Adrenal conditions

Adrenal masses are growths that develop on the adrenal glands. They can be benign or malignant, and may be functioning (hormone-producing) or non-functioning.2 The seven entries below cover the main reasons an adrenal mass is investigated and treated.

How they are assessed

The workup for any adrenal mass focuses on two questions: is it hormone-active, and is it suspicious for cancer? The answers drive whether surgery is needed and, if so, how urgently.

The core assessment is the same across conditions:

  • Hormone testing for phaeochromocytoma (plasma or urinary metanephrines), autonomous cortisol (1 mg dexamethasone suppression), and primary hyperaldosteronism (aldosterone-to-renin ratio) where indicated.3
  • Cross-sectional imaging, usually a dedicated CT adrenal protocol with unenhanced and contrast phases, or MRI. Density on non-contrast CT, washout characteristics, size and edge features all feed into risk assessment.
  • Multidisciplinary review for anything larger than ~4 cm, anything with indeterminate imaging, or anything that looks functional.

Further reading for GPs and referrers is on the for-GPs page.

Considering adrenal surgery?

You can request a second opinion on imaging, hormone testing and treatment options before you decide.