| Adrenal incidentalomas. | |
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MedLine Citation:
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PMID: 22305453 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The term adrenal incidentaloma (AI) is usually defined as an adrenal mass unexpectedly detected through an imaging procedure performed for reasons a priori unrelated to adrenal dysfunction or suspected dysfunction. The preferred approach to their management in terms of diagnosis, follow-up, and treatment remain controversial despite a state-of-the-science conference sponsored by the U.S. National Institutes of Health. Although most experts' recommendations tend to be relatively minor variations of the conference's approach, dissenting voices have been heard. Despite their frequent appearance, the challenge remains to recognize and treat the small percentage of AI that do pose a significant risk, either because of their hormonal activity or because of their malignant histology, while leaving the rest alone. Although the differential diagnosis of an incidentally discovered mass is quite extensive, most AIs are non-secreting cortical adenomas. The noninvasive differentiation of benign and malignant lesions depends upon imaging characteristics, and sometimes radiologic diagnosis can be definitive, but often it is not, Among function lesions, autonomous cortisol production seems to be the most common and may be associated with increased cardiovascular risk and clinical features of the "metabolic syndrome." Follow-up of cases in which a specific diagnosis is not made initially involves assessment for growth and development of hormonal function, but even here, controversy about the extent of evaluation persists. |
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Authors:
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David Aron; Massimo Terzolo; T J Cawood |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Best practice & research. Clinical endocrinology & metabolism Volume: 26 ISSN: 1878-1594 ISO Abbreviation: Best Pract. Res. Clin. Endocrinol. Metab. Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-02-06 Completed Date: 2012-05-29 Revised Date: 2012-11-07 |
Medline Journal Info:
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Nlm Unique ID: 101120682 Medline TA: Best Pract Res Clin Endocrinol Metab Country: Netherlands |
Other Details:
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Languages: eng Pagination: 69-82 Citation Subset: IM |
Copyright Information:
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Published by Elsevier Ltd. |
Affiliation:
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VA HSR&D Quality Enhancement Research Initiative Center for Implementation Practice & Research Support (CIPRS), Louis Stokes Cleveland Dept. of Veterans Affairs Medical Center 14(W), Cleveland, OH 44106, United States. David.Aron@va.gov |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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diagnosis Adrenal Cortex Hormones / secretion Adrenal Gland Neoplasms / diagnosis*, surgery Cost-Benefit Analysis Cushing Syndrome / diagnosis Glucocorticoids / secretion Humans Incidental Findings* Magnetic Resonance Imaging Tomography, X-Ray Computed / adverse effects |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Glucocorticoids |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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