Celejewski Krzysztof, Pogorzelski Ryszard, Toutounchi Sadegh, Krajewska Ewa, Wołoszko Tomasz, Szostek Małgorzata, Jakuczun Wawrzyniec, Fiszer Patryk, Legocka Małgorzata, Gałązka Zbigniew
Medical University of Warsaw, Warszawa, Poland.
General and Endocrine Surgery of Medical University of Warsaw, Warsaw, Poland.
Open Med (Wars). 2018 Aug 15;13:281-284. doi: 10.1515/med-2018-0043. eCollection 2018.
Incidentaloma is defined as an tumor diagnosed accidentally using imaging studies performed due to other indications. The aim of this paper was to describe the diagnostic and treatment problems experienced by patients with adrenal incidentaloma in a clinical practice.
In years 2009-2012 there were 33(16,5%) adrenal tumors diagnosed incidentally out of 200 cases treated due to adrenal pathology. The group consisted of 54 patients aged 27-77. In 15(45,5%) patients the diagnosis was made based on ultrasound examination, while in 18(54,5%) the tumor was visualized in CT/MRI.
Only after the diagnostics was finalized, in which in all cases no signs of hormonal activity were detected, 26(78,8%) patients were qualified for the surgery. In 7(21,2%) cases no indications for such a management were found. The latter group was followed-up and in all patients the indications for the surgery arose due to enlargement of the tumor or/and the existence of hormonal activity. Our observations suggest that the incident finding of adrenal tumor is an indication of long-term observation. The analysis of our material shows that all patients observed needed surgical treatment.
The small adrenal tumors under follow-up have a tendency to enlarge and acquire hormonal activity. Long-term observation significantly increases the costs of treatment in that group, which eventually results in surgical management.
偶发瘤定义为因其他指征进行影像学检查时意外诊断出的肿瘤。本文旨在描述临床实践中肾上腺偶发瘤患者所经历的诊断和治疗问题。
2009年至2012年期间,在因肾上腺病变接受治疗的200例患者中,有33例(16.5%)肾上腺肿瘤为偶然诊断。该组包括54例年龄在27至77岁之间的患者。15例(45.5%)患者的诊断基于超声检查,而18例(54.5%)患者的肿瘤在CT/MRI检查中被发现。
只有在完成诊断(所有病例均未检测到激素活性迹象)后,26例(78.8%)患者符合手术条件。7例(21.2%)病例未发现进行此类治疗的指征。对后一组患者进行了随访,所有患者均因肿瘤增大或/和存在激素活性而出现手术指征。我们的观察表明,肾上腺肿瘤的偶然发现是长期观察的指征。对我们的资料分析显示,所有接受观察的患者最终都需要手术治疗。
随访中的小肾上腺肿瘤有增大并出现激素活性的趋势。长期观察显著增加了该组患者的治疗成本,最终导致手术治疗。