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Surgical Approach to Adrenal Mass

Indications and laparoscopic adrenalectomy for adrenal gland masses.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Surgical Approach to Adrenal Mass?

Adrenal incidentaloma is an adrenal mass discovered incidentally on imaging performed for another reason. The incidence is 4-5% of CT scans. Every adrenal mass should be evaluated for hormonal activity and malignancy risk.

All adrenal incidentalomas require hormonal workup: 1 mg dexamethasone suppression test (subclinical Cushing), plasma metanephrines (pheochromocytoma), and aldosterone/renin ratio in hypertension (Conn syndrome). Density >10 HU on non-contrast CT raises suspicion for malignancy.

Surgical indications: functional mass (any size), >4 cm non-functional mass, mass with growth on follow-up (>1 cm/year), and radiologic suspicion of malignancy (high density, irregular borders, low washout).

Symptoms

Incidentally discovered adrenal mass (>1 cm)
Signs of functional adrenal tumor
>4 cm non-functional adrenal mass on CT
Growing adrenal mass on follow-up
Suspicion of adrenocortical carcinoma

Risk Factors

Intraoperative hypertensive crisis in pheochromocytoma
Adrenal insufficiency (after subclinical Cushing)
Adjacent organ injury
Bleeding
Thromboembolic complications

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When an adrenal mass is detected on imaging, refer to endocrinology and urology
  • In paroxysmal hypertension, headache, sweating attacks (pheochromocytoma)
  • After adrenalectomy for cortisol replacement follow-up
  • If mass enlargement is detected on follow-up imaging

Treatment Methods

01
Hormonal evaluation (DST, plasma metanephrines, aldosterone/renin)
02
CT density and washout analysis (malignancy risk)
03
Laparoscopic adrenalectomy (in indicated cases)
04
Follow-up CT (non-functional <4 cm: 6-12-24 months)
05
Preoperative pheochromocytoma preparation (alpha-blockade, fluid loading)

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.