Abstract
Background. Size has been considered to be the single best predictor of malignancy in adrenal
neoplasms that have been identified incidentally. However, small adrenal cortical
cancers have been reported from multiple centers. Methods. We retrospectively evaluated the value of tumor size and other clinical parameters
in the prediction of the presence of adrenal malignancy. Results. The records of 117 patients who underwent evaluation for tumors of the adrenal gland
were reviewed. The median tumor size of the adrenal cortical carcinomas (n = 38 carcinomas)
was 9.2 cm (range, 1.7-30 cm); 5 cancers (13.5%) were smaller than 5.0 cm. The median
overall size of the benign tumors, excluding pheochromocytomas, was 4.0 cm (n = 38
carcinomas); 10 benign tumors (26%) were larger than 5.0 cm. The imaging features
of 4 of 5 small adrenal cancers predicted malignancy; the remaining patients had hormonally
functioning tumors. The imaging features of 7 of 10 large benign adrenal tumors predicted
benign histologic features, including 5 of 5 myelolipomas. Conclusions. Although size remains a good predictor of the histologic features and clinical behavior
of adrenal neoplasms, both small adrenal cortical cancers and large benign tumors
occur with measurable frequency. High-quality imaging studies may be helpful in the
identification of relatively small adrenal cancers and of characteristic benign lesions
that may be selectively followed. (Surgery 2000;128:973-83.)
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Article info
Footnotes
*Reprint requests: Jeffrey E. Lee, MD, Department of Surgical Oncology, Box 106, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030.
**Surgery 2000;128:973-83.
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Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
