Diagnosis, Management, and Follow-Up of the Incidentally Discovered Adrenal Mass: CUA Guideline Endorsed by the AUA
2023; Lippincott Williams & Wilkins; Volume: 210; Issue: 4 Linguagem: Inglês
10.1097/ju.0000000000003644
ISSN1527-3792
AutoresNeal Rowe, Ravi Kumar, Nicola Schieda, Ferhan Siddiqi, Thomas McGregor, Kristen McAlpine, Philippe D. Violette, Varun Bathini, Michael K Eng, Jason Izard,
Tópico(s)Adrenal Hormones and Disorders
ResumoYou have accessJournal of UrologyAUA Guideline Article9 Aug 2023Diagnosis, management, and follow-up of the incidentally discovered adrenal mass: CUA Guideline Endorsed by the AUA Neal E. Rowe, Ravi Kumar, Nicola Schieda, Ferhan Siddiqi, Thomas McGregor, Kristen McAlpine, Phillippe Violette, Varun Bathini, Michael Eng, and Jason Izard Neal E. RoweNeal E. Rowe *Correspondence: Neal E Rowe, University of Ottawa, Ottawa, Ontario CANADA (email: E-mail Address: [email protected]). Division of Urology, Department of Surgery, University of Ottawa, 1053 Carling Ave Ottawa ON K1Y 4E9, 613-761-4500 , Ravi KumarRavi Kumar Division of Urology, Department of Surgery, University of Toronto, 200 Elizabeth St. Toronto, ON M5G 2C4 , Nicola SchiedaNicola Schieda Department of Radiology, University of Ottawa, 1093 Carling Ave Ottawa ON K1Y 0E9, 613-798-5555, ext 73865 , Ferhan SiddiqiFerhan Siddiqi Division of Endocrinology, Department of Medicine, Dalhousie University, 043-7N Victoria Bldg, 1276 South Park St. Halifax Nova Scotia B3H 2Y9, 902-473-2952 , Thomas McGregorThomas McGregor Department of Urology, Dalhousie University, Room 293, 5 Victoria, VG Site, 1276 South Park St. Halifax NS B3H 2Y9, 902-425-3940 , Kristen McAlpineKristen McAlpine Division of Urology, Department of Surgery, Credit Valley Hospital, 2000 Credit Valley Rd, Suite 411, Mississauga ON L5M 4N4, 905-608-5036 , Phillippe ViolettePhillippe Violette Department of Surgery, Department of Health Research Methods Evidence and Impact, McMaster University, 333 Athalone Ave, Unit 105 Woodstock ON N4V 0B8, , Varun BathiniVarun Bathini Division of Urology, Department of Surgery, University of Saskatchewan, #410 - 210 Avenue P S, Saskatoon, SK, S7M 2W2, 306-653-3255 , Michael EngMichael Eng Department of Urology, University of British Columbia, Room C319 St. Paul's Hospital, 1081 Burrard St. Vancouver BC V6Z 1Y6, 604-806-9610 , and Jason IzardJason Izard Department of Urology, Queen's University, Victory 4, Kingston General Hospital, 76 Stuart Street, Kingston ON K7L 2V7, 613-548-2493 View All Author Informationhttps://doi.org/10.1097/JU.0000000000003644AboutPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: Incidental adrenal masses are common and require a multidisciplinary approach to evaluation and management that includes family physicians, urologists, endocrinologists, and radiologists. The purpose of this guideline is to provide an updated approach to the diagnosis, management, and follow-up of adrenal incidentalomas, with a special focus on the areas of discrepancy/controversy existing among the published guidelines from other associations. Materials and Methods: This guideline was developed by the Canadian Urological Association (CUA) through a working group comprised of urologists, endocrinologists, and radiologists and subsequently endorsed by the American Urological Association (AUA). A systematic review utilizing the GRADE approach served as the basis for evidence-based recommendations with consensus statements provided in the absence of evidence. For each guideline statement, the strength of recommendation was reported as weak or strong, and the quality of evidence was evaluated as low, medium or high. Results: The CUA working group provided evidence- and consensus-based recommendations based on an updated systematic review and subject matter expertise. Important updates on evidence-based radiological evaluation and hormonal testing are included in the recommendations. This guideline clarifies which patients may benefit from surgery and highlights where short term surveillance is appropriate. Conclusion: Incidentally detected adrenal masses require a comprehensive assessment of hormonal function and oncologic risk. This guideline provides a contemporary approach to the appropriate clinical, radiographic, and endocrine assessments required for the evaluation, management, and follow-up of patients with such lesions. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Keywordsadrenal incidentalomaPheochromocytomaadrenalectomyadrenocortical hyperfunctionadrenocortical adenomaMetricsAuthor Information Neal E. Rowe Division of Urology, Department of Surgery, University of Ottawa, 1053 Carling Ave Ottawa ON K1Y 4E9, 613-761-4500 *Correspondence: Neal E Rowe, University of Ottawa, Ottawa, Ontario CANADA (email: E-mail Address: [email protected]). More articles by this author Ravi Kumar Division of Urology, Department of Surgery, University of Toronto, 200 Elizabeth St. Toronto, ON M5G 2C4 More articles by this author Nicola Schieda Department of Radiology, University of Ottawa, 1093 Carling Ave Ottawa ON K1Y 0E9, 613-798-5555, ext 73865 More articles by this author Ferhan Siddiqi Division of Endocrinology, Department of Medicine, Dalhousie University, 043-7N Victoria Bldg, 1276 South Park St. Halifax Nova Scotia B3H 2Y9, 902-473-2952 More articles by this author Thomas McGregor Department of Urology, Dalhousie University, Room 293, 5 Victoria, VG Site, 1276 South Park St. Halifax NS B3H 2Y9, 902-425-3940 More articles by this author Kristen McAlpine Division of Urology, Department of Surgery, Credit Valley Hospital, 2000 Credit Valley Rd, Suite 411, Mississauga ON L5M 4N4, 905-608-5036 More articles by this author Phillippe Violette Department of Surgery, Department of Health Research Methods Evidence and Impact, McMaster University, 333 Athalone Ave, Unit 105 Woodstock ON N4V 0B8, More articles by this author Varun Bathini Division of Urology, Department of Surgery, University of Saskatchewan, #410 - 210 Avenue P S, Saskatoon, SK, S7M 2W2, 306-653-3255 More articles by this author Michael Eng Department of Urology, University of British Columbia, Room C319 St. Paul's Hospital, 1081 Burrard St. Vancouver BC V6Z 1Y6, 604-806-9610 More articles by this author Jason Izard Department of Urology, Queen's University, Victory 4, Kingston General Hospital, 76 Stuart Street, Kingston ON K7L 2V7, 613-548-2493 More articles by this author Expand All Advertisement PDF downloadLoading ...
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