PDF(Pubmed)
Abstract：
Adrenal incidentalomas are common findings in clinical practice, with a prevalence of up to 4.2% in radiological studies. Due to the large number of focal lesions in the adrenal glands, it can be challenging to make a definitive diagnosis and determine the appropriate management. The purpose of this review is to present current diagnostic modalities used to preoperatively distinguish between adrenocortical adenoma (ACA) and adrenocortical cancer (ACC). Proper management and diagnosis are crucial in avoiding unnecessary adrenalectomies, which occur in over 40% of cases. A literature analysis was conducted to compare ACA and ACC using imaging studies, hormonal evaluation, pathological workup, and liquid biopsy. Before deciding on surgical treatment, the nature of the tumor can be accurately determined using noncontrast CT imaging combined with tumor size and metabolomics. This approach helps to narrow down the group of patients with adrenal tumors who require surgical treatment due to the suspected malignant nature of the lesion.
摘要：
肾上腺偶发瘤是临床实践中常见的发现，放射学研究中的患病率高达4.2%。由于肾上腺有大量的局灶性病变，做出明确的诊断并确定适当的管理可能具有挑战性.这篇综述的目的是介绍当前用于术前区分肾上腺皮质腺瘤（ACA）和肾上腺皮质癌（ACC）的诊断方法。正确的管理和诊断对于避免不必要的肾上腺切除术至关重要，发生在40%以上的病例中。使用影像学研究进行文献分析以比较ACA和ACC，荷尔蒙评估，病理检查,液体活检.在决定手术治疗之前，使用非对比CT成像结合肿瘤大小和代谢组学可以准确确定肿瘤的性质。这种方法有助于缩小由于怀疑病变的恶性性质而需要手术治疗的肾上腺肿瘤患者的范围。
