Corticotroph tumor progression speed after adrenalectomy.

Objectives: After bilateral adrenalectomy in Cushing's disease, corticotroph tumor progression occurs in one-third to half of patients. However, progression speed is variable, ranging from slow to rapid. The aim was to explore corticotroph progression speed, its consequences and its risk factors.

The 10 Hounsfield units unenhanced computed tomography attenuation threshold does not apply to cortisol secreting adrenocortical adenomas.

Context: Computed tomography (CT) unenhanced attenuation value of <10 Hounsfield units (HU) has an excellent specificity (98%) to diagnose lipid-rich adrenocortical adenomas (ACAs) with a weaker sensitivity (71%).

Objective: To determine from a routine clinical perspective if unenhanced attenuation value is influenced by cortisol secretion in ACAs.

Design: This was a retrospective study of cases collected between 2009 and 2012.

[Update in adrenal imaging].

Subclinical adrenocortical adenomas are the most frequent cause of adrenal incidentalomas that are present in 5 % of adult abdominal imaging. Pheochromocytomas and adrenocortical carcinomas, less often encountered tumors, should be diagnosed at an early stage. Unenhanced density with computed tomography below 10 Hounsfield Units (HU) is in favor of an adrenocortical adenoma.