Asymptomatic adrenal tumours: criteria for endoscopic removal.
OBJECTIVE
Assessment of criteria for videoscopic removal of adrenal lesions discovered incidentally.


METHODS
Open prospective study.


METHODS
63 patients operated on for 65 adrenal tumours.


METHODS
Relevance of proposed criteria: secreting adrenal lesion; diameter larger than 4 cm or increase in size at any re-evaluation; computed tomogram of intratumoral necrosis, haemorrhage, or irregular margins; high concentrations of dehydroepiandrosterone (DHEAS).


RESULTS
Laparoscopic adrenalectomy was successful in 61 patients (97%). There were 4 minor complications. Criteria allowed us to identify correctly : phaeochromocytoma (n = 23), primary hyperaldosteronism (n = 18), Cushing's adenoma or disease (n = 7), single metastasis (n = 4), adenoma with DHEAS or cortisol hypersecretion (n = 3). 8 non-secreting incidental tumours (13%) were operated on.


CONCLUSIONS
Simple criteria for videoscopic adrenalectomy for lesions discovered incidentally allowed us to reduce the number of doubtful indications (positive predictive value 87%).
Michel
L A
LA
Mont-Godinne University Hospital (UCL), Yvoir, Belgium.
de Cannière
L
L
Hamoir
E
E
Hubens
G
G
Meurisse
M
M
Squifflet
J P
JP
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D001530:Belgium; D002648:Child; D004724:Endoscopy; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014741:Video Recording