Página del residente-Incidentaloma suprarrenal: ¿cuándo mantener la sospecha, aunque haya un buen lavado?

Se presenta a un hombre de 58 años, con hallazgo de masa incidental en la glándula suprarrenal izquierda. La tomografía computarizada de abdomen con protocolo para suprarrenales calculó un lavado absoluto del contraste de 72 %. La imagen de resonancia magnética de abdomen mostró intensidad de señal intermedia en T2 y baja en T1, sin presencia de grasa microscópica en secuencias eco gradiente fuera de fase. La bioquímica inicial fue normal, excepto por niveles de cortisol post dexametasona mayores de 1,8 ?g/dL y una 17-hidroxiprogesterona elevada. Se discute el enfoque diagnóstico y el abordaje de las lesiones suprarrenales.

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adenoma corticosuprarrenal
neoplasias de las glándulas suprarrenales
carcinoma corticosuprarrenal
feocromocitoma
imagen por resonancia magnética
tomografía computarizada por rayos X