Incidentaloma diagnostic criteria

Jump to navigation Jump to search

Incidentaloma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Incidentaloma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Incidentaloma diagnostic criteria On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Incidentaloma diagnostic criteria

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Incidentaloma diagnostic criteria

CDC on Incidentaloma diagnostic criteria

Incidentaloma diagnostic criteria in the news

Blogs on Incidentaloma diagnostic criteria

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Incidentaloma diagnostic criteria

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Overview

The diagnosis of adrenal incidentaloma is based on the definition, which includes

Diagnostic Criteria

  • The guidelines recommend urgent assessment of adrenal mass in children, adolescents, pregnant females, and adults younger than 40 years of age because of a higher likelihood of malignancy.[1]
  • The diagnostic approach in patients with adrenal incidentalomas should focus on two main questions:
  • 1) whether the lesion is malignant
  • 2) whether it is hormonally active
  • Algorithm depicting the recommended evaluation and treatment of patients with an adrenal incidentaloma.
  • Radiological evaluation including noncontrast CT attenuation value expressed in HU is the best tool to differentiate between benign and malignant adrenal masses.
  • All adrenal tumors with suspicious radiological features, most functional tumors, and all tumors more than 4 cm in sizewith malignant radiological features should be removed.
  • All patients should undergo hormonal evaluation for subclinical Cushing's syndrome and pheochromocytoma, and those with hypertension should also be evaluated for primary hyperaldosteronism.
  • Annual biochemical follow- up of most patients with an adrenal incidentaloma (especially if the tumor is more than 3 cm in size) for up to 5 years is resonsnat.
  • Patients with adrenal masses less than 4 cm in size and a noncontrast attenuation value greater than 10 HU should have a repeat CT study in 3–6 months and then yearly for 2 years.
  • Adrenal tumors with indeterminate radiological features that grow at least 0.8 cm over 3–12 months should be considered for surgical resection once other imaging and clinical characteristics have been taken into consideration.
 
 
 
 
Adrenal mass
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CT attenuation value< 10HU
 
 
 
 
 
 
 
CT attenuation value> 10HU
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Nonfunctional
 
Functional
 
 
 
 
<4cm
 
 
>4cm
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
{{{ }}}
 
 
 
 
 
 
 
 
 
Yearly hormonal evlauation for up to 5 years
 
Surgical removal
 
Functional
 
NonfunctionalSurgical removal
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
surgical removal
 
Calculate enhancement washout within 15 minutes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
<60%
 
>60%
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Surgical removal
 
No change in size in 12 months
 
>0.8 increase in size in 12 months
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Follow up CT image for two years
 

References

  1. Sahdev A (2017). "Recommendations for the management of adrenal incidentalomas: what is pertinent for radiologists?". Br J Radiol. 90 (1072): 20160627. doi:10.1259/bjr.20160627. PMID 28181818.

Template:WH Template:WS