Strategic management of adrenal tumors.
Adrenal tumors--large and small, symptomatic and asymptomatic, benign and malignant--are being diagnosed with increasing frequency. Patients presenting with endocrine syndromes symptomatic of adrenal tumors require meticulous, considerate history taking, thorough physical examination, and careful planning for medical management and/or surgical removal. Adrenal tumors discovered in the absence of endocrine syndromes, and which are greater than 5 cm in diameter, require careful biochemical and imaging investigation before removal, since their rate of malignancy increases with size. Adrenal masses less than 4 cm in diameter present in the absence of endocrine syndromes can, after full endocrine and imaging evaluation, be carefully observed. Even with optimal surgical/medical management, malignant disease of the adrenal glands presents a poor outcome. This paper reviews the broad management of adrenal tumors, including a personal experience with a challenging case of adrenal adenocarcinoma.
Schmidt
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Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia.
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male