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What is Surgical removal of adrenal adenoma is indicated when their size is more than: and explain in detail?
Ans. B. 4 cm. (Ref. LB 25th pg. 811; Harrison 17th/pg. 2259; FIGURE 336-9)H-l7th/pg. 2258:"Features suggestive of malignancy include: large size (>4-6 cm), irregular margins and tumor inhomogeneity, soft tissue calcifications visible on CT, and high unenhanced CT attenuation values (>10 HU). Similar findings characteristic of malignancy are seen on chemical-shift MRI. In contrast, the common benign adrenocortical adenoma is characterized by diameter < 4 cm and tumor homogeneity with sharp margins and low CT values (<10 HU)."Indications for Surgical Removal of Adrenal Glands include:# Tumors of the adrenal cortex which overproduce hormones. .- Tumors of the adrenal medulla which overproduce adrenaline (pheochromocytoma).- Most solid tumors of the adrenal gland which are greater than 4 cm (~2 inches) regardless of whether they produce hormone or not (to rule out malignancy).- Primary cancers of the adrenal.# Any size adrenal mass which causes symptoms such as flank pain or tenderness.Note: Some books mention, size more than 5 cm favor adrenal carcinoma and should be criteria for surgical resection, while few books also have mentioned as more than 6 cm adenoma favor adrenal carcinoma and should be an indication for resection.