Preoperative evaluation of adrenal lesions based on imaging studies and laparoscopic adrenalectomy in patients with otherwise operable lung cancer

Hong Kwan Kim, Yong Soo Choi, Kwhanmien Kim, Jhingook Kim, Young Mog Shim

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: An unsuspected adrenal mass (AM) could be discovered in patients with operable non-small-cell lung carcinoma (NSCLC), but it is difficult to determine the nature of AM. The purpose of the study is to answer the question as to which decision should be made when assessing AM in patients with NSCLC. Patients and methods: From 1997 to 2005, 40 patients (31 male; mean age: 63 years) were identified to have both NSCLC and AM. We tried to determine the nature of AM based on imaging studies with or without laparoscopic adrenalectomy. When AM was considered benign on CT or PET-CT, surgical resection of NSCLC was performed (group 1, n = 25). When AM was considered indeterminate on CT or PET-CT, we performed MRI to determine the operability. In eight patients, surgical resection of NSCLC was performed, because AM was considered benign on MRI (group 2). In seven patients, adrenalectomy was performed to confirm AM pathologically, because all imaging studies were indeterminate (group 3). Results: Follow-up was complete for all patients with a mean duration of 33.1 months (3-104.5). In group 1, no patients showed adrenal metastases, except one who died of adrenal metastasis. In group 2, three patients revealed that they had had adrenal metastases when staging and two died of adrenal metastasis. In group 3, one patient had an adrenal metastasis and the others had benign lesions. Conclusions: We suggest that when AM is considered benign on CT or PET-CT, surgical resection of NSCLC is indicated. However, when AM is indeterminate on CT or PET-CT, histopathologic confirmation is needed to determine the nature of AM.

Original languageEnglish
Pages (from-to)342-347
Number of pages6
JournalLung Cancer
Volume58
Issue number3
DOIs
StatePublished - 1 Dec 2007

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Adrenalectomy
Lung Neoplasms
Non-Small Cell Lung Carcinoma
Neoplasm Metastasis
Positron Emission Tomography Computed Tomography

Keywords

  • Adrenal
  • Adrenalectomy
  • CT
  • MRI
  • Non-small-cell lung carcinoma
  • PET

Cite this

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title = "Preoperative evaluation of adrenal lesions based on imaging studies and laparoscopic adrenalectomy in patients with otherwise operable lung cancer",
abstract = "Purpose: An unsuspected adrenal mass (AM) could be discovered in patients with operable non-small-cell lung carcinoma (NSCLC), but it is difficult to determine the nature of AM. The purpose of the study is to answer the question as to which decision should be made when assessing AM in patients with NSCLC. Patients and methods: From 1997 to 2005, 40 patients (31 male; mean age: 63 years) were identified to have both NSCLC and AM. We tried to determine the nature of AM based on imaging studies with or without laparoscopic adrenalectomy. When AM was considered benign on CT or PET-CT, surgical resection of NSCLC was performed (group 1, n = 25). When AM was considered indeterminate on CT or PET-CT, we performed MRI to determine the operability. In eight patients, surgical resection of NSCLC was performed, because AM was considered benign on MRI (group 2). In seven patients, adrenalectomy was performed to confirm AM pathologically, because all imaging studies were indeterminate (group 3). Results: Follow-up was complete for all patients with a mean duration of 33.1 months (3-104.5). In group 1, no patients showed adrenal metastases, except one who died of adrenal metastasis. In group 2, three patients revealed that they had had adrenal metastases when staging and two died of adrenal metastasis. In group 3, one patient had an adrenal metastasis and the others had benign lesions. Conclusions: We suggest that when AM is considered benign on CT or PET-CT, surgical resection of NSCLC is indicated. However, when AM is indeterminate on CT or PET-CT, histopathologic confirmation is needed to determine the nature of AM.",
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Preoperative evaluation of adrenal lesions based on imaging studies and laparoscopic adrenalectomy in patients with otherwise operable lung cancer. / Kim, Hong Kwan; Choi, Yong Soo; Kim, Kwhanmien; Kim, Jhingook; Shim, Young Mog.

In: Lung Cancer, Vol. 58, No. 3, 01.12.2007, p. 342-347.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Preoperative evaluation of adrenal lesions based on imaging studies and laparoscopic adrenalectomy in patients with otherwise operable lung cancer

AU - Kim, Hong Kwan

AU - Choi, Yong Soo

AU - Kim, Kwhanmien

AU - Kim, Jhingook

AU - Shim, Young Mog

PY - 2007/12/1

Y1 - 2007/12/1

N2 - Purpose: An unsuspected adrenal mass (AM) could be discovered in patients with operable non-small-cell lung carcinoma (NSCLC), but it is difficult to determine the nature of AM. The purpose of the study is to answer the question as to which decision should be made when assessing AM in patients with NSCLC. Patients and methods: From 1997 to 2005, 40 patients (31 male; mean age: 63 years) were identified to have both NSCLC and AM. We tried to determine the nature of AM based on imaging studies with or without laparoscopic adrenalectomy. When AM was considered benign on CT or PET-CT, surgical resection of NSCLC was performed (group 1, n = 25). When AM was considered indeterminate on CT or PET-CT, we performed MRI to determine the operability. In eight patients, surgical resection of NSCLC was performed, because AM was considered benign on MRI (group 2). In seven patients, adrenalectomy was performed to confirm AM pathologically, because all imaging studies were indeterminate (group 3). Results: Follow-up was complete for all patients with a mean duration of 33.1 months (3-104.5). In group 1, no patients showed adrenal metastases, except one who died of adrenal metastasis. In group 2, three patients revealed that they had had adrenal metastases when staging and two died of adrenal metastasis. In group 3, one patient had an adrenal metastasis and the others had benign lesions. Conclusions: We suggest that when AM is considered benign on CT or PET-CT, surgical resection of NSCLC is indicated. However, when AM is indeterminate on CT or PET-CT, histopathologic confirmation is needed to determine the nature of AM.

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