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Adrenal metastases.
[adrenal incidentaloma]
The
adrenal
gland
is
a
frequent
location
for
metastatic
spread
of
a
various
number
of
malignant
tumors
.
Among
all
tumors
,
carcinoma
of
lung
,
breast
,
ovary
and
malignant
melanoma
count
to
the
most
frequent
ones
.
In
nononcological
and
unselected
populations
,
the
prevalence
of
adrenal
metastases
is
0
-
21
%
.
The
metastases
are
mostly
discovered
in
patients
during
their
follow-up
carried
out
in
consequence
of
their
antecedent
malignant
disease
.
A
malignant
disease
in
adrenal
gland
may
occasionally
manifest
as
a
solitary
metastasis
referred
to
as
adrenal
incidentaloma
.
If
the
malignant
disease
is
disseminated
at
the
time
of
adrenal
mass
diagnosis
,
no
further
differentiation
of
lesion
is
necessary
as
it
does
not
influence
the
further
therapeutic
process
.
If
the
dissemination
is
not
present
,
further
differentiation
of
adrenal
lesion
is
essential
.
CT
and
MRI
characteristics
of
the
adrenal
mass
play
the
key
role
in
the
differential
diagnosis
.
The
examination
of
adrenal
overproduction
is
not
necessary
in
case
of
known
adrenal
metastasis
except
when
performing
tests
in
order
to
rule
out
the
catecholamine
overproduction
.
In
case
of
bilateral
metastases
,
adrenal
insufficiency
should
be
also
excluded
.
Surgical
treatment
is
indicated
in
cases
of
solitary
metastasis
.
The
further
management
of
patients
with
adrenal
metastases
belongs
to
the
oncologist
.
The
prognosis
of
the
disease
is
usually
very
poor
with
average
survival
rate
of
three
months
(
Fig
.
2
,
Ref
.
34
)
.
Diseases
Validation
Diseases presenting
"malignant tumors"
symptom
adrenal incidentaloma
cholangiocarcinoma
coats disease
cowden syndrome
cushing syndrome
dedifferentiated liposarcoma
dentinogenesis imperfecta
esophageal carcinoma
focal myositis
junctional epidermolysis bullosa
liposarcoma
pleomorphic liposarcoma
von hippel-lindau disease
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