PL EN


Preferences help
enabled [disable] Abstract
Number of results
2008 | 80 | 7 | 364-370
Article title

Operations on Adrenal Gland Tumours in A Multicentre Study at the Łódź Medical University

Content
Title variants
Languages of publication
EN
Abstracts
EN
The aim of the study was to determine the prevalence of adrenal tumours and their types based on the analysis of material from university surgical centres participating in a 5-year study between the years 2001 and 2005.Material and methods. A total of 178 patients, 169 (94.9%) adults and 9 (5.1%) children, with adrenal tumours were treated during the study period. Amongst the operated upon patients, there were 111 (62.4%) females (106 adults and 5 girls) and 67 (37.6%) males (63 adults and 4 boys). The age of patients ranged from 7 months to 82 years (mean 55.4 ± 11.8 years). For children, ages ranged from 7 months to 17 years, while for adults ages ranged from 24 to 82 years.Results. Incidentalomas were detected in 36 (21.3%) of 169 adults, and seven (19.4%) of them were found to be hormonally active in biochemical tests.The patients underwent surgery after the preparation depending on the general state, type of tumour, its functioning, and concomitant diseases. Adrenalectomy was performed using a classical open technique through the lumbal access in 146 (86.4%) adults, and a laparoscopic technique through the retro- or transperitoneal access in 23 (13.6%) adults. In the videolaparoscopic operations, retroperitoneal access was preferred. All children were operated upon by means of the classical technique with trans-abdominal access.Adrenal tumours were most frequent in the 6th decade of life (33.2% of all tumours). In the adult group, 143 (84.6%) cases of histologically diagnosed benign tumours and 26 (15.4%) cases of malignant neoplasms were found. Sixteen (9.5% of all tumours and 61.5% of malignancies) of them appeared to be secondary metastatic tumours. Moreover, six (66.7%) children had primary malignant adrenal tumours.In three adult patients whose tumours were up to 3 cm in size in the remaining adrenal gland (after previous adrenalectomy on the other side), enucleation was carried out in one patient and partial resection of the only adrenal gland in two patients. The follow-up cortisol levels in the blood sera of these patients appeared to be normal.Conclusions. 1. Adrenal tumours most commonly occur in the 6th and 7th decades of patients' lives; an increase in the incidence rate is affected by the percentage of metastases to adrenal glands. 2. Adrenal incidentalomas reveal subclinical hormonal activity in a significant percentage of patients and require adequate preparation prior to surgery. 3. Operations preserving the cortex of the only adrenal gland allow the patients to avoid hormonal substitution therapy. 4. Tumours in children are a separate phenomenon with specific tumour characteristics and origin.
Publisher
Year
Volume
80
Issue
7
Pages
364-370
Physical description
Dates
published
1 - 7 - 2008
online
23 - 7 - 2008
References
  • Tołłoczko T:. Nowotwory nadnercza. W: Szawłowski AW, Szmidt J (red.) Zasady diagnostyki i chirurgicznego leczenia nowotworów w Polsce. Fundacja Polski Przegląd Chirurgiczny, Warszawa 2003; s.143-51.
  • DeLellis RA, Lloyd RV, Heitz PhU, Eng Ch. (red.) World Health Organization Classification of Tumours. Pathology & Genetics. Tumours of Endocrinre Organs. IARC Press Lyon 2004.
  • Kloss RT, Gross MD, Francis IR et al.: Incidentally discovered adrenal masses. Endocr Rev 1995; 16: 460-84.
  • Steward PM:. The adrenal cortex W: Larsen PR, Kronenberg HM, Melmed S, Polonsky KS.(red) Textbook of Endocrinology Wyd 10. Saunders. Philadelphia 2002; 491-551.
  • Wajda Z, Kwieciñska B, Stefaniak T:. Chirurgia nadnerczy. W: Gruca Z (red.) Pamiętnik 61. Zjazdu Towarzystwa Chirurgów Polskich. Gdañsk 17-20. 09.2003 - Chirurgia Endokrynologiczna. Gdañsk 2003; 36-41.
  • Didkowska M, Wojciechowska U, Tarkowski W. i wsp.: Nowotwory złośliwe w Polsce w 1999 r. Centrum Onkologii - Instytut im. M. Skłodowskiej-Curie, Warszawa 2002.
  • Didkowska M, Wojciechowska U, Tarkowski W. i wsp.: Nowotwory złośliwe w Polsce w 2000 roku. Centrum Onkologii - Instytut im. M. Skłodowskiej-Curie, Warszawa 2003.
  • Wojciechowska U, Didkowska J, Tarnowski W. i wsp.: Nowotwory złośliwe w Polsce w roku 2003. Centrum Onkologii - Instytut im. M. Skłodowskiej-Curie, Warszawa 2004.
  • Pomorski L, Kołomecki K, Jakubiak M. i wsp.: Guzy nadnerczy typu incidentaloma w badaniach autopsyjnych. Endokrynol Pol 1999; 50 supl. 1 do z. 3: s. 326.
  • Rossi R, Tuchmanova L, Luciano A et al.:. Subclinical Cushings symdome in patients with adrenal incidentaloma: clinical and biochemical features. J Clin Endocrinol Metab 2000; 85: 1440-48.[Crossref]
  • Solcia E, Kloppel G, Sobin LH:. World Health Organization Histological Classification of Tumours. Wyd. 2. Springer, Verlag, Berlin, Heidelberg, New York, Geneva 2000.
  • Neblett WW, Frexes-Steed M, Scott HW Jr:.. Experience with adrenocortical neoplasms in childhood. Am Surg 1987; 53: 117-25.[PubMed]
  • Bruckel J, Boehm BO:. Nebennierenrind karzinom. W: Lutz P, Adler G, Seufferlein T (red.) Gastrointestinale und endokrine tumoren Aktuelle diagnostik und therapie. W. Zuckschwerdt Verlag GmbH Munchen 2003; s.150-54.
  • Walz MK, Peigen K, Diesing D et al.:. Endoscopic treatment of large adrenal tumors. W:1st Meeting of the European Society of Endocrine Surgeons. Pisa 13-15 May 2004. Procedings. S. 38.
  • Liao CH, Chueh SC, Lai MK et al.:. Laparoscopic adrenalectomy for potentially malignant adrenal tumors greater than 5 centimeters. J Clin Endocrinol Metab 2006; 91: 3080-83.[Crossref]
  • Pampaloni F, Valeri A, Mattei R et al.:. Experience with laparoscopic adrenalectomy in children. Chir Ital 2006; 58: 45-54.
  • Saad DF, Gow KW, Milas Z et al.:. Laparoscopic adrenalectomy for neuroblastoma in children: a report of 6 cases. J Pediatr Surg 2005; 4: 1948-50.[Crossref]
  • Porpiglia F, Destefanis P, Bovio S et al.:. Cortical-sparing laparoscopic adrenalectomy in patient with multiple endocrine neoplasia type IIA. Horm Res 2002; 57: 197-99.[Crossref]
  • Budzyñski A, Lubikowski J, Rembiasz K. i wsp.: Laparoscopic adrenalectomy; retroperitoneal v. transperitoneal. W: European Society of Endocrine Surgeons ESES 2nd Biennial Congress May 18-20, 2006 Kraków. Procedings.s.50.
  • Walz MK, Peigten K, Diesing D et al.:. Partial versus total adrenalectomy by the posterior retroperitoneoscopic approach: early and long-term results of 325 consecutive procedures in primary adrenal neoplasias. World J Surg 2004; 28: 1323-29.
  • Lombardi CP, Raffaelli M, De Crea C et al.:. Role of laparoscopy in the management of adrenal malignancies. J Surg Oncol 2006; 94: 128-31.[Crossref]
  • Henry JF, Sebag F, Iacobone M et al.:. Results of laparoscopic adrenalectomy for large and potentially malignant tumors. World J Surg 2002; 26: 1043-47.[Crossref]
Document Type
Publication order reference
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_v10035-008-0048-8
Identifiers
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.