Doenças benignas e malignas das supra-renais / Benign and malignant diseases of the adrenal

RESUMO

The purpose of this article is to provide the reader with a comprehensive, simplified and didactic vision of the adrenal diseases. The main characteristics of adrenal cortical tumors (aldosterona producing tumors and adrenal cortical tumors), medullary tumors (pheochromocytoma, neuroblastoma, ganglioneuroma and ganglioneuroblastoma), stromal tumors, metastatic tumors, as well as benign lesion (adrenal cortical hyperplasia, cysts, psudocysts, granulomas and abcesses) are described. A minimal biochemical assessment which may be more cost-effective is suggested. The role of ultrasonography, computed tomography and magnetic resonance in each of the above situations is emphasized. The surgical removal of the lesion by laparoscopy, lumbotomy or thoraco-laparotomy is the best treatment in almost all patients. The surgical procedures are safe when adequate pre-operative preparation in undertaken. The surgical exploration provides the pathological diagnosis avoiding the need for life-term follow-up with expensive exams and offers the best chance of definitive cure