Benign Adrenal Mass - Differential Diagnosis Algorithm Hyperplasia - Often Bilateral • Congenital Adrenal Hyperplasia • ACTH Dependent • ACTH Independent • Macronodular Hyperplasia Androgen Excess - Virilization / Hirsutism • High DHEAS • Low DHEAS Estrogen Excess - Feminization, Early Puberty, Heavy Menses • Estrogen Releasing Adenoma (High Plasma E2 +Clinical Picture) Glucocorticoid Excess - Cushingoid Features • Glucocorticoid Releasing Adenoma (Positive Dexamethasone Suppression Test) Aldosterone Excess - Hypertension +/- Hypokalemia/Alkalosis • Aldosterone Releasing Adenoma (High Aldosterone:Renin Ratio) Positive 24- Hour Metanephrine + Nor-Metanephrines • Pheochromocytoma (Paroxysmal Hypertension, Headache, Diaphoresis, Palpitations, Anxiety) Silent/Non-Functioning Mass • Normal DHEAS • Other #AdrenalMass #Benign #Differential #Diagnosis #Algorithm #Endocrinology
