When to worry about incidental renal and adrenal masses

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Abstract

Greater use of imaging has led to a corresponding rise in the detection of renal and adrenal incidentalomas— and left many primary care physicians unsure of what to do about the masses they've found.

PRACTICE RECOMMENDATIONS

> Use computed tomography studies and the Bosniak classification system to guide management of renal cystic masses.Symbol

PRACTICE RECOMMENDATIONS

> Perform laboratory tests for hypercortisolism, hyperaldosteronism, and hypersecretion of catecholamines (pheochromocytoma) on any patient with an incidental adrenal mass, regardless of signs or symptoms.Symbol

PRACTICE RECOMMENDATIONS

> Refer patients with adrenal masses >4 cm for surgical evaluation. Refer any individual who has a history of malignancy and an adrenal mass for oncologic evaluation.Symbol

Strength of recommendation (SOR)

Symbol Good-quality patient-oriented evidence

Strength of recommendation (SOR)

Symbol Inconsistent or limited-quality patient-oriented evidence

Strength of recommendation (SOR)

Symbol Consensus, usual practice, opinion, disease-oriented evidence, case series

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