Q: 52-year-old female is admitted to ICU with abdominal pain. CT scan reports described adrenal mass. All of the followings are in favour of benign adrenal mass (incidentaloma) except?

A) Size less than 4 cm in diameter
B) Smooth border
C) Rapid contrast medium washout
D) Tumor calcification
E) Low attenuation value


Answer:  D

A Characteristics of incidentaloma are: size less than 4 cm in diameter, a smooth border, an attenuation value less than 10 Hounsfield unit (HU) on unenhanced CT, and rapid contrast medium washout (more than 50 percent at 10 minutes). On the contrary, mass more than 4 cm in diameter, irregular shape, tumor calcification, a high attenuation value on unenhanced CT and delayed contrast medium washout (less than 50 percent at 10 minutes) are highly suggestive of either adrenal carcinoma or metastases.