REVIEW   

Minerva Endocrinologica 2019 September;44(3):288-300

DOI: 10.23736/S0391-1977.19.02969-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Adrenal biopsy: performance and use

Catherine D. ZHANG ¹, Danae A. DELIVANIS ², Patrick W. EIKEN ³, Thomas D. ATWELL ³, Irina BANCOS ² ✉

¹ Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA; ² Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA; ³ Department of Radiology, Mayo Clinic, Rochester, MN, USA

The widespread use of cross-sectioning abdominal imaging in recent years has led to the increased detection of adrenal masses. In each case, determining whether a newly identified adrenal mass is benign or malignant is essential for management, but can be challenging. A significant proportion of adrenal lesions remain indeterminate after initial evaluation due to limitations of current imaging modalities. Adrenal biopsy can be considered for further diagnostic workup in select cases, particularly in patients with an active or previously diagnosed extra-adrenal malignancy. In this review, we describe the various types of image-guided adrenal biopsy, including percutaneous and endoscopic techniques, highlight the utility of adrenal biopsy in various clinical scenarios, and, examine the diagnostic performance and adverse event rate of the procedure. Finally, we outline a suggested algorithm for the use of adrenal biopsy in the evaluation of an adrenal mass.

KEY WORDS: Adrenal glands; Image-guided biopsy; Endoscopic ultrasound-guided fine needle aspiration; Neoplasms