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Carcinoma da glandula supra-renal

DOI: 10.1590/S0102-67202007000300002

Keywords: adrenal glands neoplasms, diagnosis, surgery.

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Abstract:

background: adrenal gland neoplasm may be originated from diverse histological types. carcinomas are rare findings, and correspond to only 0,02% of all neoplasms. aim: to review the latest advances in relation to the treatment of adrenal gland carcinomas. methods: a literature review was performed using medline, text books and authors, as well as references obtained from relevant articles. conclusion: approximately 79% of adrenal gland carcinomas are functional. the most commonly secreted hormone is cortisol, which causes cushing′s syndrome. patients with non-functional lesions may complain about local growth of the lesion. this type of carcinoma is present in a series of other neoplasic syndromes of familiar origen. according to the symptoms, initial diagnostic investigation involves dosage of urinary cortisol, as well as aldosterone and renin serum levels. abdominal tomography or magnetic ressonance are first class image tests. fluorodeoxyglucose pet scan is a tool that can be used to differentiate benign and malignant lesions. fine needle biopsy is not indicated due to the high rate of complications. the choosen treatment is usually surgery with block ressection of adjacent organs if necessary. aortic and retroperitoneal lymphadenectomy should be performed. local recurrence and metastasis occur in 80% of the cases. cytoreductive surgical procedures benefit cases of advanced disease. quimiotherapy using mitotane is indicated to patients who were submitted to cytoreductive surgery, who have had local recurrence and in those with metastasis. radiotherapy is the treatment of choice in the event of bone metastasis and adjuvant treatment is used in a few cases with elevated recurrence risks. in adults, the overall average life span in 5 years varies between 10% to 35%. after curative surgery it varies between 20% to 58%.

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