Incidentaloma history and symptoms: Difference between revisions
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===Common Symptoms=== | ===Common Symptoms=== | ||
* By definition, an adrenal incidentaloma is an adrenal mass detected on imaging not performed for any suspected adrenal disease. The imaging study is not done for symptoms related to adrenal hormone excess. Although, 10 to 15 percent secrete excess amounts of hormones such as [[cortisol]], [[catecholamines]], and [[aldosterone]] as follow: | * By definition, an adrenal incidentaloma is an adrenal mass detected on imaging not performed for any suspected adrenal disease. The imaging study is not done for symptoms related to adrenal hormone excess. Although, 10 to 15 percent secrete excess amounts of hormones such as [[cortisol]], [[catecholamines]], and [[aldosterone]] as follow: | ||
* Most patients with nonfunctioning tumors present with clinical manifestations related to tumor growth or constitutional symptoms (weight loss, anorexia). | |||
* The most common clinical presentation is called subclinical [[Cushing's syndrome]] which includes [[diabetes]], and a high incidence of [[vertebral fractures]], [[dyslipidemia]], [[impaired glucose tolerance]] or [[Diabetes mellitus type 2|type 2 diabetes mellitus]], and evidence of [[atherosclerosis]]. These patients lack many of the usual stigmata of [[Cushing's syndrome]]. | * The most common clinical presentation is called subclinical [[Cushing's syndrome]] which includes [[diabetes]], and a high incidence of [[vertebral fractures]], [[dyslipidemia]], [[impaired glucose tolerance]] or [[Diabetes mellitus type 2|type 2 diabetes mellitus]], and evidence of [[atherosclerosis]]. These patients lack many of the usual stigmata of [[Cushing's syndrome]]. | ||
* [[Pheochromocytoma]]: Paroxysmal attacks of [[Hypertension|hypertension,]] [[palpitation]], [[diaphoresis]], [[headache]], [[pallor]], and [[Tremor|tremor.]] | * [[Pheochromocytoma]]: Paroxysmal attacks of [[Hypertension|hypertension,]] [[palpitation]], [[diaphoresis]], [[headache]], [[pallor]], and [[Tremor|tremor.]] | ||
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* Primary [[hyperaldosteronism]]: [[hypertension]] and [[hypokalemia]]. So, hypertensive patients should be evaluated for an [[Hyperaldosteronism|aldosteronoma]] even if the serum [[potassium]] concentration is normal. | * Primary [[hyperaldosteronism]]: [[hypertension]] and [[hypokalemia]]. So, hypertensive patients should be evaluated for an [[Hyperaldosteronism|aldosteronoma]] even if the serum [[potassium]] concentration is normal. | ||
* Approximately 60 percent of adrenocortical carcinomas (ACCs) are sufficiently secretory to present clinical syndrome of hormone excess [39,41,45,76-78]. | |||
* Adults with hormone-secreting ACCs usually present with Cushing's syndrome alone (45 percent), or a mixed Cushing's and virilization syndrome, with overproduction of both glucocorticoids and androgens (25 percent) [39,79]. Fewer than 10 percent present with virilization alone, but the presence of virilization in a patient with an adrenal neoplasm suggests an ACC rather than an adenoma. | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
History and Symptoms
History
Common Symptoms
- By definition, an adrenal incidentaloma is an adrenal mass detected on imaging not performed for any suspected adrenal disease. The imaging study is not done for symptoms related to adrenal hormone excess. Although, 10 to 15 percent secrete excess amounts of hormones such as cortisol, catecholamines, and aldosterone as follow:
- Most patients with nonfunctioning tumors present with clinical manifestations related to tumor growth or constitutional symptoms (weight loss, anorexia).
- The most common clinical presentation is called subclinical Cushing's syndrome which includes diabetes, and a high incidence of vertebral fractures, dyslipidemia, impaired glucose tolerance or type 2 diabetes mellitus, and evidence of atherosclerosis. These patients lack many of the usual stigmata of Cushing's syndrome.
- Pheochromocytoma: Paroxysmal attacks of hypertension, palpitation, diaphoresis, headache, pallor, and tremor.
- Cushing's syndrome: central obesity, proximal muscle weakness, supraclavicular fat pad, and plethora in face.
- Primary hyperaldosteronism: hypertension and hypokalemia. So, hypertensive patients should be evaluated for an aldosteronoma even if the serum potassium concentration is normal.
- Approximately 60 percent of adrenocortical carcinomas (ACCs) are sufficiently secretory to present clinical syndrome of hormone excess [39,41,45,76-78].
- Adults with hormone-secreting ACCs usually present with Cushing's syndrome alone (45 percent), or a mixed Cushing's and virilization syndrome, with overproduction of both glucocorticoids and androgens (25 percent) [39,79]. Fewer than 10 percent present with virilization alone, but the presence of virilization in a patient with an adrenal neoplasm suggests an ACC rather than an adenoma.