Adrenal adenoma: Difference between revisions
(Created page with "'''Adrenal adenomas''' are small (1 – 5 cm), yellow, soft benign tumors of the adrenal cortex. Only a small percentage of them are functional (hormone-secreting), while the majority are non-functional. Adrenal tumours are often discovered incidentally on CT imaging, giving them the nickname '''adrenal incidentaloma'''. In most cases, these incidentalomas are harmless non-functional adrenal adenomas. Incidentalomas are found on 0,3 – 5% of abdominal CT scans...") |
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'''Adrenal adenomas''' are small (1 – 5 cm), yellow, soft benign | <section begin="radiology" />'''Adrenal adenomas''' are small (1 – 5 cm), yellow, soft benign [[Adrenal tumour|adrenal tumours]]. Only a small percentage of them are functional (hormone-secreting), while the majority are non-functional. | ||
Adrenal tumours are often discovered incidentally on [[CT]] imaging, giving them the nickname '''adrenal incidentaloma'''. In most cases, these incidentalomas are harmless non-functional adrenal adenomas. Incidentalomas are found on 0,3 – 5% of abdominal [[CT]] scans and are therefore quite common. | Adrenal tumours are often discovered incidentally on [[CT]] imaging, giving them the nickname '''adrenal incidentaloma'''. In most cases, these incidentalomas are harmless non-functional adrenal adenomas. Incidentalomas are found on 0,3 – 5% of abdominal [[CT]] scans and are therefore quite common.<section end="radiology" /> | ||
These tumours may grow or become malignant, and they may worsen other endocrine diseases like [[diabetes mellitus]], [[osteoporosis]], or [[hypertension]]. For these reasons, the patient must be evaluated for the likelihood for it being malignant and whether it’s hormonally active ([[Cushing syndrome]], [[phaeochromocytoma]], [[aldosteronoma]]). | |||
<section begin="radiology" /> | |||
==Evaluation== | ==Evaluation== | ||
Certain [[CT]] characteristics increase the risk of the incidentaloma being [[adrenal carcinoma]]. Benign findings include small size, low density (< 10 HU) due to containing mostly adipose tissue, smooth border, rapid contrast washout. Malignant findings include irregular shape, inhomogeneous density, and delayed contrast washout. MRI with in-phase and out-phase can also help distinguish it from carcinoma. <section end="radiology" /> | |||
Adrenal washout refers to the rate of intravenous CT contrast washout of the adrenal gland, which can help distinguish adenoma from other pathologies: | |||
* > 60% absolute washout (AWO) or > 40% relative washout (RWO) makes adenoma most likely | |||
* < 50% washout indicates adrenal metastasis | |||
If phaeochromocytoma is suspected, 24-hour urinary metanephrines should be measured. Patients may undergo dexamethasone suppression test to detect subclinical Cushing syndrome. | If phaeochromocytoma is suspected, 24-hour urinary metanephrines should be measured. Patients may undergo dexamethasone suppression test to detect subclinical Cushing syndrome. | ||
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==Treatment== | ==Treatment== | ||
For indications of treatment, see [[Adrenal tumour|adrenal tumours]]. | For indications of treatment, see [[Adrenal tumour|adrenal tumours]]. | ||
<noinclude>[[Category:Endocrinology]] | <noinclude> | ||
[[Category:Endocrine surgery]]</noinclude> | [[Category:Endocrinology]] | ||
[[Category:Endocrine surgery]] | |||
</noinclude> | |||
Latest revision as of 13:56, 21 December 2023
Adrenal adenomas are small (1 – 5 cm), yellow, soft benign adrenal tumours. Only a small percentage of them are functional (hormone-secreting), while the majority are non-functional.
Adrenal tumours are often discovered incidentally on CT imaging, giving them the nickname adrenal incidentaloma. In most cases, these incidentalomas are harmless non-functional adrenal adenomas. Incidentalomas are found on 0,3 – 5% of abdominal CT scans and are therefore quite common.
These tumours may grow or become malignant, and they may worsen other endocrine diseases like diabetes mellitus, osteoporosis, or hypertension. For these reasons, the patient must be evaluated for the likelihood for it being malignant and whether it’s hormonally active (Cushing syndrome, phaeochromocytoma, aldosteronoma).
Evaluation
Certain CT characteristics increase the risk of the incidentaloma being adrenal carcinoma. Benign findings include small size, low density (< 10 HU) due to containing mostly adipose tissue, smooth border, rapid contrast washout. Malignant findings include irregular shape, inhomogeneous density, and delayed contrast washout. MRI with in-phase and out-phase can also help distinguish it from carcinoma.
Adrenal washout refers to the rate of intravenous CT contrast washout of the adrenal gland, which can help distinguish adenoma from other pathologies:
- > 60% absolute washout (AWO) or > 40% relative washout (RWO) makes adenoma most likely
- < 50% washout indicates adrenal metastasis
If phaeochromocytoma is suspected, 24-hour urinary metanephrines should be measured. Patients may undergo dexamethasone suppression test to detect subclinical Cushing syndrome.
Treatment
For indications of treatment, see adrenal tumours.