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Adrenal incidentaloma imaging - the first steps in therapeutic management.
[adrenal incidentaloma]
The
term
"
adrenal
incidentaloma
"
refers
to
clinically
unapparent
adrenal
mass
detected
during
imaging
examination
performed
for
reasons
other
than
the
evaluation
of
adrenal
glands
.
These
tumors
must
be
carefully
examined
in
order
to
assess
the
indications
for
surgical
treatment
.
The
main
method
of
finding
evidence
of
potential
malignancy
in
these
lesions
is
computed
tomography
(
CT
)
,
before
and
after
i
.
v
.
contrast
media
enhancement
.
Density
of
a
malignant
lesion
is
higher
than
10
HU
and
the
relative
percentage
washout
is
less
than
40
%
at
10
min
.
Other
useful
methods
utilized
in
tumor
assessment
,
include
magnetic
resonance
imaging
(
MRI
)
,
scintigraphy
techniques
(
SPECT
)
and
PET
.
Basal
hormonal
investigations
include
urine
and
plasma
catecholamines
with
their
metabolites
,
plasma
cortisol
before
and
after
dexamethasone
administration
,
plasma
renin
activity
and
aldosterone
level
.
Cases
not
suitable
for
surgery
should
be
followed
with
repeat
imaging
techniques
and
hormonal
testing
at
the
recommended
6
,
12
,
and
24
months
.
Surgery
should
be
performed
when
tumor
growth
rate
exceeds
0
,
8
cm
per
year
.
Diseases
Validation
Diseases presenting
"tumor growth rate"
symptom
adrenal incidentaloma
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