Management of the Clinically Inapparent Adrenal Mass
Authors: Glenn D. Braunstein
Journal: Annals of Internal Medicine (2004)

Letters2 March 2004Management of the Clinically Inapparent Adrenal MassGlenn D. Braunstein, MD, for the National Institutes of Health State-of-the Science Adrenal Incidentaloma PanelGlenn D. Braunstein, MDFrom Cedars-Sinai Medical Center, Los Angeles, CA 90048., for the National Institutes of Health State-of-the Science Adrenal Incidentaloma PanelAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-5-200403020-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Copeland raises some good points. However, although several publications have appeared since our conference, high-quality data in sufficient numbers of patients are still lacking, thus the need for "additional research." Our specific responses are as follows.1. The major issue to resolve with the various imaging techniques is the differentiation of benign adrenal adenomas from adrenal cortical carcinoma, since biochemical tests can distinguish an adrenal adenoma from a pheochromocytoma. As Dr. Copeland has noted, approximately half of the adrenal masses in patients with known cancer represent metastasis (1). It is in that group of patients that fine-needle ...References1. Copeland PM. The incidentally discovered adrenal mass: an update. The Endocrinologist. 1999;9:415-23. CrossrefGoogle Scholar2. 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 Scholar3. Terzolo M, Pia A, Ali A, Osella G, Reimondo G, Bovio S, et al . Adrenal incidentaloma: a new cause of the metabolic syndrome? J Clin Endocrinol Metab. 2002;87:998-1003. [PMID: 11889151] CrossrefMedlineGoogle Scholar4. Chiodini I, Torlontano M, Carnevale V, Guglielmi G, Cammisa M, Trischitta V, et al . Bone loss rate in adrenal incidentalomas: a longitudinal study. J Clin Endocrinol Metab. 2001;86:5337-41. [PMID: 11701701] CrossrefMedlineGoogle Scholar5. Chiodini I, Tauchmanova L, Torlontano M, Battista C, Guglielmi G, Cammisa M, et al . Bone involvement in eugonadal male patients with adrenal incidentaloma and subclinical hypercortisolism. J Clin Endocrinol Metab. 2002;87:5491-4. [PMID: 12466342] CrossrefMedlineGoogle Scholar6. 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 Scholar7. Bernini G, Moretti A, Iacconi P, Miccoli P, Nami R, Lucani B, et al . Anthropometric, haemodynamic, humoral and hormonal evaluation in patients with incidental adrenocortical adenomas before and after surgery. Eur J Endocrinol. 2003;148:213-9. [PMID: 12590640] CrossrefMedlineGoogle Scholar8. Lenders JW, Pacak K, Walther MM, Linehan WM, Mannelli M, Friberg P, et al . Biochemical diagnosis of pheochromocytoma: which test is best? JAMA. 2002;287:1427-34. [PMID: 11903030] CrossrefMedlineGoogle Scholar9. Eisenhofer G. Editorial: biochemical diagnosis of pheochromocytoma—is it time to switch to plasma-free metanephrines? [Editorial]. J Clin Endocrinol Metab. 2003;88:550-2. [PMID: 12574178] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Glenn D. Braunstein, MDAffiliations: From Cedars-Sinai Medical Center, Los Angeles, CA 90048.Acknowledgments: The Panel acknowledges and thanks David C. Aron, MD; Stefan R. Bornstein, MD; Melvyn Korobkin, MD; and David E. Schteingart, MD, for their thoughtful and judicious contributions. 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 Paul M. Copeland Metrics Cited byEvaluation of the Cardiovascular Risk in Patients with Subclinical Cushing Syndrome Before and After Surgery 2 March 2004Volume 140, Issue 5 Page: 401-402 Keywords Adrenal adenoma Adrenalectomy Blood pressure Fibrinogen Imaging techniques Lesions Metabolic syndrome Pheochromocytoma Specificity Surgery ePublished: 2 March 2004 Issue Published: 2 March 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...