Should all adrenal nodules be evaluated with percutaneous biopsy?
No. Percutaneous biopsy is reserved for patients who have a history of extraadrenal malignancy with an adrenal mass, and only if the results of the biopsy will alter the treatment plan for the extraadrenal malignancy. Pheochromocytoma must be excluded with biochemical testing prior to biopsy to avoid potentially precipitating a hypertensive crisis. Percutaneous biopsy cannot differentiate an adrenal adenoma from an adrenocortical carcinoma.