James C. Higgins, DO, CAPT, MC, USN, Ret; Michael J. Arnold, MD, LCDR, MC, USN Family Medicine Department, Naval Hospital, Jacksonville, Fla (Dr. Higgins); Branch Health Clinic Capodichino, Naval Hospital, Naples, Italy (Dr. Arnold) James.Higgins@med.navy.mil
The authors reported no potential conflict of interest relevant to this article.
The opinions and assertions contained herein are the private views of the authors and are not to be construed as official, or as reflecting the views of the US Naval Medical Service or the US Navy at large.
Some guidelines recommend repeat biochemical screening every 3 to 4 years.28,29 AACE guidelines quote a 47% rate of progression over 3 years, but most adrenal masses progress to subclinical Cushing syndrome— a condition of uncertain significance. Subclinical Cushing’s has not been reported to progress to the overt syndrome, and new catecholamine or aldosterone secretion is rare.
Many endocrinologists reduce the frequency of follow-up, depending on the type of adrenal mass (cyst or solid) and its size. AACE suggests CT for adenomas one to 4 cm at 12 months. AACE and NIH recommend hormonal evaluation annually for 4 years. Adrenal cysts or myelolipoma in patients without cancer need no follow-up.29
CORRESPONDENCE James C. Higgins, DO, CAPT, MC, USN, Ret., Naval Hospital Jacksonville, Family Medicine Department, 2080 Child Street, Box 1000, Jacksonville, FL 32214; James.higgins@med.navy.mil
