Adrenal Adenoma

Benign neoplasm emerging from the cells of the adrenal cortex

Aetiology

  • Found in almost all age groups but increase in frequency with age

Pathophysiology

  • Majority (~95%) are non-functioning and asymptomatic
  • Well circumscribed, encapsulated lesions
  • Solitary, small (2 to 3 cm), bright yellow (lipid) and buried within the gland - do not cause a mass lesion

Histological features

  • Composed of cells resembling adrenocortical cells
  • Well-differentiated, small nuclei
notion image

Clinical presentation

  • Often incidental finding during abdominal imaging
  • Patients with hyperfunctioning adrenal gland adenomas present with manifestations of excess hormone secretion e.g. Cushing's, Conn syndrome

Investigations

  • Imaging (CT, MRI)
  • Hormonal testing

Management

  • A small adrenal lesion with typical features of an adenoma and without biochemical abnormality can be safely left in situ
  • Surgical excision required if:
    • Functioning lesion
    • Large lesion (>3-5 cm) as considered potentially malignant
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