Russian Association of Endocrinologists clinical practice guideline for adrenal incidentalomas differential diagnosis
Abstract
This article discusses the management guidelines for serendipitously diagnosed adrenal masses cases, assessment of their hormonal activity and malignancy potential, pro- and contra indications for surgical treatment and follow-up algorithm for hormonally inactive tumors.
Hypercathecholaminemya, endogenous hypercortisolism, primary hyperaldosteronism should be considered as variants of specific hormonal activity of tumor. The midnight suppression test with dexametasone 1 mg is recommended in all cases. Evaluation of basal ACTH in case of negative result of the test with dexametasone 1 mg (absence of morning cortisol level suppression) should be considered as confirmation test. For primary diagnosis of pheohromocytoma/paraganglioma (PPGL) a free plasma or fractionated urine methanephrines concentrations evaluation should be recommended. If test is positive, comprehensive examination to exclude or confirm PPGL is necessity. The aldosterone/rennin ratio exposure should be considered for patients with arterial hypertension to exclude primary hyperaldosteronism. To evaluate malignant pattern of a tumor in all unclear cases should be provide assessment of computed tomography quantitative indices. Adrenal incidentalomas treatment guidelines isn’t considered in the field of this recommendations and reported in relevant guidelines.
About the Authors
Dmitriy G. BeltsevichEndocrinology Research Centre
Russian Federation
MD, PhD, Chief researcher at the Surgery department
Galina A. Melnichenko
Endocrinology Research Centre
Russian Federation
MD, PhD, Professor
Nikolay S. Kuznetsov
Endocrinology Research Centre
Russian Federation
MD, PhD
Ekaterina A. Troshina
Endocrinology Research Centre
Russian Federation
MD, PhD, Professor
Nadezhda M. Platonova
Endocrinology Research Centre
Russian Federation
MD, PhD
Vladimir E. Vanushko
Endocrinology Research Centre
Russian Federation
MD, PhD
Marina Y. Yukina
Endocrinology Research Centre
Russian Federation
MD, PhD
Natalia V. Molashenko
Endocrinology Research Centre
Russian Federation
MD, PhD
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1. Эпидемилогическая встречаемость различного типа опухолей при случайном их выявлении (сводные данные литературы) | |
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Type | Исследовательские инструменты | |
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For citations:
Beltsevich D.G., Melnichenko G.A., Kuznetsov N.S., Troshina E.A., Platonova N.M., Vanushko V.E., Yukina M.Y., Molashenko N.V. Russian Association of Endocrinologists clinical practice guideline for adrenal incidentalomas differential diagnosis. Endocrine Surgery. 2016;10(4):31-42. (In Russ.)