From the Guidelines
An adrenal adenoma is typically evaluated by a multidisciplinary team including family physicians, urologists, endocrinologists, and radiologists.
Evaluation Team
- Family physicians: involved in the initial assessment and management
- Urologists: play a role in the surgical management of adrenal adenomas
- Endocrinologists: crucial in evaluating and managing hormonal function and excess
- Radiologists: essential in interpreting imaging studies to characterize the adrenal mass As stated in the guideline endorsed by the AUA, a multidisciplinary approach is necessary for the evaluation and management of incidentally discovered adrenal masses 1.
Key Considerations
- A low threshold for multidisciplinary review is recommended when imaging is not consistent with a benign lesion, there is evidence of hormone hypersecretion, or adrenal surgery is being considered 1.
- The evaluation team should work together to determine the best course of management, which may include imaging studies, hormonal function tests, and surgical intervention. The guideline provides a comprehensive approach to the evaluation, management, and follow-up of patients with adrenal incidentalomas, emphasizing the importance of a multidisciplinary team 1.
From the Research
Evaluation of Adrenal Adenoma
The evaluation of an adrenal adenoma involves a multidisciplinary approach, including:
- Clinical examination and history to assess for signs and symptoms of hormonal excess or malignancy 2, 3, 4
- Biochemical testing to evaluate for hormonal secretion, such as subclinical Cushing's syndrome, pheochromocytoma, and hyperaldosteronism 2, 3, 4
- Imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI), to assess the size and characteristics of the adrenal mass 2, 3, 5
Role of Different Specialists
The evaluation and management of adrenal adenomas involve:
- Endocrinologists to assess and manage hormonal excess or deficiency 2, 3, 6, 4
- Radiologists to interpret imaging studies and guide further evaluation or treatment 2, 3, 5
- Surgeons to perform adrenalectomy or other surgical procedures as needed 2, 3, 6, 4
- Primary care physicians to provide ongoing care and monitoring of patients with adrenal adenomas 6, 4
Key Considerations
Key considerations in the evaluation and management of adrenal adenomas include:
- Differentiating between benign and malignant tumors 2, 3, 5
- Assessing for hormonal excess or deficiency 2, 3, 4
- Evaluating the size and characteristics of the adrenal mass to guide further treatment or surveillance 2, 3, 5
- Considering the patient's overall health and medical history in determining the best course of treatment 6, 4