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Evaluation of the incidentally discovered adrenal mass

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Abstract

The increased use of abdominal ultrasonography, computed tomography, and magnetic resonance imaging has led to the classification of adrenal lesions termed the incidentally identified adrenal mass or adrenal incidentaloma. Unlike for the large, clinically, or biochemically symptomatic adrenal mass, the evaluation of patients with small, asymptomatic, or nonfunctional adrenal lesions remains controversial. The evaluation of these adrenal incidentalomas presents a challenge to endocrinologists, radiologists, and urologic surgeons alike. A multidisciplinary approach with biochemical screening and radiologic evaluation is essential to assess the nature and function of these lesions. Furthermore, it is of great importance to identify patients who are morbidly affected by hormonal hypersecretion or malignant potential. This article describes the emerging guidelines for the evaluation of the incidental adrenal mass.

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References and Recommended Reading

  1. Belldegrun A, deKernion JB: What to do about the incidentally found adrenal mass. World J Urol 1989, 7:117–120.

    Article  Google Scholar 

  2. Pender SM, Buland GW, Lee MJ: The incidental nonhyperfunctioning adrenal mass: an imaging algorithm for characterization. Clin Radiol 1998, 53:796–804.

    Article  PubMed  CAS  Google Scholar 

  3. Barzon L, Boscaro M: Diagnosis and management of adrenal incidentalomas: J Urol 2000, 163:398–407.

    Article  PubMed  CAS  Google Scholar 

  4. Copeland PM: The incidentally discovered adrenal mass. Ann Intern Med 1983, 98:940–945.

    PubMed  CAS  Google Scholar 

  5. Abecassis M, McLoughlin MJ, Langer B, Kudlow JE: Serendipitous adrenal masses: prevalence, significance, and management. Am J Surg 1985, 149:783–788.

    Article  PubMed  CAS  Google Scholar 

  6. Ross NS, Aron DC: Hormonal evaluation of the patient with an incidentally discovered adrenal mass. N Engl J Med 1990, 323:1401–1405.

    Article  PubMed  CAS  Google Scholar 

  7. Russi S, Blumenthal HT, Gray SH: Small adenomas of the adrenal cortex in hypertension and diabetes. Arch Intern Med 1945, 76:284–291.

    Google Scholar 

  8. Hedeland H, Ostberg G, Hokfeld B: On the prevalence of adrenal cortical adenomas in an autopsy and autopsy material in relation to hypertension and diabetes. Acta Med Scand 1968, 184:211–214.

    Article  PubMed  CAS  Google Scholar 

  9. Caplan RH, Strutt PJ, Wickus GG: Subclinical hormone secretion by incidentally discovered adrenal masses. Arch Surg 1994, 129:291–296.

    PubMed  CAS  Google Scholar 

  10. Copeland PM: The incidentally discovered adrenal mass. Ann Surg 1984, 199:116–122.

    Article  PubMed  CAS  Google Scholar 

  11. Gross MD, Shapiro B, Francis IR, et al.: Scintigraphic evaluation of clinically silent adrenal masses. J Nucl Med 1994, 35:1145–1152.

    PubMed  CAS  Google Scholar 

  12. Cook DM, Loriaux DL: The incidental adrenal mass. Am J Med 1996, 101:88–94.

    Article  PubMed  CAS  Google Scholar 

  13. Ambrosi B, Passini E, Re T, Barbetta L: The clinical evaluation of silent adrenal masses. J Endocrinol Invest 1997, 20:90–107.

    PubMed  CAS  Google Scholar 

  14. Mitchell DG, Crovello M, Matteucci T, et al.: Benign adrenocortical masses: diagnosis with chemical shift MR imaging. Radiology 1992, 185:345–351.

    PubMed  CAS  Google Scholar 

  15. Pruthi RS, Mitchell JB, Fielding JR, Issa MM: The incidental adrenal mass: emerging guidelines on evaluation and treatment. Contemp Urol 2003, 15:43–55.

    Google Scholar 

  16. Korobkin M, Brodeur FJ, Yutzy GG, et al.: Differentiation of adrenal adenomas from nonadenomas using CT attenuation values. AJR Am J Roentgenol 1996, 166:531–536.

    PubMed  CAS  Google Scholar 

  17. Boland GW, Lee MJ, Gazelle GS, et al.: Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature. AJR Am J Roentgenol 1998, 171:201–204.

    PubMed  CAS  Google Scholar 

  18. Korobkin M, Brodeur FJ, Francis IR, et al.: CT time-attenuation washout curves of adrenal adenomas and nonadenomas. AJR Am J Roentgenol 1998, 170:747–752. Important study.

    PubMed  CAS  Google Scholar 

  19. Caoili EM, Korobkin M, Francis IR, et al.: Delayed enhanced CT of lipid-poor adrenal adenomas. AJR Am J Roentgenol 2000, 175:1411–1415. Critical study.

    PubMed  CAS  Google Scholar 

  20. Korobkin M, Lombardi TJ, Aisen AM, et al.: Characterization of adrenal masses with chemical shift and gadoliniumenhanced MR imaging. Radiology 1995, 197:411–418.

    PubMed  CAS  Google Scholar 

  21. Troncone L, Rufini V, Montemaggi P, et al.: The diagnostic and therapeutic utility of radioiodinated metaiodobenzylguanidine (MIBG): 5 years of experience. Eur J Nucl Med 1990, 16:325–335.

    Article  PubMed  CAS  Google Scholar 

  22. Terzolo M, Ali A, Osella G, Mazza E: Prevalence of adrenal carcinoma among incidentally discovered adrenal masses. Arch Surg 1997, 132:914–919.

    PubMed  CAS  Google Scholar 

  23. Korobkin M, Brodeur FJ, Francis IR, et al.: Delayed enhanced CT for differentiation of benign from malignant adrenal masses. Radiology 1996, 200:737–742.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Hackensack University Medical Center, 20 Prospect Avenue, Suite 703, 07601, Hackensack, NJ, USA

    Ravi Munver MD, Debra L. Fromer MD, Richard A. Watson MD & Ihor S. Sawczuk MD

Authors
  1. Ravi Munver MD
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  2. Debra L. Fromer MD
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  3. Richard A. Watson MD
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  4. Ihor S. Sawczuk MD
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Munver, R., Fromer, D.L., Watson, R.A. et al. Evaluation of the incidentally discovered adrenal mass. Curr Urol Rep 5, 73–77 (2004). https://doi.org/10.1007/s11934-004-0015-9

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  • DOI: https://doi.org/10.1007/s11934-004-0015-9

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