caa a22 4500 477035191 CHVBK 20180405111303.0 cr unu---uuuuu 170330e19960701xx s 000 0 eng 10.1007/s002689900120 doi (NATIONALLICENCE)springer-10.1007/s002689900120 Adrenaloma: A Call for More Aggressive Management [Elektronische Daten] [Dimitrios A. Linos, Nikolaos Stylopoulos, Sotirios A. Raptis] Abstract. We review our experience from the surgical management of 57 patients (24 males, 33 females) with a mean age of 48.5 years who underwent adrenalectomy because of the computed tomography (CT) finding of a "nonfunctioning” adrenal tumor (adrenaloma). We found that CT consistently underestimated the real histologic size of the adrenal tumor (: p = 0.001). Of the 57 resected tumors, 23 were cortical adenomas, 7 myelolipomas, 8 adrenal cysts, 11 nodular hyperplasias, 2 primary adenocarcinomas, 2 metastatic carcinomas, and 4 pheochromocytomas. The mean diameter was 5.89 cm and the mean weight 114.07 g. The mean diameter of the resected primary adenocarcinomas was 3.0 cm and 4.5 cm, respectively. The operative mortality was zero and the perioperative morbidity minimal. The mean operating time was 137 minutes (range 60-240 minutes). The posterior approach had the shortest operating time and the laparoscopic approach the shortest hospital stay and the least postoperative need for narcotics. During the 6.2 years mean follow-up period, five patients with preoperative hypertension remained normotensive, and both patients with the resected primary adenocarcinomas are alive without recurrence. We suggest a more liberal surgical approach to patients with adrenalomas because: (1) even small tumors can be malignant or potentially lethal (e.g., pheochromocytomas); (2) some tumors that appear to be nonfunctioning may in reality be functioning; and (3) other nonfunctioning tumors may, with time (and without prior notice), function. The low risk of adrenalectomy especially via the laparoscopic approach can provide an early definitive diagnosis and treatment, avoiding the cost of repeated CT scans and other studies as suggested by the currently prevailing conservative management of these tumors. 1996 by the Société Internationale de Chir, ugie Linos Dimitrios A. Department of Surgery, Athens Medical School, Mikras Asias 75, Goudi, Athens 115 27, Greece, GR aut Stylopoulos Nikolaos Department of Surgery, Athens Medical School, Mikras Asias 75, Goudi, Athens 115 27, Greece, GR aut Raptis Sotirios A. Ipsilantou 45-47, Evangelismos Hospital, Athens 115 10, Greece, GR aut https://doi.org/10.1007/s002689900120 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900120 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Linos Dimitrios A. Department of Surgery, Athens Medical School, Mikras Asias 75, Goudi, Athens 115 27, Greece, GR aut NATIONALLICENCE 700 1- Stylopoulos Nikolaos Department of Surgery, Athens Medical School, Mikras Asias 75, Goudi, Athens 115 27, Greece, GR aut NATIONALLICENCE 700 1- Raptis Sotirios A. Ipsilantou 45-47, Evangelismos Hospital, Athens 115 10, Greece, GR aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer