Adrenal Tumours & Incidentalomas

What is an adrenal incidentaloma?

An adrenal incidentaloma is an adrenal mass discovered unexpectedly during an imaging scan performed for another reason.

Does an adrenal mass always mean cancer?

No.

Many adrenal masses are benign.

However, an adrenal mass may need evaluation to determine:

• Whether it produces hormones
• Whether its imaging characteristics suggest benign or malignant disease

Can an adrenal tumour produce cortisol?

Yes.

Some adrenal tumours produce excess cortisol, sometimes without obvious classical features of Cushing syndrome.

Can an adrenal tumour produce aldosterone?

Yes.

An aldosterone-producing adrenal adenoma can cause primary aldosteronism and hypertension.

Can an adrenal tumour produce adrenaline?

A phaeochromocytoma can produce excess catecholamines.

When does an adrenal mass require specialist evaluation?

Evaluation is particularly important when there is:

• An adrenal mass found incidentally
• High blood pressure with low potassium
• Features suggesting cortisol excess
• Episodic headache, sweating or palpitations
• A rapidly enlarging or suspicious adrenal lesion
• A personal or family history suggesting an endocrine tumour syndrome