Department of Endocrinology, Beaumont Hospital, Dublin, Ireland.
Royal College of Surgeons in Ireland, Dublin, Ireland.
Endocr Rev. 2020 Dec 1;41(6):775-820. doi: 10.1210/endrev/bnaa008.
An adrenal incidentaloma is now established as a common endocrine diagnosis that requires a multidisciplinary approach for effective management. The majority of patients can be reassured and discharged, but a personalized approach based upon image analysis, endocrine workup, and clinical symptoms and signs are required in every case. Adrenocortical carcinoma remains a real concern but is restricted to <2% of all cases. Functional adrenal incidentaloma lesions are commoner (but still probably <10% of total) and the greatest challenge remains the diagnosis and optimum management of autonomous cortisol secretion. Modern-day surgery has improved outcomes and novel radiological and urinary biomarkers will improve early detection and patient stratification in future years to come.
现在已经确定,肾上腺意外瘤是一种常见的内分泌诊断,需要采用多学科方法进行有效管理。大多数患者可以得到安抚并出院,但在每种情况下都需要根据影像分析、内分泌检查以及临床症状和体征采取个性化方法。肾上腺皮质癌仍然是一个真正令人担忧的问题,但仅限于所有病例的<2%。功能性肾上腺意外瘤病变更为常见(但仍可能<10%),最大的挑战仍然是自主皮质醇分泌的诊断和最佳管理。现代手术已经改善了预后,新的影像学和尿液生物标志物将在未来几年提高早期检测和患者分层的水平。