CT and MRI Findings in Adrenal Cancer

Abstract

With the expanding use of cross-sectional imaging in the abdomen, the incidental detection of adrenal lesions (“incidentalomas”) has increased. When an adrenal lesion is encountered, the major question to be answered is whether the lesion is benign or malignant. Fortunately, most of these lesions will prove to be benign (adrenal adenomas), while adrenocortical carcinoma is rare. However, accurate characterization of an adrenal lesion is important, particularly in patients with a known primary carcinoma, because the probability of metastasis significantly increases. CT and MRI can overcome the challenges of characterizing an incidentally detected adrenal mass with a high level of accuracy. The combination of conventional morphologic features, unenhanced CT, and washout values correctly differentiates nearly all adrenal adenomas from malignant lesions.