[Ultrasound-proven adrenal gland tumor. References for diagnostic management]

Due to the increasing number of ultrasonographic examinations, tumors of the adrenal glands are being detected more and more often. In the present paper, suggestions for the further diagnostic evaluation are made: in the case of sonographically detected solid tumors of the adrenals, computed tomography is the next procedure of choice. If CT scan also fails to enable an unequivocal diagnosis, the next step must be laboratory investigations. Hormone-producing tumors, irrespective of size, as well as non-hormone-producing tumors larger than 6 cm in diameter or symptomatic neoplasms are all treated by surgery. In the case of an oncological patient with an asymptomatic non-hormone-producing tumor, differential diagnosis via needle aspiration should be attempted in all tumors measuring less than 6 cm in diameter. In the event of an incidental finding, fine needle aspiration is performed only in lesions measuring between 4 and 6 cm; for tumors of less than 4 cm, we consider a wait-and-see approach, with follow-up examinations at 3-month intervals to be justified.