{"title":"肾上腺皮质肿瘤的诊断和病因进展","authors":"A. Verónica Araya MD","doi":"10.1016/j.rmclc.2025.08.013","DOIUrl":null,"url":null,"abstract":"<div><div>The frequent finding of adrenal incidentalomas (AI) is mainly due to the increased request for The frequent finding of adrenal incidentalomas (AI) is mainly due to the increased request for computed tomography (CT) scans and their improved resolution. Currently, evidence-based clinical computed tomography (CT) scans and their improved resolution. Currently, evidence-based clinical guidelines have established recommendations for the management of these lesions.guidelines have established recommendations for the management of these lesions.</div><div>The aim of this article is to highlight the main recommendations for the correct evaluation of AI. We The aim of this article is to highlight the main recommendations for the correct evaluation of AI. We will review the main elements used in the differential diagnosis of benign and malignant adrenal will review the main elements used in the differential diagnosis of benign and malignant adrenal lesions, such as Hounsfield units (HU) and AI size on unenhanced CT; the indication for additional lesions, such as Hounsfield units (HU) and AI size on unenhanced CT; the indication for additional imaging; tests indicated in the evaluation of hyperfunction; the definition of mild autonomous imaging; tests indicated in the evaluation of hyperfunction; the definition of mild autonomous cortisol secretion (MACS) and its implications; and the introduction of adrenal steroid metabolite cortisol secretion (MACS) and its implications; and the introduction of adrenal steroid metabolite testing, which has proven useful in the differential diagnosis of SI with testing, which has proven useful in the differential diagnosis of SI with ≥10 HU on unenhanced CT. 10 HU on unenhanced CT. We will also review new mutations associated with multiple endocrine neoplasia syndromes, which We will also review new mutations associated with multiple endocrine neoplasia syndromes, which should be suspected especially in bilateral adrenal lesions. Finally, we will mention the current should be suspected especially in bilateral adrenal lesions. Finally, we will mention the current approach regarding the follow-up of non-functioning benign lesions and patients with MACS.approach regarding the follow-up of non-functioning benign lesions and patients with MACS.</div></div>","PeriodicalId":31544,"journal":{"name":"Revista Medica Clinica Las Condes","volume":"36 4","pages":"Pages 348-356"},"PeriodicalIF":0.4000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Avances en el diagnóstico y etiología de los tumores de la corteza suprarrenal\",\"authors\":\"A. Verónica Araya MD\",\"doi\":\"10.1016/j.rmclc.2025.08.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>The frequent finding of adrenal incidentalomas (AI) is mainly due to the increased request for The frequent finding of adrenal incidentalomas (AI) is mainly due to the increased request for computed tomography (CT) scans and their improved resolution. Currently, evidence-based clinical computed tomography (CT) scans and their improved resolution. Currently, evidence-based clinical guidelines have established recommendations for the management of these lesions.guidelines have established recommendations for the management of these lesions.</div><div>The aim of this article is to highlight the main recommendations for the correct evaluation of AI. We The aim of this article is to highlight the main recommendations for the correct evaluation of AI. We will review the main elements used in the differential diagnosis of benign and malignant adrenal will review the main elements used in the differential diagnosis of benign and malignant adrenal lesions, such as Hounsfield units (HU) and AI size on unenhanced CT; the indication for additional lesions, such as Hounsfield units (HU) and AI size on unenhanced CT; the indication for additional imaging; tests indicated in the evaluation of hyperfunction; the definition of mild autonomous imaging; tests indicated in the evaluation of hyperfunction; the definition of mild autonomous cortisol secretion (MACS) and its implications; and the introduction of adrenal steroid metabolite cortisol secretion (MACS) and its implications; and the introduction of adrenal steroid metabolite testing, which has proven useful in the differential diagnosis of SI with testing, which has proven useful in the differential diagnosis of SI with ≥10 HU on unenhanced CT. 10 HU on unenhanced CT. We will also review new mutations associated with multiple endocrine neoplasia syndromes, which We will also review new mutations associated with multiple endocrine neoplasia syndromes, which should be suspected especially in bilateral adrenal lesions. Finally, we will mention the current should be suspected especially in bilateral adrenal lesions. Finally, we will mention the current approach regarding the follow-up of non-functioning benign lesions and patients with MACS.approach regarding the follow-up of non-functioning benign lesions and patients with MACS.</div></div>\",\"PeriodicalId\":31544,\"journal\":{\"name\":\"Revista Medica Clinica Las Condes\",\"volume\":\"36 4\",\"pages\":\"Pages 348-356\"},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista Medica Clinica Las Condes\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0716864025000768\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Medica Clinica Las Condes","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0716864025000768","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Avances en el diagnóstico y etiología de los tumores de la corteza suprarrenal
The frequent finding of adrenal incidentalomas (AI) is mainly due to the increased request for The frequent finding of adrenal incidentalomas (AI) is mainly due to the increased request for computed tomography (CT) scans and their improved resolution. Currently, evidence-based clinical computed tomography (CT) scans and their improved resolution. Currently, evidence-based clinical guidelines have established recommendations for the management of these lesions.guidelines have established recommendations for the management of these lesions.
The aim of this article is to highlight the main recommendations for the correct evaluation of AI. We The aim of this article is to highlight the main recommendations for the correct evaluation of AI. We will review the main elements used in the differential diagnosis of benign and malignant adrenal will review the main elements used in the differential diagnosis of benign and malignant adrenal lesions, such as Hounsfield units (HU) and AI size on unenhanced CT; the indication for additional lesions, such as Hounsfield units (HU) and AI size on unenhanced CT; the indication for additional imaging; tests indicated in the evaluation of hyperfunction; the definition of mild autonomous imaging; tests indicated in the evaluation of hyperfunction; the definition of mild autonomous cortisol secretion (MACS) and its implications; and the introduction of adrenal steroid metabolite cortisol secretion (MACS) and its implications; and the introduction of adrenal steroid metabolite testing, which has proven useful in the differential diagnosis of SI with testing, which has proven useful in the differential diagnosis of SI with ≥10 HU on unenhanced CT. 10 HU on unenhanced CT. We will also review new mutations associated with multiple endocrine neoplasia syndromes, which We will also review new mutations associated with multiple endocrine neoplasia syndromes, which should be suspected especially in bilateral adrenal lesions. Finally, we will mention the current should be suspected especially in bilateral adrenal lesions. Finally, we will mention the current approach regarding the follow-up of non-functioning benign lesions and patients with MACS.approach regarding the follow-up of non-functioning benign lesions and patients with MACS.