Adrenal Masses Flashcards
are adrenal adenoma hyperfunctioning or nonhyperfunctioning
both
Cushing syndrome (Hypercortisolism) excessive secretion assoc with
- administration of glucocorticoids for disorders such as astham, rheumatoid arthritis or transplant immunosuppression
- increased ACTH from a pituitary adenoma
- primary adrenal adenoma
- ectopic ACTH
Conn Syndrome (Primary Aldosteronism) excessive aldosterone secretion assoc with
- adrenal adenomas
- bilateral idiopathic adrenal hyperplasia
Hirsutism (overadbundance of hair) is caused by excessive androgen production as a result of
- congenital adrenal hyperplasia
- cushing syndrome
- pituitary tumor
- adrenocortical carcinoma
- ov tumors
- PCOS
- idiopathic
Adenoma is in pt with a known
primary malignancy
What is often performed to exclude metastic disease with adenomas
biopsy
rare tumor with a poor prog
adrenal cortical carcinoma
majority of pt with adrenal cortical carcinoma present with
cushings syndrome
mestastases disease
Differentiation for adrenal cortical carcinoma
benign adenoma
Tumor removal of adrenal cortical carcinoma is based on
size 3-6 cm
adrenal cortical carcinoma have a tendency to invade the
renal v and ivc
pheochromocytoma originate in the adrenal medulla nit may occur in ectopic locations like
along the paraaortic sympathetic nerve chain
Most pheochromocytomas are
benign
Pheochromocytomas secretes catecholamines
- nonrepinephrine
- epinephrine
pheochromocytomas are assoc with
- multiple endocrine neopalsia
- von hippel lindau disease
malignant tumor arising from the sympothetic nervous system
neuroblastoma
neuroblastoma commonly occur in the
adrenal medulla but may also occur in the neck, chest or pelvis
most common presentation is can be diagnosed of a neuroblastoma a
palp abd mass
most common adrenal mass of infancy ans early childhood
neuroblastoma
neuroblastoma can be diagnosed
prenatally, typically in the 3rd trimester
neuroblastoma commonly occurs between ages
2 mons and 2 yrs
sonographically, neuroblastoma is seen as a
solid mass that displaces the ipsilateral kidney inferiorly into the pelvis
How is neuroblastoma different from Wilms tumor
Wilms tumors originates from and invades the kidneys
neuroblastoma will have increased
blood and urine catecholamines
neuroblastoma most abundant catecholamines
- epinephrine
- noreppinephrine
- dopamine
majority of pt with neuroblastoma present with
metastatic disease
benign, nonfunctioning adrenal masses that contain fat and bone elements
myelolipomas
sonographically myelolipomas are seen as
hyper mass in adrenal bed
myelolipomas assoc with
propagation speed artifact due to fat composition
Adrenal involvement with lymphoma is
common and bilateral
Adrenal involvement with lymphoma may be diffuse, resembling
hyperplasia or mass like
most common cell type
nonhodgkins disease
4th most common metastatic primary site after lungs, liver, and bone
adrenal gland
Most common primary sites are
lungs breast skin kidneys thyroid colom
differentiation for adrenal mestastatis is
unilateral adrenal mass
*difficult in a pt with primary cancer
Adrenal hemorrhage is most common in
neonates
caused by their large size of the neonatal adrenals and their high degree of vascularity which make them vulnerable to birth trauma
adrenal hemorrhage
Sonographically, the appearance fo an adrenal hemorrhage
varies due to blood coagulation
Normal evolution of a hematoma ends with a
pseudocyst formation
If a mass is identified adj to adrenal gland of a newborn, it is most likely a
hemorrhage
