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adrenal cortical adenoma
Pathology:
- adrenal adenomas are generally < 4 cm [1]
- most associated with Cushing's syndrome are unilateral
- most hyperaldosteronism associated are unilateral & solitary
- androgen-secreting neoplasm
- nonfunctioning adenomas or nodules seen with increasing age
Genetics:
- occasionally associated with mutations in APC gene
- other implicated genes GADD45GIP1
Clinical manifestations:
- may be associated with
- overproduction of glucocorticoids (Cushing's syndrome)
- overproduction of androgenic/estrogenic steroids (adrenogenital syndrome)
- overproduction of mineralocorticoids (Conn's syndrome)
- adrenal adenomas can exhibit both Cushing's syndrome & hyperandrogenism but this is uncommon [3]
Laboratory:
- see adrenal incidentaloma
Radiology:
- contrast-enhanced abdominal computed tomography
- generally < 4 cm with round with clear margins*
- homogenous enhancement*
- density < 10 HU*
- contrast washout > 50% in 10 minutes [1]*
- magnetic resonance imaging (MRI)
- isointense on T2 weighted images [1]*
* compare with adrenal cortical carcinoma
Differential diagnosis:
- adrenal cortical hyperplasia
- adrenal cortical carcinoma (distinguishing CT characteristics)
Management:
- see adrenal incidentaloma
Related
adrenal cortical carcinoma
Specific
adrenal incidentaloma
General
adenoma
adrenal neoplasm
References
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18.
American College of Physicians, Philadelphia 2015, 2018.
- Cordera F, Grant C, van Heerden J, Thompson G, Young W.
Androgen-secreting adrenal tumors.
Surgery. 2003 Dec;134(6):874-80; discussion 880.
PMID: 14668717
- Tanaka S, Tanabe A, Aiba M, et al.
Glucocorticoid- And Androgen-Secreting Black Adrenocortical Adenomas: Unique Cause
of Corticotropin-Independent Cushing Syndrome.
Endocrine Practice. 2011 May-Jun;17(3):e73-8
PMID: 21700558
Images
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