Falavolti C and Buscarini M*
Department of Urology, Campus Biomedico University, ItalyFulltext PDF
In the modern era, the use of abdominal imaging has led to increased detection of adrenal lesions. These are found incidentally during the work up of other problems and are thus defined “incidentalomas”. The significance of these masses, as well as the optimal management approach to treatment, has sparked some debate regarding their evaluation and therapy. The authors reviewed the literature regarding the evaluation and management of these masses, particularly adrenal incidentalomas. Based on their institutional experience, they propose a diagnostic, evaluation, and management algorithm for treating adrenal masses. Radiological appearance and clinical picture should guide on how to perform the biochemical evaluation, keeping in mind that the presence of pheochromocytomas must always be excluded. Radiological evaluation by CT or MRI provides useful parameters to identify suspicious lesions. According to the majority of studies, surgery is recommended for masses that are larger than 5 cm in diameter or suspected of malignancy. Fineneedle aspiration biopsy should be used when other extra-adrenal malignancies are suspected and after pheochromocytoma has been ruled out. Careful analysis and work up of each adrenal mass is crucial to effectively avoid potential problems.
Adrenal mass; CT; MRI
Falavolti C, Buscarini M. Work up of Incidental Adrenal Mass. Clin Surg. 2016; 1: 1131.