FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 356:601-610 February 8, 2007 Number 6 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF PDA Full Text  Full Text Audio PowerPoint Slide Set CME Exam Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear

This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A 68-year-old woman is incidentally found to have a left adrenal mass, 2.8 cm in diameter, on abdominal computed tomography that was ordered to evaluate right lower abdominal discomfort (which has since resolved). Her medical history is notable only for hypertension that has been well controlled with hydrochlorothiazide, at a dose of 25 mg daily. She reports no sweating, palpitations, headache, weight . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Hormonal Evaluation

            Subclinical Cushing's Syndrome

            Clinically Silent Pheochromocytoma

            Primary Aldosteronism

            Other Hormonally Active Processes

Assessment of Malignant Potential

            Size of Adrenal Mass

            Imaging Phenotype

            Metastatic Disease

            Fine-Needle Aspiration Biopsy

Bilateral Adrenal Masses

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Division of Endocrinology, Diabetes, Metabolism, Nutrition, and Internal Medicine, Mayo Clinic, Rochester, MN.

Address reprint requests to Dr. Young at the Division of Endocrinology, Diabetes, Metabolism, Nutrition, and Internal Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, or at young.william@mayo.edu.

This article has been cited by other articles:

• Hahner, S., Stuermer, A., Kreissl, M., Reiners, C., Fassnacht, M., Haenscheid, H., Beuschlein, F., Zink, M., Lang, K., Allolio, B., Schirbel, A. (2008). [123I]Iodometomidate for Molecular Imaging of Adrenocortical Cytochrome P450 Family 11B Enzymes. J. Clin. Endocrinol. Metab. 93: 2358-2365 [Abstract] [Full Text]  
• Else, T., Giordano, T. J., Hammer, G. D. (2008). Evaluation of Telomere Length Maintenance Mechanisms in Adrenocortical Carcinoma. J. Clin. Endocrinol. Metab. 93: 1442-1449 [Abstract] [Full Text]  
• Greenblatt, D. Y., Shenker, Y., Chen, H. (2008). The Utility of Metaiodobenzylguanidine (MIBG) Scintigraphy in Patients with Pheochromocytoma. Ann. Surg. Oncol. 15: 900-905 [Abstract] [Full Text]  
• Karagiannis, A., Mikhailidis, D. P, Athyros, V. G, Harsoulis, F. (2007). Pheochromocytoma: an update on genetics and management. Endocr Relat Cancer 14: 935-956 [Abstract] [Full Text]  
• Song, J. H., Chaudhry, F. S., Mayo-Smith, W. W. (2007). The Incidental Indeterminate Adrenal Mass on CT (> 10 H) in Patients Without Cancer: Is Further Imaging Necessary? Follow-Up of 321 Consecutive Indeterminate Adrenal Masses. Am. J. Roentgenol. 189: 1119-1123 [Abstract] [Full Text]  
• Solorzano, C. C., Lew, J. I., Wilhelm, S. M., Sumner, W., Huang, W., Wu, W., Montano, R., Sleeman, D., Prinz, R. A. (2007). Outcomes of Pheochromocytoma Management in the Laparoscopic Era. Ann. Surg. Oncol. 14: 3004-3010 [Abstract] [Full Text]  
• Ilias, I., Sahdev, A., Reznek, R. H, Grossman, A. B, Pacak, K. (2007). The optimal imaging of adrenal tumours: a comparison of different methods. Endocr Relat Cancer 14: 587-599 [Abstract] [Full Text]  
• Tauchmanova, L., Pivonello, R., De Martino, M. C., Rusciano, A., De Leo, M., Ruosi, C., Mainolfi, C., Lombardi, G., Salvatore, M., Colao, A. (2007). Effects of sex steroids on bone in women with subclinical or overt endogenous hypercortisolism. Eur J Endocrinol 157: 359-366 [Abstract] [Full Text]  
• Kaplan, N. M., Calhoun, D. A. (2007). Is There an Unrecognized Epidemic of Primary Aldosteronism? (Con). Hypertension 50: 454-458 [Full Text]  
• Hood, S. J., Taylor, K. P., Ashby, M. J., Brown, M. J. (2007). The Spironolactone, Amiloride, Losartan, and Thiazide (SALT) Double-Blind Crossover Trial in Patients With Low-Renin Hypertension and Elevated Aldosterone-Renin Ratio. Circulation 116: 268-275 [Abstract] [Full Text]  
• Pacak, K., Eisenhofer, G., Grossman, A., Gavras, I. (2007). The Incidentally Discovered Adrenal Mass. NEJM 356: 2005-2006 [Full Text]