The adrenal incidentaloma. A pediatric perspective
E. S. Lightner and L. S. Levine
In our commentary, we have reviewed the literature on adrenal
incidentalomas and specifically have tried to relate it to the pediatric
population. The studies of others have shown that adrenal tumors are very
common in patients with CAH (homozygote and heterozygote) and that these
tumors are very rarely malignant and therefore should not routinely be
surgically removed. In fact, we suggest that only under very rare
circumstances is surgical removal justified. Perhaps, in the future,
biochemical markers will allow us to distinguish between adrenal adenomas
and carcinomas. We have tried to give broad guidelines for the care of
patients with CAH with adrenal tumors, but these are guidelines only--they
are not laws chiseled in stone. Finally, as radiological imaging is done
more frequently and becomes even better at finding small adrenal tumors,
this general topic will become increasingly relevant. We hope our thoughts
will lead to lively discussion and useful studies in this "newly
discovered" medical dilemma.
