Incidental adrenal masses
From IDWiki
Definition
- Adrenal lesions found on CT or ultrasound done for other indications
- Can be functioning or non-functioning and malignant or benign
Clinical Presentation
- Assess for Cushing's syndrome, pheochromocytoma, primary aldosteronism and adrenocortical carcinoma
Investigations
- Unenhanced CT, or contrast CT with washout
- For Cushing: overnight 1 mg dexamethasone suppression test (DST), sensitivity and specificity 73% to 100% and 90%
- For pheochromocytoma: 24-hour urinary metanephrines and/or catecholamines, sensitivity and specificity 95% and 95%
- For Conn, in hypertensive patients: plasma renin to aldosterone ratio
Further Reading
- Kapoor A, Morris T, and Rebello R. Guidelines for the management of the incidentally discovered adrenal mass. Can Urol Assoc J. 2011 Aug; 5(4): 241–247.
