Incidental adrenal masses

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Definition

  • Adrenal lesions found on CT or ultrasound done for other indications
  • Can be functioning or non-functioning and malignant or benign

Clinical Manifestations

  • 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