The Clinically Inapparent Adrenal Mass: Update in Diagnosis and Management

Clinically inapparent adrenal masses are incidentally detected after imaging studies conducted for reasons other than the evaluation of the adrenal glands. They have frequently been referred to as adrenal incidentalomas. In preparation for a National Institutes of Health State-of-the-Science Confere...

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Bibliographic Details
Published in:Endocrine reviews 2004-04, Vol.25 (2), p.309-340
Main Authors: Mansmann, Georg, Lau, Joseph, Balk, Ethan, Rothberg, Michael, Miyachi, Yukitaka, Bornstein, Stefan R
Format: Article
Language:English
Subjects:
Adrenal Cortex Neoplasms - diagnosis
Adrenal Cortex Neoplasms - therapy
Adrenal Gland Neoplasms - diagnosis
Adrenal Gland Neoplasms - epidemiology
Adrenal Gland Neoplasms - therapy
Adrenal glands
Adrenal Glands - pathology
Adrenalectomy
Adrenals. Adrenal axis. Renin-angiotensin system (diseases)
Aldosterone - secretion
Biological and medical sciences
Biomarkers, Tumor
Biopsy, Fine-Needle
Diagnostic Imaging
Endocrinopathies
Glucocorticoids
Gonadal Steroid Hormones - secretion
Hormones - analysis
Humans
Hydrocortisone - secretion
Imaging techniques
Medical imaging
Medical sciences
MEDLINE
Neoplasm Metastasis
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Pheochromocytoma
Pheochromocytoma - diagnosis
Pheochromocytoma - therapy
Tumor markers
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Description
Summary:Clinically inapparent adrenal masses are incidentally detected after imaging studies conducted for reasons other than the evaluation of the adrenal glands. They have frequently been referred to as adrenal incidentalomas. In preparation for a National Institutes of Health State-of-the-Science Conference on this topic, extensive literature research, including Medline, BIOSIS, and Embase between 1966 and July 2002, as well as references of published metaanalyses and selected review articles identified more than 5400 citations. Based on 699 articles that were retrieved for further examination, we provide a comprehensive update of the diagnostic and therapeutic approaches focusing on endocrine and radiological features as well as surgical options. In addition, we present recent developments in the discovery of tumor markers, endocrine testing for subclinical disease including autonomous glucocorticoid hypersecretion and silent pheochromocytoma, novel imaging techniques, and minimally invasive surgery. Based on the statements of the conference, the available literature, and ongoing studies, our aim is to provide practical recommendations for the management of this common entity and to highlight areas for future studies and research.
ISSN:0163-769X
1945-7189
DOI:10.1210/er.2002-0031