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Abstract
Purpose
Benign adrenal tumors other than hyper-functioning tumor and non-functioning cortical adenoma are extremely rare. The purpose of this study is to review the clinical features of these rare benign adrenal tumors and to analyze their prevalence and the proper surgical approach for them.
Methods
Among patients who underwent adrenalectomy in Samsung Medical Center, between 1997 and 2013, patients with benign adrenal tumor except non-functioning cortical adenoma, malignancy, and hyper-functioning tumor such as pheochromocytoma, aldosteronoma, and cortisol producing tumor were included. Clinical details, radiologic findings and pathologic findings as well as data associated with the surgical procedure were analyzed retrospectively.
Results
The percentage of these tumors among 703 surgically removed adrenal tumors was 10.7% (75 cases). They included 30 adrenal cysts, 18 ganglioneuromas, 11 myelolipomas, seven schwannomas, and the other six were rare adrenal tumors. Approximately 40% of the patients were operated under a diagnosis different from original tumors. Operation time and hospital stay of patients who underwent laparoscopic adrenalectomy were shorter than those of patients who underwent open adrenalectomy.
References
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Table 1.
Prevalence of adrenal tumors in patient who underwent adrenalectomy
Table 2.
Demographics of patients
Table 3.
Radiologic findings of adrenal cyst according to pathologic findings
| No. of patient | % | Calcification | Hemorrhage | Solid portion | |
|---|---|---|---|---|---|
| Total Endothelial | 30 15 | 100 50.0 | 14 8 | 5 1 | 9 2 |
| Pseudocyst | 9 | 30.0 | 5 | 4 | 5 |
| Epithelial | 1 | 3.3 | 0 | 0 | 0 |
| Unclassified | 5 | 16.7 | 1 | 0 | 2 |
Table 4.
Comparison between operative methods
|
Type of operation |
P value | ||
|---|---|---|---|
| Laparoscopic adrenalectomy | Open adrenalectomy | ||
| Period 1997∼2013 (n=75, %) | 38 (50.7) | 37 (49.3) | |
| Tumor size (mean, cm) | 5.9 (0.5∼12.0) | 7.5 (1.2∼17.0) | 0.026 |
| Operation time (mean, min)* | 119.4 | 170.2 | 0.003 |
| Hospital day (mean, day)* | 4.7 | 8.9 | 0.000 |
| Period 2002∼2013 (n=54, %) | 32 (59.3) | 22 (40.7) | |
| Tumor size (mean, cm) | 6.0 (0.5∼12.0) | 7.3 (1.2∼17.0) | 0.172 |
| Operation time (mean, min)* | 103.0 | 163.4 | 0.006 |
| Hospital day (mean, day)* | 4.4 | 8.8 | 0.003 |
Table 5.
Preop image results according to adrenal tumor
Table 6.
Characteristics of rare benign adrenal tumors
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