El tamaño de los tumores suprarrenales ¿está en relación al tiempo de evolución o expresa una diferencia biológica?

Abstract

El tamaño de los tumores suprarrenales ¿está en relación al tiempo de evolución o expresa una diferencia biológica?Background: Adrenal tumor (AT) malignancy has been related to tumor size. Since laparoscopic surgery is being used, smaller adrenal tumors are being excised. Aim: To evaluate eventual clinical and histological differences between adrenal tumors smaller than 4 cm. and those larger than 6 cm. Patients and Methods: Retrospective review of pathological reports and clinical records of patients operated for adrenal tumors, dividing them in two groups. Group 1 had 29 patients aged 52 ± 13 years with AT < 4 cm operated during the period 2000-2005, and Group 2 was formed by 52 patients aged 46 ± 18 years with AT >6 cm operated between . Tumors between 4 and 6 cm were not included in the study to establish clear cut differences between groups. Results: Tumors were functional in 40 and 41% of cases in groups 1 and 2 respectively. Fifty percent of functional tumors of group 1 were pheochromocytomas and the rest secreted aldosterone. In group 2, 66% of tumors were phechromocytomas and no aldosterone secreting tumors were found. Fifty two and eight percent of tumors in Groups 1 and 2 were adenomas, respectively (p <0.001). Nineteen tumors of group 2 were malignant, compared with one of group 1 (p <0.001). Conclusions: The tumor size of adrenal cortical tumors may represent biological differences, suggesting two different tumor populations. At time of diagnosis adrenal carcinomas are almost always larger than 6 cm (Rev Méd Chile 2007; 135: 1526-29). (

Manejo quirúrgico del incidentaloma suprarrenal

“…El nivel de corte no está completamente estandarizado, con algunos autores sugiriendo manejo quirúrgico de las lesiones mayores de 3 cm 18 , mayores de 4 cm 3,11 y mayores de 6 cm, o mayores de 4 cm asociadas a alguna característica sospechosa en las imágenes 16 . Stehr y cols, en una experiencia nacional retrospectiva para determinar la importancia del tamaño en los tumores suprarrenales, evaluó 2 grupos de pacientes con lesiones suprarrenales operadas, 29 pacientes con tumores < de 4 cm y 52 pacientes con tumores > de 6 cm, no encontrando ningún carcinoma en el primero y 10 en el segundo grupo 21 . Los registros internacionales muestran que en las lesiones menores de 4 cm, menos del 2% son carcinomas suprarrenales primarios, aumentando a 6% en tumores entre 4,1 a 6 cm y a 25% en lesiones mayores de 6 cm 16 .…”