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Bracci B, De Santis D, Del Gaudio A, Faugno MC, Romano A, Tarallo M, Zerunian M, Guido G, Polici M, Polidori T, Pucciarelli F, Matarazzo I, Laghi A, Caruso D. Adrenal Lesions: A Review of Imaging. Diagnostics (Basel) 2022; 12:diagnostics12092171. [PMID: 36140572 PMCID: PMC9498052 DOI: 10.3390/diagnostics12092171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
Adrenal lesions are frequently incidentally diagnosed during investigations for other clinical conditions. Despite being usually benign, nonfunctioning, and silent, they can occasionally cause discomfort or be responsible for various clinical conditions due to hormonal dysregulation; therefore, their characterization is of paramount importance for establishing the best therapeutic strategy. Imaging techniques such as ultrasound, computed tomography, magnetic resonance, and PET-TC, providing anatomical and functional information, play a central role in the diagnostic workup, allowing clinicians and surgeons to choose the optimal lesion management. This review aims at providing an overview of the most encountered adrenal lesions, both benign and malignant, including describing their imaging characteristics.
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Affiliation(s)
- Benedetta Bracci
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Domenico De Santis
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Antonella Del Gaudio
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Maria Carla Faugno
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Allegra Romano
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Mariarita Tarallo
- Department of Surgery “Pietro Valdoni”, Sapienza University of Rome, 00185 Rome, Italy
| | - Marta Zerunian
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Gisella Guido
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Michela Polici
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Tiziano Polidori
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Francesco Pucciarelli
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Iolanda Matarazzo
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Andrea Laghi
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Damiano Caruso
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza—University of Rome, Radiology Unit—Sant’Andrea University Hospital, 00189 Rome, Italy
- Correspondence:
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Cavallaro G, Tarallo M, Chiappini A, Crocetti D, Polistena A, Petramala L, Sibio S, De Toma G, Fiori E, Letizia C. Surgical Management of Adrenocortical Carcinoma: Current Highlights. Biomedicines 2021; 9:909. [PMID: 34440112 DOI: 10.3390/biomedicines9080909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Adrenocortical carcinoma (ACC) is a rare tumor, often discovered at an advanced stage and associated with poor prognosis. Treatment is guided by staging according to the European Network for the Study of Adrenal Tumors (ENSAT) classification. Surgery is the treatment of choice for ACC. The aim of this review is to provide a complete overview on surgical approaches and management of adrenocortical carcinoma. METHODS This comprehensive review has been carried out according to the PRISMA statement. The literature sources were the databases PubMed, Scopus and Cochrane Library. The search thread was: ((surgery) OR (adrenalectomy)) AND (adrenocortical carcinoma). RESULTS Among all studies identified, 17 were selected for the review. All of them were retrospective. A total of 2498 patients were included in the studies, of whom 734 were treated by mini-invasive approaches and 1764 patients were treated by open surgery. CONCLUSIONS Surgery is the treatment of choice for ACC. Open adrenalectomy (OA) is defined as the gold standard. In recent years laparoscopic adrenalectomy (LA) has gained more popularity. No significant differences were reported for overall recurrence rate, time to recurrence, and cancer-specific mortality between LA and OA, in particular for Stage I-II. Robotic adrenalectomy (RA) has several advantages compared to LA, but there is still a lack of specific documentation on RA use in ACC.
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