What would you recommend for an adrenal lesion seen only on a contrast-enhanced CT?

Instruction: Give a specific initial imaging recommendation, identify the missing clinical information, and explain how a reassuring prior study would change that recommendation.

Context: A portal venous CT for abdominal pain shows a homogeneous 2.5 cm left adrenal lesion. No unenhanced series or previous images are available, so its unenhanced attenuation is unknown. After a call, the referring clinician confirms no known cancer history and no previous adrenal assessment. Hormonal evaluation has not been performed. The acute abdominal complaint has a separate explanation.

Updated

Official answer available

Read the opening below, then unlock the full answer and practical guidance.

I would describe this as an incompletely characterized adrenal lesion, rather than diagnose an adenoma from its size or its appearance after contrast alone. I would request any outside examinations first and, if none establish a benign diagnosis, recommend noncontrast adrenal CT for initial characterization...

Upgrade to view official answer

Related Questions