Info
🌱 來自: Huppert’s Notes
Adrenal Masses🚧 施工中
Adrenal Masses
Incidentally discovered adrenal mass
• Epidemiology: Common (at least 2% in the general population, more common with increasing age)
• Differential diagnosis:
- Nonfunctioning mass: Benign adenoma (most common), hemorrhage, lipoma, cyst, malignancy (metastasis from another site more common than primary adrenal malignancy)
- Functioning mass: Pheochromocytoma, adenoma or carcinoma that produces catecholamine, aldosterone, or cortisol
• Diagnosis:
- Consider need to screen for excess hormones (consider pheochromocytoma, hyperaldosteronism, and cortisol secretion)
- Identify patients who are at risk for malignancy (risk factors: >4 cm adrenal mass, patient with known malignancy)
- Imaging characteristics (density <10 Hounsfield units [HU] on CT suggests adrenal adenoma, and makes malignancy much less likely)
- Almost never biopsy an adrenal mass
Adrenocortical carcinoma
• Epidemiology: Rare, associated with excessive production of adrenal hormones and local mass effect (abdominal fullness). Typically poor prognosis.