Management of the Clinically Inapparent Adrenal Mass
Authors: Paul M. Copeland
Journal: Annals of Internal Medicine (2004)

Letters2 March 2004Management of the Clinically Inapparent Adrenal MassPaul M. Copeland, MDPaul M. Copeland, MDFrom Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-5-200403020-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The summary of the National Institutes of Health Consensus Statement on the management of the clinically inapparent adrenal mass is comprehensive and strives to provide an important service (1). I am concerned, however, that it included some recommendations that hinder good patient care. Following are concerns organized in order of their impact.The recommendations state, “Lesions that are less than 4 cm and are defined as low risk by imaging criteria are unlikely to have malignant potential and are generally not resected.” Elsewhere, it is noted that adrenal cortical carcinoma represents 2% of tumors of this size. ...References1. Grumbach MM, Biller BM, Braunstein GD, Campbell KK, Carney JA, Godley PA, et al . Management of the clinically inapparent adrenal mass (“incidentaloma”). Ann Intern Med. 2003;138:424-9. [PMID: 12614096] LinkGoogle Scholar2. Korobkin M, Brodeur FJ, Yutzy GG, Francis IR, Quint LE, Dunnick NR, et al . Differentiation of adrenal adenomas from nonadenomas using CT attenuation values. AJR Am J Roentgenol. 1996;166:531-6. [PMID: 8623622] CrossrefMedlineGoogle Scholar3. Pena CS, Boland GW, Hahn PF, Lee MJ, Mueller PR. Characterization of indeterminate (lipid-poor) adrenal masses: use of washout characteristics at contrast-enhanced CT. Radiology. 2000;217:798-802. [PMID: 11110946] CrossrefMedlineGoogle Scholar4. Copeland PM. The incidentally discovered adrenal mass: an update. The Endocrinologist. 1999;9:415-23. CrossrefGoogle Scholar5. Tauchmanova L, Rossi R, Biondi B, Pulcrano M, Nuzzo V, Palmieri EA, et al . Patients with subclinical Cushing's syndrome due to adrenal adenoma have increased cardiovascular risk. J Clin Endocrinol Metab. 2002;87:4872-8. [PMID: 12414841] CrossrefMedlineGoogle Scholar6. Sawka AM, Jaeschke R, Singh RJ, Young WF. A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24-hour urinary metanephrines and catecholamines. J Clin Endocrinol Metab. 2003;88:553-8. [PMID: 12574179] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Paul M. Copeland, MDAffiliations: From Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of the Clinically Inapparent Adrenal Mass (Incidentaloma) Melvin M. Grumbach , Beverly M.K. Biller , Glenn D. Braunstein , Karen K. Campbell , J. Aidan Carney , Paul A. Godley , Emily L. Harris , Joseph K.T. Lee , Yolanda C. Oertel , Mitchell C. Posner , Janet A. Schlechte , and H. Samuel Wieand Management of the Clinically Inapparent Adrenal Mass Glenn D. Braunstein , for the National Institutes of Health State-of-the Science Adrenal Incidentaloma Panel Metrics Cited byIdentifying functioning and nonfunctioning adrenal tumors based on blood serum surface-enhanced Raman spectroscopyPredictive factors for adrenal metastasis in extra‐adrenal malignancy patients with solitary adrenal massFeminizing Adrenal Neoplasms: Case Presentations and Review of the LiteratureEvaluation of the Cardiovascular Risk in Patients with Subclinical Cushing Syndrome Before and After SurgeryAdrenocortical Carcinoma: Contrast Washout Characteristics on CT 2 March 2004Volume 140, Issue 5Page: 401KeywordsAdenomasBlood plasmaComputed axial tomographyDiagnostic radiologyGlucose toleranceHypertensionLesionsPheochromocytomaRadionuclide imagingSurgery ePublished: 2 March 2004 Issue Published: 2 March 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...