Image-guided ablation of adrenal tumors

Adrenal neoplasms are a frequently encountered lesion, seen in approximately 4%-6% of patients undergoing diagnostic imaging studies. Although benign, nonfunctioning adenomas are the most common neoplasms of the adrenal, other primary tumors that affect the gland include myelolipomas, cortisol-producing adenomas, aldosteronomas, pheochromocytomas, and adrenocortical carcinomas. In addition, the adrenal gland is a common site of metastatic disease. Because the overall patient clinical picture varies with each one of these entities, there are a range of treatment options for adrenal tumors. Although surgical resection has been well described, the increased detection of incidental adrenal lesions because of widespread use of medical imaging and the need to treat patients with multiple comorbidities by using less invasive techniques has drawn greater attention to percutaneous ablative treatment of adrenal neoplasms. The purpose of this article is to review these techniques, which include percutaneous radiofrequency ablation, cryoablation, microwave ablation, and chemical ablation.