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Adrenal Incidentaloma — RACP Paediatrics MCQ

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ModerateEndocrinologyAdrenal IncidentalomaRACP Paediatrics

A 2-year-old child is found to have an incidental adrenal mass on ultrasound. Serum cortisol, aldosterone, and catecholamines are normal. CT shows a well-circumscribed, small adrenal mass with fat density. What is the most likely diagnosis?

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Correct answer: C — Adrenal adenoma (incidentaloma)

Adrenal incidentalomas in children are uncommon but important. A small, well-circumscribed mass with fat density and normal hormonal workup most likely represents a benign adenoma. However, all adrenal masses in children require hormonal assessment (cortisol, catecholamines, aldosterone, sex steroids, DHEAS) and follow-up imaging.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Adrenal Masses