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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Incidentaloma secondary prevention

Introduction

Overview

Overview

Effective measures for the secondary prevention of adrenal incidentaloma include annual biochemical follow-up for up to 5 yr, no routine follow-up of adrenal incidentalomas with a non-contrast attenuation value no greater than 10 HU. Patients with adrenal masses less than 4 cm in size and a non-contrast attenuation value more than 10 HU should have a repeat CT study in 3–6 months and then yearly for 2 yr.

Secondary Prevention

Secondary Prevention

Effective measures for the secondary prevention of adrenal incidentaloma include:[1][2][3][4][5]

  • Excess hormone secretion may develop in up to 20% of patients with previously non-functional adrenal tumors during follow-up.
  • The transformation rate of non-functional adrenal masses to functional tumors seems to be higher in adrenal masses greater than 3 cm in size.
  • Annual biochemical follow-up for up to 5 years may be reasonable for patients with adrenal incidentalomas, especially if the tumor is more than 3 cm in size.
  • No routine follow-up of adrenal incidentalomas with a non-contrast attenuation value no greater than 10 HU.
  • Malignancy can be detected by an absolute increase in size of 0.8 cm, 0.64 cm growth per year or a 25% increase in size per year.
  • A one-time follow-up scan in 6–12 months may be reassuring to the physician and the patient.
  • Patients with adrenal masses less than 4 cm in size and a non-contrast attenuation value more than 10 HU should have a repeat CT study in 3–6 months and then yearly for 2 yr.
  • Surgical excision may be considered for tumors with indeterminate radiological features that grow at least 0.8 cm over 3- to 12-month follow-up.
References

References

  1. ↑ Barzon L, Scaroni C, Sonino N, Fallo F, Paoletta A, Boscaro M (1999). “Risk factors and long-term follow-up of adrenal incidentalomas”. J Clin Endocrinol Metab. 84 (2): 520–6. doi:10.1210/jcem.84.2.5444. PMID 10022410.
  2. ↑ 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.
  3. ↑ Pantalone KM, Gopan T, Remer EM, Faiman C, Ioachimescu AG, Levin HS; et al. (2010). “Change in adrenal mass size as a predictor of a malignant tumor”. Endocr Pract. 16 (4): 577–87. doi:10.4158/EP09351.OR. PMID 20150023.
  4. ↑ Zeiger MA, Thompson GB, Duh QY, Hamrahian AH, Angelos P, Elaraj D; et al. (2009). “American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons Medical Guidelines for the Management of Adrenal Incidentalomas: executive summary of recommendations”. Endocr Pract. 15 (5): 450–3. doi:10.4158/EP.15.5.450. PMID 19632968.
  5. ↑ Cawood TJ, Hunt PJ, O’Shea D, Cole D, Soule S (2009). “Recommended evaluation of adrenal incidentalomas is costly, has high false-positive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant; time for a rethink?”. Eur J Endocrinol. 161 (4): 513–27. doi:10.1530/EJE-09-0234. PMID 19439510.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]