Advances in the management of adrenal tumors

Adrenal tumors are very common, with the majority being non-hypersecretory and benign and less than 1 % being malignant. Most primary adrenal tumors a re sporadic, but may be associated with other endocrine and familiar disord ers, especially pheochromocytoma. All patients with "sporadic" pheochromocy toma should be screened for MEN-2 and Von Hippel-Lindau disease. As in many endocrine tumors, there are no uniform definitive histologic criteria to d istinguish malignancy, which is dependent on the clinical behavior of the t umor and is accurately diagnosed in the presence of adjacent organ invasion , recurrence, or distant metastasis. Surgery remains the corner-stone and t he treatment of choice for functional and primary malignant adrenal tumors, both for cure and palliation, with low morbidity and mortality. (C) 2000 L ippincott Williams & Wilkins, Inc.