title: Determinants for malignancy in surgically treated adrenal lesions.
abstract: OBJECTIVE
  It is difficult to definitively rule out or establish malignancy pre-operatively in patients with adrenal lesions referred for adrenal surgery. The aim of this study was to identify risk factors for a malignant diagnosis in patients treated with adrenalectomy.
  
  
  METHODS
  Consecutive adrenalectomies at the Department of Surgery, Lund University Hospital between 2000 and 2009 were identified. Pre-operative clinical, radiological and biochemical data, as well as details on the operation and histology, were retrieved from patients' medical records.
  
  
  RESULTS
  There were 175 adrenal operations in 172 patients (98 female and 77 male). There were 28 malignancies. Malignant tumours were larger than in benign cases (p = 0.003), had radiological signs of malignancy more often (p = 0.001) and the patients were more likely to have a history of malignancy (p = 0.001). There were no differences regarding age, gender, body mass index or mode of detection (incidental vs. clinical) between patients with benign and malignant diagnoses. A unilateral uptake on fluorine-18 deoxyglucose positron emission tomography was more frequent in malignant cases than in benign; however, this association did not reach statistical significance.
  
  
  CONCLUSIONS
  Size of adrenal lesion, suspicious radiological findings and history of malignancy were factors associated with malignancy.
authors.affiliation: Lund University, Lund, Sweden.
authors.forename: Lucie
authors.initials: L
authors.lastname: Wright
authors.forename: Erik
authors.initials: E
authors.lastname: Nordenström
authors.forename: Martin
authors.initials: M
authors.lastname: Almquist
mesh_terms: D000293:Adolescent; D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D000311:Adrenal Glands / Q000473:pathology* / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D015331:Cohort Studies; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult