Lightner E S, Levine L S
Am J Dis Child. 1993 Dec;147(12):1274-6. doi: 10.1001/archpedi.1993.02160360016002.
In our commentary, we have reviewed the literature on adrenal incidentalomas and specifically have tried to relate it to the pediatric population. The studies of others have shown that adrenal tumors are very common in patients with CAH (homozygote and heterozygote) and that these tumors are very rarely malignant and therefore should not routinely be surgically removed. In fact, we suggest that only under very rare circumstances is surgical removal justified. Perhaps, in the future, biochemical markers will allow us to distinguish between adrenal adenomas and carcinomas. We have tried to give broad guidelines for the care of patients with CAH with adrenal tumors, but these are guidelines only--they are not laws chiseled in stone. Finally, as radiological imaging is done more frequently and becomes even better at finding small adrenal tumors, this general topic will become increasingly relevant. We hope our thoughts will lead to lively discussion and useful studies in this "newly discovered" medical dilemma.
在我们的评论中，我们回顾了有关肾上腺偶发瘤的文献，并特别尝试将其与儿科人群联系起来。其他研究表明，肾上腺肿瘤在先天性肾上腺皮质增生症（纯合子和杂合子）患者中非常常见，而且这些肿瘤极少为恶性，因此不应常规进行手术切除。事实上，我们认为只有在非常罕见的情况下手术切除才是合理的。也许，将来生化标志物将使我们能够区分肾上腺腺瘤和癌。我们试图为患有肾上腺肿瘤的先天性肾上腺皮质增生症患者的护理提供广泛的指导方针，但这些只是指导方针——它们不是一成不变的法律。最后，随着放射影像学检查越来越频繁，并且在发现小肾上腺肿瘤方面变得更加出色，这个总体话题将变得越来越相关。我们希望我们的想法将引发关于这个“新发现”的医学难题的热烈讨论和有益研究。
