Abstrakt
Benign or malignant tumours within the adrenal glands can give rise to of a number of hypersecretion syndromes dependent on where the tumour is located. These include oversecretion of aldosterone (Conn syndrome), cortisol (Cushing syndrome) or androgens (androgenital syndrome) and adrenaline or noradrenaline (pheochromocytoma).
It is very difficult to distinguish benign and malignant adrenocortical tumours. However, a number of criteria can be applied, including size; benign tumours of the adrenal cortex are generally smaller than malignant tumours.
Benign tumours tend to be homogeneous in cross-section compared with heterogeneous malignant tumours. The presence of distant metastases is an absolute indication of malignancy.
Open adrenalectomy remains still a safe and effective surgical technique for treatment of complicated and recurrent adrenal tumours. However, in experienced hands, laparoscopic adrenalectomy is a safe and minimally invasive surgical technique with a short hospitalization stay and minimal complication rate.
Generally, adrenocortical carcinomas are curable only when they are small and localized. Adjuvant treatment regimes for more advanced adrenocortical carcinoma involves the chemotherapeutic agent mitotane, while conventional multiagent chemotherapy still needs to be evaluated in randomized trials.