Endocrine Abstracts

Adrenal incidentalomas represent an increasingly common diagnostic problem facing clinical Endocrinologists. Swift and accurate differentiation of benign from malignant disease is essential, but the diagnostic performance of current imaging modalities is sub-optimal and often leads to ill-advised management decisions. Urinary steroid profiling by modern mass spectrometry-based techniques can provide a comprehensive profile of steroidogenesis, quantifying both precursor molecules and end products. Adrenocortical carcinomas display a premature pattern of steroidogenesis, dominated by precursor hormone synthesis, which can be captured in the urinary profile. Emerging evidence highlights the unique diagnostic opportunities presented by this feature. The combination of high-sensitivity biochemical analysis and computational data processing is expected to transform the management of adrenal tumours, from the diagnostics of adrenal incidentalomas to the post-operative surveillance of adrenocortical carcinomas.