[Surgery of adrenal diseases]

Area of Science:

• Endocrinology
• Surgical Oncology

Background:

• Adrenal alterations are frequently discovered incidentally during imaging for other conditions.
• Distinguishing clinically significant adrenal diseases from incidental findings is crucial for patient management.

Purpose of the Study:

• To outline a diagnostic and therapeutic strategy for incidentally discovered adrenal alterations.
• To differentiate between benign, familial, and metastatic adrenal lesions requiring specific interventions.

Main Methods:

• Classification of adrenal lesions based on imaging, hormonal function, and clinical presentation.
• Surgical approaches are tailored: minimally invasive for benign/early-stage malignant tumors, open for advanced disease.
• Interdisciplinary assessment guides treatment decisions and patient referral.

Main Results:

• Adrenal tumors can be sporadic, familial, or metastatic, necessitating distinct diagnostic pathways.
• Minimally invasive surgery is effective for benign and select malignant adrenal cortical tumors.
• Open surgery is reserved for large, invasive malignant adrenal tumors with lymph node metastasis.

Conclusions:

• A systematic approach is essential for managing adrenal incidentalomas.
• Treatment strategies must be individualized based on tumor characteristics and patient factors.
• Referral to specialized centers improves outcomes for complex adrenal diseases requiring surgery.