2 ADRENAL MASSES General Discussion Adrenal masses may be discovered incidentally on abdominal CT scans and ultrasounds. The vast majority of these lesions are benign and do not require referral or treatment. The two most important factors in the diagnostic evaluation are the lesion’s size and functional status. Lesions larger than 6 cm in greatest diameter are more likely to be malignant. To determine the functional status of an adrenal mass, the patient should be assessed for signs and symptoms of Cushing’s syndrome, pheochromocytoma, and hyperaldosteronism. These signs and symptoms are outlined below. The differential diagnosis of incidental adrenal mass, in descending order of frequency, includes adenoma, metastatic cancer, adrenal cancer, cyst, pheochromocytoma, hyperplasia, lipoma, and myelolipoma. If the adrenal mass is less than 3 cm, the patient has no signs or symptoms, and the screening laboratory tests noted below are normal, the patient should have a repeat CT scan or ultrasound in 3 months and then every 6 months for 2 years. If the patient has signs or symptoms or the laboratory tests are not normal, referral to a surgeon is indicated. If the adrenal mass is 3–6 cm in size, magnetic resonance imaging (MRI) should be obtained and endocrine referral should be made. If the adrenal mass is more than 6 cm in largest diameter, surgical evaluation should be obtained. Any patient with a history of malignancy who is found to have an adrenal mass should probably have a needle biopsy of the adrenal lesion since metastatic disease is the most likely cause of the adrenal lesion in this situation. Signs and Symptoms of Systemic Disease Cushing’s syndrome • Abdominal striae Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: ARTHRITIS AND ARTHRALGIA GYNECOMASTIA INFERTILITY, MALE SYNCOPE Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Medicine Aug 17, 2016 | Posted by admin in PEDIATRICS | Comments Off on ADRENAL MASSES Full access? Get Clinical Tree
2 ADRENAL MASSES General Discussion Adrenal masses may be discovered incidentally on abdominal CT scans and ultrasounds. The vast majority of these lesions are benign and do not require referral or treatment. The two most important factors in the diagnostic evaluation are the lesion’s size and functional status. Lesions larger than 6 cm in greatest diameter are more likely to be malignant. To determine the functional status of an adrenal mass, the patient should be assessed for signs and symptoms of Cushing’s syndrome, pheochromocytoma, and hyperaldosteronism. These signs and symptoms are outlined below. The differential diagnosis of incidental adrenal mass, in descending order of frequency, includes adenoma, metastatic cancer, adrenal cancer, cyst, pheochromocytoma, hyperplasia, lipoma, and myelolipoma. If the adrenal mass is less than 3 cm, the patient has no signs or symptoms, and the screening laboratory tests noted below are normal, the patient should have a repeat CT scan or ultrasound in 3 months and then every 6 months for 2 years. If the patient has signs or symptoms or the laboratory tests are not normal, referral to a surgeon is indicated. If the adrenal mass is 3–6 cm in size, magnetic resonance imaging (MRI) should be obtained and endocrine referral should be made. If the adrenal mass is more than 6 cm in largest diameter, surgical evaluation should be obtained. Any patient with a history of malignancy who is found to have an adrenal mass should probably have a needle biopsy of the adrenal lesion since metastatic disease is the most likely cause of the adrenal lesion in this situation. Signs and Symptoms of Systemic Disease Cushing’s syndrome • Abdominal striae Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: ARTHRITIS AND ARTHRALGIA GYNECOMASTIA INFERTILITY, MALE SYNCOPE Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Medicine Aug 17, 2016 | Posted by admin in PEDIATRICS | Comments Off on ADRENAL MASSES Full access? Get Clinical Tree
