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Risk of malignancy in adrenal tumors in patients with a history of cancer

PURPOSE: Adrenal gland is a common site of metastasis and on the other hand, metastases are the most frequent malignant adrenal tumors. The aim of this study was to estimate the risk of malignancy in suspicious adrenal mass in patients with a history of cancer. METHODS: This is a single-center retro...

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Autores principales: Samsel, Radosław, Nowak, Karolina, Papierska, Lucyna, Karpeta, Edyta, Roszkowska-Purska, Katarzyna, Smiertka, Wacław, Ostrowski, Tomasz, Chrapowicki, Eryk, Grabowski, Alan, Leszczyńska, Dorota, Cichocki, Andrzej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083405/
https://www.ncbi.nlm.nih.gov/pubmed/37051540
http://dx.doi.org/10.3389/fonc.2023.1018475
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author Samsel, Radosław
Nowak, Karolina
Papierska, Lucyna
Karpeta, Edyta
Roszkowska-Purska, Katarzyna
Smiertka, Wacław
Ostrowski, Tomasz
Chrapowicki, Eryk
Grabowski, Alan
Leszczyńska, Dorota
Cichocki, Andrzej
author_facet Samsel, Radosław
Nowak, Karolina
Papierska, Lucyna
Karpeta, Edyta
Roszkowska-Purska, Katarzyna
Smiertka, Wacław
Ostrowski, Tomasz
Chrapowicki, Eryk
Grabowski, Alan
Leszczyńska, Dorota
Cichocki, Andrzej
author_sort Samsel, Radosław
collection PubMed
description PURPOSE: Adrenal gland is a common site of metastasis and on the other hand, metastases are the most frequent malignant adrenal tumors. The aim of this study was to estimate the risk of malignancy in suspicious adrenal mass in patients with a history of cancer. METHODS: This is a single-center retrospective analysis of patients with adrenal tumors treated previously for different types of cancers. Between 2004 and 2021 a hundred and six such patients were identified. Mean age of patients was 62.6 years (30-78), and mean time from oncologic treatment was 55.8 months (0-274). The most common primary cancer was kidney (RCC): 29 (27.4%), colon/rectum (CRC): 20 (18.9%) and lung (NSCLC): 20 (18.9%). RESULTS: Of 106 patients, 12 had hormonally active (HA) (11,3%) and 94 (88,7%) non active (HNA) tumors In group of patients with HA tumours 4 had hypercortisolaemia and 8 had elevation of urinary metanephrines. In the first group of HA patients pathology confirmed preoperative diagnosis of adrenocortical cancer and no metastasis was found. In all patients from the second group pheochromocytomas were confirmed. Primary (PM) and secondary (SM) malignancies were found in 50 patients (47.2%). In hormone inactive group only SM - 46/94 (48.9%) were diagnosed. The odds that adrenal lesion was a metastasis were higher if primary cancer was RCC (OR 4.29) and NSCLC (OR 12.3). Metastases were also more likely with high native tumor density, and bigger size in CT. The cut-off values for tumor size and native density calculated from receiver operating characteristic (ROC) curves were 37mm and 24, respectively. CONCLUSION: Risk of malignancy of adrenal mass in a patient with a history of cancer is high (47,2%), regardless of hormonal status. 47,2% risk of malignancy. In preoperative assessment type of primary cancer, adrenal tumour size and native density on CT should be taken into consideration as predictive factors of malignancy. Native density exceeding 24 HU was the strongest risk factor of adrenal malignancy (RR 3.23), followed by history of lung or renal cancer (RR 2.82) and maximum tumor diameter over 37 mm (RR 2.14).
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spelling pubmed-100834052023-04-11 Risk of malignancy in adrenal tumors in patients with a history of cancer Samsel, Radosław Nowak, Karolina Papierska, Lucyna Karpeta, Edyta Roszkowska-Purska, Katarzyna Smiertka, Wacław Ostrowski, Tomasz Chrapowicki, Eryk Grabowski, Alan Leszczyńska, Dorota Cichocki, Andrzej Front Oncol Oncology PURPOSE: Adrenal gland is a common site of metastasis and on the other hand, metastases are the most frequent malignant adrenal tumors. The aim of this study was to estimate the risk of malignancy in suspicious adrenal mass in patients with a history of cancer. METHODS: This is a single-center retrospective analysis of patients with adrenal tumors treated previously for different types of cancers. Between 2004 and 2021 a hundred and six such patients were identified. Mean age of patients was 62.6 years (30-78), and mean time from oncologic treatment was 55.8 months (0-274). The most common primary cancer was kidney (RCC): 29 (27.4%), colon/rectum (CRC): 20 (18.9%) and lung (NSCLC): 20 (18.9%). RESULTS: Of 106 patients, 12 had hormonally active (HA) (11,3%) and 94 (88,7%) non active (HNA) tumors In group of patients with HA tumours 4 had hypercortisolaemia and 8 had elevation of urinary metanephrines. In the first group of HA patients pathology confirmed preoperative diagnosis of adrenocortical cancer and no metastasis was found. In all patients from the second group pheochromocytomas were confirmed. Primary (PM) and secondary (SM) malignancies were found in 50 patients (47.2%). In hormone inactive group only SM - 46/94 (48.9%) were diagnosed. The odds that adrenal lesion was a metastasis were higher if primary cancer was RCC (OR 4.29) and NSCLC (OR 12.3). Metastases were also more likely with high native tumor density, and bigger size in CT. The cut-off values for tumor size and native density calculated from receiver operating characteristic (ROC) curves were 37mm and 24, respectively. CONCLUSION: Risk of malignancy of adrenal mass in a patient with a history of cancer is high (47,2%), regardless of hormonal status. 47,2% risk of malignancy. In preoperative assessment type of primary cancer, adrenal tumour size and native density on CT should be taken into consideration as predictive factors of malignancy. Native density exceeding 24 HU was the strongest risk factor of adrenal malignancy (RR 3.23), followed by history of lung or renal cancer (RR 2.82) and maximum tumor diameter over 37 mm (RR 2.14). Frontiers Media S.A. 2023-03-27 /pmc/articles/PMC10083405/ /pubmed/37051540 http://dx.doi.org/10.3389/fonc.2023.1018475 Text en Copyright © 2023 Samsel, Nowak, Papierska, Karpeta, Roszkowska-Purska, Smiertka, Ostrowski, Chrapowicki, Grabowski, Leszczyńska and Cichocki https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Samsel, Radosław
Nowak, Karolina
Papierska, Lucyna
Karpeta, Edyta
Roszkowska-Purska, Katarzyna
Smiertka, Wacław
Ostrowski, Tomasz
Chrapowicki, Eryk
Grabowski, Alan
Leszczyńska, Dorota
Cichocki, Andrzej
Risk of malignancy in adrenal tumors in patients with a history of cancer
title Risk of malignancy in adrenal tumors in patients with a history of cancer
title_full Risk of malignancy in adrenal tumors in patients with a history of cancer
title_fullStr Risk of malignancy in adrenal tumors in patients with a history of cancer
title_full_unstemmed Risk of malignancy in adrenal tumors in patients with a history of cancer
title_short Risk of malignancy in adrenal tumors in patients with a history of cancer
title_sort risk of malignancy in adrenal tumors in patients with a history of cancer
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083405/
https://www.ncbi.nlm.nih.gov/pubmed/37051540
http://dx.doi.org/10.3389/fonc.2023.1018475
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