EUS-guided FNA of the left adrenal gland in patients with thoracic or GI malignancies

Academic Article


  • Background: The diagnostic yield and safety of trans-gastric EUS-guided FNA of the left adrenal gland are not well defined. Methods: All patients with an enlarged left adrenal gland on abdominal imaging and known or suspected malignancy referred to two EUS centers over a 3-year period were included in this study. EUS-guided FNA was performed on an outpatient basis by one of 4 experienced endosonographers. Results: Thirty-one consecutive patients (21 men, 10 women; mean age 64.8 years) were evaluated. Tissue adequate for interpretation was obtained in all patients; no attempt to obtain tissue was unsuccessful. The median number of needle passes was 4.5 (range 1-8). No immediate complications were encountered. EUS-guided FNA confirmed malignant left adrenal involvement in 42% (13/31) of the patients. Patients with malignant left adrenal masses were more likely to have known cancer at another site (OR 12.0: 95% CI[1.6, 87.9]). Patients with benign masses were more likely to have preservation of the normal sonographic appearance of the adrenal gland ("seagull" configuration) compared with those with malignant masses (OR 9.8: 95% CI[1.9, 51.0]). The accuracy of EUS imaging based on size (≥3 cm) alone was 81%: 95% CI[63, 93]). Of the patients with malignant adrenal masses, 85% (11/13) died or their clinical condition deteriorated during follow-up, while 15% (2/13) were being treated and were stable clinically. Conclusions: EUS-guided FNA of the left adrenal gland is a minimally Invasive, safe, and highly accurate method that confirms or excludes malignant adrenal involvement in patients with thoracic or GI malignancies.
  • Authors

    Published In

    Digital Object Identifier (doi)

    Pubmed Id

  • 16614590
  • Author List

  • Eloubeidi MA; Seewald S; Tamhane A; Brand B; Chen VK; Yasuda I; Cerfolio RJ; Omar S; Topalidis T; Wilcox CM
  • Start Page

  • 627
  • End Page

  • 633
  • Volume

  • 59
  • Issue

  • 6