Retroperitoneum - Part 3 Flashcards
Adenoma
Benign cortical mass
What are the risk factors for an adenoma? (4)
- Diabetes mellitus
- Obesity
- Hypertension
- Older population
What are the clinical findings for an adenoma? (2)
- Asymptomatic
2. Elevated adrenal hormones
What is the US appearance for an adenoma? (4)
- Hypo echoic
- Homogeneous mass
- Smooth wall margins
- May demonstrate necrosis or hemorrhage
What are 4 differential diagnosis for an adenoma?
- Adrenal hyperplasia 2. Adrenocortical
carcinoma - Renal or liver mass 4. Adrenal
hemorrhage
Is an adrenal cyst unilateral or bilateral?
Unilateral
What are the clinical findings for an adrenal cyst? (2)
- Asymptomatic
2. Hypertension
What is the US appearance for an adrenal cyst? (4)
- Anechoic mass
- Well-defined wall margins
- Posterior acoustic
enhancement - Walls may calcify
What are 2 differential diagnosis for an adrenal cyst?
- Cyst of the liver, spleen, or kidney
2. Hydronephrosis
What are the causes of an adrenal hemorrhage? (4)
- Adrenal mass
- Hypoxia
- Traumatic delivery 4. Septicemia
What are the clinical findings for an adrenal hemorrhage? (3)
- Asymptomatic
- Palpable abdominal mass
- Decrease in hematocrit
What is the US appearance for an adrenal hemorrhage? (2)
- Cystic or complex adrenal mass
2. Frequently located on the right
What are 3 differential diagnosis for an adrenal hemorrhage?
- Cyst or neoplasm of the liver, spleen, or kidney
- Adenoma
- Adrenocortical
carcinoma
Adrenal hyperplasia
Proliferation in adrenal cells
Is adrenal hyperplasia typically unilateral or bilateral?
Bilateral
What are the clinical findings for adrenal hyperplasia? (3)
- Asymptomatic
- Hypertension
- Elevated ACTH level
What is the US appearance for adrenal hyperplasia? (2)
- Enlargement of the adrenal gland(s)
2. Change in the normal triangular shape
What are 2 differential diagnosis for adrenal hyperplasia?
- Adenoma
- Adrenocortical
carcinoma
Pheochromocytoma
Rare vascular tumour of the medulla
- small percentage is malignant
What side of the adrenal is pheochromocytoma most common in?
Right side
What are the clinical findings for pheochromocytoma? (8)
- Hypertension
- Sweating
- Tachycardia
- Chest or epigastric pain
- Headache
- Palpitations
- Severe anxiety
- Increase in epinephrine and
norepinephrine
What is the US appearance for pheochromocytoma? (5)
- Solid mass
- Homogeneous texture
- May appear complex because of necrosis or hemorrhage
- May calcify
- Metastasis to liver, lymph nodes, lung, and bone if malignant
What are 4 differential diagnosis for pheochromocytoma?
- Renal mass
- Adrenocortical
carcinoma - Adrenal adenoma 4. Adrenal hemorrhage
Adrenocortical carcinoma
Neoplasm of the adrenal cortex
What are the clinical findings for adrenocortical carcinoma? (5)
- Hypertension
- Weakness
- Abdominal pain
- Weight loss
- Weakening of the
bones
What is the US appearance for adrenocortical carcinoma? (4)
- Complex or echogenic mass
- Irregular wall margins
- Tends to invade the IVC
- Metastasis to the lungs and bone
What are 4 differential diagnosis for adrenocortical carcinoma?
- Renal mass
2. Adrenal hemorrhage 3. Pheochromocytoma 4. Metastases
Where is metastases most common?
In the lungs
What are clinical findings for metastases? (2)
- Hypertension
2. Abdominal pain
What are US appearance for metastases? (2)
- Focal mass
2. Variable in appearance
What are 4 differential diagnosis for metastases?
- Renal mass
- Adrenal hemorrhage 3. Pheochromocytoma 4. Adrenocortical
carcinoma
What is the 3rd most common malignancy in infancy?
Neuroblastoma
Neuroblastoma
Neoplasm of the
adrenal gland common in young children
Is neuroblastoma more common in males or females?
Males
When do neuroblastoma normally occur?
Half occur before 2 years of age
What side are neuroblastoma more common in?
Left
What are the clinical findings for neuroblastoma? (6)
- Palpable mass
- Abdominal
distention - Sweating
- Weight loss
- Fatigue
- Tachycardia
What is the US appearance for neuroblastoma? (7)
- Heterogeneous mass
- Poorly defined wall margins
- Pinpoint calcifications
- 30% - Lymphadenopathy
- Mass encases the aorta, IVC, SMA and SMV
- No invasion of the renal vein
- Metastasis to the liver, bone, lung, and
lymph nodes
What are 3 differential diagnosis for neuroblastoma?
- Nephroblastoma
- Lymphoma
- Adrenal
hemorrhage