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==History and Symptoms== | ==History and Symptoms== | ||
===History=== | ===History=== | ||
Family history | |||
===Common Symptoms=== | ===Common Symptoms=== | ||
By definition, an [[Adrenal gland|adrenal]] incidentaloma is an [[Adrenal gland|adrena]]<nowiki/>l [[mass]] detected on imaging not performed for any suspected [[Adrenal gland|adrenal]] disease. The imaging study is not done for symptoms related to [[Adrenal gland|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). | * Most patients with nonfunctioning tumors present with clinical manifestations related to [[tumor]] growth or constitutional symptoms [[Weight loss|(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.]] | ||
* [[Cushing's syndrome]]: [[central obesity]], [[Muscle weakness|proximal muscle weakness]], supraclavicular [[fat]] pad, and [[plethora]] in face. | * [[Cushing's syndrome]]: [[central obesity]], [[Muscle weakness|proximal muscle weakness]], supraclavicular [[fat]] pad, and [[plethora]] in face. | ||
* 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, [[Hypertension|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 | * Approximately 60 percent of [[Adrenocortical carcinoma|adrenocortical carcinomas]] (ACCs) are sufficiently secretory to present clinical [[syndrome]] of [[hormone]] excess.<ref name="pmid11571723">{{cite journal| author=Vassilopoulou-Sellin R, Schultz PN| title=Adrenocortical carcinoma. Clinical outcome at the end of the 20th century. | journal=Cancer | year= 2001 | volume= 92 | issue= 5 | pages= 1113-21 | pmid=11571723 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11571723 }}</ref> | ||
* Adults with hormone-secreting ACCs usually present with Cushing's syndrome alone | * Adults with [[hormone]]-secreting ACCs usually present with [[Cushing's syndrome]] alone or a mixed [[Cushing's syndrome|Cushing's]] and [[virilization]] [[syndrome]], with overproduction of both [[glucocorticoids]] and [[androgens]].<ref name="pmid10679640">{{cite journal| author=Wajchenberg BL, Albergaria Pereira MA, Medonca BB, Latronico AC, Campos Carneiro P, Alves VA et al.| title=Adrenocortical carcinoma: clinical and laboratory observations. | journal=Cancer | year= 2000 | volume= 88 | issue= 4 | pages= 711-36 | pmid=10679640 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10679640 }}</ref> | ||
* Presence of [[virilization]] in a patient with an [[Adrenal gland|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
Family 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.[1]
- Adults with hormone-secreting ACCs usually present with Cushing's syndrome alone or a mixed Cushing's and virilization syndrome, with overproduction of both glucocorticoids and androgens.[2]
- Presence of virilization in a patient with an adrenal neoplasm suggests an ACC rather than an adenoma.
References
- ↑ Vassilopoulou-Sellin R, Schultz PN (2001). "Adrenocortical carcinoma. Clinical outcome at the end of the 20th century". Cancer. 92 (5): 1113–21. PMID 11571723.
- ↑ Wajchenberg BL, Albergaria Pereira MA, Medonca BB, Latronico AC, Campos Carneiro P, Alves VA; et al. (2000). "Adrenocortical carcinoma: clinical and laboratory observations". Cancer. 88 (4): 711–36. PMID 10679640.