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Published on: September 15, 2017
Adrenal incidentaloma: evaluation and management.
1Endocrinology and Diabetes, University Hospitals of North Staffordshire, Stoke on Trent, UK.
Journal of Clinical Pathology
|October 29, 2008
Summary
Adrenal incidentalomas, or adrenal masses, are common. Most are benign, but assessment is key to rule out hormone secretion or malignancy, guiding treatment decisions.
Area of Science:
- Endocrinology
- Oncology
- Radiology
Background:
- Adrenal incidentalomas are adrenal masses found incidentally during imaging.
- Their increasing prevalence poses diagnostic and management challenges.
- Most are benign, non-functioning adenomas, but require evaluation.
Purpose of the Study:
- To outline the diagnostic and management strategies for adrenal incidentalomas.
- To determine criteria for surgical intervention versus observation.
- To assess the risk of malignancy and hormone hypersecretion.
Main Methods:
- Biochemical screening for hormone hypersecretion in all cases.
- Radiological assessment (size, imaging characteristics) for malignancy risk.
- Observational policy for low-risk, non-functioning incidentalomas with periodic reassessment.
Main Results:
- Surgical removal is indicated for phaeochromocytoma, symptomatic tumors, and high malignancy risk.
- Biochemical screening is mandatory due to potentially silent hormone hypersecretion.
- Low risk of malignancy or autonomous hypersecretion in benign, non-functioning lesions.
Conclusions:
- Adrenal incidentaloma management requires careful biochemical and radiological assessment.
- Observation with follow-up is appropriate for low-risk lesions.
- Most patients with benign, non-functioning incidentalomas can be discharged after 2 years of follow-up.
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