Endocrine Abstracts

Definition: Adrenal incidentalomas are masses found on imaging performed for reasons other than investigating adrenal pathology.

Prevalence: Rare in childhood Prevalence increases with age - around 10% of the population aged >70y have adrenal incidentaloma.

Aetiology: Most are benign adrenocortical adenoma, but there is a wide differential for unilateral and bilateral lesions. In children any adrenal mass is likely to be clinically relevant and require investigation and intervention.

<>has two main aims:

1. <>Is the lesion(s) benign?

2. <>Is the lesion(s) hormonally functioning?

Management: Unilateral benign lesions causing clinically apparent hormonal excess usually require resection by minimally invasive surgery by an expert surgeon. Surgery for MACS may be indicated where basal ACTH is suppressed there are clear co-morbidities that can be driven by cortisol – e.g. hypertension, diabetes mellitus. Benefit is likely to be greater in younger patients. Malignant and indeterminant disease need careful multi-disciplinary discussion to discuss surgical approach and adjuvant therapies.