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Adrenal Gland Pathology Reporting Among Genitourinary Pathologists: An Orphan Field Handled by Foster Pathologists?
Ankur R Sangoi1, Courtney C Sparger1, Sean R Williamson2
1Department of Pathology, Stanford Medical Center, Stanford, CA, USA.
International Journal of Surgical Pathology
|April 13, 2025
Summary
Genitourinary (GU) pathologists often handle adrenal specimens but express discomfort. Many believe endocrine pathology should manage these complex cases, citing training gaps and specimen volume limitations.
Area of Science:
- Pathology
- Urology
- Endocrinology
Background:
- Adrenal glands are frequently resected by urologists and evaluated by genitourinary (GU) pathologists.
- Adrenal pathology is complex, and a dedicated endocrine pathology subspecialty is emerging.
Purpose of the Study:
- To assess the sentiment of GU pathologists regarding adrenal pathology.
- To understand current practices and future recommendations for handling adrenal specimens.
Main Methods:
- A survey was administered to 128 GU pathologists (junior and experienced, academic and private practice).
- The survey assessed training, comfort levels, current specimen handling, and perceived ideal management of adrenal pathology.
Main Results:
- Most GU pathologists receive "on the job" or fellowship training in adrenal pathology.
- While many feel "comfortable" or "neutral," a significant portion reports discomfort with adrenal specimens.
- Participants indicated a preference for endocrine pathology (74%) or GU pathology (58%) to handle adrenal specimens, with limitations in dedicated endocrine pathology services.
Conclusions:
- GU pathologists are involved in adrenal pathology but often lack specialized training and feel uncomfortable.
- There is a strong sentiment favoring endocrine pathology for managing adrenal specimens, contingent on addressing limitations like specimen volume and pathologist availability.
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