• TC não contrastada
• Se incerto: TC com contraste, RM, Medicina Nuclear
Estabelecer diagnóstico definitivo e discussão em equipa multidisciplinar
Lesão benigna assintomática não funcionante (Possível) Secreção autónoma de cortisol Excesso hormonal clinicamente significativo ou doença maligna Lesão de características indeterminadas Investigação adicional, vigilância ou cirurgia Sem necessidade de adrenalectomia ou seguimento imagiológico ou hormonal Cirurgia, nomeadamente adrenalectomia laparoscópica sobretudo se diâmetro < 6 cm. Se PSAC ou SAC não associada a comorbilidades atribuíveis ao excesso de cortisol, a cirurgia não é habitualmente recomendada. Se SAC associada a essas comorbilidades, ponderar cirurgia.
Figura 3 - Imagens da TC pulmonar do doente que permitiram identificar os incidentalomas da Suprarrenal.
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