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[Adrenal gland incidentaloma in the oncologic patient: is its histologic study obligatory?]
I Iborra Juan1, J V Ricós Torrent, J L Monrós Lliso
1Servicio de Urología, Instituto Valenciano de Oncología, Valencia.
Objectives:
To analyze the need for histological study in suprarenal incidentalomas in the specific status of the oncological patient.
Material And Methods:
21 patients with tumoral suprarenal masses, 12 diagnosed in the initial study and 9 during the follow-up
Results:
16 masses were benign in nature and 5 were metastatic. Neither the location nor the staging of the initial tumour, the time of diagnosis, or the hormonal study were of any use to separate the primitive tumour from the metastasis. All metastasis were equal to or greater than 5 cm in size. Radiological study only confirmed the nature of the tumour in a few cases. Percutaneous biopsy was resolutive in 4/8 cases (50%). Suprarenalectomy was performed in 15 occasions, associated in 10 to surgical treatment of the primary therapy with not added morbidity.
Conclusion:
When incidentaloma is detected in tumoral patients at the time of diagnosis, it requires an histological study which in 1 out of 3 cases will modify the therapeutic attitude in the presence of metastasis. If the incidentaloma is detected during follow-up, it may be monitored in terms of evolution as we would only be delaying a palliative treatment.