When is adrenal gland biopsy indicated

When is adrenal gland biopsy indicated? 

In patients with no history of malignancy, most incidentally discovered adrenal masses less than 4 cm in diameter are benign and should be evaluated with CT scans or MRI. For adrenal masses greater than 4 cm and not typical for adenoma, myelolipoma, hemorrhage, or simple cysts, surgical resection should be considered. In patients with histories of malignancy, an incidental adrenal mass is more often malignant and even small lesions are suspect. In these situations, a biopsy is indicated when noninvasive tests are inconclusive unless the presence of widespread nonadrenal metastases makes the presence or absence of adrenal metastases unlikely to change patient management. Adrenal biopsies are also indicated when enlarging masses are seen on follow-up imaging and the imaging characteristics are suspicious for malignancy.

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