Incidentaloma screening: Difference between revisions
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|[[Pheochromocytoma]] | |[[Pheochromocytoma]]<ref name="pmid12614096">{{cite journal| author=Grumbach MM, Biller BM, Braunstein GD, Campbell KK, Carney JA, Godley PA et al.| title=Management of the clinically inapparent adrenal mass ("incidentaloma"). | journal=Ann Intern Med | year= 2003 | volume= 138 | issue= 5 | pages= 424-9 | pmid=12614096 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12614096 }}</ref> | ||
|'''24-hour urine:''' | |'''24-hour urine:''' | ||
* [[Metanephrine|Fractionated metanephrines]] | * [[Metanephrine|Fractionated metanephrines]] | ||
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* 1 mg overnight [[dexamethasone suppression test]] | * 1 mg overnight [[dexamethasone suppression test]] | ||
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|[[Primary hyperaldosteronism|Primary aldosteronism]] | |[[Primary hyperaldosteronism|Primary aldosteronism]]<ref name="pmid17287480">{{cite journal| author=Young WF| title=Clinical practice. The incidentally discovered adrenal mass. | journal=N Engl J Med | year= 2007 | volume= 356 | issue= 6 | pages= 601-10 | pmid=17287480 | doi=10.1056/NEJMcp065470 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17287480 }}</ref> | ||
|[[Aldosterone|Plasma aldosterone concentration]], [[plasma renin activity]] | |[[Aldosterone|Plasma aldosterone concentration]], [[plasma renin activity]] | ||
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Revision as of 15:44, 6 September 2017
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Incidentaloma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Incidentaloma screening On the Web |
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American Roentgen Ray Society Images of Incidentaloma screening |
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Risk calculators and risk factors for Incidentaloma screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
According to the European Society of Endocrinology Clinical Practice Guideline, screening for adrenal incidentaloma includes: family screening for patients with bilateral macronodular hyperplasia, patients with asymptomatic vertebral fractures, patients with possible autonomous cortisol secretion, patients with a hereditary syndrome leading to adrenal tumors. Screening test include 24-hour urine fractionated metanephrines for pheochromocytoma, 24-hour urinary free cortisol for patients with symptoms of Cushing's syndrome, and Plasma aldosterone concentration, plasma renin activity for patients with Primary aldosteronism.
Screening
- According to the European Society of Endocrinology Clinical Practice Guideline, screening for adrenal incidentaloma includes:[1]
Indications for adrenal incidentaloma screening
- Patients with possible autonomous cortisol secretion for hypertension and type 2 diabetes mellitus.
- Patients with asymptomatic vertebral fractures.
- Screening imaging in patients with a hereditary syndrome leading to adrenal tumors.
- Family screening with 1 mg dexamethasone test can be considered in cases of bilateral macronodular hyperplasia, especially in younger patients.
Screening measures
| Disease | Laboratory tests |
|---|---|
| Pheochromocytoma[2] | 24-hour urine:
Blood: |
| Cushing's syndrome[3] | For patients with symptoms of Cushing's syndrome:
For patients lacking symptoms of Cushing's syndrome:
|
| Primary aldosteronism[4] | Plasma aldosterone concentration, plasma renin activity |
References
- ↑ Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A; et al. (2016). "Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors". Eur J Endocrinol. 175 (2): G1–G34. doi:10.1530/EJE-16-0467. PMID 27390021.
- ↑ Grumbach MM, Biller BM, Braunstein GD, Campbell KK, Carney JA, Godley PA; et al. (2003). "Management of the clinically inapparent adrenal mass ("incidentaloma")". Ann Intern Med. 138 (5): 424–9. PMID 12614096.
- ↑ Valli N, Catargi B, Ronci N, Vergnot V, Leccia F, Ferriere JM; et al. (2001). "Biochemical screening for subclinical cortisol-secreting adenomas amongst adrenal incidentalomas". Eur J Endocrinol. 144 (4): 401–8. PMID 11275951.
- ↑ Young WF (2007). "Clinical practice. The incidentally discovered adrenal mass". N Engl J Med. 356 (6): 601–10. doi:10.1056/NEJMcp065470. PMID 17287480.