Investigation and assessment of adrenal incidentalomas

Cuthbertson, Daniel J ORCID: 0000-0002-6128-0822, Alam, Uazman ORCID: 0000-0002-3190-1122, Davison, Andrew S, Belfield, Jane, Shore, Susannah L and Vinjamuri, Sobhan (2024) Investigation and assessment of adrenal incidentalomas. CLINICAL MEDICINE, 23 (2). pp. 135-140.

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Official URL: http://dx.doi.org/10.7861/clinmed.2023-0042

Abstract

With the increasing volume of diagnostic imaging undertaken in an ageing population, adrenal incidentalomas (AIs) are increasingly commonly seen. These masses are most likely to be benign, but a small proportion may be malignant. Similarly, they are usually non-functional, but ∼14% are functional, ie hormone-secreting tumours. Clinical, biochemical and radiological assessment is mandated to stratify patients into those requiring radiological surveillance, medical management or surgical intervention or who can be discharged. Mass characteristics on cross-sectional (CT/MRI) imaging influence the need for radiological surveillance. Functional tumours where excess cortisol, aldosterone or catecholamine are secreted should be excluded, with mild autonomous cortisol secretion (MACS) and primary aldosteronism (PA) as the two most common functional states. MACS and PA are associated with an increased risk of cardiometabolic disease (eg hypertension, type 2 diabetes) and cardiovascular morbidity/mortality (eg coronary heart disease). Multidisciplinary management is critical for selected cases; the majority of adrenal incidentalomas only require a single assessment.

Item Type:	Article
Uncontrolled Keywords:	Adrenal incidentaloma, CT, hormone excess, mild autonomous cortisol secretion, MRI, primary aldosteronism
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	15 May 2024 09:01
Last Modified:	15 May 2024 09:02
DOI:	10.7861/clinmed.2023-0042
Open Access URL:	https://doi.org/10.7861/clinmed.2023-0042
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3180982