title: Surgical considerations for removal of giant tumor of the right adrenal.
abstract: OBJECTIVE
  Complete surgical removal is the only potentially curative approach for adrenal tumors. Our series of patients affected with giant right adrenal tumors, as well as the open surgical modalities used to obtain a complete tumor resection with safe vascular control were analyzed.
  
  
  METHODS
  Nine patients (mean age=57 years) affected with a giant right adrenal tumor who underwent open surgical removal of the mass form the basis of the present analysis. A midline incision was performed. Large mobilization of the liver was performed to obtain good and safe exposure of the vascular pedicles.
  
  
  RESULTS
  An en bloc R0 tumor resection was accomplished in all cases. Histology revealed an adrenal cortical carcinoma in all patients. No local recurrence was noted at a mean follow-up of 14 months.
  
  
  CONCLUSIONS
  Radical surgery is the only curative approach and is recommended for all patients, whenever technically feasible, through open access in cases of giant right adrenal carcinoma.
authors.affiliation: Pietro Valdoni Department of Surgery, Sapienza University of Rome, Rome, Italy giuseppe.pedulla@uniroma1.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pedullà
authors.affiliation: Pietro Valdoni Department of Surgery, Sapienza University of Rome, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Sapienza
authors.affiliation: Pietro Valdoni Department of Surgery, Sapienza University of Rome, Rome, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Paliotta
authors.affiliation: Pietro Valdoni Department of Surgery, Sapienza University of Rome, Rome, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Giordano
authors.affiliation: Pietro Valdoni Department of Surgery, Sapienza University of Rome, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Crocetti
authors.affiliation: Pietro Valdoni Department of Surgery, Sapienza University of Rome, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: DE Toma
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
keywords: Giant adrenal tumor; adrenalectomy; radical surgery