Interventional radiology of the adrenal glands

Interventional radiology of the adrenal glands comprises angiographic and percutaneous procedures. Vascular maneuvers have never received widespread application. Venous retrograde adrenal gland ablation fell into disuse because it induced only temporary reduction of adrenal function, caused intense long lasting pain, and was considered unsafe. Chemoembolization of cortico-adrenal carcinoma has been shown to slow tumor growth and may be employed if the patient is inoperable. Percutaneous FNB, routinely performed in large hospital centers, has a high diagnostic yield and a low complication rate. The procedure is performed in the staging of oncological cases or in patients with incidentally found adrenal lesion with no evidence of adreno-cortical or adrenal medullary hypersecretion. Abscesses and adrenal cysts are rarely encountered in clinical practice. Percutaneous drainage of such lesions is readily accomplished under radiological guidance with little hazard for the patient. Furthermore treatment failure does not compromise surgical treatment. Percutaneous ethanol injection has been recently suggested for treatment of hormone producing adreno-cortical adenomas in patients at high surgical risk. Results are promising but further trials are required to ascertain the efficacy and the safety of the procedure.