The malignant potential of a canine incidental adrenal mass cannot be predicted by lesion size, but outcomes following laparoscopic adrenalectomy are excellent.

Small incidental adrenal masses cannot be assumed benign; laparoscopic adrenalectomy is safe with excellent outcomes.

This retrospective study analyzed 214 dogs undergoing laparoscopic adrenalectomy, comparing incidental adrenal masses (In-AMs, n=61) with clinical masses (Cl-AMs). Key findings demonstrated that incidental masses were more frequently pheochromocytomas (32.8% vs 8.5%) compared to clinical masses. Importantly, maximal mass dimension could not predict malignancy, as 6 of 11 small noninvasive In-AMs were malignant or had malignant potential, including 3 carcinomas and 3 pheochromocytomas. Vascular invasion strongly suggested medullary rather than cortical origin (OR 11.31). Short-term outcomes were excellent, with only 3.3% mortality from adrenalectomy-related complications. The study challenges previous recommendations to monitor small noninvasive adrenal masses, suggesting elective laparoscopic adrenalectomy is a safe and justified approach with favorable perioperative outcomes.

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