Abstract
This study provides a base for evaluating incidentalomas. The incidence and type of pathological findings in a large group of surgically removed adrenal glands were analyzed: 282 resected adrenals from the years 1995 to 2004 were examined; 242 adrenals were removed for therapy of renal cell carcinomas (in one case both adrenals were removed). Other indications for adrenalectomies were malignant tumors (urothelial carcinoma, squamous cell carcinoma, sarcoma, lymphoma, etc.) and benign findings (oncocytoma, angiomyolipoma, pyelonephritis, etc.). A total of 18 adrenals exhibited a metastasis or diffuse infiltration of the adrenal or para-adrenal tissue by a malignant tumor (17 renal cell carcinomas, 1 non-Hodgkin's lymphoma). Seven adrenals exhibited an adenoma. Eighty-nine adrenal hyperplasias were diagnosed. Eighty-six adrenals included myelolipomatous or lipomatous foci. One hundred and thirteen adrenals (40.1%) did not exhibit any pathological findings. The adrenals exhibited infiltration or metastasis by malignant tumors (6.4%), adrenal adenomas (2.5%), adrenal hyperplasias (31.6%), and other alterations (38.7%).
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References
Kloos RT, Gross MD, Francis IR, Korobkin M, Shapiro B. Incidentally discovered adrenal masses. Endocr Rev 16:460–484, 1995.
Courcoutsakis NA, Patronas NJ, Cassarino D, et al. Hypodense nodularity on computes tomography: novel imaging and pathology of micronodular adrenocortical hyperplasis associated with myelolipomatous changes. J Clin Endocrinol Metab 89:3737–3738, 2004.
Russell RR, Masi AT. Adrenal cortical adenomas and hypertension. Medicine 51:211–225, 1972.
Meagher AP, Hugh TB, Casey JH, Chisholm DJ, Farrell JC, Yeates M. Primary adrenal tumours—a ten-year experience. Aust N Z J Surg 58:457–462, 1988.
Granger P, Genest J. Autopsy study of adrenals in unselected normotensive and hypertensive patients. Canad Med Assoc J 103:34–36, 1970.
Caplan RH, Strutt PJ, Wickus GG. Subclinical hormone secretion by incidentally discovered adrenal masses. Arch Surg 129:291–296, 1994.
Herrera MF, Grant CS, van Heerden JA, Sheedy PF, Ilstrup DM: Incidentally discovered adrenal tumors: an institutional perspective. Surgery 110:1014–1021, 1991.
Belldegrun A, Hussain S, Seltzer SE, Loughlin KR, Gittes RF, Richie JI: Incidentally discovered mass of the adrenal gland. Surg Gynecol Obstet 163:203–208, 1986.
Robson CJ, Churchill BM, Anderson W, The results of radical nephrectomy for renal cell carcinoma. J Urol 101:297–301, 1969.
Grignon DJ, Eble JN, Bonsib, SM, Moch H. Clear cell renal cell carcinoma. In: Eble JN, Sauter G, Epstein JI, Sesterhenn IA, eds. Pathology and genetics, tumours of the urinary system and male genital organs. Lyon: IARC Press 2004; 23–31.
Carney JA, Adrenal gland. In: Sternberg SS, ed. Histology for pathologists. Philadelphia-New York: Lippincott-Raven Publ., 1997; 1107–1132.
Saeger W, Reinhard K, Reinhard C, Hyperplastic and tumorous lesions of the adrenals in an unselected autopsy series. Endocr Pathol 9:235–239, 1998.
Moudouni SM, En-Nia I, Patard JJ, Manunta A, Guille F, Lobel B. Real indications for adrenalectomy in renal cell carcinoma. Scand J Urol Nephrol 36:273–277, 2002.
Siemer S, Lehmann J, Kamradt J, et al. Adrenal metastases in 1635 patients with renal cell carcinoma: outcome and indication for adrenalectomy. J Urol 171: 2155–2159, 2004
Yokoyama H, Tanaka M, Incidence of adeenal involvement and assessing adrenal function in patients with renal cell carcinoma: is ipsilateral adrenalectomy indispensable during radical nephrectomy? BJU Int 95:526–529 2005.
Ito A, Satoh, M, Ohyama C, et al. Adrenal metastasis from renal cell carcinoma: significance of adrenalectomy. Int J Urol 9:125–128, 2002
Shalev M, Cipolla, B, Guille F, Staerman F, Lobel B. Is ipsilateral adrenalectomy a necessary component of radical nephrectomy? J Urol 153: 1415–1417, 1995.
Tsui KH, Shvarts O, Barbaric Z, Figlin R, de Kernion JB, Belldegrun A: Is adrenalectomy a necessary component of radical nephrectomy? UCLA experience with 511 radical nephrectomies. J Urol 163:437–441 2000
Hedeland H, Ostberg G, Hokfelt B. On the prevalence of adrenocortical adenomas in an autopsy material in relation to hypertension and diabetes. Acta Med Scand 184:211–214 1968.
Kokko JP, Brown TC, Berman MM. Adrenal adenoma and hypertension. Lancet 1:468–470. 1967.
Reinhard C, Saeger W, Schubert B. Adrenocortical nodules in post-mortem series. Development, functional significance, and differentiation from adenomas. Gen Diagn Pathol 141:203–208, 1996.
Russi S, Blumenthal H, Small adenomas of the adrenal cortex in hypertension and diabetes. Arch Intern Med 286:284–291, 1945.
Abecassis M, McLoughlin MJ, Langer B, Kudlow JE, Serendipitous adrenal masses: prevalence, significance, and management. Am J Surg 149:783–788, 1985.
Devenyi I: Possibility of normokalaemic primary adrenal cortical adenomas. J Clin Pathol 20:49–51, 1967.
Studzinski GP, Hay DC, Symington T. Observations on the weight of the human adrenal gland and the effect of preparations of corticotropin of different purity on the weight and morphology of the human adrenal gland. J Clin Endocrinol Metab 23:248–254, 1963.
Dhom G, Die Nebennierenrinde. In: Doerr W, Seifert G, ed. Pathologie der endokrinen Organe. Berlin: Springer, 1981; 729–970
Reinhard C, Saeger, W., Schubert B, Adrenocortical nodules in post-mortem series. Development, functional significance, and differentiation from adenomas. Gen Diagn Pathol 141: 203–208, 1996.
Debbie JW, Adrenocortical nodular hyperplasia: the aging adrenal. J Pathol 99:1–8, 1969.
Selye H, Stone H, Hormonally induced transformation of adrenal into myeloid rissue. Am J Pathol 26:211–233, 1950.
Symington T. The adrenal cortex. In: Symington T ed. The adrenal gland. Edinburgh-London: Livingstone, 1969; 3–218.
Mäusle E. Ultrastructure and function of the mesenchyme of the rat adrenal cortex. Pathol Anat Allg Pathol 151:344–360, 1974.
Saeger, W, Reinhard K. Fat-cell metaplasia in the adrenal cortex: incidence, structure, and correlation to basic diseases in a postmortem series. Endocr Pathol 9:241–247, 1998.
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Buurman, H., Saeger, W. Abnormalities in incidentally removed adrenal glands. Endocr Pathol 17, 277–282 (2006). https://doi.org/10.1385/EP:17:3:277
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DOI: https://doi.org/10.1385/EP:17:3:277