Approach to the Patient with an Incidental Adrenal Mass

Med Clin North Am. 2021 Nov;105(6):1047-1063. doi: 10.1016/j.mcna.2021.06.009. Epub 2021 Sep 9.

Abstract

Adrenal masses are frequently incidentally identified from cross-sectional imaging studies, which are performed for other reasons. The intensity of the approach to the patient with such a mass is tailored to the clinical situation, ranging from a quick evaluation to a detailed work-up. In all cases, the three components of the evaluation are clinical assessment, review of the images, and biochemical testing with the goal of ruling out malignancy and identifying hormonally active lesions. This article incorporates recent information to produce a logical, systematic assessment of these patients with risk stratification and proportionate follow-up.

Keywords: Adenoma; Adrenal; Aldosterone; Cortisol; Hypertension; Pheochromocytoma.

Publication types

  • Review

MeSH terms

  • Adenoma / diagnostic imaging
  • Adenoma / pathology
  • Adrenal Gland Diseases / blood
  • Adrenal Gland Diseases / diagnosis*
  • Adrenal Gland Diseases / diagnostic imaging
  • Adrenal Gland Diseases / pathology*
  • Adrenal Gland Neoplasms / diagnosis
  • Adrenal Gland Neoplasms / pathology
  • Aldosterone / biosynthesis
  • Catecholamines / biosynthesis
  • Diagnosis, Differential
  • Humans
  • Hyperaldosteronism / diagnosis
  • Hyperaldosteronism / pathology
  • Incidental Findings
  • Pheochromocytoma / diagnosis
  • Pheochromocytoma / pathology

Substances

  • Catecholamines
  • Aldosterone