You are here:

Radiology/Adrenal Mass (Adenoma or Nodular Hyperplasia)

Advertisement


Question
Hello Michael,

I am going in for a follow-up abdomenal scan for a adrenal mass identified in May, 2012.  The imaging center is requesting that a barium swallow be taken prior to CT scan and this is not consistent with previous imaging for this condition.  

The mass was identified vis CT after a car accident, not due to investigation of other symptoms/conditions in May 2012.  I have since had 1 MRI (w/ and w/out contrast) and 2 CT scans.  The CT transcripts (oldest to newwest) are found below with my DHEA-S results from the same time points.  

I would appreciate your opinion on the findings of the attached imaging transcripts and if a barium swallow is appropriate for follow-up imaging.  I recently moved, so my medical "team" has changed.  I am consulting my new endocrinologist, but he has not yet responded and the imaging is scheduled through a center that I have not previously used.  I appreciate any information you can provide.

Kind Regards

------------------------------------------------------
DATE OF EXAM: Sep 22 2012 9:01AM

TWC 0321 - CT ADRENALS WWO CONTRAST / ACCESSION # 89566464

PROCEDURE REASON: BENIGN NEOPLASM OF ADRENAL GLAND
* * * * Physician Interpretation * * * *

RESULT:
CT ADRENALS WWO CONTRAST
BENIGN NEOPLASM OF ADRENAL GLAND

CT imaging of adrenal glands was performed before and after
administration of contrast IV 125 mL of ULTRAVIST 300.

Dose-Length Product (DLP): 938 mGy*cm.
CT Dose Reduction Employed: Yes

Comparison: No previous CT adrenal examination. Right adrenal mass
reported on MRI from outside institution.

ABDOMEN: The lung bases are unremarkable.

Liver and spleen appear normal size, shape and density. The gallbladder
and biliary ducts are nondilated.

An ovoid nodular enlargement of the right adrenal gland measures 2.4-cm
AP diameter x less than 1 cm side-to-side diameter, 11HU noncontrast
enhanced scan, and 45HU contrast enhanced scan with rapid washout.

Kidneys are non-hydronephrotic with symmetrical nephrograms. No solid
renal nodule. No urolithiasis. Aorta is normal caliber.

Imaged intestinal loops are unremarkable.

IMPRESSION: Most likely benign adenoma or nodular hyperplasia involving
right adrenal gland measuring 2.4-cm AP x less than 1.0-cm side-to-side
diameter.
------------------------------------------------



Collected:
1/7/2013 7:33 AM
Resulted:
1/7/2013 2:20 PM

DHEA-S

255.9

10.0 - 319.0

ug/dL
----------------------------------------------------------
Collected:
7/2/2013 9:21 AM
Resulted:
7/2/2013 3:59 PM




DHEA-S

316.7

10.0 - 319.0

ug/dL

-----------------------------------------------------
Hello Shane,

Your right adrenal adenoma is STABLE in size. Next scan will be in 1-2 years.

* * *Final Report* * *

DATE OF EXAM: Jul 20 2013 8:15AM

TWC 0322 - CT ADRENALS WO CONTRAST / ACCESSION # 92311270

PROCEDURE REASON: Unspecified disorder of adrenal glands
* * * Physician Interpretation * * *

HISTORY: Unspecified disorder of adrenal glands, followup right adrenal
nodule

CT OF ADRENAL GLANDS 7/20/2013 8:15 AM:

Technique: CT images of the adrenal gland/abdomen is performed without
oral or intravenous contrast. 3 mm reconstruction axial and coronal
images with 2.5 mm overlapping are obtained.

CT Radiation dose: Integrated Dose-length product (DLP) for this visit =
278 mGy*cm.
CT Dose Reduction Employed: Yes

Comparison: 09/27/2012

RESULT:

2.4 x 0.7 x 1.4 cm (in AP, transverse and craniocaudal diameter) ovoid
mass or thickening of the medial limb of the right adrenal gland is again
seen without significant interval change. Findings again could be due to
adrenal adenoma or adrenal hyperplasia.

The left adrenal gland shows normal configuration without enlargement or
focal mass lesion.

No other obvious abnormality or interval change in the visualized liver,
spleen, pancreas or kidneys on this noncontrast study.

No renal stone or hydronephrosis is seen.

No ascites is noted.

The visualized lung bases shows no significant abnormality.
IMPRESSION:

Stable right adrenal mass or adrenal hyperplasia.

No other acute abdominal process or other interval change on this
noncontrast study from 09/22/2012.




Transcriptionist: PSC
Transcribe Date/Time: Jul 20 2013 11:14A
----------------------------------------

Answer
Shane,
If the scan is for the adrenal finding, there is not indication for the barrium swallow or any oral contrast for that CT.  The reports certainly indicate a stable adrenal lesion.

You should definitely inquire why they request a barium swallow. I would be interested in what they say.

Hope this helps.
Michael K>

Radiology

All Answers


Answers by Expert:


Ask Experts

Volunteer


Michael K.

Expertise

Almost any kind of questions regarding any types of radiology exams, procedures, meaning of radiology reports etc...

Experience

12 year experience in the field of radiology

Organizations
American Society of Neuroradiology, Senior Member Society of Pediatric Radiology, Active Member

Publications
Radiology Seminars in pediatric neurology American Journal of Roentgenology American Journal of Neuroradiology

Education/Credentials
Board Certified in Diagnostic Radiology Additional Certificate of Qualification in Neuroradiology

©2016 About.com. All rights reserved.