Retrospective analysis of the operated patients with adrenal masses between 2004-2009

Retrospective analysis of the operated patients with adrenal masses between2004 - 2009Purpose: Surrenal masses can be benign or malign, functioning or non-functioning.Development and wide spread usage of radiologic imaging techniques allow thediagnosis of smaller, localized adrenocortical malignancies which is more amenable tocurative therapy. The increased use of abdominal ultrasound and abdominal tomographyscanning has led to the frequent finding of an unexpected adrenal mass, or anincidentaloma. Adrenal masses usually small than 2 cm in 80%, benign (94%), and nonfunctioning(90%). Adrenal carcinoma is a rare disease and has a poor prognosis.Adrenal malignancies are usually larger than 5 cm and exploration must be performedwhen the mass is bigger than 5 cm on computerized tomography and magneticresonance imaging.Materials and Methods: This retrospective study was performed on 42 patients withadrenal masses who operated at the Department of Surgery in Medical Faculty ofÇukurova University between 2004 and 2009. The patients were evaluated with medicalhistory, physical examination, ultrasonography, computerized tomography, magneticresonance imaging, serum biochemistry, serum cortisol, serum aldosterone, serumepinephrine, serum norepinephrine, urinary cortisol, urinary epinephrine, urinarynorepinephrine, urinary vanil mandelic acid and urinary metanefrin levels.Results: The mean age of the patients was 43±13 (range: 21-76 ) years. In men andwomen, the mean age was 44 and 42 years, respectively (p<0.669). Histopathologicalexamination revealed adenoma in 13 patients, feochromositoma in 12 patients,myelipoma in 3 patients, ganglioneuroma in 1 patient, adrenal carcinoma in 6 patients,adrenal cyst in 1 patient, adrenal pseudocyst in 2 patients, schawnnoma in 1 patient,gagnglioneuroma in 1 patient, hematom in 1 patient, mixt tumor in 1 patient, adrenalkortical hyperplasia in 1 patient were diagnosed. Transabdominal open surgery andlaparoscopic approach was our surgical choice for adrenal surgery. Preoperative serumand urinary biochemistry parameters were higher than normal ranges in the patientswith feochromositoma, adrenal carcinoma and adrenal kortical hyperplsia.Conclusion: The adrenal masses should be evaluated by the combination of clinical,biochemical and radiological methods. The mass size, patient?s symptoms andfunctional mass are critical points in the evaluation of surrenal masses. Benign adrenalmasses can easily be diagnosed and successfully excised. Hormone levels should bedetermined in symptomatic and asymptomatic patients with adrenal masses. Early stagemalign tumors are suitable for curative resection with additional treatment.Keywords: adrenal mass, surgical treatment