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Polish Journal of Surgery

The Journal of Foundation of the Polish Journal of Surgery

12 Issues per year

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Volume 84, Issue 4 (Apr 2012)


Cystic Adrenal Lesions - Analysis of Indications and Results of Treatment

Piotr Major / Michał Pędziwiatr / Maciej Matłok / Mateusz Ostachowski
  • Students' Society of Science, 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Marek Winiarski / Kazimierz Rembiasz / Andrzej Budzyński
Published Online: 2012-06-14 | DOI: https://doi.org/10.2478/v10035-012-0030-3

Cystic Adrenal Lesions - Analysis of Indications and Results of Treatment

Cysts are a rare pathology of adrenal glands. As the development of new diagnostic techniques takes place, the occurrence of adrenal cystic lesions has been rapidly increasing. The majority of them are solid adrenal lesions, but localized fluid collections are also more frequently diagnosed. In case of solid adrenal lesions, there are straight indications for surgery, but on the other hand there are no clear guidelines and recommendations in case of adrenal cysts.

The aim of the study was to analyze surgical methods and evaluate treatment effects in patients who were qualified for laparoscopic adrenalectomy due to adrenal cystic lesions.

Metarial and methods. Identical criteria were used to qualify patients with solid and cystic lesions of the adrenal gland for surgery. Out of the whole number of 345 patients who underwent laparoscopic surgery for adrenal tumors, 28 had adrenal cysts. 16 of them (57%) were women and 12 (43%) men. The average age of the studied group was 46.4 years (25-62 years). The average cyst diameter in CT was 5.32 cm (1.1-10 cm). Most of the lesions were hormonally inactive (22 patients), but in 6 cases increased level of adrenal hormones was observed.

Results. Pathological analysis revealed 4 (14%) pheochromocytomas and 2 (7%) dermoid cysts. In case of 22 (79%) patients, the postoperative material was profiled by pathologists as insignificant according to potential neoplasmatic transformation risk: 5 (17.5%) - endothelial vascular cysts, 3 (11%) endothelial lymphatic cysts, 7 (25.5%) pseudocysts, 3 (11%) simple cysts, 2 (7%) bronchogenic cysts, 1 (3.5%) - cortical adenoma and 1 (3.5%) cyst was of myelolipoma type.

Conclusions. Based on the performed research and previous experience in treating patients with adrenal lesions we can conclude that application of the same evaluating algorithm for both cystic and solid lesions is valid.

Keywords: cystic adrenal lesions; laparoscopic adrenalectomy; endocrinological surgery; minimally invasive surgery; adrenal gland surgery; indications for surgery

  • Wahl HK: Adrenal cysts. Am J Pathol 1951; 27: 75.Google Scholar

  • Wedmid A, Palese M: Diagnosis and Treatment of the Adrenal Cyst. Curr Urol Rep 2010; 11: 44-50.CrossrefPubMedGoogle Scholar

  • Gonzalez R, Smith CD, McClusky DA: Laparoscopic approach reduces likelihood of peri operative complications in patients undergoing adrenaleetomy. Am Surg 2004; 70: 668-74.Google Scholar

  • Budzyński A, Pędziwiatr M, Matłok M et al.: Preliminary experience with transpertitoneal SILS adrenalectomy. Videosurgery and other miniinvasive techniques 2010; 5: 87-92.Google Scholar

  • Budzyński A, Matłok M, Pędziwiatr M et al.: SILS (Single Incision Laparoscopic Surgery) - New surgical approach to peritoneal cavity. Adv Med Sci 2011.Web of ScienceGoogle Scholar

  • Narula VK, Melvin WS: Laparoscopic adrenalectomy. John L. Cameron, ed.: Current surgical theraphy. 9th ed., Philadelphia, Mosby 2008; 1362-67.Google Scholar

  • Budzyński A, Huszno B, Rembiasz K i wsp.: Przezotrzewnowa laparoskopowa adrenalektomia w leczeniu hormonalnie czynnych i niemych guzów nadnerczy. Pol Przegl Chir 2005, 77: 1161-71.Google Scholar

  • Budzyński A, Rembiasz K, Biesiada Z i wsp.: Laparoskopowe operacje narządów miąższowych. Pol Przeg Chir 2006, 78: 257-70.Google Scholar

  • Rembiasz K, Migaczewski M, Matłok M i wsp.: Operacje złośliwych nowotworów nadnerczy techniką laparoskopową z dostępu przezotrzewnowego. Pol Przegl Chir 2009: 81: 1092-08.Google Scholar

  • Bellantone R, Ferrante A, Raffaelli M: Adrenal cystic lesions: report of 12 surgically treated cases and review of the literature. J Endocrinol Invest 1998, 21: 109-14.PubMedGoogle Scholar

  • Tanmay G, Kaulback KR, Bombanati A: Surgical Managment of Adrenal Cysts. The American Surgeon 2003, 69: 812-14.Google Scholar

  • Greiselius: cited by Doran AHG. Cystic tumor of suprarenal body successtully removed by operation. Br ed.1 908, 1558-63.Google Scholar

  • Chien HP, Chang YS, Hsu PS: Adrenal cystic lesions: a clinicopathological analysis of 25 cases with proposed histogenesis and review of the literature. Endocr Pathol 2008, 19: 274-81.Web of ScienceCrossrefGoogle Scholar

  • Kuruba R, Gallagher SF: Current management of adrenal tumors. Curr Opin Oncol 2008; 20: 34-46.PubMedCrossrefGoogle Scholar

  • Vilar L, Freitas Mda C, Canadas V: Adrenal incidentalomas: diagnostic evaluation and long-term follow-up. Endocr Pract 2008; 14: 269-78.CrossrefPubMedGoogle Scholar

  • Song JH, Chaudhry FS, Mayo-Smith WW: The incidental adrenal mass on CT: prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known malignancy. AJR Am J Roentgenol 2008; 190: 1163-68.Google Scholar

  • Guo YK, Yang ZG, Li Y et al.: Uncommon adrenal masses: CT and MRI features with histopathologic correlation. Eur J Radiol 2007; 62: 359-70. This article details imaging techniques for uncommon adrenal masses, including cystic masses.CrossrefWeb of ScienceGoogle Scholar

  • Erickson LA, Lloyd RV, Hartman R et al.: Cystic adrenal neoplasms. Cancer 2004; 101: 1537-44.CrossrefGoogle Scholar

  • Ping-Chien: Adrenal Cystic Lesions: A Clinicopathological analysis of 25 Cases with Proposed Histogenesis and Review of the Literature, Endocr Pathol 2008; 19: 274-81.Web of ScienceGoogle Scholar

  • Temer F, Lecene P: Les grands kystes de la capsule Surrenale. Kev Chir 1906; 34: 321-37.Google Scholar

  • Absehouse GA, Goldstein RB, Absehouse BS: Adrenal cysts: Review of the literature and report of three eases. J Urol 1959; K 1: 711-19.Google Scholar

  • Foster DG: Adrenal cysts. Areh Surg 1966, 92: 131-43.Google Scholar

  • Barron SH, Emanuel B: Adrenal cyst. A case report and a review ok the pediatric literature. J Pediatr 1961; 59: 592-99.PubMedCrossrefGoogle Scholar

  • Wang HS, Li CC, Chou YH et al.: Comparison of laparoscopic adrenalectomy with open surgery for adrenal tumors. Kaohsiung J Med Sei 2009; 25: 438-44.CrossrefWeb of ScienceGoogle Scholar

  • Brunt LM, Doherty GM, Norton JA et al.: Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms. J Am Coll Surg 1996; 183: 1-10.Google Scholar

  • Major P, Matłok M, Pędziwiatr M et al.: Do we really need routine drainage after laparoscopic adrenalectomy and splenectomy? Videosurgery and other miniinvasive techniques 2012; 7(1): 33-39.Google Scholar

  • Lal TG, Kaulback KR, Bombonati A et al.: Surgical management of adrenal cysts. Am Surg 2003; 69: 812-14.Google Scholar

  • Klingler PJ, Fox TP, Menke DM: Pheochromocytoma in an incidentally discovered asymptomatic cystic adrenal mass. May Clin Proc 2000; 75(5): 517-20.Google Scholar

  • Pradeep PV, Anand K, Mishra MS: Adrenal Cysts: An Institutional Experience. World J Surg 2006; 30: 1817-20.PubMedCrossrefGoogle Scholar

  • Scheible W, Coel M, Siemers PT: Percutaneus aspiration of adrenal cysts. Am J Roentgenol 1977; 128: 1013-16.CrossrefGoogle Scholar

  • Karstaedt N, Sagel SS, Stanley RJ: Computed tomography of the adrenal gland. Radiology 1978; 129: 723-30.PubMedGoogle Scholar

  • Falke THM, Strake L: MR imaging of the adrenals; Corelation with computed tomography. J Comput Assisted Tomogr 1986; 10: 242-53.Google Scholar

  • Neri LM, Nance FC: Management of Adrenal Cysts. American Surgeon 1999; 151-63.Google Scholar

  • Otto M, Dzwonkowski J, Jedrasik J: Over 10 years of experience in the laparoscopic treatment of adrenal lesions via lateral transperitoneal approach. Pol Przegl Chir 2008; 80(9): 478-86.Google Scholar

About the article

Published Online: 2012-06-14

Published in Print: 2012-04-01

Citation Information: Polish Journal of Surgery, ISSN (Print) 0032-373X, DOI: https://doi.org/10.2478/v10035-012-0030-3.

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