Manejo quirúrgico de incidentalomas suprarrenales en un hospital de segundo nivel: experiencia institucional mexicana

Objective: to analyze the clinical, imaging and surgical characteristics of patients with adrenal incidentalomas undergoing exclusively surgical treatment in a secondary level hospital. Design: retrospective, observational, and descriptive study including patients diagnosed with adrenal incidentalomas who underwent surgical treatment. Results: a total of 18 cases were identified, with a mean patient age of 49.8 years (range 29–76). Female predominance was observed (61.1 %), with left-sided lesions in 72.2 % of cases. Laparoscopic adrenalectomy was performed in 66.7 % of patients, mainly for benign tumors (75 %), whereas open surgery was reserved for lesions ≥ 6 cm or with clinical or radiologic suspicion of malignancy. The most frequent histopathological diagnosis was adrenal adenoma (38.9 %), followed by adrenocortical carcinoma (22.2 %) and pheochromocytoma (11.1 %). Limitations: small sample size and retrospective design; however, the findings are consistent with previously published international series. Originality: this study represents the first institutional series of adrenal incidentalomas reported from a secondary-level hospital in northwest Mexico, providing local evidence on their clinical and surgical management. Conclusion: although adrenal incidentalomas are relatively uncommon findings, accurate preoperative functional and imaging assessment combined with an appropriate surgical approach favoring minimally invasive techniques when feasible significantly improves clinical and surgical outcomes.