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Surgery pp 119–126Cite as

Incidentally Discovered Adrenal Mass on CT Scan

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Abstract

A 55-year-old female was involved in a motor vehicle accident, at which time she underwent an abdominal CT scan that was negative for any injury. However, a 1.7-cm right adrenal nodule was incidentally noted. The patient complains of difficulty losing weight but denies any recent weight gain, abnormal hair growth, or muscle weakness. She has a long-standing history of diabetes and hypertension. She denies headache, palpitations, and flushing. Physical exam is significant for central obesity, but she does not have supraclavicular fat accumulation or purple striae. Workup for the adrenal mass revealed an elevated 24-hour urine cortisol level (170 mcg/dL; normal <45 mcg/dL). This was followed by a low-dose dexamethasone suppression test, which resulted in lack of cortisol suppression (AM cortisol 14.2 mcg/dL, normal <2 mcg/dL). Further biochemical workup including catecholamines and metanephrines as well as plasma aldosterone and renin levels was normal.

Keywords

  • Adrenal mass
  • Adenoma
  • Incidentaloma
  • Adrenocortical carcinoma
  • Functional tumor
  • Cortisol
  • Pheochromocytoma
  • Glomerulosa
  • Fasciculata
  • Reticularis
  • Aldosterone

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Suggested Reading

  • Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016;175(2):G1–G34.

    CAS  CrossRef  Google Scholar 

  • Iacobone M, Citton M, Scarpa M, Viel G, Boscaro M, Nitti D. Systematic review of surgical treatment of subclinical Cushing’s syndrome. Br J Surg. 2015;102(4):318–30.

    CAS  CrossRef  Google Scholar 

  • Lockhart ME, Smith JK, Kenney PJ. Imaging of adrenal masses. Eur J Radiol. 2002;41(2):95–112.

    CrossRef  Google Scholar 

  • Mansmann G, Lau J, Balk E, Rothberg M, Miyachi Y, Bornstein SR. The clinically inapparent adrenal mass: update in diagnosis and management. Endocr Rev. 2004;25(2):309–40.

    CrossRef  Google Scholar 

  • Newell-Price J, Bertagna X, Grossman AB, Nieman LK. Cushing’s syndrome. Lancet. 2006;367(9522):1605–17.

    CAS  CrossRef  Google Scholar 

  • Nieman LK. Approach to the patient with an adrenal incidentaloma. J Clin Endocrinol Metab. 2010;95(9):4106–13.

    CAS  CrossRef  Google Scholar 

  • Ogilvie JB, Duh QY. New approaches to the minimally invasive treatment of adrenal lesions. Cancer J. 2005;11(1):64–72.

    CrossRef  Google Scholar 

  • Rossi GP, Auchus RJ, Brown M, et al. An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension. 2014;63(1):151–60.

    CAS  CrossRef  Google Scholar 

  • Terzolo M, Bovio S, Pia A, Reimondo G, Angeli A. Management of adrenal incidentaloma. Best Pract Res Clin Endocrinol Metab. 2009;23(2):233–43.

    CrossRef  Google Scholar 

  • Young WF. Clinical practice. The incidentally discovered adrenal mass. N Engl J Med. 2007;356(6):601–10.

    CAS  CrossRef  Google Scholar 

  • Zeiger MA, Siegelman SS, Hamrahian AH. Medical and surgical evaluation and treatment of adrenal incidentalomas. J Clin Endocrinol Metab. 2011;96(7):2004–15.

    CAS  CrossRef  Google Scholar 

  • Zeiger MA, Thompson GB, Duh QY, Hamrahian AH, Angelos P, Elaraj D, et al. The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas. Endocr Pract. 2009;15(Suppl 1):1–20.

    CrossRef  Google Scholar 

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Correspondence to Eugene J. Park .

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Park, E.J., Livhits, M.J., Yeh, M.W. (2020). Incidentally Discovered Adrenal Mass on CT Scan. In: de Virgilio, C., Grigorian, A. (eds) Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-05387-1_11

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  • DOI: https://doi.org/10.1007/978-3-030-05387-1_11

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