Adrenal Incidentaloma

被引:179
|
作者
Sherlock, Mark [1 ,2 ]
Scarsbrook, Andrew [3 ]
Abbas, Afroze [4 ]
Fraser, Sheila [5 ]
Limumpornpetch, Padiporn [6 ]
Dineen, Rosemary [1 ,2 ]
Stewart, Paul M. [6 ]
机构
[1] Beaumont Hosp, Dept Endocrinol, Beaumont Rd, Dublin 9, Ireland
[2] Royal Coll Surgeons Ireland, Dublin, Ireland
[3] Leeds Teaching Hosp NHS Trust, St James Univ Hosp, Dept Radiol, Beckett St, Leeds LS9 7TF, W Yorkshire, England
[4] Leeds Teaching Hosp NHS Trust, St James Univ Hosp, Dept Endocrinol, Beckett St, Leeds LS9 7TF, W Yorkshire, England
[5] Leeds Teaching Hosp NHS Trust, St James Univ Hosp, Dept Endocrine Surg, Beckett St, Leeds LS9 7TF, W Yorkshire, England
[6] Univ Leeds, Fac Med & Hlth, Worsley Bldg,Clarendon Way, Leeds LS2 9NL, W Yorkshire, England
关键词
adrenal adenoma; adrenal incidentaloma; adrenal computed tomography; autonomous cortisol secretion; adrenal cortical carcinoma; SUBCLINICAL CUSHINGS-SYNDROME; PROTEIN-KINASE-A; DUAL-ENERGY CT; SPORADIC ADRENOCORTICAL TUMORS; ALDOSTERONE-PRODUCING ADENOMAS; POSITRON-EMISSION-TOMOGRAPHY; CLINICAL-PRACTICE GUIDELINE; TANDEM MASS-SPECTROMETRY; NIGHT SALIVARY CORTISOL; URINARY FREE CORTISOL;
D O I
10.1210/endrev/bnaa008
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
An adrenal incidentaloma is now established as a common endocrine diagnosis that requires a multidisciplinary approach for effective management. The majority of patients can be reassured and discharged, but a personalized approach based upon image analysis, endocrine workup, and clinical symptoms and signs are required in every case. Adrenocortical carcinoma remains a real concern but is restricted to <2% of all cases. Functional adrenal incidentaloma lesions are commoner (but still probably <10% of total) and the greatest challenge remains the diagnosis and optimum management of autonomous cortisol secretion. Modern-day surgery has improved outcomes and novel radiological and urinary biomarkers will improve early detection and patient stratification in future years to come.
引用
收藏
页码:775 / 820
页数:46
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