Benign Adrenal Adenoma Follow-Up — RACP Adult Medicine MCQ

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ModerateEndocrinologyBenign Adrenal Adenoma Follow-UpRACP Adult Medicine

A 45-year-old woman has a 1.5 cm adrenal incidentaloma (<10 HU, lipid-rich adenoma). All biochemical workup is normal. What is the appropriate follow-up?

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Correct answer: E — No biochemical workup needed

A small (<4 cm), lipid-rich (<10 HU) adrenal adenoma with normal biochemistry does NOT require routine imaging follow-up per the 2016 Endocrine Society guideline update (changed from prior recommendations of serial imaging). Repeat biochemical testing is only needed if new clinical features develop (hypertension, metabolic syndrome). No further workup is needed in this scenario.

Reference: Endocrine Society – 2016 – Adrenal Incidentaloma; ESA 2024