Remde Hanna, Kimpel Otilia, Fassnacht Martin
Dtsch Med Wochenschr. 2022 Jan;147(3):85-91. doi: 10.1055/a-1370-6005. Epub 2022 Jan 31.
Adrenal masses are common incidental findings on imaging procedures.In most cases, adrenal incidentalomas are nonfunctioning adrenocortical adenomas, but in up to 20 % they require therapeutic intervention. The aim of this article is to provide essential guidance for clinicians regarding clinical management of patients with adrenal incidentalomas based on the respective current clinical guidelines. The following main questions are addressed: How to distinguish a nonfunctioning incidentaloma from a functioning one and how to assess risk of malignancy? How to define and manage low-level autonomous cortisol secretion, formerly called "subclinical" Cushing's syndrome? Which patients have to be treated surgically and which approach should be used? What follow-up is indicated if the adrenal incidentaloma is not surgically removed?
肾上腺肿块是影像学检查中常见的偶然发现。在大多数情况下，肾上腺偶发瘤是无功能的肾上腺皮质腺瘤，但高达20%的病例需要进行治疗干预。本文旨在根据当前各自的临床指南，为临床医生提供有关肾上腺偶发瘤患者临床管理的基本指导。探讨了以下主要问题：如何区分无功能偶发瘤和有功能偶发瘤，以及如何评估恶性风险？如何定义和管理低水平自主性皮质醇分泌，即以前所称的“亚临床”库欣综合征？哪些患者必须接受手术治疗，应采用哪种手术方式？如果肾上腺偶发瘤未行手术切除，应进行何种随访？
