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Adrenal incidentaloma: Histopathological correlation and risk of malignancy
Australian and New Zealand Journal of Surgery, 05/04/09

O'neill CJ et al. - Study concludes that surgery for adrenal incidentaloma likely reduces the risk of death from adrenal carcinomas (ACC). Surgeons should be aware of the variety of non adrenal pathologies which may mimic adrenal tumours.

• A review of the histopathology and clinical outcomes of pts undergoing surgery for adrenal incidentaloma
• Retrospective study of consecutive pts undergoing adrenalectomy for incidentaloma
• Data retrieved from adrenal tumour database and medical records

• During 2003 to 2008, 131 pts underwent adrenalectomy
• 28% where characterized pre-operatively as incidentalomas
• Two (5%) of these incidentalomas were ACC and both pts remain alive and disease free 2 yrs post surgery
• Incidence of ACC in non-incidentaloma group was 9 from 94 (9.4%)
• Relative risk reduction of death from ACC for pts undergoing surgery for incidentaloma was 0.051 vs those presenting with clinically apparent tumours
• Number needed to treat for adrenal incidentaloma to avoid 1 death from adrenal cancer was 20
• In 5 (14%) pts with a pre-operative diagnosis of an adrenal incidentaloma, histopathology revealed tissue of non-adrenal origin
• Pathology of these included: bronchogenic cyst, leiomyosarcoma, pseudocyst, haematoma and GIST

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