Diagnosis
Due to their asymptomatic nature, most reported cases of adrenal adenomas have been discerned fortuitously through autopsy, or during medical imaging, particularly CT scan (computed tomography) and magnetic resonance imaging. Hence, they have earned the title incidentaloma referring to small adenoma discovered incidentally. Though adrenocortical adenomas are considered challenging to differentiate from the normal adrenal cortex, they appear as well-circumscribed lesions once isolated.Imaging Diagnostics

Computed Tomography (CT scan)
Magnetic Resonance Imaging (MRI)
Laboratory Tests

CRH Stimulation Test
High-dose-dexamethasone suppression test

Gross Description
Well-circumscribed lesion
Size ≤ 5 cm
Weight ≤ 50 grams
often appear as golden-yellow color mass(may have focal dark regions corresponding to hemorrhage, lipid-depletion, and increased lipofuscin)

Histopathology
The microscopic histopathology analysis of the tissue samples obtained from the adrenal cortex of individuals presenting with adenoma-associated symptoms such as primary aldestronism (PA) indicates that adenoma cells are relatively larger with different cytoplasm, and increased variation in nuclear size. This indication is based on comparison between the healthy (normal) and affected (adenoma-associated) adrenal cortex tissue samples. Adrenocortical adenomas are most commonly distinguished from adrenocortical carcinomas (their malignant counterparts) by the Weiss system, as follows:
Total score indicates:
0-2: Adrenocortical adenoma
3: Undetermined
4-9: Adrenocortical carcinoma

Treatment
Non-functioning cases of adrenocortical adenoma can be managed through long-term followups and monitoring. The treatment approach for the functioning cases of adrenocortical adenoma depends on the type of disorders they induce and their advancement.
Surgical excision may be required if its presence is resulting in atrophy of the adrenal glands and the surrounding tissues.In order to acquire better treatment strategies, it is important to further examine, study and discern the distinct molecular mechanisms involved in the formation of endogenous Adrenal Adenomas, hyperplasias, and ACTH-independent Cushings Syndrome to improve the available diagnostic and prognostic markers that can assist clinicians in the management and advance-treatment of such conditions. Prognosis
The long-term outlook for individuals diagnosed with non-functional adrenocortical adenoma is usually excellent. The long-term outlook for individuals diagnosed with functional adrenocortical adenoma is good with early diagnosis and treatment. Epidemiology
Prevalence: Female > Male
More common in adults
Relatively earlier onset in females (ages ≤ 20) than males (ages ≤ 30)
Most common cause of ACTH-independent Cushings syndrome

See also
Hyperplasia
Adrenal tumor
Cushings syndrome
Conns syndrome
Hypercortisolism
Hyperaldosteronism
Hyperandrogenism
Adrenal gland
Adrenal paraganglioma
Adrenal Pheochromocytoma
Adrenal ganglioneuroma

References


== External links ==