Evaluation of a patient with adrenal incidentaloma

René Rodríguez-Gutiérrez

Should every patient with an incidentally discovered adrenal mass be evaluated for pheochromocytoma and hyperaldosteronism even in the absence of hypertension?

René Rodríguez-Gutiérrez: The answer to this question is no. Patients with adrenal incidentaloma should ideally be tested for Cushing syndrome—and that is what a low-dose 1-mg dexamethasone suppression test at night or 24-hour urinary cortisol [excretion test is for]—and for pheochromocytoma. Only patients with hypertension should be tested for aldosteronism.

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