IX Sesión de Formación Continuada URO-MIR

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Transcripción de la presentación:

IX Sesión de Formación Continuada URO-MIR MANEJO DEL INCIDENTALOMA SUPRARRENAL POR EL URÓLOGO De la consulta al quirófano IX Sesión de Formación Continuada URO-MIR

Moderador: Dr. Daniel A. Pérez Fentes MANEJO DEL INCIDENTALOMA SUPRARRENAL POR EL URÓLOGO De la consulta al quirófano Pruebas funcionales y estudios de imagen Panelista: Dr. Daniel León (R5 CHUVI) Adenoma y carcinoma suprarrenal. Enfermedad metastásica. Panelista: Dr. Benito Blanco (R2 CHUS) Síndrome de Cushing. Síndrome de Conn. Hiperplasia adrenal congénita. Panelista: Dra. Patricia Cordeiro (R4 CHUS) Feocromocitomas y paragangliomas. Panelista: Dr. Luciano Honorato (R5 CHUS) Casos clínicos interactivos. Moderador: Dr. Daniel A. Pérez Fentes

Adrenal incidentaloma “Mass lesion greater than 1 cm in diameter, serendipitously discovered by radiologic examination”

Adrenal incidentaloma In a study of 61,054 abdominal CT scans performed from 1985 to 1990, incidentaloma detected in 259 patients (0.4 percent of all CT scans) Herrera MF, Grant CS, Van Heerden JA, et al. Incidentally discovered adrenal tumors: an institutional perspective. Surgery 1991; 110:1014. With high resolution CT scans, the prevalence of adrenal indicentaloma reported is 4.4 percent Bovio S, Cataldi A, Reimondo G, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest 2006; 29.228.

Adrenal incidentaloma In autopsy studies, the prevalence of incidentalomas ranges from 1 to 9 percent. The prevalence is higher in obese, diabetic and hypertensive patients Hedeland H, Ostberg G, Hökfelt B. On the prevalence of adrenocortical adenomas in an autopsy material in relation to hypertension and diabetes. Acta Med Scand 1968; 184: 211. The prevalence of adrenal incidentaloma is higher in older patients (10 percent) Terzolo M, Stigliano A, Chiodini I, et al. AME position statement on adrenal incidentaloma. Eur J Endocrinol 2011; 164: 851.

Adrenal incidentaloma Discovery of an adrenal mass raises two questions that determine the degree of evaluation and the need for therapy: Is it malignant? Is it functioning?

Adrenal incidentaloma Differential diagnosis Adrenal Benign adenomas Other Adenoma Myelolipoma Nodular hyperplasia Neurofibroma Carcinoma Hamartoma Adrenal Medulla Teratoma Xanthomatosis Pheochromocytoma Amyloidosis Ganglioneuroma Cyst Ganglioneuroblastoma Hematoma Metastases Granulomatosis Breast, lung, lymphoma Pseudoadrenal Leukemia, other - Renal, Pancreas, Spleen, etc... Technical Artifacts

Adrenal incidentaloma: a multidisciplinar approach CARDIOLOGY ENDOCRINOLOGY ADRENAL INCIDENTALOMA INTERNAL MEDICINE GENERAL SURGERY UROLOGY RADIOLOGY

Moderador: Dr. Daniel A. Pérez Fentes MANEJO DEL INCIDENTALOMA SUPRARRENAL POR EL URÓLOGO De la consulta al quirófano Pruebas funcionales y estudios de imagen Panelista: Dr. Daniel León (R5 CHUVI) Adenoma y carcinoma suprarrenal. Enfermedad metastásica. Panelista: Dr. Benito Blanco (R2 CHUS) Síndrome de Cushing. Síndrome de Conn. Hiperplasia adrenal congénita. Panelista: Dra. Patricia Cordeiro (R4 CHUS) Feocromocitomas y paragangliomas. Panelista: Dr. Luciano Honorato (R5 CHUS) Casos clínicos interactivos. Moderador: Dr. Daniel A. Pérez Fentes