Editing Diagnosis and Evaluation of Adrenal Mass (section)

=== Observation ===

* '''<span style="color:#ff0000">Follow-up protocol</span>'''
** '''<span style="color:#ff0000">Myelolipomas, hemorrhages, cysts do not necessarily require further evaluation</span>'''
** '''<span style="color:#ff0000">Non-functioning adenomas, typically < 4 cm, and masses not deemed resectable at initial diagnosis should undergo clinical, hormonal, and radiological surveillance.</span>'''
** No consensus on the proper methodology for follow-up. 
*** '''Surveillance proposed in 2011 CUA Guidelines''':
**** '''Annual clinical and hormonal testing for up to 4 years'''
***** There is no agreement on the best mechanism and frequency for hormonal follow-up. However, it should include the same screening tests used at primary evaluation
**** '''Radiographic assessments (depends on lesion characteristics +/- size)'''
***** Benign appearing masses
****** <1 cm, consider no further follow-up or enrolment in a clinical trial
****** 1-2cm, first follow-up scan at 12 months if clinical picture warrants
****** 2-4cm, first follow-up scan at 12 months
***** Radiologically suspicious lesions not initially removed
****** Any size, first follow-up scan should be at 3-6 months
***** Further imaging follow-up should be directed by clinical judgment. Consider 1-3 assessments with the first 2 years of diagnosis.
**** '''Tumours that remain stable on imaging and annual hormonal evaluation may be considered for discharge from follow-up after 4 years'''