ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
46
TERMINOLOGY AND CLASSIFICATION OF ADRENAL
INCIDENTALOMAS.
Madaminov Fakhriddin Adilbekovich
Khorezm branch of the Republican
Scientific Center for Emergency Medical Care
Urologist 2nd Department of Surgery
https://doi.org/10.5281/zenodo.14184352
The term adrenal incidentaloma, literally meaning "adrenal tumor
discovered by chance" (incidentally discovered adrenal mass) first appeared in
the early 80s. It was from this time that a constant increase in the number of
"accidentally" detected adrenal tumors was noted, which is associated with the
widespread introduction of non-invasive methods of topical diagnostics
(ultrasound, CT, MRI) into clinical practice. In medical literature, one can also find
several other names for these neoplasms: clinically silent adrenal masses,
"asymptomatic", "non-functioning", "hormonally inactive", etc. At the same time,
in works that use these terms, the same researchers identify clinical symptoms of
adrenal hyperfunction and changes in the hormonal profile in a significant
proportion of patients. According to most authors, the term incidentaloma is the
most accurate, since it indicates, first of all, the “accidental” nature of the detection
of a neoplasm in the adrenal region.
There are also different opinions regarding the criteria for including the
detected neoplasms in the IN group. Most researchers classify incidentalomas as
accidentally detected space-occupying adrenal formations detected during
radiological studies undertaken for other diseases of the abdominal cavity and
retroperitoneal space or during a routine dispensary examination. Some also
include those neoplasms that are diagnosed in patients with arterial hypertension
during a targeted examination of the adrenal glands [3], as well as as a result of
searching for oncological pathology [1]. The literature offers various options for
generalizing and systematizing adrenal incidentalomas. In reality, these are
neoplasms of heterogeneous etiology originating not only from all zones of the
cortex and medulla of the adrenal glands, but also from elements of the
mesenchyme and neuroectoderm, metastatic tumors, and pseudo-adrenal
lesions. The classification of incidentalomas proposed by American researchers
M. Gross and B. Shapiro (1993) is considered generally accepted [4].
1. Formations originating from the adrenal cortex: adenoma, nodular
hyperplasia, carcinoma. 2. Formations originating from the medulla:
pheochromocytoma, ganglioneuroma, ganglioneuroblastoma. 3. Other adrenal
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
47
lesions: myelolipoma, neurofibroma, hamartoma, teratoma, xanthomatosis,
amyloidosis, cyst, hematoma, granuloma, leiomyoma, leiomyosarcoma. 4.
Metastases: breast cancer, lung cancer, kidney cancer, lymphoma, etc. 5.
Pseudoadrenergic lesions: formations originating from the kidneys, pancreas,
spleen, lymph nodes, vessels. 6. Technical artifacts. Adrenal incidentaloma is not
a clinical diagnosis, but an initial diagnosis based on the results of using
radiographic imaging methods and requiring further detailing. About a third of
adrenal incidentalomas (32.6%) have some degree of hormonal activity, and
every sixth (16.7%) is malignant.
The sensitivity of imaging methods in detecting IN was 93.8% for ultrasound,
99.6% for CT, and 100% for MRI. Specificity in diagnosing adrenocortical
carcinomas was 87.1%, metastatic adrenal tumors - 85.7%, and
pheochromocytomas - 61.1%. Ultrasound was more specific than CT in
diagnosing adrenal cysts. The information content of percutaneous puncture
biopsy in verifying IN was 43.7%.
List of used literature:
1.
Молашенко Н.В. Дифференциальная диагностика инциденталом
надпочечников // Н.В. Молашенко, Н.М. Платонова, Д.Г. Бельцевич и др. //
Ожирение и метаболизм. - 2016. - Т. 13. - №. 4-С.39-44.
2.
Пиньчук С.В. Вопросы клиники, диагностики и лечения первично-
множественных и метастатических поражений легких / С.В. Пиньчук, М.А.
Сеньчукова, А.В. Литвинов // Поволжский онкологический вестник. - 2016.
-№. 4 (26). -С.32-38.
3.
Саблин И.В. Соматоформная дисфункция вегетативной нервной
системы у больных со случайно выявленными новообразованиями
надпочечников / И.В. Саблин, Л.М. Краснов, Е.А. Фёдоров и др.// Вестник
Северо-Западного государственного медицинского университета им. И.И.
Мечникова. - 2018. -Т. 10. - №. 3.-С.45-52.
4.
Токпанов С.И. Эндовидеохирургия новообразований надпочечников
// С.И. Токпанов, А.А. Ахетов, В.И. Котлобовский и др. // Медицина и
экология. -2017. - №. 1 (82)-С.103-112.
