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Related Experiment Videos

Adrenal macrotumors diagnosed by computed tomography.

J M López1, C Fardella, E Arteaga

  • 1Department of Endocrinology, School of Medicine, Catholic University of Chile, Santiago.

Journal of Endocrinological Investigation
|July 1, 1990
PubMed
Summary

Adrenal macrotumors (AMT), larger than 6 cm, are often malignant and non-hormone secreting. Percutaneous needle biopsy is valuable for diagnosing these unusual adrenal masses.

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Area of Science:

  • Endocrinology
  • Oncology
  • Radiology

Background:

  • Adrenal tumors larger than 6 cm (adrenal macrotumors, AMT) are uncommon.
  • Limited data exists on the characteristics and outcomes of AMT.
  • AMT have a higher likelihood of malignant causes compared to smaller adrenal tumors.

Purpose of the Study:

  • To prospectively investigate the clinical characteristics, CT findings, and histologic diagnoses of adrenal macrotumors.
  • To describe the incidence and nature of these large adrenal masses.

Main Methods:

  • Prospective study of 18 patients diagnosed with adrenal masses >= 6 cm via computed tomography (CT) between 1984-1988.
  • Analysis of clinical presentation, tumoral secretory activity, CT findings, and histopathology.
  • Evaluation of percutaneous needle biopsy as a diagnostic tool.

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Main Results:

  • Adrenal macrotumors represented 0.3% of abdominal CT studies.
  • 72% of AMT were non-cortisol or catecholamine secreting; 38% of these were malignant, presenting with rapid weight loss.
  • Four of five hormone-secreting AMT were pheochromocytomas; one was cortisol-secreting bilateral macronodular hyperplasia.
  • Two cases were not true adrenal masses (malignant histocytoma, hydatidic cyst).
  • Percutaneous needle biopsy successfully diagnosed lymphoma and tuberculoma in two cases.

Conclusions:

  • Adrenal macrotumors are frequently malignant and non-functional (not secreting cortisol or catecholamines).
  • Computed tomography (CT) may misidentify non-adrenal masses as adrenal.
  • Percutaneous needle biopsy is a useful diagnostic method for non-functioning solid adrenal macrotumors.