Aim: The aim of this study is to evaluate the role of pre-operative radiologic imaging findings, per-operative findings, and post-operative patho-logical examination in the prediction of adrenal gland involvement.
Material and Methods: Between 2005 and 2012, from 3 different hospitals, medical records of 69 patients who had radical nephrectomy with ipsilateral adrenalectomy for renal cell carcino-ma were reviewed. Demographic data and pre-operative abdominal computerized tomography (CT) findings including size, side and localization of the tumor were recorded. Pre-operative con-dition of the adrenal gland in CT, per-operative palpation findings, and post-operative histopat-hological examination were evaluated.
Results: 25 patients (36.2%) were female and 44 (63.8%) were male with a mean age of 59.7 ± 12.4 (39-81) and 58.2 ± 11.9 (37-80) ye-ars, respectively. Mean tumor size was 7.9 ± 3 cm (2.4-16). In 6 cases (8.6%), we have found an evi-dence suggesting adrenal gland involvement in pre-operative CT. These six patients had possible signs of adrenal involvement in CT, described as irregular surface and nodule formation. The three of six patients had signs of adrenal involvement on per-operative palpation. In histopathological examination of these patients, tumor involve-ment was detected in adrenal gland. In one pa-tient tumor involvement in adrenal gland was detected without preoperative CT findings.
Conclusion: Consistent with the recent literature, we found that routine adrenalectomy in addition to the radical nephrec-tomy is unnecessary, particularly when pre-operative CT and per-operative findings are negative. In addition, we think that peri-ope-rative palpation findings are as valuable as pre-operative radiologi-cal findings in the prediction of adrenal gland involvement.
Key Words: Adrenal gland, kidney tumor, radical nephrectomy
Abstract
Aim: The aim of this study is to evaluate the role of pre-operative radiologic imaging findings, per-operative findings, and post-operative patho-logical examination in the prediction of adrenal gland involvement.
Material and Methods: Between 2005 and 2012, from 3 different hospitals, medical records of 69 patients who had radical nephrectomy with ipsilateral adrenalectomy for renal cell carcino-ma were reviewed. Demographic data and pre-operative abdominal computerized tomography (CT) findings including size, side and localization of the tumor were recorded. Pre-operative con-dition of the adrenal gland in CT, per-operative palpation findings, and post-operative histopat-hological examination were evaluated.
Results: 25 patients (36.2%) were female and 44 (63.8%) were male with a mean age of 59.7 ± 12.4 (39-81) and 58.2 ± 11.9 (37-80) ye-ars, respectively. Mean tumor size was 7.9 ± 3 cm (2.4-16). In 6 cases (8.6%), we have found an evi-dence suggesting adrenal gland involvement in pre-operative CT. These six patients had possible signs of adrenal involvement in CT, described as irregular surface and nodule formation. The three of six patients had signs of adrenal involvement on per-operative palpation. In histopathological examination of these patients, tumor involve-ment was detected in adrenal gland. In one pa-tient tumor involvement in adrenal gland was detected without preoperative CT findings.
Conclusion: Consistent with the recent literature, we found that routine adrenalectomy in addition to the radical nephrec-tomy is unnecessary, particularly when pre-operative CT and per-operative findings are negative. In addition, we think that peri-ope-rative palpation findings are as valuable as pre-operative radiologi-cal findings in the prediction of adrenal gland involvement.
Key Words: Adrenal gland, kidney tumor, radical nephrectomy