A Report of Three Cases of Cystic Adrenal Masses. Incidence, Presentation and Management. A Case Series with a Short Rev
- PDF / 1,335,476 Bytes
- 5 Pages / 595.276 x 793.701 pts Page_size
- 22 Downloads / 153 Views
Hellenic Journal of Surgery (2020) 92:3-4, 133-137
A Report of Three Cases of Cystic Adrenal Masses. Incidence, Presentation and Management. A Case Series with a Short Review of the Literature Elbaset MA1, Zahran MH1, Badawy M2, Abd Elhameed M2, Osman Y1
Abstract Background: Benign cystic and vascular adrenal tumours comprise a group of lesions characterised by their rarity. Nevertheless, they are still conflicting with other adrenal lesions. We reviewed our experience with cystic benign adrenal tumours in adults and evaluated previous reports to determine the appropriate diagnosis and management of these tumours. Methods: We retrospectively reviewed our records for all cases of adrenal tumours managed at our institution between 2010 and 2017. Patients aged >18 years were included in the study. The patients’ characteristics, presentation, diagnostic tools, laboratory metabolic workup, mode of treatment, pathological characteristics and outcomes were assessed. We reviewed previous reports that addressed adrenal tumours, using a Medline/PubMed search. Results: Out of 291 patients, three patients (median age 40 years) presented as cystic benign incidentalomas (18 years were included in the study. The data collected were age, clinical features, adrenal metabolic profile, radiological tumour characteristics, treatment methods, and histopathological characteristics. In all cases, contrast enhanced computed tomography (CECT) was performed unless contraindicated where MRI was performed. Also, basic hormonal assay including 24-hour urinary cortisol and
134 Elbaset MA, et al
plasma metanephrines were requested for all cases. Under general anesthesia, patients were explored laparoscopically or via an open approach. Patients on third postoperative day were discharged unless hormonal replacement therapy was required for a longer time. Patients were followed up by metabolic profile and imaging after 6 and 12 months postoperatively, then annually.
Results During the study period, 291 cases diagnosed with adrenal tumours were treated. The mean ± SD age was 46.9 ± 13.6 years. Demographic criteria of studied cases and different types of pathologies are illustrated in Table 1. Out of those patients, three cases were diagnosed to have cystic and vascular histopathological variants including cavernous haemangioma, capillary haemangioma and adrenal teratoma. All cases were incidentally diagnosed and were non-adenomatous in imaging. A transperitoneal laparoscopic approach was performed in two cases and open approach was done for the other one. Dissection of the mass was done with early control of the adrenal vein. No intraoperative hypertension bouts or complications during dissection of the mass were reported with minimal blood loss. At median follow-up of 12 months, contralateral adrenal glands were normal with no evidence of recurrent disease. Summary of the three cases is depicted in Table 2.
Case presentation Case (1)
A 27-year-old male presented with incidentally discovered right adrenal mass, with normal metabolic workup.
Data Loading...
