Incidental asymptomatic XXXX detected by computed tomographic scanning. Is operation required?

@entity1 @entity101 @entity1911 @entity362 @entity17081 @entity6533 @entity1425 @entity17640 @entity134 @entity2922 @entity6392 @entity652 @entity1063 @entity774
Until recently, @entity774 came to clinical attention either from local symptoms due to massive enlargement or from manifestations of excess hormones production. During the last year, an adrenal mass was identified as an incidental finding in nine @entity1 undergoing abdominal computed tomographic (CT) scanning for unrelated problems. These five @entity1 and four @entity1 ranged in age from 41 to 73 years. Eight were @entity101 . After the CT scan, each was evaluated for @entity2922 or @entity134 hypersecretion. Only one had clearly elevated urinary @entity17081 , @entity6533 , and @entity2922 levels. Equivocal evidence of @entity2922 excess was seen in five @entity1 who had slight elevation of one urinary metabolite or of plasma @entity1425 or @entity1063 levels. Three @entity1 had no evidence of medullary or cortical @entity6392 on repeated testing. Eight @entity1 were good operative risks and underwent unilateral adrenalectomy without complication. Masses ranging in size from 1 to 4 cm were found in each. These included four cortical @entity652 , two @entity17640 , one @entity362 , and one @entity1911 . The @entity1911 occurred in the @entity1 with strong biochemical evidence of disease. With wider application of CT imaging, increasing numbers of asymptomatic @entity774 will be detected. Care in interpreting the clinical significance of these masses and caution in recommending treatment are required.
