Incidentaloma screening
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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:
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 |
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| Pheochromocytoma | 24-hour urine:
Blood: |
| Cushing's syndrome | For patients with symptoms of Cushing's syndrome:
For patients lacking symptoms of Cushing's syndrome:
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| Primary aldosteronism | Plasma aldosterone concentration, plasma renin activity |