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From the radiologic pathology archives: Adrenal tumors and tumor-like conditions in the adult: radiologic-pathologic correlation.
[cushing syndrome]
Advanced
imaging
often
reveals
adrenal
tumors
and
tumor
-like
conditions
in
both
symptomatic
and
asymptomatic
patients
.
When
adrenal
disease
is
clinically
suspected
,
cross-sectional
imaging
can
be
helpful
in
evaluating
the
etiology
of
the
patient
's
symptoms
.
When
adrenal
disease
is
incidentally
identified
,
what
the
clinician
and
patient
really
want
to
know
is
whether
the
findings
are
benign
or
malignant
,
as
this
ultimately
will
affect
their
next
step
in
management
.
Using
radiologic-pathologic
correlation
,
we
broadly
classify
common
,
uncommon
,
and
rare
tumors
and
tumor
-like
conditions
that
can
occur
in
the
adrenal
as
benign
or
malignant
.
This
classification
follows
predominant
trends
in
observed
biologic
behavior
while
acknowledging
those
tumors
that
may
behave
in
the
minority
in
an
unpredictable
manner
.
We
review
the
clinical
background
and
presentation
of
functional
adrenal
tumors
including
Conn
syndrome
,
Cushing
syndrome
,
and
catecholamine-secreting
tumors
,
as
well
as
their
relationship
with
adrenal
anatomy
.
We
discuss
a
variety
of
benign
tumors
,
including
adrenal
cortical
adenoma
(
including
oncocytoma
)
and
pheochromocytoma
,
as
well
as
uncommonly
and
rarely
encountered
tumors
such
as
myelolipoma
,
hemangioma
,
lymphangioma
,
schwannoma
,
ganglioneuroma
,
and
adenomatoid
tumor
.
A
variety
of
tumefactive
but
nonneoplastic
lesions
are
addressed
,
including
adrenal
cortical
hyperplasia
,
adrenal
hemorrhage
,
adrenal
cysts
,
and
infections
.
Malignant
tumors
discussed
include
adrenal
cortical
carcinoma
,
the
rare
malignant
pheochromocytoma
,
lymphoma
,
metastases
,
and
sarcomas
.
For
each
tumor
and
tumor
-like
lesion
,
the
clinical
presentation
,
epidemiology
,
key
imaging
findings
,
diagnostic
differential
considerations
,
and
management
options
are
briefly
addressed
.
Finally
,
an
approach
to
the
workup
of
suspected
or
incidentally
discovered
tumors
is
presented
based
on
a
selected
literature
survey
and
our
clinical
experience
.
Radiologists
play
an
important
role
in
identification
and
diagnosis
of
adrenal
tumors
and
tumor
-like
conditions
in
both
symptomatic
and
asymptomatic
patients
.
Diseases
Validation
Diseases presenting
"adrenal disease"
symptom
cushing syndrome
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