医学
嗜铬细胞瘤
肾上腺腺瘤
病理
神经节细胞瘤
腺瘤
骨髓脂肪瘤
肾上腺
肾上腺皮质腺瘤
肾上腺皮质
转移
神经内分泌肿瘤
肾上腺皮质癌
内科学
癌症
神经母细胞瘤
生物
遗传学
细胞培养
作者
Ryan Chung,Joanie Garratt,Erick M. Remer,Patrick J. Navin,Michael A. Blake,Myles T. Taffel,C. Hackett,Kedar G. Sharbidre,Wendy Tu,Gavin Low,M Bara,Benjamin Carney,Michael T. Corwin,Michael J. Campbell,James T. Lee,Cortney Y. Lee,Julie C. Dueber,Mostafa Shehata,Elaine M. Caoili,Nicola Schieda,Khaled M. Elsayes
出处
期刊:Radiographics
[Radiological Society of North America]
日期:2023-07-01
卷期号:43 (7)
被引量:3
摘要
The radiologic diagnosis of adrenal disease can be challenging in settings of atypical presentations, mimics of benign and malignant adrenal masses, and rare adrenal anomalies. Misdiagnosis may lead to suboptimal management and adverse outcomes. Adrenal adenoma is the most common benign adrenal tumor that arises from the cortex, whereas adrenocortical carcinoma (ACC) is a rare malignant tumor of the cortex. Adrenal cyst and myelolipoma are other benign adrenal lesions and are characterized by their fluid and fat content, respectively. Pheochromocytoma is a rare neuroendocrine tumor of the adrenal medulla. Metastases to the adrenal glands are the most common malignant adrenal tumors. While many of these masses have classic imaging appearances, considerable overlap exists between benign and malignant lesions and can pose a diagnostic challenge. Atypical adrenal adenomas include those that are lipid poor; contain macroscopic fat, hemorrhage, and/or iron; are heterogeneous and/or large; and demonstrate growth. Heterogeneous adrenal adenomas may mimic ACC, metastasis, or pheochromocytoma, particularly when they are 4 cm or larger, whereas smaller versions of ACC, metastasis, and pheochromocytoma and those with washout greater than 60% may mimic adenoma. Because of its nonenhanced CT attenuation of less than or equal to 10 HU, a lipid-rich adrenal adenoma may be mimicked by a benign adrenal cyst, or it may be mimicked by a tumor with central cystic and/or necrotic change such as ACC, pheochromocytoma, or metastasis. Rare adrenal tumors such as hemangioma, ganglioneuroma, and oncocytoma also may mimic adrenal adenoma, ACC, metastasis, and pheochromocytoma. The authors describe cases of adrenal neoplasms that they have encountered in clinical practice and presented to adrenal multidisciplinary tumor boards. Key lessons to aid in diagnosis and further guide appropriate management are provided. © RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center.