google ads
Adrenal: Functioning Adrenal Masses Imaging Pearls - Educational Tools | CT Scanning | CT Imaging | CT Scan Protocols - CTisus
Imaging Pearls ❯ Adrenal ❯ Functioning Adrenal Masses

-- OR --

  • “Adrenal hemangioma (AH) is an extremely rare benign vascular tumor occurring in adrenal glands. Its clinical presentation is usually vague and it is frequently discovered as incidentaloma during imaging by ultrasonography, computed tomography or magnetic resonance imaging (MRI). It represents 0.01% of adrenal tumors and nearly 70 surgical cases have been reported in different data base since 1955.”
    Adrenal gland hemangioma: A rare case of the incidentaloma: Casereport
    I. Zemnia et al.
    International Journal of Surgery Case Reports 41 (2017) 417–422  
  • “These benign tumors are usually discovered as incidental radiological findings in abdominal imaging performed for various reasons. Generally CT and MR imaging are useful for the diagnosis of hemangioma. Contrast enhanced CT displays a characteristic peripheral patchy enhancement and highly dense peripheral rim.This pattern of peripheral spotty contrast enhancement is crucial for diagnosing adrenal hemangioma. When the hemangioma is seen as only a thin-rim enhancement, the preoperative diagnosis is very difficult because this pattern is seen in other adrenal tumors.”
    Adrenal gland hemangioma: A rare case of the incidentaloma: Casereport
    I. Zemnia et al.
    International Journal of Surgery Case Reports 41 (2017) 417–422
  • “Adrenal incidentalomas larger than 5 cm in diameter must be excised since the risk of adrenal cancer ranges from 35% to 98%. For lesions measuring 4 cm–5 cm, other imaging features, history of extra adrenal malignancy, patient’s preference, age and comorbidities should be taken into consideration. Adrenalectomy and follow-up with imaging are both acceptable in such cases.”
    Adrenal gland hemangioma: A rare case of the incidentaloma: Casereport
    I. Zemnia et al.
    International Journal of Surgery Case Reports 41 (2017) 417–422
  • Functionality
    1. Hormonal secretion
    2. 11% of adenomas
    - Cushing syndrome
    - Conn syndrome
    3. Nearly all pheochromocytomas secrete metanephrines
  • Cushing’s Syndrome
    1. Hypercortisolism
    - Increased fat (upper body, neck)
    - Fragile bones and skin
    - Hypertension
    2. Causes
    - Adrenal adenoma or hyperplasia
    - Pituitary tumor
    - Ectopic ACTH secretion (lung, carcinoid)
  • Conn Syndrome
    1. Hyperaldosteronism
    - Hypertension
    - Hypokalemia, hypernatremia
    - Metabolic alkalosis
    - Neuromuscular symptoms
    2. Causes
    - Aldosterone producing adenoma
    - Bilateral adrenal hyperplasia
  • Dual phase MDCT
    1. Adenomas
    - Less than or equal to 85 HU on the early arterial phase
    - usually higher enhancement on the venous phase
    2. Pheochromocytomas
    - often enhance ?115 HU on the early arterial phase 
    - can show higher enhancement on arterial phase
    3. Heterogeneity
    - more common in pheochromocytomas (~60%) than adenomas (~20%).

Privacy Policy

Copyright © 2024 The Johns Hopkins University, The Johns Hopkins Hospital, and The Johns Hopkins Health System Corporation. All rights reserved.