[Therapeutic trends in adrenal incidentaloma]

The term incidentally discovered adrenal mass or incidentaloma includes several tumors, mainly benign, involving the adrenal space. From 1983 to 1990, at the 1st Surgical Department of the Careggi Hospital of Florence, 10 patients (8 females and 2 males), with age ranging from 31 to 66 years, were found to have an incidentaloma. The size of the mass ranged from 2 to 10 cms; the left side was interested in 2 cases and the right one in 8 cases. The first diagnostic approach was abdominal ultrasound scanning in 8 out of 10 patients, whereas computerized tomography was the first used in the remaining 2 patients. Overall, all patients underwent CT scanning, while abdominal ultrasound scanning was performed in 9, urography in 2, and MNR in 1. Fine needle aspiration was performed in one case of adrenal cyst both for diagnostic and therapeutic purposes. The Authors suggest a therapeutic-diagnostic program in which cytology, obtained through fine needle aspiration, may have a prominent role in reducing the need for surgical interventions, as it recently happened for thyroid disorders. Although technically more complex compared to thyroid fine needle aspiration, adrenal ultrasound-guided FNA may bring to a better classification of the different adrenal disorders reducing at the same time the need for surgery, which at present has a prevalent diagnostic intent.