Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPNOGUEIRA, T. M.LIROV, R.CAOILI, E. M.LERARIO, A. M.MILLER, B. S.FRAGOSO, M. C. B. V.DUNNICK, N. R.HAMMER, G. D.ELSE, T.2015-10-262015-10-262015HORMONES & CANCER, v.6, n.4, p.176-181, 20151868-8497https://observatorio.fm.usp.br/handle/OPI/12014Incidentally discovered adrenal masses are common and the clinical evaluation and surveillance aims to diagnose hormone excess and malignancy. Adrenocortical cancer (ACC) is a very rare malignancy. This study aims to define the imaging characteristics of adrenal tumors preceding the diagnosis of ACC. Patients with prior (> 5 months) adrenal tumors (< 6 cm) subsequently diagnosed with ACC were identified in a large registry at a tertiary referral center. Retrospective chart and image review for patient characteristics and initial, interval, and diagnostic imaging characteristics (size, homogeneity, borders, density, growth rate, etc.) was conducted. Twenty patients with a diagnosis of ACC and a prior adrenal tumor were identified among 422 patients with ACC. Of these, 17 patients were initially imaged with CT and 3 with MR. Only 2 of the 20 patients had initial imaging characteristics suggestive of a benign lesion. Of initial tumors, 25 % were < 2 cm in size. Surveillance led to the diagnosis of ACC within 24 months in 50 % of patients. The growth pattern was variable with some lesions showing long-term stability (up to 8 years) in size. In conclusion, antecedent lesions in patients with a diagnosis of ACC are often indeterminate by imaging criteria and can be small. Surveillance over 2 years detected only 50 % of ACCs. Current practice and guidelines are insufficient in diagnosing ACCs. Given the rarity of ACC, the increased risk and health care costs of additional evaluation may not be warranted.engrestrictedAccesscomputed-tomographyf-18-fdg pet/ctcarcinomactincidentalomasmalignancyadenomasriskarticleCopyright SPRINGER10.1007/s12672-015-0225-2OncologyEndocrinology & Metabolism1868-8500