title: Adrenal incidentalomas: A collection of six interesting cases and brief review of literature.
abstract: BACKGROUND
  Adrenal incidentalomas (AI) are detected in approximately 4-7% of patients in imaging studies. Majority are benign, but careful evaluation is warranted to rule out carcinoma and functional adenomas.
  
  
  OBJECTIVE
  The purpose of presenting these cases is to highlight the approach to management of AI in terms of diagnosis, follow-up, and treatment.
  
  
  METHODS
  Seven patients presenting in the endocrine clinic with AI were evaluated for their presenting clinical features and investigated.
  
  
  RESULTS
  Case 1 was a 49-year-old female, with adrenal androgen secreting adrenocortical carcinoma with amenorrhoea which was mistaken as menopause. She had minimal hirsutism, which was mistaken as postmenopausal hirsutism. Case 2 was a 39-year-old male, presenting with hyperglycemia found to have Conns' syndrome with aldosterone producing adenoma on routine ultrasound. Case 3 was a 32-year-old male, presenting with gastritis and bloating, where ultrasound showed bilateral large adrenal masses revealed as diffuse large B cell lymphoma on biopsy. Case 4 was a 21-year-old boy, who had pheochromocytoma misdiagnosed as benign intracranial hypertension (HTN). Case 5 was a 59-year-old hypertensive male, presenting with fever had pheochromocytoma with catecholamine excess, producing fever. Case 6 was isolated adrenal tuberculosis who presented with chronic diarrhea.
  
  
  CONCLUSIONS
  AI are common, though prevalence varies depending on the reason for scanning, the characteristics of the population studied, and the radiological techniques used. Most are non-secreting cortical adenomas. AI should be evaluated both biochemically and radiologically. When a hormonal disorder is suspected clinically, targeted, diagnostic testing for autonomous cortisol secretion, pheochromocytoma, and hyperaldosteronism is indicated.
authors.affiliation: Department of Endocrinology, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi, India.
authors.forename: Roopal
authors.initials: R
authors.lastname: Panchani
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Goyal
authors.forename: Tarun
authors.initials: T
authors.lastname: Varma
authors.forename: Nitinranjan
authors.initials: N
authors.lastname: Gupta
authors.forename: Sudhir
authors.initials: S
authors.lastname: Tripathi
authors.forename: Surender
authors.initials: S
authors.lastname: Kumar
keywords: Adrenal incidentalomas; Conn's syndrome; pheochromocytoma
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