Incidentally discovered adrenal mass on CT scan

Abstract

© Springer Science+Business Media New York 2015. A 55-year-old female was involved in a motor vehicle accident several weeks ago at which time she underwent an abdominal CT scan which was negative for any injury. However, a 1.7-cm right adrenal nodule was incidentally noted. The patient complains of difficulty losing weight but denies any recent weight gain, abnormal hair growth, or muscle weakness. She has a long-standing history of diabetes and hypertension. She denies headache, palpitations, and flushing. Physical exam is significant for central obesity, but she does not have supraclavicular fat accumulation or purple striae. Workup for the adrenal mass revealed an elevated 24-h urine cortisol level (170 mcg/24 h; normal <45). This was followed by a low-dose dexamethasone suppression test, which resulted in lack of cortisol suppression (AM cortisol 14.2 mcg/dl, normal <2). Further biochemical workup including catecholamines and metanephrines as well as plasma aldosterone and renin levels was normal.