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What Does Detection Of Adrenal Mass In A CT Scan Indicate?

Posted on Mon, 15 Sep 2014

Question: Have adrenal mass, had 24 hr. urine, results Cortisol 11280X, Catecholamines 416, Metanephrines 14962X, what is the normal range? I am 49 yr. old female, have had about 6 UA's done, all show Hematuria

Answered by Dr. Binu Parameswaran Pillai (11 minutes later)

Brief Answer:
Hi

Detailed Answer:
Hello,
Good day.
It is extremely important to know the units of these tests. Could you attach the reports please. That will be very helpful. Besides, what is the size of adrenal mass? Was a CT scan done? What is the HU units given in the ct scan ?
How much is the post contrast enhancement? How much is the contrast retention in delayed phase ??

What symptoms do you have ? Weight gain, palpitations, episodic headache? Severe episodic headache , sweating or flushing??

Sorry, that i am asking too many questions, but these are extremely important to analyse the test results. If possible, please attach the CT scan report, and blood and urine reports to this question

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (22 hours later)

CT scan was done, doctor did not tell me size, but said it was small. Have hypotension, palpitations, CT done was urogram, with 3-D reformatting. UA RBC's ranged 3 to 12, all other on UA was normal. Sorry do not know how to attach reports,

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Hi

Detailed Answer:
Thank you for the reply, You may email the reports to customer care.
If it is difficult, you may type in detail. ( for example, metanephrines: 1492 mg/dl etc) The unit given in the reports and the normal range is important. It varies from country to country and lab to lab. Interpretation is easy if we have full reports
Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (27 hours later)

Will get copy of reports on Thursday with the additional information.

Answered by Dr. Binu Parameswaran Pillai (15 hours later)

Brief Answer:
sure

Detailed Answer:
Please try to include all the relevent reports

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (3 days later)

Cortisol, Free Urine 53.9 (Normal 4.0 - 50.0 MCG/24H)
Creatinine , Urine- 1.50 (0.63- 2.50 G/24H)
Epinephrine - 7 (2-24 mcg/24H)
Norepinephrine 34 (15-100 mcg/24H)
Calculated Total (E+) 41 (26-121 mcg/24H)
Metanephrine 93 (58 - 203mcg/24H)
Normetanephrine 249 (88-649 mcg/24H)
Still waiting for the Cortisol and Aldosterone levels

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Hi

Detailed Answer:
All of them looks good. Do you have hypertension? If not, not to worry.

I guess, the adrenal mass showed up on a CT scan done for hematuria. This is called as incidentaloma. Since the hormone profilr is normal, do not worry. If the nodule is more than 4 cm, then surgery may be needed Otherwise, a rpt scan after an year woud do to compare the size.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (2 hours later)

Do not have hypertension, but I have hypotension and palpatations

Answered by Dr. Binu Parameswaran Pillai (6 hours later)

Brief Answer:
Hi

Detailed Answer:
Good day.

Catecholamine producing adrena tumours are known to cause episodic low blood pressure due to change in blood volume. But the commonest presentation is hypertension. Palpitation is often associated with this. Your available hormones are normal. You may discuss with your doctor about doing a urine VMA, Dopamine, Medroxytyramine tests. These are products of rare cateholamine producing masses. If that too is normal, and if you still have symptoms, it may be worthwhile repeating the tests ( i know it can be expensive to repeat, but i have seen alteast 2-3 cases where on one occasion results were negative and when repeated it came positive).

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (3 days later)

Will send Aldosterone and Cortisol results as soon as I get them

Answered by Dr. Binu Parameswaran Pillai (14 minutes later)

Brief Answer:
Sure

Detailed Answer:
.Please upload the reports as soon as available

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar