Endocrine Abstracts

Introduction: The adrenal glands are paired organs neuroendocrine, formed by the adrenal cortex and medulla, two distinct structures for histology, function, and embryological origin. The processes that most frequently affect the adrenals are adenomas 81.8%, 11.8% cysts, metastases, 11.8%, 5.9% carcinoma, pheochromocytoma 2.9%, 2.9% adrenalitis. 20–40% of adrenal masses are afuncionantes and/or discovered incidentally (incidentalomas) scans during abdominal imaging.

The objetive of this study is to present a bibliographical update and our experience in the diagnosis and treatment of the surgical pathology of the suprarenal glands.

Methods/design: Retrospective study of 48 patients diagnosed and treaties of suprarenal masses (2000–2011). Clinical history has been reviewed: signs and symptoms of adrenal pathology, radiological, hormonal study, stay average post-operating and anatomo-pathological diagnosis.

Results: Of 48 cases, 48% are men and 52% women. In 4 patients bilateral disease was detected. Average stays post-operating, 12 days. Anatomo-pathological diagnoses: pheochromocytoma 15 cases; functional adenoma 13 cases (Cushing 7; Conn 5; diffuse virilizante adrenogenital syndrome 1), hyperplasia two cases (syndrome of Cushing), hyperplasia to nodular two cases (hyperaldosteronism), suprarenal carcinoma three cases, non-functional masses 13 cases.

Conclusions: Before the hypercortisolims suspicion free cortisol is determined in tinkles of 24 h plasmatic ACTH, and test of weak suppression of dexametasona. In hyperaldosteronism, seric potassium concentration, aldosterone and ratio aldosterone-activity of plasmatic renina. Before pheochromocytoma we determined plasmatic catecholamine’s and tinkles of 24 h. If the hormonal study is suspected to a suprarenal carcinoma it will depend on the type of suspected endocrine syndrome. The location of the suprarenal masses is made with computerized tomography, magnetic resonance nuclear, ultrasounds or gammagraphy. At the moment the surgery laparoscopic and ‘Da Vinci robotic system’ are considered ‘gold standard” for the surgical treatment of the suprarenal pathology.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.