The majority of lesions were adrenal adenomas, myelolipomas, and cysts [6]. FDG-PET/CT Skull Base to Mid-Thigh For lesions <1 cm and no history of malignancy, there is no primary evidence supporting the use of FDG-PET/CT for initial evaluation. Metastatic disease to the adrenal gland without a known history of primary malignancy is unusual [4,5]. In a study of 1,049 incidental adrenal masses in patients with no known history of cancer, none were malignant. The majority of lesions were adrenal adenomas, myelolipomas, and cysts [6]. Adrenal Mass Evaluation It is recognized that FDG-PET is less sensitive and specific for lesions <10 mm [25], and although PET has the potential to detect very small adrenal metastases, one study showed that 2 of 5 lesions that proved to be false- negative for malignancy on PET were <10 mm [26]. Therefore, the specificity of FDG-PET for characterizing adrenal lesions <10 mm may be limited. Image-Guided Biopsy Adrenal Gland For lesions <1 cm and no history of malignancy, there is no primary evidence supporting the use of biopsy for initial evaluation [27-30]. MRI Abdomen For lesions <1 cm and no history of malignancy, there is no primary evidence supporting the use of MRI for initial evaluation. Metastatic disease to the adrenal gland without a known history of primary malignancy is unusual [4,5]. In a study of 1,049 incidental adrenal masses in patients with no known history of cancer, none were malignant. The majority of lesions were adrenal adenomas, myelolipomas, and cysts [6]. Variant 2: Indeterminate adrenal mass, 1 to 2 cm on initial imaging. No diagnostic benign imaging features. No history of malignancy. Follow-up imaging in 12 months. For patients with no prior history of malignancy and an incidentally detected adrenal mass between 1 and 2 cm without diagnostic benign imaging characteristics on initial study, the mass is most likely benign [12,24].
Adrenal Mass Evaluation. The majority of lesions were adrenal adenomas, myelolipomas, and cysts [6]. FDG-PET/CT Skull Base to Mid-Thigh For lesions <1 cm and no history of malignancy, there is no primary evidence supporting the use of FDG-PET/CT for initial evaluation. Metastatic disease to the adrenal gland without a known history of primary malignancy is unusual [4,5]. In a study of 1,049 incidental adrenal masses in patients with no known history of cancer, none were malignant. The majority of lesions were adrenal adenomas, myelolipomas, and cysts [6]. Adrenal Mass Evaluation It is recognized that FDG-PET is less sensitive and specific for lesions <10 mm [25], and although PET has the potential to detect very small adrenal metastases, one study showed that 2 of 5 lesions that proved to be false- negative for malignancy on PET were <10 mm [26]. Therefore, the specificity of FDG-PET for characterizing adrenal lesions <10 mm may be limited. Image-Guided Biopsy Adrenal Gland For lesions <1 cm and no history of malignancy, there is no primary evidence supporting the use of biopsy for initial evaluation [27-30]. MRI Abdomen For lesions <1 cm and no history of malignancy, there is no primary evidence supporting the use of MRI for initial evaluation. Metastatic disease to the adrenal gland without a known history of primary malignancy is unusual [4,5]. In a study of 1,049 incidental adrenal masses in patients with no known history of cancer, none were malignant. The majority of lesions were adrenal adenomas, myelolipomas, and cysts [6]. Variant 2: Indeterminate adrenal mass, 1 to 2 cm on initial imaging. No diagnostic benign imaging features. No history of malignancy. Follow-up imaging in 12 months. For patients with no prior history of malignancy and an incidentally detected adrenal mass between 1 and 2 cm without diagnostic benign imaging characteristics on initial study, the mass is most likely benign [12,24].