Adrenal Masses, Malignancies, and Other Disorders

Imaging algorithm for adrenal incidentaloma, from Campbell's

Biopsy algorithm, from Campbell's

Surveillance algorithm of adrenal adenoma, from Campbell's

Surveillance algorithm of adrenal adenoma, from Maas 2021

Adrenalectomy indications, from Campbell's

How to Workup an Adrenal Incidentaloma

Identification

Metabolic Workup

Imaging

Biopsy

Surveillance (based on guideline summary from Maas 2021)

Surgery recommendations

Relevant Physiology and Embryology to Keep in Mind

Adrenal layers (outer to inner)

Potential Congenital Abnormalities

Benign Adrenal Neoplasms

Adrenal Adenomas

Other adrenal lesions (all are rare)

Weiss Criteria, from Campbell's

Adrenocortical carcinoma TNM staging, from AJCC

5yr survival, from Campbell's

Adrenal Malignancies

Primary Adrenocortical Carcinoma

Metastases to the Adrenal Gland

Kutikov, A., P. L. Crispen, and R. G. Uzzo. "Pathophysiology, evaluation, and medical management of adrenal disorders." Campbell-Walsh Urology 12 (2020).

Hypercortisolism (Cushing Syndrome)

Causes

Urologic Indications for Hypercortisol Workup

Workup

Autonomous Cortisol Secretion

Treatment

Kutikov, A., P. L. Crispen, and R. G. Uzzo. "Pathophysiology, evaluation, and medical management of adrenal disorders." Campbell-Walsh Urology 12 (2020).

Kutikov, A., P. L. Crispen, and R. G. Uzzo. "Pathophysiology, evaluation, and medical management of adrenal disorders." Campbell-Walsh Urology 12 (2020).

Hyperaldosteronism (Conn Syndrome)

Causes

Workup

Treatment

Adrenal Insufficiency (Addison Disease)

Causes

Evaluation and Management

Kutikov, A., P. L. Crispen, and R. G. Uzzo. "Pathophysiology, evaluation, and medical management of adrenal disorders." Campbell-Walsh Urology 12 (2020).

Kutikov, A., P. L. Crispen, and R. G. Uzzo. "Pathophysiology, evaluation, and medical management of adrenal disorders." Campbell-Walsh Urology 12 (2020).

Pheochromocytoma (PCC) and Paragangliomas (Extra-adrenal PCCs)

Symptoms/Presentation

Workup

Treatment/Follow-Up

References