![]() | Only 14 pages are availabe for public view |
Abstract Adrenal masses are difficult to be diagnosed & mostly they are diagnosed accidentally, what is known by incidentallomas. The tumors of the adrenal gland are classified according to the origin either cortical or medullary, benighn or malignant. According to Kloos, et al., 2001: (I) Adrenal cortex (I-a) Cortisol producing adenoma (Cushing’s) (I-b) Aldostronoma (Hyperaldostronism) (I-c) Cortical adenoma (non functional) (II) Adrenocortical Carcinoma (II-a) Nonfunctional (II-b) Functional Cushing’s syndrome Cushing’s + virilization Virilization alone Feminization Hyperaldosteronism (III) Pheochromocytoma (IV) Metastasis Patient with no cancer history Patient with a history of cancer (V) Other Many modalities are used to diagnose adrenal masses , differ from each others in accuracy, cost efficacy & radiation hazards. These modalities are : - Ultrasonography, which is an easy bedside test. - Computed Tomography. - Magnetic Resonant Imaging (MRI). - Positron Emission Tomography (PET). - Angiography. - Fine Needle Aspiration Cytology. Management & Treatment of Adrenal tumors could be medical treatment by non surgical methods or surgical management by either open or laparoscopic surgery. During medical treatment of such masses, special care should be done if discovered during pregnancy. Other non surgical management includes, Radiofrequency& Cryoablation. Surgical management should be tailored according to the patient. special conditions like obesity, pregnancy& pediatric adrenal tumors are put in mind. Special considerations are taken for preoperative management. Open Vs laparoscopic adrenalectomy still needs more studies. Hand assisted surgery& robotic surgery are amazing advances in such field. Good care should be done to avoid post operative complications. |