Adrenolipoma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

Surgery is the mainstay of treatment of large adrenolipomas.

Surgery

Surgery is the mainstay of treatment of large adrenolipomas.

  • Management of adrenal myelolipoma is decided based upon the size of lesion and presence of symptoms.
  • Small lesions measuring less than 5 cm, and those who are asymptomatic are usually monitored via imaging over a period of one to two years.
  • Symptomatic tumors or myelolipomas larger than 7 cm should undergo elective surgical excision.
  • The approach is based on the reported incidence of life-threatening emergencies caused by spontaneous rupture and hemorrhage within large lesions.
  • Conventional or endoscopic access may be chosen according to the size of the tumor.
  • Mini-invasive and endoscopic techniques are best utilized for smaller-sized lesions, depending on the expertise of the operator.
  • Conventional methods including transabdominal, lumbar, subcostal or posterior access laparotomy operations have all been described in the literature.
  • An extraperitoneal approach is preferable as it leads to quicker recovery of the patient and lesser postoperative complications.
  • The midline approach is indicated for masses larger than 10 cm or in cases where there are adhesions and infiltration of the surrounding structures.
  • Follow up is mandatory regardless of which surgical method has been employed.

References

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