UNSUSPECTED ADRENAL tumors ON CT SCAN

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Unsuspected tumors in the adrenal gland

With wide spread use of high resolution CT technology, many patients are now found to have unsuspected tumors (swellings) in their adrenal glands. When an enlargement of the adrenal gland is found the two questions that arise are:

What should be done about unsuspected tumors in the adrenal gland found on CT scan

A patient found with an unsuspected adrenal tumor on CT scan should be seen by an endocrinologist or an endocrine surgeon for evaluation. The patient may require a detail evaluation to examine for excessive secretion of adrenal hormones in the blood from the adrenal tumor.

Size of the tumor: The size of adrenal tumor on CT is an important criteria in determining the potential of cancer in the tumor. In general adrenal cancers are greater than 6cm in diameter. Most tumors under 6cm are benign (non-cancerous). However occasionally small tumors 4cm or greater may be cancerous. Early detection of small cancers may allow possible treatment and cure for adrenal cancer.

Laparoscopic surgery: Laparoscopic surgery for removal of the adrenal gland is extremely safe since very few complications have been reported in hands of surgeons who have been trained to perform this procedure. Given the safety of a laparoscopic adrenalectomy, young patients that have an adrenal tumor that is 4cm or larger on the CT scan should be evaluated for surgery. Fine needle biopsy of the tumor is not recommended since it has limited value in separating a benign from a cancerous tumor.

We recommend that a patient who has an unsuspected adrenal tumor that is discovered on CT and is greater than 4cm should be evaluated for laparoscopic adrenalectomy.

Long term follow up: If the tumor is less than 4cm then a repeat CT scan at 3 to 6 months should be performed to evaluate for possible growth of the mass. Evaluation and removal by surgery of small adrenal tumors may provide an opportunity for detecting early cancers with better long-term outcomes.



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