Angeli A, Osella G, Alì A, Terzolo M
Dipartimento di Scienze Cliniche e Biologiche; Cattedra di Medicina Interna, Azienda Ospedaliera S. Luigi, Università di Torino, Italia.
Horm Res. 1997;47(4-6):279-83. doi: 10.1159/000185477.
The incidental discovery of an adrenal mass raises the problem of distinguishing the frequent benign masses from the infrequent malignant ones that require surgery. At present, univocal guidelines to approach this problem are not available. The aim of the present study was to perform a multicentric retrospective analysis of adrenal masses incidentally discovered (adrenal incidentalomas).
Hospital records of adrenal incidentalomas diagnosed over a 15-year period in 29 surgical and medical centers in Italy were scrutinized. Collected cases were 1,013, and 887 were analyzed.
The majority of patients were in the 5th and 6th decade and females were predominantly affected. The frequency of adrenocortical cancer was 12% among operated patients (316 cases). The tumor diameter was highly correlated with the risk of malignancy, as well as the CT characteristics such as density, shape and margins. The frequency of pheochromocytoma was 10% among operated patients.
The occurrence of incidentally discovered adrenocortical carcinomas and pheochromocytomas is not rare. Evaluation of the mass size and CT characteristics are simple and effective methods to differentiate malignant lesions. Biochemical screening for pheochromocytoma is mandatory before surgery.
肾上腺肿块的偶然发现引发了区分常见良性肿块与罕见恶性肿块（需要手术治疗）的问题。目前，尚无明确的指南来解决这一问题。本研究的目的是对偶然发现的肾上腺肿块（肾上腺偶发瘤）进行多中心回顾性分析。
对意大利29个外科和内科中心在15年期间诊断的肾上腺偶发瘤的医院记录进行了仔细审查。收集到的病例有1013例，其中887例进行了分析。
大多数患者年龄在50多岁和60多岁，女性受影响更为显著。在接受手术的患者中（316例），肾上腺皮质癌的发生率为12%。肿瘤直径与恶性风险高度相关，CT特征如密度、形状和边缘也是如此。在接受手术的患者中，嗜铬细胞瘤的发生率为10%。
偶然发现的肾上腺皮质癌和嗜铬细胞瘤并不罕见。评估肿块大小和CT特征是区分恶性病变的简单有效方法。术前必须对嗜铬细胞瘤进行生化筛查。
