The Diagnosis And Surgical Treatment Of Adrenal Incidentalomas

Purpose: To evaluate the diagnosis and management of adrenal incidentalomas.Methods: From Jan 1998 to Jun 2004, 72 cases of incidental adrenal masses were analyzed retrospectively. Results: In all cases hormonal screening, radiological evaluation were performed. Surgery and pathological study were undertaken in 19 cases of and 53 cases of normosecreting tumors. 5 cases of malignancy including 3 cases of primary adrenal tumor, 2 cases of metastatic or non-adrenal origin tumor were found.Conclusions: Before surgical management,it was essential to perform hormone detecting, radiological evaluation and scintigaphy to screen the hypersecreting and malignant tumors from all adrenal incidentalomas. Those cases with diagnosis of preclinlical Cushings syndrome, hypersecreting and malignant tumor (primary and metastatic), should undergo surgical treatment more positively. In cases of normosecreting tumor, if the diameter of tumor was less than 6cm, simultaneously was no adhesion to peripheral organs comfirmed by imaging investigations, laparoscopic surgery was preferred. On the contrary, if the tumor was bigger than 6cm and pheochromocytoma was suspected, and adhered to peripheral organs, the open surgical treatment was the first choice.