Contemporary review of large adrenal tumors in a tertiary referral center.

Abstract

BACKGROUND:

Large adrenal tumors (LATs, ≥6 cm) are uncommon and associated with malignancy in 25% of cases. Their surgical management remains debatable. The aim of the present report was to evaluate the current incidence, nature and management of LAT.

PATIENTS AND METHODS:

We carried out a retrospective review of LATs managed in a tertiary referral center (2002-2011).

RESULTS:

Eighty-one patients were included (out of a total of 750 with adrenal tumors, 11%). Nine patients had no surgical intervention (11%). Fifty-two LATs were malignant (64%): adrenocortical carcinoma (44%), metastasis (27%) and pheochromocytoma (21%). Patients with malignant tumors exhibited a poorer 5-year overall survival than those with benign tumors (53.4% versus 96.3%, p=0.001). Disease-related mortality was approximately 60%, 29% and 0% for those with metastasis, adrenal carcinoma and malignant pheochromocytoma, respectively. The recurrence rate was the same for the three malignant sub-groups (30%).

CONCLUSION:

LATs are rare and more frequently malignant than previously reported. Some are benign and do not require for surgical intervention. Surgical indication and approach should be tailored for each patient.

• Authors: Diane Mege, David Taieb, Aoife Lowery, Anderson Loundou, Catherine DE Micco, Frederic Castinetti, Isabelle Morange, Jean-François Henry, Frederic Sebag
• Journal: Anticancer research (Anticancer Res) Vol. 34 Issue 5 Pg. 2581-8 (May 2014) ISSN: 1791-7530 [Electronic] Greece
• PMID: 24778080 (Publication Type: Journal Article, Review)

Topics

• Adolescent
• Adrenal Gland Neoplasms (diagnosis, epidemiology, surgery)
• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Retrospective Studies
• Tertiary Care Centers
• Young Adult