Fact-sheet: Metastases to adrenal gland
Updated on 10/03/2018 at 9:01 AM
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Definition
Primary tumors: lung, melanoma, breast, lymphoma, colon, pancreas.
Unilateral or bilateral involvement (if bilateral: screening for adrenal insufficiency with a Synacthen test)
Frequency: 2%
NB: any lesion not corresponding to a typical benign lesion (adenoma, myelolipoma, cyst) should be considered a metastasis to adrenal gland.
CT
- Measurement of unenhanced values (AV) before injection >> 10HU
- Washout at 15 min < 50% with AV > 35HU
Management
Histologic proof is only necessary when the presence of a metastasis would change management:
- Single adrenal lesion in a case of a locally controllable primary tumor
- Single suspicious adrenal lesion with a remote oncologic history.
- Single adrenal lesion in a patient with multiple primary tumors.
Differential diagnosis
- Non-secreting adenomas or other incidentalomas.
- Secreting and non-secreting nodular hyperplasias.
