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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
"malignant tumors"
symptom
adrenal incidentaloma
cholangiocarcinoma
coats disease
cowden syndrome
cushing syndrome
dedifferentiated liposarcoma
dentinogenesis imperfecta
esophageal carcinoma
focal myositis
junctional epidermolysis bullosa
liposarcoma
pleomorphic liposarcoma
von hippel-lindau disease
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