Malignancy workup-adrenal incidentalomas
- CT and MRI characteristics may suggest adenoma vs. carcinoma
- Benign features:
- unenhanced CT <10 Hounsfield units or CT contrast-medium washout >50% at 10 min
- size <4 cm
- smooth margins, homogenous and hypodense appearance
- can follow such incidentalomas w/ periodic scans
- Suspicious features:
- size ≥4 cm or ↑ size on repeat scan;
- >10 Hounsfield units on CT, irregular margins, heterogeneous, dense or vascular appearance;
- h/o malignancy or young age.
- Such incidentalomas warrant resection or repeat scan at short interval.
- Rule out metastatic cancer (and infection) in Pts w/ h/o cancer; ~50% of adrenal incidentalomas are malignant
from adrenal incidentalomas