Incidentaloma

An incidentaloma (English Incidentaloma ) is a neologism derived for the Anglo-Saxon "incidental tumor". It is a case of radiological investigations randomly found tumor are present without clinical symptoms or suspicion.

A common problem is that seven percent of all patients over 60 years of a benign growth, often have the adrenal gland that is discovered in diagnostic imaging for the investigation of other symptoms. With the increase of whole-body CT analyzes to health care (USA), a more rapid early detection is expected.

With the unexpected discovery of diagnostic images, the physician is faced with the question of whether the changes are actually harmless. Most therefore further tests are necessary.

Incidentalomas of the adrenal gland

With adrenal tumors dexamethasone suppression test is often performed in order to detect a cortisol excess within the framework of Cushing's syndrome. Other endocrinological investigations are a laboratory diagnosis with detection of metanephrines and Normetanephrinen the exclusion of a pheochromocytoma and the determination of the renin -aldosterone ratio to exclude primary hyperaldosteronism. Tumors under three inches size are generally considered to be benign and treated at diagnosis of Cushing's syndrome, primary hyperaldosteronism, pheochromocytoma.

Pituitary incidentaloma

Routine investigations revealed that pituitary tumors are relatively common. It is believed that about ten percent of adults have such endocrinological lesions ( Hall et al ). When they occur long-term monitoring is recommended ( Molitch ). And basic adrenal hormone functions, should be ( as a test for the activity of growth hormones IGF-1 ) studied by measuring the ThyreotropinTHC levels, prolactin and insulin - like growth factor 1. Similarly, a dexamethasone suppression test is possible.

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Other organs may also be affected by incidentalomas, the liver (often a hemangioma ), thyroid, parathyroid and kidney.

Scientific criticism

The concept of incidentalomas is criticized because such lesions to the incidental finding and the fact that they are seen clinically inactive, does not have many similarities. The pathology shows no consistent histological pattern.