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Adrenal cysts less than 10 cm can be safely observed.
Rodriguez, Emily; Fedorova, Tatiana; Daskam, Maria; Baraban, Ezra; Foote, Darci C; Salvatori, Roberto; Singla, Nirmish; Fishman, Elliot K; Chen Cardenas, Stanley M; Ball, Douglas W; Hamrahian, Amir H; Mathur, Aarti; Morris-Wiseman, Lilah F.
Afiliación
  • Rodriguez E; Division of Endocrine Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Fedorova T; Division of Endocrine Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Daskam M; Division of Endocrine Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Baraban E; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Foote DC; Division of Endocrine Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Salvatori R; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Singla N; Johns Hopkins University School of Medicine Brady Urological Institute, Baltimore, Maryland, USA.
  • Fishman EK; Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Chen Cardenas SM; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Ball DW; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Hamrahian AH; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Mathur A; Division of Endocrine Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Morris-Wiseman LF; Division of Endocrine Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
World J Surg ; 48(8): 1934-1940, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38972990
ABSTRACT

BACKGROUND:

Adrenal cysts are rare and appropriate management is unclear due to a lack of data on their natural history. Understanding adrenal cyst growth patterns would assist in clinical management.

METHODS:

This single-institution study included all adult patients diagnosed with simple adrenal cysts between 2004 and 2021. Baseline characteristics and outcomes of those who underwent resection (ADX) or observation (OBS) were compared using the chi-squared test, student's t-test, and Wilcoxon rank-sum test. Growth curves and sensitivity analysis were plotted for all patients who had follow-up imaging.

RESULTS:

We identified 77 patients with imaging-confirmed adrenal cysts. The majority were female (75.3%) and more than half were white (55.8%). One-third of patients underwent ADX, and the remaining were observed. ADX patients were younger (median age [IQR] 55.5 y [45.0-68.2 y] vs. 44.2 y [38.7-55.0 y], p = 0.01) and more likely to be Hispanic (12% vs. 0%, p = 0.05). ADX patients presented with larger cysts (5.6 vs. 2.6 cm, p = 0.002). The median time from diagnosis to last follow-up was 1.1 y for ADX and 4.1 y for OBS. Average growth for OBS was 0.3 cm/y, while average growth for ADX was 3.9 cm/y. In ADX patients, cysts >10 cm grew significantly faster than cysts <10 cm (median growth rate 13.2 cm/y vs. 0.3 cm/y, p < 0.05). There was no adrenal malignancy diagnosis, hyperfunctionality, or observation-related complications (e.g., rupture).

CONCLUSION:

While size >4-6 cm has guided surgical referral for solid adrenal masses, this study demonstrates a size threshold of 10 cm, below which asymptomatic, simple adrenal cysts can safely be observed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de las Glándulas Suprarrenales / Quistes Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: World J Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de las Glándulas Suprarrenales / Quistes Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: World J Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos