MANAGEMENT OF ADRENAL NEOPLASMS

Abstract

The adrenal cortex is derived from mesenchyme. Development begins m a group of cells known as the cortical primordium. These cells are located at the angle between the genital ridge and the root of the mesentery. The cells grow rapidly and penetrate the retroperitoneal mesenchyme superior to the mesonephros to form the primitive or fetal cortex (Pommier and Brennan, 1991). Permanent cortex developed at the 7th week of gestation and enveloped the fetal cortex. Development progresses till at birth where the fetal cortex atrophies and completely absorbed by the end of the Ist year leaving permanent cortex to be completely developed by the 3rd year (David et aL, 1988).

The adrenal neoplasms m general are divided m to four major categories:

I. Cortical neoplasms including benign lesions as adenomas.

2. Medullary neoplasms includes pheochromocytoma and paraganglioma.

3. Incidental adrenal masses.

4. Adrenal metastases.

Within these categories the embryology of adrenal gland, incidence, etiology, physiology, diagnosis (including symptoms, signs and investigations), operative management, follow-up and prognosis of the adrenal neoplasms are presented (Jaques and Brennan, 1989).