Approach to the patient with Adrenal Incidentalomas

Approach to the patient with Adrenal Incidentalomas

SH. Alamdari, MD

Associate professor of Internal Medicine, Endocrinology & Metabolism

Chief, Department of Internal Medicine

Shahid Beheshti University of Medical Sciences

Increasing prevalence

• The prevalence of incidentally discovered adrenal masses (also referred to as adrenal incidentalomas or adrenal nodules) has grown substantially with the increased use of cross-sectional imaging such as computed tomography (CT) and magnetic resonance imaging (MRI).

Clinical Scenarios

• Adrenal masses may be discovered incidentally during emergency room visits or during the course of ambulatory or hospitalization-related imaging of the abdomen or chest.
• Increasingly, adrenal masses may also be discovered during the course of surveillance imaging associated with cancer care, though these findings are not truly incidental.

Aim of this symposium

• Though adrenal masses, or adrenal hyperplasia or thickening, of any size may have clinical relevance, this symposium will focus on the evaluation of incidentally discovered adrenal masses greater than or equal to 1 cm in size.

True prevalence

• The true prevalence of adrenal masses is not known; rather, estimates are extrapolated from limited observations.
• The prevalence of incidental adrenal masses based on 25 postmortem series is about 6% (range, 1.1 to 32%).
• The prevalence of incidentally discovered adrenal masses using high-resolution CT scans is slightly lower, at approximately 4% and generally observed to be higher with older age