Adrenal incidentaloma

From Ganfyd

Jump to: navigation, search


First coined in 1982 in this paper.[1]

Clinically unsuspected adrenal masses (adrenal incidentalomas, AI)[2][3] are commonly found on abdominal imaging performed for other purposes than adrenal imaging. Such masses less than 1cm in size do not need further assessment and are therefore often excluded from the definition of an adrenal incidentaloma. Adrenal incidentaloma incidence is up to 4% . Large series have defined the cause to be :

Multiple case series have defined the potential for over investigation with only perhaps 6% of adenoma cases being sub clinical Cushings syndrome[4][5]. Further investigation is recommended if:

  1. Attenuation threshold on plain CT scan , if this is the index imaging modality, is greater or equal to 10 HU
    • Specific adrenal CT scanning or MRI unless metastatic malignancy already diagnosed
    • ECr, FBC, LFT, CRP as a general screen for abnormalities suggestive of malignancy or hypokalaemia
  2. Hypokalaemia, hypertension or clinical features Cushing's syndrome
    • Appropriate endocrine work up[6]