Australia.
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MeSH Terms
Adrenal Cortex Neoplasms / pathology*,  surgery
Adrenocortical Carcinoma / pathology*,  surgery
Incidental Findings*
Kaplan-Meiers Estimate
Middle Aged
Retrospective Studies
Treatment Outcome
Young Adult

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