Primary Adrenal Malignancy

Adrenal masses are found in 2% to 9% of adults. The vast majority of incidental adrenal lesions tend to be benign adenomas, followed by other benign lesions such as myelolipomas, hematomas, cysts, and granulomatous lesions. Adrenal metastases remain in the differential diagnoses, especially in patients who have history of prior malignancies. Although benign adrenal tumors are frequently encountered, primary malignant adrenal neoplasms such as adrenal cortical carcinoma and malignant pheochromocytoma are relatively rare. Often, these tumors are diagnosed at advanced stages of disease and tend to be associated with poor survival rates. Multimodal imaging including computed tomography, magnetic resonance imaging, and positronemission tomography/computed tomography is useful in the management of these rare primary malignant adrenal tumors.