الفهرس 
Introduction and aim of theOnly 14 pages are availabe for public view
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Abstract
Introduction: Adrenal tumors are rare tumors. We review and analyze clinical data on the diagnosis and management of patients with adrenal masses in a single center (UNC) over 29 years. Patients and Methods: Between 1976 and 2005, 238 patients admitted to our institute with adrenal masses were reviewed. The series comprised 134 males with mean age of 36.1 years (R+ (B21.2 (range 6 months82 years) and 104 females with mean age of 29.7 years (R+ (B18.5 (range 4 months66 years). A retrospective study was conducted to analyze the incidence, clinical features, imaging technique findings, surgical approaches, intra and postoperative morbidity and mortality, as well as pathological diagnosis. Results: Over the last 29 years, the incidence of adrenal tumors was 0.2 % of all patients with genitourological diseases or 2.25 % of patients with genitourinary tumors at our institution. The prevalence of adrenal tumors was more in males (56.9 %) and right sided masses were more common (63.4 %) with mean size of 7.7 (R+ (B4 cm. Pain was the presenting symptom in most of our patients (53.3%). Of the 238 patients, 62 (26 %) had a functional tumor while 176 (74 %) were nonfunctioning. Both CT and MRI showed high diagnostic yield (sensitivities of 98.9 % and 100 % respectively). Open adrenalectomy was performed for 153 patients (64.3 %) while laparoscopic approach was employed in 53 patients (22.3 %). In another 31 patients conservation and follow up was decided (13 %). One patient was subjected to aspiration of an adrenal cyst and injection of a sclerosing agent. Intraoperative complication rate was 14.7 %, postoperative complication rate was 6.1 % and the perioperative mortality was 1.7 %. Most of the excised masses were pheochromocytoma (26.4 %). Conclusion: Computed tomography is recommended as the first diagnostic modality to define and localize adrenal masses. Laparoscopic adrenalectomy is currently replacing the open surgery as the standard surgical management of adrenal masses. Proper and prompt management of adrenal masses would result in reasonable morbidity and minimal mortality.