Adrenal gland surgical pathology. Report of our case series and bibliographic review

OBJECTIVES: Adrenal masses have different presentations, from an incidentally diagnosed mass to a blooming Cushing's syndrome, this stimulated our interest to evaluate and describe our case series over the last 10 years, besides to perform a bibliographic update. METHODS: Retrospective and descriptive study of 22 patients suffering from adrenal masses, evaluating their clinical and radiological characteristics, functional disturbances, and histological diagnosis, emphasizing the first suspicion or finding suggesting adrenal disease. RESULTS: Men were more often affected than women in this series, 12 men vs. 10 women. Mean age was 51.2 years (33-71). Regarding side, 10 cases were right, 8 left and 2 presented bilateral disease, one of them bilateral adenoma and the other asynchronous renal carcinoma metastasis. The inverted "Y" morphology usually observed on CT scan was lost in 14 patients. Size varied between the following ranges: 2-4 cm - 9 cases, 4-6 cm - 12 cases, and one case of a gigantic cyst within the left hemi-abdomen. CONCLUSIONS: Results in our series are similar to those in the literature, adrenal masses are uncommon and despite their low incidence they have different clinical and a histological forms presentation. 27% of them. were incidental, which represents a significant percentage in comparison with other series. Adequate clinical and functional studies as well as their radiological characteristics will set the indication for adrenalectomy or follow-up. Most cases < 4 cm (7/9) were renal carcinoma metastasis or pheochromocytoma. Incidentally diagnosed cases have increased with the development of new imaging technologies as well as with more frequent use of them. The functional study of adrenal masses has suffered little change. Surgical treatment of these pathologies is suffering important changes with the advent of laparoscopic urologic surgery.