Evaluation and management of adrenal masses.
BACKGROUND
The widespread use of abdominal imaging has led to increased detection of adrenal tumors. The significance of these masses, as well as the optimal management approach to treatment, has generated some controversy regarding further evaluation and therapy.


METHODS
The authors reviewed the literature regarding the evaluation and management of these masses, particularly adrenal incidentalomas. Based on their institutional experience, they propose a diagnostic, evaluation, and management algorithm for treating adrenal masses.


RESULTS
Appearance and clinical history should indicate how to perform the biochemical evaluation, keeping in mind that the presence of pheochromocytomas must be ruled out. Radiological evaluation by CT or MRI provides useful parameters to identify malignant lesions. Surgery is indicated for masses that are larger than 5 cm in diameter or suspected of malignancy. Fine-needle aspiration biopsy should be used when other extra-adrenal malignancies are suspected and after pheochromocytoma has been ruled out.


CONCLUSIONS
Careful analysis of each adrenal mass is essential to effectively avoid potential problems. Guidelines to manage patients with adrenal masses are needed.
Moreira
Sergio G
SG
Department of Surgery, University of South Florida, Tampa, 33612, USA.
Pow-Sang
Julio M
JM
D000304:Adrenal Cortex Function Tests; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D001707:Biopsy, Needle; D002395:Catecholamines / Q000097:blood / Q000652:urine; D003952:Diagnostic Imaging; D006728:Hormones / Q000097:blood / Q000652:urine; D006801:Humans; D010912:Pituitary-Adrenal Function Tests; D012084:Renin-Angiotensin System / Q000502:physiology
D002395:Catecholamines; D006728:Hormones