CT scans are the first-line imaging technique for detecting adrenal tumors. They provide detailed and precise images.

With the use of imaging tests, adrenal masses are being detected more frequently, often during routine exams for other health conditions.

Distinguishing between cancerous and noncancerous adrenal tumors is crucial for treatment and prognosis, and CT scans are an important part of this process.

On a CT scan, a benign adrenal gland tumor, or adenoma, typically appears as a well-defined round or oval lesion that stands out from surrounding tissues due to its high fat content.

A cancerous adrenal tumor, also known as an adrenal carcinoma, may appear as a large, irregularly shaped mass. It typically has an uneven density with areas of low and high visibility due to varying tissue composition.

However, not all cancerous tumors will look like this, and the appearance may vary depending on the specific tumor type and other factors.

A cancerous tumor might also show increased blood flow or enhanced contrast uptake during the CT scan. This suggests that it’s an aggressive tumor.

A CT scan of an adrenal gland tumor can provide essential information about its size, shape, and location. It can help also distinguish between benign (noncancerous) and malignant tumors (cancerous).

Benign tumors appear well defined and stand out from surrounding tissues, while malignant tumors may show irregular borders or signs of invasion and metastasis (the spread of cancer to other parts of the body).

It’s fairly common to discover an adrenal mass while conducting imaging for another health issue. In fact, incidental adrenal masses occur in about 3–7% of adults, and the majority of these are benign and non-hyperfunctioning — meaning they don’t produce excess hormones.

A CT scan is effective at detecting most adrenal gland cancers. However, distinguishing between a benign and malignant adrenal tumor based solely on CT imaging can sometimes be challenging, as some malignant tumors may also exhibit similar features to benign ones.

Further evaluation and additional imaging tests, such as MRI or PET scans, along with clinical and laboratory findings, are usually needed to accurately distinguish between benign and malignant adrenal masses.

Biopsy or fine-needle aspiration may also be necessary to obtain a definitive diagnosis in some cases.

Ultimately, the interpretation of CT findings will be by experienced radiologists and a multidisciplinary approach involving endocrinologists, oncologists, and surgeons.

CT scans are commonly used and considered the first-line imaging technique for detecting and characterizing adrenal gland tumors. They offer clear and detailed images with quick results, allowing radiologists to visualize the size, shape, and location of the tumor.

However, an unenhanced CT scan — meaning those not done without dye or contrast — may not always give a clear diagnosis. That’s because some adrenal adenomas (15–30%) have less fat content, making them harder to distinguish from malignant tumors.

In cases like this, an MRI can also be used as a second-level technique because it provides higher contrast resolution and can distinguish certain tissue types based on their chemical composition.

While ultrasound is useful for distinguishing cystic from solid masses, it has limited accuracy in detecting and characterizing small tumors compared with CT and MRI. Ultrasound is a useful tool for detecting adrenal gland tumors in infants.

The process of diagnosing adrenal gland tumors typically involves a combination of clinical evaluation, imaging tests, and sometimes hormone-level assessments.

Here’s an overview of the steps involved in diagnosing adrenal gland tumors:

  • Clinical evaluation: Diagnosis begins with a thorough medical history and physical examination by a healthcare professional.
  • CT scan: CT scans are the primary imaging modality for evaluating adrenal gland tumors.
  • MRI scans: An MRI may be used as a second-level technique if more detailed information is needed.
  • Nuclear medicine techniques: In certain cases, nuclear medicine techniques may be used to evaluate functioning adrenal lesions, especially if hormonal activity is suspected.
  • PET scans: PET scans help evaluate non-hyperfunctioning adrenal masses and can accurately characterize malignant lesions.
  • Hormone level assessments: Blood tests may be done to measure hormone levels produced by the adrenal glands. Elevated levels of certain hormones, such as cortisol or aldosterone, can indicate a functional adrenal tumor.
  • Biopsy: In some cases, when the imaging results are inconclusive or indicate a potential malignancy, a healthcare professional may perform a biopsy. They will take a small tissue sample from the adrenal tumor for further examination under a microscope to determine its nature.
  • Consultation with specialists: Depending on the findings, patients may be referred to endocrinologists or oncologists for further evaluation and treatment planning.

CT scans are a reliable tool for detecting adrenal gland tumors. They offer high spatial resolution, a quick answer, and the ability to provide important information about the size, location, and characteristics of the tumor.

If you have concerns about adrenal tumors or need further evaluation, reach out to your healthcare professional. Early detection and precise evaluation of adrenal tumors through CT scans can lead to better outcomes and improved quality of life.