Editing CUA: Adrenal Mass (2011) (section)

== Follow-up protocol ==

* '''Myelolipomas, hemorrhages, cysts do not necessarily require further evaluation'''
* '''Non-functioning adenomas, typically < 4 cm, and masses not deemed resectable at initial diagnosis should undergo clinical, hormonal, and radiological surveillance'''. Currently, there is no consensus on the proper methodology for follow-up. '''Surveillance proposed in the 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.
** '''Patients with tumours that remain stable on imaging and annual hormonal evaluation may be considered for discharge from follow-up after 4 years'''