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[adrenal incidentaloma]
Incidentally
detected
adrenal
masses
occur
frequently
especially
in
the
elderly
.
This
is
due
to
technical
advances
as
well
as
to
widespread
use
of
radiologic
imaging
performed
for
other
reasons
.
After
discovery
of
an
adrenal
mass
two
major
questions
arise
:
firstly
,
is
the
lesion
malignant
and
,
secondly
,
is
it
hormonally
active
?
Malignancy
is
only
very
rarely
the
cause
for
incidental
adrenal
masses
.
However
,
in
patients
with
a
history
of
malignant
disease
these
are
suspicious
for
metastases
.
Imaging
may
help
distinguish
adrenal
masses
in
terms
of
size
and
signal
characteristics
.
About
10
-
15
%
of
adrenal
incidentalomas
are
hormonally
active
.
Clinically
significant
are
an
overproduction
of
catecholamines
,
aldosterone
and
cortisol
.
Hormonal
evaluation
should
be
considered
according
to
the
clinical
context
:
screening
for
hyperaldosteronism
is
recommended
if
hypertension
is
present
and
screening
for
cortisol-excess
should
be
performed
in
patients
with
typical
clinical
signs
.
In
contrast
,
a
pheochromocytoma
should
be
ruled
out
in
almost
all
patients
with
adrenal
incidentaloma
.
Often
only
a
combination
of
different
tests
can
prove
hormone-excess
.
These
tests
are
influenced
by
a
variety
of
factors
and
should
therefore
be
interpreted
with
caution
.
Diseases
Validation
Diseases presenting
"typical clinical signs"
symptom
adrenal incidentaloma
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