Abstract

Introduction: Cavernous hemangioma of the adrenal gland is a rare benign tumor characterized by the presence of blood-fil- led, dilated vascular spaces. These adrenal masses are usually non-functioning and the patients have no symptoms so the diagnosis is incidental. Methods: We performed a systematic literature review for all articles published until April 2015. The initial search identified 98 publications. We considered some characteristics: the mean age of the patients at diagnosis was 59 years (range 19 - 84); there were approximately 1.7 times more female patients than male patients; mean diameter of the lesions was 10.3 cm (range 2 - 25). Surgical treatment was more often open with midline or subcostal incision. Results: From literature analysis we know that small adrenal hemangiomas are usually asymptomatic. Only four patients in our literature review show endocrinologic disturbances with three cases of subclinical Cushing’s syndrome and a case of hyperaldo- steronism. The pre-operative radiologic features play a fundamental role for correct surgical approach. On enhanced Computed Tomography (CT) scan adrenal hemangiomas tend to be heterogeneous, hypodense lesions with high-density rim of tissue at the periphery. On Magnetic Resonance Imaging (MRI) common findings associated with adrenal hemangiomas are hypointense inhomo- geneous masses with central hyperintensity on T1 images and a high intensity peripheral rim on T2 images due to hemorrhage or necrosis. Conclusion: Laparoscopic adrenalectomy is considered the standard treatment in case of benign lesions. Some authors sugge- st that the main limitation during laparoscopic dissection for large and potentially malign adrenal tumors is incomplete resection and capsular disruption with increased risk of local recurrence and intra-abdominal neoplastic dissemination. We recommend for these patients an integrated multidisciplinary approach that considers endocrine studies, preoperative radiologic findings and the expe- rience of surgical team.
Lingua originaleEnglish
pagine (da-a)385-389
Numero di pagine5
RivistaActa Medica Mediterranea
Volume32
Stato di pubblicazionePublished - 2016

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Cavernous Hemangioma
Decision Making
Hemangioma
Hyperaldosteronism
Glandular and Epithelial Neoplasms
Cushing Syndrome
Adrenalectomy
Adrenal Glands
Blood Vessels
Publications
Dissection
Necrosis
Tomography
Magnetic Resonance Imaging
Hemorrhage
Recurrence
Therapeutics
Neoplasms

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Adrenal cavernous hemangioma: which correct decision making process? / Amato, G.

In: Acta Medica Mediterranea, Vol. 32, 2016, pag. 385-389.

Risultato della ricerca: Article

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title = "Adrenal cavernous hemangioma: which correct decision making process?",
abstract = "Introduction: Cavernous hemangioma of the adrenal gland is a rare benign tumor characterized by the presence of blood-fil- led, dilated vascular spaces. These adrenal masses are usually non-functioning and the patients have no symptoms so the diagnosis is incidental. Methods: We performed a systematic literature review for all articles published until April 2015. The initial search identified 98 publications. We considered some characteristics: the mean age of the patients at diagnosis was 59 years (range 19 - 84); there were approximately 1.7 times more female patients than male patients; mean diameter of the lesions was 10.3 cm (range 2 - 25). Surgical treatment was more often open with midline or subcostal incision. Results: From literature analysis we know that small adrenal hemangiomas are usually asymptomatic. Only four patients in our literature review show endocrinologic disturbances with three cases of subclinical Cushing’s syndrome and a case of hyperaldo- steronism. The pre-operative radiologic features play a fundamental role for correct surgical approach. On enhanced Computed Tomography (CT) scan adrenal hemangiomas tend to be heterogeneous, hypodense lesions with high-density rim of tissue at the periphery. On Magnetic Resonance Imaging (MRI) common findings associated with adrenal hemangiomas are hypointense inhomo- geneous masses with central hyperintensity on T1 images and a high intensity peripheral rim on T2 images due to hemorrhage or necrosis. Conclusion: Laparoscopic adrenalectomy is considered the standard treatment in case of benign lesions. Some authors sugge- st that the main limitation during laparoscopic dissection for large and potentially malign adrenal tumors is incomplete resection and capsular disruption with increased risk of local recurrence and intra-abdominal neoplastic dissemination. We recommend for these patients an integrated multidisciplinary approach that considers endocrine studies, preoperative radiologic findings and the expe- rience of surgical team.",
author = "{Amato, G.} and Gaspare Gulotta and Pasquale Mansueto and Giorgio Romano and {Dominguez Rodriguez}, {Ligia Juliana} and Antonino Agrusa and Massimo Galia and Roberto Citarrella and {Di Buono}, Giuseppe and Vincenzo Sorce and Laura Vernuccio",
year = "2016",
language = "English",
volume = "32",
pages = "385--389",
journal = "Acta Medica Mediterranea",
issn = "0393-6384",
publisher = "A. CARBONE Editore",

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TY - JOUR

T1 - Adrenal cavernous hemangioma: which correct decision making process?

AU - Amato, G.

AU - Gulotta, Gaspare

AU - Mansueto, Pasquale

AU - Romano, Giorgio

AU - Dominguez Rodriguez, Ligia Juliana

AU - Agrusa, Antonino

AU - Galia, Massimo

AU - Citarrella, Roberto

AU - Di Buono, Giuseppe

AU - Sorce, Vincenzo

AU - Vernuccio, Laura

PY - 2016

Y1 - 2016

N2 - Introduction: Cavernous hemangioma of the adrenal gland is a rare benign tumor characterized by the presence of blood-fil- led, dilated vascular spaces. These adrenal masses are usually non-functioning and the patients have no symptoms so the diagnosis is incidental. Methods: We performed a systematic literature review for all articles published until April 2015. The initial search identified 98 publications. We considered some characteristics: the mean age of the patients at diagnosis was 59 years (range 19 - 84); there were approximately 1.7 times more female patients than male patients; mean diameter of the lesions was 10.3 cm (range 2 - 25). Surgical treatment was more often open with midline or subcostal incision. Results: From literature analysis we know that small adrenal hemangiomas are usually asymptomatic. Only four patients in our literature review show endocrinologic disturbances with three cases of subclinical Cushing’s syndrome and a case of hyperaldo- steronism. The pre-operative radiologic features play a fundamental role for correct surgical approach. On enhanced Computed Tomography (CT) scan adrenal hemangiomas tend to be heterogeneous, hypodense lesions with high-density rim of tissue at the periphery. On Magnetic Resonance Imaging (MRI) common findings associated with adrenal hemangiomas are hypointense inhomo- geneous masses with central hyperintensity on T1 images and a high intensity peripheral rim on T2 images due to hemorrhage or necrosis. Conclusion: Laparoscopic adrenalectomy is considered the standard treatment in case of benign lesions. Some authors sugge- st that the main limitation during laparoscopic dissection for large and potentially malign adrenal tumors is incomplete resection and capsular disruption with increased risk of local recurrence and intra-abdominal neoplastic dissemination. We recommend for these patients an integrated multidisciplinary approach that considers endocrine studies, preoperative radiologic findings and the expe- rience of surgical team.

AB - Introduction: Cavernous hemangioma of the adrenal gland is a rare benign tumor characterized by the presence of blood-fil- led, dilated vascular spaces. These adrenal masses are usually non-functioning and the patients have no symptoms so the diagnosis is incidental. Methods: We performed a systematic literature review for all articles published until April 2015. The initial search identified 98 publications. We considered some characteristics: the mean age of the patients at diagnosis was 59 years (range 19 - 84); there were approximately 1.7 times more female patients than male patients; mean diameter of the lesions was 10.3 cm (range 2 - 25). Surgical treatment was more often open with midline or subcostal incision. Results: From literature analysis we know that small adrenal hemangiomas are usually asymptomatic. Only four patients in our literature review show endocrinologic disturbances with three cases of subclinical Cushing’s syndrome and a case of hyperaldo- steronism. The pre-operative radiologic features play a fundamental role for correct surgical approach. On enhanced Computed Tomography (CT) scan adrenal hemangiomas tend to be heterogeneous, hypodense lesions with high-density rim of tissue at the periphery. On Magnetic Resonance Imaging (MRI) common findings associated with adrenal hemangiomas are hypointense inhomo- geneous masses with central hyperintensity on T1 images and a high intensity peripheral rim on T2 images due to hemorrhage or necrosis. Conclusion: Laparoscopic adrenalectomy is considered the standard treatment in case of benign lesions. Some authors sugge- st that the main limitation during laparoscopic dissection for large and potentially malign adrenal tumors is incomplete resection and capsular disruption with increased risk of local recurrence and intra-abdominal neoplastic dissemination. We recommend for these patients an integrated multidisciplinary approach that considers endocrine studies, preoperative radiologic findings and the expe- rience of surgical team.

UR - http://hdl.handle.net/10447/177822

M3 - Article

VL - 32

SP - 385

EP - 389

JO - Acta Medica Mediterranea

JF - Acta Medica Mediterranea

SN - 0393-6384

ER -