Limitations of size as a criterion in the evaluation of adrenal tumors

Jr Barnett C.C., D. G. Varma, A. K. El-Naggar, A. P B Dackiw, G. A. Porter, A. S. Pearson, A. P. Kudelka, R. F. Gagel, D. B. Evans, J. E. Lee, N. Thompson, J. Monchik, N. Dudley, B. Hamberger, J. Farndon, J. Pasieka

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Abstract

Background. Size has been considered to be the single best predictor of malignancy in adrenal neoplasms that have been identified incidentally. However, small adrenal cortical cancers have been reported from multiple centers. Methods. We retrospectively evaluated the value of tumor size and other clinical parameters in the prediction of the presence of adrenal malignancy. Results. The records of 117 patients who underwent evaluation for tumors of the adrenal gland were reviewed. The median tumor size of the adrenal cortical carcinomas (n = 38 carcinomas) was 9.2 cm (range, 1.7-30 cm); 5 cancers (13.5%) were smaller than 5.0 cm. The median overall size of the benign tumors, excluding pheochromocytomas, was 4.0 cm (n = 38 carcinomas); 10 benign tumors (26%) were larger than 5.0 cm. The imaging features of 4 of 5 small adrenal cancers predicted malignancy; the remaining patients had hormonally functioning tumors. The imaging features of 7 of 10 large benign adrenal tumors predicted benign histologic features, including 5 of 5 myelolipomas. Conclusions. Although size remains a good predictor of the histologic features and clinical behavior of adrenal neoplasms, both small adrenal cortical cancers and large benign tumors occur with measurable frequency. High-quality imaging studies may be helpful in the identification of relatively small adrenal cancers and of characteristic benign lesions that may be selectively followed.

Original languageEnglish (US)
Pages (from-to)973-983
Number of pages11
JournalSurgery
Volume128
Issue number6
StatePublished - 2000

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Glandular and Epithelial Neoplasms
Adrenal Gland Neoplasms
Neoplasms
Carcinoma
Myelolipoma
Adrenocortical Carcinoma
Pheochromocytoma
Adrenal Glands

ASJC Scopus subject areas

  • Surgery

Cite this

Barnett C.C., J., Varma, D. G., El-Naggar, A. K., Dackiw, A. P. B., Porter, G. A., Pearson, A. S., ... Pasieka, J. (2000). Limitations of size as a criterion in the evaluation of adrenal tumors. Surgery, 128(6), 973-983.

Limitations of size as a criterion in the evaluation of adrenal tumors. / Barnett C.C., Jr; Varma, D. G.; El-Naggar, A. K.; Dackiw, A. P B; Porter, G. A.; Pearson, A. S.; Kudelka, A. P.; Gagel, R. F.; Evans, D. B.; Lee, J. E.; Thompson, N.; Monchik, J.; Dudley, N.; Hamberger, B.; Farndon, J.; Pasieka, J.

In: Surgery, Vol. 128, No. 6, 2000, p. 973-983.

Research output: Contribution to journalArticle

Barnett C.C., J, Varma, DG, El-Naggar, AK, Dackiw, APB, Porter, GA, Pearson, AS, Kudelka, AP, Gagel, RF, Evans, DB, Lee, JE, Thompson, N, Monchik, J, Dudley, N, Hamberger, B, Farndon, J & Pasieka, J 2000, 'Limitations of size as a criterion in the evaluation of adrenal tumors', Surgery, vol. 128, no. 6, pp. 973-983.
Barnett C.C. J, Varma DG, El-Naggar AK, Dackiw APB, Porter GA, Pearson AS et al. Limitations of size as a criterion in the evaluation of adrenal tumors. Surgery. 2000;128(6):973-983.
Barnett C.C., Jr ; Varma, D. G. ; El-Naggar, A. K. ; Dackiw, A. P B ; Porter, G. A. ; Pearson, A. S. ; Kudelka, A. P. ; Gagel, R. F. ; Evans, D. B. ; Lee, J. E. ; Thompson, N. ; Monchik, J. ; Dudley, N. ; Hamberger, B. ; Farndon, J. ; Pasieka, J. / Limitations of size as a criterion in the evaluation of adrenal tumors. In: Surgery. 2000 ; Vol. 128, No. 6. pp. 973-983.
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abstract = "Background. Size has been considered to be the single best predictor of malignancy in adrenal neoplasms that have been identified incidentally. However, small adrenal cortical cancers have been reported from multiple centers. Methods. We retrospectively evaluated the value of tumor size and other clinical parameters in the prediction of the presence of adrenal malignancy. Results. The records of 117 patients who underwent evaluation for tumors of the adrenal gland were reviewed. The median tumor size of the adrenal cortical carcinomas (n = 38 carcinomas) was 9.2 cm (range, 1.7-30 cm); 5 cancers (13.5{\%}) were smaller than 5.0 cm. The median overall size of the benign tumors, excluding pheochromocytomas, was 4.0 cm (n = 38 carcinomas); 10 benign tumors (26{\%}) were larger than 5.0 cm. The imaging features of 4 of 5 small adrenal cancers predicted malignancy; the remaining patients had hormonally functioning tumors. The imaging features of 7 of 10 large benign adrenal tumors predicted benign histologic features, including 5 of 5 myelolipomas. Conclusions. Although size remains a good predictor of the histologic features and clinical behavior of adrenal neoplasms, both small adrenal cortical cancers and large benign tumors occur with measurable frequency. High-quality imaging studies may be helpful in the identification of relatively small adrenal cancers and of characteristic benign lesions that may be selectively followed.",
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AU - Barnett C.C., Jr

AU - Varma, D. G.

AU - El-Naggar, A. K.

AU - Dackiw, A. P B

AU - Porter, G. A.

AU - Pearson, A. S.

AU - Kudelka, A. P.

AU - Gagel, R. F.

AU - Evans, D. B.

AU - Lee, J. E.

AU - Thompson, N.

AU - Monchik, J.

AU - Dudley, N.

AU - Hamberger, B.

AU - Farndon, J.

AU - Pasieka, J.

PY - 2000

Y1 - 2000

N2 - Background. Size has been considered to be the single best predictor of malignancy in adrenal neoplasms that have been identified incidentally. However, small adrenal cortical cancers have been reported from multiple centers. Methods. We retrospectively evaluated the value of tumor size and other clinical parameters in the prediction of the presence of adrenal malignancy. Results. The records of 117 patients who underwent evaluation for tumors of the adrenal gland were reviewed. The median tumor size of the adrenal cortical carcinomas (n = 38 carcinomas) was 9.2 cm (range, 1.7-30 cm); 5 cancers (13.5%) were smaller than 5.0 cm. The median overall size of the benign tumors, excluding pheochromocytomas, was 4.0 cm (n = 38 carcinomas); 10 benign tumors (26%) were larger than 5.0 cm. The imaging features of 4 of 5 small adrenal cancers predicted malignancy; the remaining patients had hormonally functioning tumors. The imaging features of 7 of 10 large benign adrenal tumors predicted benign histologic features, including 5 of 5 myelolipomas. Conclusions. Although size remains a good predictor of the histologic features and clinical behavior of adrenal neoplasms, both small adrenal cortical cancers and large benign tumors occur with measurable frequency. High-quality imaging studies may be helpful in the identification of relatively small adrenal cancers and of characteristic benign lesions that may be selectively followed.

AB - Background. Size has been considered to be the single best predictor of malignancy in adrenal neoplasms that have been identified incidentally. However, small adrenal cortical cancers have been reported from multiple centers. Methods. We retrospectively evaluated the value of tumor size and other clinical parameters in the prediction of the presence of adrenal malignancy. Results. The records of 117 patients who underwent evaluation for tumors of the adrenal gland were reviewed. The median tumor size of the adrenal cortical carcinomas (n = 38 carcinomas) was 9.2 cm (range, 1.7-30 cm); 5 cancers (13.5%) were smaller than 5.0 cm. The median overall size of the benign tumors, excluding pheochromocytomas, was 4.0 cm (n = 38 carcinomas); 10 benign tumors (26%) were larger than 5.0 cm. The imaging features of 4 of 5 small adrenal cancers predicted malignancy; the remaining patients had hormonally functioning tumors. The imaging features of 7 of 10 large benign adrenal tumors predicted benign histologic features, including 5 of 5 myelolipomas. Conclusions. Although size remains a good predictor of the histologic features and clinical behavior of adrenal neoplasms, both small adrenal cortical cancers and large benign tumors occur with measurable frequency. High-quality imaging studies may be helpful in the identification of relatively small adrenal cancers and of characteristic benign lesions that may be selectively followed.

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