Role of laparoscopy in the management of adrenal malignancies.
OBJECTIVE
The role of laparoscopic approach for the treatment of malignant adrenal diseases is still controversial. The aim of this study was to verify the results of laparoscopic adrenalectomy (LA) in the management of adrenal malignancies.


METHODS
The medical records of all the patients who underwent laparoscopic procedures for adrenal diseases and in whom malignancy was demonstrated at final histology were reviewed.


RESULTS
Nine patients were included (three malignant pheochromocytomas, four adrenocortical carcinomas, and two adrenal metastases). At a mean follow-up of 23.0 months, all but two patients were alive. One patient died for metastatic disease and the other one for unrelated causes. One patient operated on for an adrenocortical carcinoma developed a pelvic recurrence. One patient operated on for a malignant pheochromocytoma developed multiple intra-abdominal recurrences. No other case of recurrence was observed.


CONCLUSIONS
The results of this study demonstrate that LA can have a role also in case of adrenal malignancies. Conversion to open surgery is mandatory in case of local invasion and when the dissection cannot be as accurate as in conventional operations. A preliminary laparoscopic exploration can be planned in case of suspected malignant lesions to confirm the diagnosis and to evaluate their operability.
Lombardi
Celestino Pio
CP
Division of Endocrine Surgery, Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Raffaelli
Marco
M
De Crea
Carmela
C
Bellantone
Rocco
R
D000008:Abdominal Neoplasms / Q000556:secondary; D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery*; D000311:Adrenal Glands / Q000473:pathology; D000315:Adrenalectomy / Q000379:methods*; D018268:Adrenocortical Carcinoma / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000556:secondary; D010673:Pheochromocytoma / Q000556:secondary / Q000601:surgery*; D012042:Registries