Incidentaloma screening
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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
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, and 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:
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| 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.