| Abstract: |
This chapter discusses tumors of the adrenal gland. It is divided into neuroblastomas, adrenal cortical carcinoma, and paragangliomas. Neuroblastoma can be discussed with adrenal tumors because 75% of abdominal neuroblastomas occur in the adrenal gland. With regard to neuroblastoma, the great progress achieved in understanding the risk posed by the tumor over the last 30 years is discussed. Since there is now an accurate algorithm for risk assessment, therapy becomes a function of risk. The different treatment approaches for individual risk, including surgical goals, are discussed. The importance of image-defined risk factors, biological determinants of risk, like MYCN amplification, the International Neuroblastoma Pathology Classification, and the International Neuroblastoma Staging System, are emphasized. The techniques and goals of surgery are defined. For adrenal cortical carcinoma clinical factors, such as virilization, and the results of imaging studies are reviewed. Clinical, radiographic, and pathologic findings associated with poor prognosis are considered. The association of adrenal cortical carcinoma with p53 mutation is also introduced. For pheochromocytomas and paragangliomas imaging findings are reviewed and the need for preoperative alpha blockade is emphasized. © 2022 Taylor & Francis Group, LLC. |
