adrenal cortical adenoma
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Pathology
- adrenal adenomas are generally < 4 cm[1]
- most associated with Cushing's syndrome are unilateral
- most hyperaldosteronism associated are unilateral & solitary
- androgen-secreting neoplasm
- nonfunctioning adenomas or nodules seen with increasing age
Genetics
- occasionally associated with mutations in APC gene
- other implicated genes GADD45GIP1
Clinical manifestations
- may be associated with
- overproduction of glucocorticoids (Cushing's syndrome)
- overproduction of androgenic/estrogenic steroids (adrenogenital syndrome)
- overproduction of mineralocorticoids (Conn's syndrome)
- adrenal adenomas can exhibit both Cushing's syndrome & hyperandrogenism but this is uncommon[3]
Laboratory
Radiology
- contrast-enhanced abdominal computed tomography
- generally < 4 cm with round with clear margins*
- homogenous enhancement*
- density < 10 HU*
- contrast washout > 50% in 10 minutes[1]*
- magnetic resonance imaging (MRI)
- isointense on T2 weighted images[1]*
* compare with adrenal cortical carcinoma
Differential diagnosis
- adrenal cortical hyperplasia
- adrenal cortical carcinoma (distinguishing CT characteristics)
Management
More general terms
More specific terms
Additional terms
References
- ↑ 1.0 1.1 1.2 1.3 Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
- ↑ Cordera F, Grant C, van Heerden J, Thompson G, Young W. Androgen-secreting adrenal tumors. Surgery. 2003 Dec;134(6):874-80; discussion 880. PMID: https://pubmed.ncbi.nlm.nih.gov/14668717
- ↑ 3.0 3.1 Tanaka S, Tanabe A, Aiba M, et al. Glucocorticoid- And Androgen-Secreting Black Adrenocortical Adenomas: Unique Cause of Corticotropin-Independent Cushing Syndrome. Endocrine Practice. 2011 May-Jun;17(3):e73-8 PMID: https://pubmed.ncbi.nlm.nih.gov/21700558