TY - JOUR
T1 - The evaluation of incidentally discovered adrenal masses
AU - behalf of the AACE Pituitary, Gonad, Adrenal, and Neuroendocrine Disease State Network
AU - Vaidya, Anand
AU - Hamrahian, Amir
AU - Bancos, Irina
AU - Fleseriu, Maria
AU - Ghayee, Hans K.
N1 - Funding Information:
A.V. has been a consultant and/or scientific advisory board member for Corcept Therapeutics, Ionis Pharmaceuticals, Selenity Therapeutics, HRA Pharma, and Orphagen Pharmaceuticals, all unrelated to the content of this manuscript. I.B. reports serving on a scientific advisory committee for HRA Pharma, unrelated to the content of this manuscript. M.F. has been principal investigator with research grants to OHSU from Novartis and Strongbridge and a scientific consultant for Novartis, Millendo, and Strongbridge, all unrelated to the content of this manuscript. H.G. has been a consultant for Corcept Therapeutics, received research funding from Strongbridge, and received royalties from the University of Texas Southwestern Medical Center at Dallas, all unrelated to the content of this manuscript. A.H. has no multiplicities of interest to disclose.
Publisher Copyright:
Copyright © 2019 AACE.
PY - 2019/2
Y1 - 2019/2
N2 - Objective: The objective of this Disease State Clinical Review is to provide clinicians with a practical approach to the evaluation of incidentally discovered adrenal masses. Methods: A case-based clinical approach to the evaluation of adrenal masses is presented. Recommendations were developed using available prospective and randomized studies, cohort studies, cross-sectional studies, anecdotal observations, and expert opinions. Results: Incidentally discovered adrenal masses are common. The approach to the patient with an adrenal mass should involve assessment of malignant potential via imaging characteristics and adrenal hormone excess via clinical and biochemical features. The roles of biopsy, surgical or medical therapy, and longitudinal surveillance are also important to consider and are influenced by case-specific factors. Inappropriate or inadequate evaluations may put patients at increased risk for developing preventable adverse cardiometabolic outcomes or cancer. Conclusion: Incidentally discovered adrenal masses require a multimodal assessment that involves interpretation of multiple imaging characteristics, dynamic and static hormonal measurements, and a nuanced approach to considering interventional diagnostics, treatments, and longitudinal surveillance. Herein, we review these evaluations and provide a practical approach for clinicians.
AB - Objective: The objective of this Disease State Clinical Review is to provide clinicians with a practical approach to the evaluation of incidentally discovered adrenal masses. Methods: A case-based clinical approach to the evaluation of adrenal masses is presented. Recommendations were developed using available prospective and randomized studies, cohort studies, cross-sectional studies, anecdotal observations, and expert opinions. Results: Incidentally discovered adrenal masses are common. The approach to the patient with an adrenal mass should involve assessment of malignant potential via imaging characteristics and adrenal hormone excess via clinical and biochemical features. The roles of biopsy, surgical or medical therapy, and longitudinal surveillance are also important to consider and are influenced by case-specific factors. Inappropriate or inadequate evaluations may put patients at increased risk for developing preventable adverse cardiometabolic outcomes or cancer. Conclusion: Incidentally discovered adrenal masses require a multimodal assessment that involves interpretation of multiple imaging characteristics, dynamic and static hormonal measurements, and a nuanced approach to considering interventional diagnostics, treatments, and longitudinal surveillance. Herein, we review these evaluations and provide a practical approach for clinicians.
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U2 - 10.4158/DSCR-2018-0565
DO - 10.4158/DSCR-2018-0565
M3 - Review article
C2 - 30817193
AN - SCOPUS:85062394143
SN - 1530-891X
VL - 25
SP - 178
EP - 192
JO - Endocrine Practice
JF - Endocrine Practice
IS - 2
ER -