When a patient presents with an acute onset of severe Cushing syndrome (CS) due to metastatic adrenocortical carcinoma (ACC), clinicians ask: “Should the primary tumor be resected?” This is a…
Adrenocortical carcinoma (ACC) presents with overt symptoms of hormone excess (usually androgen, cortisol, or combined hypersecretion) in 30%–40% of cases. Notably, even patients with incidentally discovered ACC or those presenting…
Adrenocortical carcinoma (ACC) can present with overt symptoms of hormone excess (usually androgen, cortisol, or combined hypersecretion) in 30%–40% of cases. Imaging characteristics include unenhanced attenuation >20 Hounsfield units (HU),…
The Weiss scoring system is the most popular system used in the histologic diagnosis of adrenocortical carcinoma (ACC) and includes assessment of diffuse architecture; clear cells; nuclear grade; mitotic rate;…
Adrenal “incidentaloma” is frequently ignored by clinicians. However, approximately 50% of all patients with adrenocortical carcinomas (ACCs), pheochromocytomas, and overt hormone excess are discovered incidentally. When imaging characteristics of the…
When a patient is incidentally discovered with an adrenal mass, two questions need to be answered: (1) Is the adrenal mass malignant? (2) Is the adrenal mass hormonally active? Age,…
Carney triad (described in 1977) is a rare, nonfamilial, multitumoral syndrome, with three tumors in the initial description: gastrointestinal stromal tumor (GIST), pulmonary chondroma, and extraadrenal paraganglioma. Subsequently, two other…
Symptoms of overt glucocorticoid excess should prompt appropriate biochemical and imaging workup. In this case, despite imaging characteristics of myelolipoma and contralateral adrenal gland without abnormalities, ipsilateral adrenal adenoma was…
The diagnosis of corticotropin (ACTH)-independent hypercortisolism with adrenal imaging that does not demonstrate unilateral or bilateral nodules should prompt consideration of bilateral micronodular hyperplasia (Table C.2). Primary pigmented nodular adrenocortical…
Bilateral macronodular adrenal hyperplasia (BMAH) is an uncommon cause of adrenal hypercortisolism. It is a progressive disease that may present with a spectrum of cortisol and aldosterone secretion. BMAH can…
