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Incidentally discovered adrenal masses

R T Kloos1, M D Gross, I R Francis

  • 1Division of Endocrinology and Metabolism, University of Michigan, Ann Arbor, USA.

Endocrine Reviews
|August 1, 1995
PubMed
Summary
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Differentiating incidental adrenal masses requires integrating endocrinology, radiology, and nuclear medicine. Adrenocortical scintigraphy, particularly NP-59, aids in classifying these lesions, distinguishing benign adenomas from potentially malignant ones.

Area of Science:

  • Endocrinology
  • Radiology
  • Nuclear Medicine
  • Oncology

Background:

  • Incidental adrenal masses are increasingly detected due to advanced imaging.
  • CT and MRI can characterize only a subset of adrenal lesions.
  • Biochemical screening for hormone excess is crucial for all incidental adrenal masses.

Purpose of the Study:

  • To evaluate the utility of adrenocortical scintigraphy in characterizing incidental adrenal masses.
  • To differentiate benign nonhypersecretory adenomas from potentially malignant lesions.
  • To guide further diagnostic and therapeutic interventions for adrenal masses.

Main Methods:

  • Utilized NP-59 and [75Se]selenomethylnorcholesterol scintigraphy.
  • Correlated scintigraphic findings with biochemical screening and imaging characteristics.

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  • Assessed the diagnostic accuracy of scintigraphy in classifying adrenal masses.

    • Main Results:

    • Concordant NP-59 patterns in patients with normal biochemistry diagnose benign adenomas.
    • Discordant NP-59 patterns indicate a significant risk of malignancy, necessitating tissue diagnosis (e.g., FNA).
    • Nonlateralizing NP-59 scans in larger lesions suggest periadrenal or pseudoadrenal masses, requiring further imaging review.

    Conclusions:

    • Integrated endocrinology, radiology, and nuclear medicine are essential for adrenal mass evaluation.
    • Adrenocortical scintigraphy provides valuable functional and anatomical information for noninvasive characterization.
    • Scintigraphy aids in differentiating benign from potentially malignant adrenal lesions, guiding management decisions.