Adrenal incidentalomas -- a continuing management dilemma.
Adrenal incidentalomas (AI), adrenal tumors detected through an imaging procedure done for reasons unrelated to adrenal dysfunction, is becoming a common clinical problem with the more frequent utilization of different imaging techniques. Most such tumors are benign and hormonally inactive. A variety of diagnostic strategies have been developed to distinguish the latter; however, they are still controversial. Even after a commissioned systematic review of the literature and a state of the science conference sponsored by the National Institutes of Health, the optimal strategy for hormonal screening of a patient with AI is unknown, but we anticipate further refinements and major advances in the field. Surgery is the ultimate solution for the diagnostic-therapeutic dilemma of AI. Careful planning is required, and the learning curve which influences clinical decision making is especially relevant to immediate outcomes. The benefit of making a diagnosis of a clinically significant AI must be considered in the context of the patient's overall condition and preferences.
Nawar
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Division of Clinical and Molecular Endocrinology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
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D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000209:etiology; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D033162:Incidental Findings; D009316:National Institutes of Health (U.S.); D010673:Pheochromocytoma / Q000175:diagnosis; D014481:United States