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Cytological Assessment of Adrenal Tumours: Insights From 22‐Years Single Centre Experience

Year: 2025

Type: article

Abstract: OBJECTIVE: The incidence of adrenal tumours has increased in the last decades, mainly due to increased use of imaging. The diagnostic evaluation of adrenal masses can be complex and, in some cases, necessitates cytological evaluation. However, concerns remain regarding the potential complications associated with adrenal gland biopsy. DESIGN: We conducted a retrospective cohort study to evaluate the safety and diagnostic effectiveness of cytology in patients who underwent fine-needle aspiration (FNA) of adrenal glands at Karolinska University Hospital in Stockholm, Sweden, between 2000 and 2022. The aim was to evaluate the accuracy of the sample and the complication rate. PATIENTS AND MEASUREMENTS: A total of 241 patients and 251 FNAs were included, with 10 patients undergoing two FNAs each. Data on clinical, radiological and laboratory presentation was collected and corelated with cytological findings and outcomes. RESULTS: Diagnostic FNA was obtained in 90% of patients (n = 217) with endoscopic ultrasound technique being most successful (95.8%), followed by CT (88.7%) and transabdominal ultrasound technique (86.7%). The sensitivity and the specificity were 93.8% respectively 96.7%. More than half of the FNA samples (52.7%) indicated a diagnosis consistent with metastases to the adrenal gland. The complication rate was 7.9% (n = 20). Based on the FNA results, adrenalectomy was performed on 13.6%, while 52.8% of the patients with benign findings were managed conservatively. Chemotherapy was started for 78.7% of patients with malignant findings. CONCLUSION: FNA of the adrenal glands is a safe, minimally invasive diagnostic procedure that can be useful in the assessment of adrenal lesions.

Source: Clinical Endocrinology

DOI: 10.1111/cen.15254

Authors: Ana Carasel, Jan Calissendorff, C. Christofer Juhlin, Henrik Falhammar

Institutions: Karolinska University Hospital, Karolinska Institutet

Language: English

Topic: Adrenal and Paraganglionic Tumors

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,250