Sudarsana Rao M1 , Prasada Rao M.2 , Arun S.3 , Roja Sushmita M.4
BACKGROUND Adrenal neoplasms range from asymptomatic cysts to fatal carcinomas. They have a variety of presentations starting from asymptomatic, to features of hypo- or hyper-functioning of the native adrenal hormones or mass effect. The aim of this study was to evaluate the clinicopathological features of adrenal tumours and their management at our tertiary care hospital. METHODS In this prospective observational study, 24 patients of adrenal tumours have been studied, out of which 16 patients underwent surgical management and 8 patients were managed conservatively with serial follow up. A detailed clinical evaluation, serological study and imagining was done in all patients to determine different characteristics of lesions, especially to identity the exact size and functional status of adrenal tumours. RESULTS In the present study, the peak incidence of adrenal tumours was seen in 4th decade with a mean of 35.62 years. The incidence of adrenal tumours is higher in females than males with a ratio of 2.4:1 and are more frequent on the left side. Asymptomatic cases (incidentalomas) comprised of 54.16%. Hypertension & pain abdomen were the predominant symptoms. 41.66% (10) cases were functional and predominantly these are pheochromocytomas. The mean tumour size in the present study was 4.75 cms with a range of 2.1 - 10 cms. Out of the 24 patients, 16 patients underwent adrenalectomy. Postoperative biopsy showed that 87.50% (14) patients had benign tumours and 12.50% (2) patients had malignant tumours. Mean hospital stay in the postoperative period in open adrenalectomy patients was 8.73 days and 2.5 days for laparoscopic adrenalectomy patients. CONCLUSIONS Though adrenal tumours are infrequent, identifying their functional status and size is very important for further management like surgical vs watchful conservative approach. In our study, we observed female sex and left sided predominance with more number of cases in fourth decade of life. Out of the symptomatic patients, hypertension and abdominal pain is predominant as pheochromocytoma was the most common histopathologic variant in our series. Benign tumours outnumbered the malignant tumours. Adenomas were most common incidentalomas.
