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https://observatorio.fm.usp.br/handle/OPI/12014
Title: | Radiographic Characteristics of Adrenal Masses Preceding the Diagnosis of Adrenocortical Cancer |
Authors: | NOGUEIRA, T. M.; LIROV, R.; CAOILI, E. M.; LERARIO, A. M.; MILLER, B. S.; FRAGOSO, M. C. B. V.; DUNNICK, N. R.; HAMMER, G. D.; ELSE, T. |
Citation: | HORMONES & CANCER, v.6, n.4, p.176-181, 2015 |
Abstract: | Incidentally discovered adrenal masses are common and the clinical evaluation and surveillance aims to diagnose hormone excess and malignancy. Adrenocortical cancer (ACC) is a very rare malignancy. This study aims to define the imaging characteristics of adrenal tumors preceding the diagnosis of ACC. Patients with prior (> 5 months) adrenal tumors (< 6 cm) subsequently diagnosed with ACC were identified in a large registry at a tertiary referral center. Retrospective chart and image review for patient characteristics and initial, interval, and diagnostic imaging characteristics (size, homogeneity, borders, density, growth rate, etc.) was conducted. Twenty patients with a diagnosis of ACC and a prior adrenal tumor were identified among 422 patients with ACC. Of these, 17 patients were initially imaged with CT and 3 with MR. Only 2 of the 20 patients had initial imaging characteristics suggestive of a benign lesion. Of initial tumors, 25 % were < 2 cm in size. Surveillance led to the diagnosis of ACC within 24 months in 50 % of patients. The growth pattern was variable with some lesions showing long-term stability (up to 8 years) in size. In conclusion, antecedent lesions in patients with a diagnosis of ACC are often indeterminate by imaging criteria and can be small. Surveillance over 2 years detected only 50 % of ACCs. Current practice and guidelines are insufficient in diagnosing ACCs. Given the rarity of ACC, the increased risk and health care costs of additional evaluation may not be warranted. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - LIM/33 Artigos e Materiais de Revistas Científicas - LIM/42 Artigos e Materiais de Revistas Científicas - ODS/03 |
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art_NOGUEIRA_Radiographic_Characteristics_of_Adrenal_Masses_Preceding_the_Diagnosis_2015.PDF | publishedVersion (English) | 1.46 MB | Adobe PDF | View/Open |
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