Background: Cystic adrenal lesions (CALs) represent a rare entity having heterogeneity in etiology and clinical manifestations. Due to their very low incidence and heterogeneity in clinical aspects, many controversials still exist about their management. Methods: From 1984 to 2012, 21 patients (7 M, 14 F, mean age 48.2 years) underwent adrenalectomy for CALs. 9 patients suffered from hypertension, and 7 were affected by thyroid disorders. Results: 4 patients presented with vague abdominal pain, while in 17 patients the CAL was incidentally identified during imaging examinations. All patients underwent evaluation of adrenal functionality and imaging study. We found 1 case of cystic pheochromocytoma (confirmed by urinary and blood sampling, and MIBG-scan). All patients underwent adrenalectomy (open approach in the first 10 patients treated from 1984 to 1996, laparoscopic lateral transabdominal approach in the other 11 cases). Indication to surgery included: size over 4.5 cm in 16 cases, suspected malignancy at imaging evaluation (not confirmed by histology) in 4 cases, cystic pheochromocytoma in 1 case. Histology revealed 11 endothelial cysts, 3 pseudocysts, 6 epithelial cysts and 1 cystic pheochromocytoma. Conclusions: The presence of CAL, even asymptomatic, requires complete endocrinological evaluation and imaging study. In the presence of large size, endocrine activity or any suspicion of malignancy, patients must be referred to surgery. (C) 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Cystic adrenal lesions: clinical and surgical management. The experience of a referral centre / Cavallaro, Giuseppe; Crocetti, Daniele; Paliotta, Annalisa; De Gori, Antonietta; Tarallo, Maria Rita; Letizia, Claudio; De Toma, Giorgio. - In: INTERNATIONAL JOURNAL OF SURGERY. - ISSN 1743-9159. - STAMPA. - 13:(2015), pp. 23-26. [10.1016/j.ijsu.2014.11.023]

Cystic adrenal lesions: clinical and surgical management. The experience of a referral centre

Cavallaro, Giuseppe
;
Crocetti, Daniele;Paliotta, Annalisa;De Gori, Antonietta;Tarallo, Maria Rita;Letizia, Claudio;De Toma, Giorgio
2015

Abstract

Background: Cystic adrenal lesions (CALs) represent a rare entity having heterogeneity in etiology and clinical manifestations. Due to their very low incidence and heterogeneity in clinical aspects, many controversials still exist about their management. Methods: From 1984 to 2012, 21 patients (7 M, 14 F, mean age 48.2 years) underwent adrenalectomy for CALs. 9 patients suffered from hypertension, and 7 were affected by thyroid disorders. Results: 4 patients presented with vague abdominal pain, while in 17 patients the CAL was incidentally identified during imaging examinations. All patients underwent evaluation of adrenal functionality and imaging study. We found 1 case of cystic pheochromocytoma (confirmed by urinary and blood sampling, and MIBG-scan). All patients underwent adrenalectomy (open approach in the first 10 patients treated from 1984 to 1996, laparoscopic lateral transabdominal approach in the other 11 cases). Indication to surgery included: size over 4.5 cm in 16 cases, suspected malignancy at imaging evaluation (not confirmed by histology) in 4 cases, cystic pheochromocytoma in 1 case. Histology revealed 11 endothelial cysts, 3 pseudocysts, 6 epithelial cysts and 1 cystic pheochromocytoma. Conclusions: The presence of CAL, even asymptomatic, requires complete endocrinological evaluation and imaging study. In the presence of large size, endocrine activity or any suspicion of malignancy, patients must be referred to surgery. (C) 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
2015
adrenal cysts; adrenal tumors; adrenalectomy
01 Pubblicazione su rivista::01a Articolo in rivista
Cystic adrenal lesions: clinical and surgical management. The experience of a referral centre / Cavallaro, Giuseppe; Crocetti, Daniele; Paliotta, Annalisa; De Gori, Antonietta; Tarallo, Maria Rita; Letizia, Claudio; De Toma, Giorgio. - In: INTERNATIONAL JOURNAL OF SURGERY. - ISSN 1743-9159. - STAMPA. - 13:(2015), pp. 23-26. [10.1016/j.ijsu.2014.11.023]
File allegati a questo prodotto
File Dimensione Formato  
Cavallaro_Cystic-adrenal_2015.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 209.92 kB
Formato Adobe PDF
209.92 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1680376
Citazioni
  • ???jsp.display-item.citation.pmc??? 9
  • Scopus 26
  • ???jsp.display-item.citation.isi??? 25
social impact