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Enlarging hypermetabolic nodule: benign non-functional adrenocortical adenoma
  1. Fady Hannah-Shmouni1,
  2. Georgios Z Papadakis1,2,
  3. Constantine A Stratakis1,
  4. Jenny Blau1
  1. 1Section on Endocrinology and Genetics, National Institute of Child Health and Human Development, Bethesda, Maryland, USA
  2. 2Foundation for Research and Technology Hellas (FORTH), Institute of Computer Science (ICS), Computational Biomedicine Laboratory, Heraklion, Crete, Greece
  1. Correspondence to Dr Fady Hannah-Shmouni, fady.hannah-shmouni{at}

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A 70-year-old woman with controlled type 2 diabetes mellitus and hypertension presented for evaluation of chronic abdominal discomfort. An incidental 3.2×3.5×3 cm left adrenal mass was identified on CT. Physical examination revealed obesity stage 2 without a Cushingoid appearance and controlled hypertension with a regular heart rate. Biochemical evaluations for Cushing syndrome, primary aldosteronism and pheochromocytoma were negative. A 1-year follow-up CT of the adrenal glands with washout showed a larger left-sided adrenal mass, measuring 4.3x3.4x3 cm (figure 1A). The attenuation values of the mass were indeterminate: non-contrast, 15 Hounsfield unit (HU); portal venous, 70 HU; delayed, 42 HU; absolute washout, …

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