Is there a role for open access surgery in adrenal gland malignancies?

Two different primary malignancies can arise from the adrenal gland: the adrenocortical carcinoma (ACC) from the adrenal cortex and the malignant pheochromocytoma from the adrenal medulla. Both malignancies are extremely rare. ACC has an estimated incidence of 0.5-2% new cases per million people per year. We present the case of a 55-year-old male affected by a non-characterized right adrenal gland lesion. The lesion (9x7 cm of diameter) was discovered accidentally by performing an abdominal ultrasound for gallstones. Then the patient performed a MRI in order to better characterize the lesion. We performed an open adrenalectomy (OA) for suspected malignancy of the right adrenal gland mass. We review the literature to assess if there is still a role for open surgery in the treatment of malignant tumors of the adrenal gland.