Surgical approach in adrenal incidentalomas: Report of thirteen cases and review of the literature

Abstract

Objective: The rate of adrenal incidentalomas detected in routine diagnostic imaging techniques is approximately 4-7%. Although the lesions are generally benign, carcinoma and functional adenomas can be diagnosed with careful clinic and laboratory evaluation. Material and Methods: Data of 13 patients who underwent surgery for an adrenal mass between January 2010-June 2014 were analyzed retrospectively. Results: Seven (54%) patients were male, 6 (46%) were female, and the mean age was 38.2. The clinical diagnosis was pheochromacytoma in 5 patients (38.4%), non-functional adenoma in 5 (38.4), and metastatic lesion, Cushing syndrome, and adrenal carcinoma each in one patient (7.6%). Conventional open adrenalectomy was performed in 8 patients, while 5 patients underwent laparoscopic adrenalectomy. Conclusion: Adrenal incidentalomas should be carefully evaluated for hormonal activity even if asymptomatic, and non-functional lesions should be considered as suspicious-for-malignancy. Laparoscopic adrenalectomy has become the gold standard for patients with a mass less than 6 cm, and without infiltration to adjacent organs.