Abstract
A 55-year-old female was involved in a motor vehicle accident, at which time she underwent an abdominal CT scan that was negative for any injury. However, a 1.7-cm right adrenal nodule was incidentally noted. The patient complains of difficulty losing weight but denies any recent weight gain, abnormal hair growth, or muscle weakness. She has a long-standing history of diabetes and hypertension. She denies headache, palpitations, and flushing. Physical exam is significant for central obesity, but she does not have supraclavicular fat accumulation or purple striae. Workup for the adrenal mass revealed an elevated 24-hour urine cortisol level (170 mcg/dL; normal <45 mcg/dL). This was followed by a low-dose dexamethasone suppression test, which resulted in lack of cortisol suppression (AM cortisol 14.2 mcg/dL, normal <2 mcg/dL). Further biochemical workup including catecholamines and metanephrines as well as plasma aldosterone and renin levels was normal.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Suggested Reading
Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016;175(2):G1–G34.
Iacobone M, Citton M, Scarpa M, Viel G, Boscaro M, Nitti D. Systematic review of surgical treatment of subclinical Cushing’s syndrome. Br J Surg. 2015;102(4):318–30.
Lockhart ME, Smith JK, Kenney PJ. Imaging of adrenal masses. Eur J Radiol. 2002;41(2):95–112.
Mansmann G, Lau J, Balk E, Rothberg M, Miyachi Y, Bornstein SR. The clinically inapparent adrenal mass: update in diagnosis and management. Endocr Rev. 2004;25(2):309–40.
Newell-Price J, Bertagna X, Grossman AB, Nieman LK. Cushing’s syndrome. Lancet. 2006;367(9522):1605–17.
Nieman LK. Approach to the patient with an adrenal incidentaloma. J Clin Endocrinol Metab. 2010;95(9):4106–13.
Ogilvie JB, Duh QY. New approaches to the minimally invasive treatment of adrenal lesions. Cancer J. 2005;11(1):64–72.
Rossi GP, Auchus RJ, Brown M, et al. An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension. 2014;63(1):151–60.
Terzolo M, Bovio S, Pia A, Reimondo G, Angeli A. Management of adrenal incidentaloma. Best Pract Res Clin Endocrinol Metab. 2009;23(2):233–43.
Young WF. Clinical practice. The incidentally discovered adrenal mass. N Engl J Med. 2007;356(6):601–10.
Zeiger MA, Siegelman SS, Hamrahian AH. Medical and surgical evaluation and treatment of adrenal incidentalomas. J Clin Endocrinol Metab. 2011;96(7):2004–15.
Zeiger MA, Thompson GB, Duh QY, Hamrahian AH, Angelos P, Elaraj D, et al. The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas. Endocr Pract. 2009;15(Suppl 1):1–20.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Park, E.J., Livhits, M.J., Yeh, M.W. (2020). Incidentally Discovered Adrenal Mass on CT Scan. In: de Virgilio, C., Grigorian, A. (eds) Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-05387-1_11
Download citation
DOI: https://doi.org/10.1007/978-3-030-05387-1_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-05386-4
Online ISBN: 978-3-030-05387-1
eBook Packages: MedicineMedicine (R0)