Dr. med. Dirk Manski



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Adrenal Tumor: Symptoms and Differential Diagnosis

An incidentally discovered adrenal tumor is also called incidentaloma. 80% of incidentalomas have no hormone production and are without clinical significance. In 20%, treatment is necessary because of hormonal activity or tumor growth.

Signs and Symptoms of Adrenal Tumors

Most of the adrenal tumors do not cause any symptoms. Symptoms depending on hormone production are Cushing's syndrome, virilization, feminization, Conn's syndrome. Rarely, adrenal tumor cause abdominal pain due to local growth and infiltration.

Differential Diagnosis of Adrenal Tumor

Diagnostic Work-Up of an Adrenal Tumor

Determination of Hormone Activity

Hormone activity of the adrenal tumor is assessed with blood tests and hormone assays from 24-hour urine collection:

Imaging of an Adrenal Tumor

Abdominal CT:

Adrenal masses larger than 5 cm are suspicious for a malignant tumor. CT characteristics for an adrenal adenoma is a native density of less than 10 HU, which increases after administration of contrast media. 15 min after contrast media administration, the enhancement wash-out of contrast media should be at least 60% [Joudi et al, 2006].

MRI Abdomen:

A high signal intensity on T2-weighted images is suspicious for a malignancy.







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References

Barzon und Boscaro 2000 BARZON, L. ; BOSCARO, M.:
Diagnosis and management of adrenal incidentalomas.
In: J Urol
163 (2000), Nr. 2, S. 398–407


  Deutsche Version: Differentialdiagnose Nebennierentumor