Diagnostic and therapeutic management of patients with adrenal incidentaloma

Routine and frequent use of computerized tomography (CT) angiography in vascular disease detection has led to frequent suprarenal gland abnormal findings that could, if undiagnosed, significantly complicate the course of the future treatment. The term adrenal incidentaloma refers to adrenal lesion discovered serendipitously during an imaging investigation. Adrenal incidentalomas do not constitute a single pathological entity. Major concerns are risks of malignancy and autonomous hormone secretion. The majority of all adrenal incidentalomas (approximately 79%) are nonfunctioning benign lesions. Among functioning lesions subclinical cortisol excess is most frequently found. All patients with adrenal incidentaloma should undergo clinical, biochemical, and imaging evaluation for malignancy and hormone production. In this review, we discuss the current issues in diagnostic and therapeutic management of patients with adrenal incidentaloma. Follow-up of patients with adrenal incidentalomas involves the assessment of growth and development of hormonal function. After this review analysis several useful protocols could be designed to help vascular surgeons to adequately treat patients with concomitant vascular disease and adrenal incidentaloma.

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