Summary of Main Causes of Adrenal Masses in Nononcologic Patients and Those with Long-Term Remission (in Decreasing Order of Frequency)
| Etiology | Clinical picture |
|---|---|
| Adrenocortical adenoma | Usually normal, possible Cushing syndrome, primary hyperaldosteronism or hyperandrogenism |
| Pheochromocytoma | Hypertension, paroxysms (palpitations, pallor, tremor, headache, diaphoresis), possible family history of hereditary disease or syndromic, manifestations, increased urinary or plasma metanephrines, May be asymptomatic |
| Myelolipoma | Usually normal, possible chronic flank pain and abdominal discomfort |
| Adrenal hemorrhage | Possible history of trauma, thrombophilia (including antiphospholipid, antibody syndrome), underlying adrenal tumor, adrenal venous sampling, possible acute adrenal insufficiency (if bilateral) |
| ACC | Severe Cushing syndrome or hyperandrogenism (frequent mixed secretion), rare hyperaldosteronism or estrogen secretion, abdominal or flanck pain |
| Ganglioneuroma | Usually normal, possible catecholamines secretion in composite tumors |
| Adrenal cyst | Usually normal, possible chronic flank pain and abdominal discomfort |
| Adrenal metastasis | History of an extraadrenal cancer, cancer-associated signs and markers, possible adrenal insufficiency (if bilateral) |
| Primary adrenal lymphoma | Worsening general state, abdominal or flank pain, increased LDH, β2 microglobulin, CRP or ferritinemia levels, possible adrenal insufficiency (if bilateral) |
LDH = serum lactate dehydrogenase; CRP = serum C-reactive protein.