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Adrenal mass


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Adrenal tumour with suspicious features for malignancy and / or > 4 cm
    • Adrenal tumour with evidence that it is functional
      • excess cortisol (Cushing's syndrome)
      • excess aldosterone
      • excess catecholamines (phaeochromocytoma)
      • excess androgens
  • Category 2
    (appointment within 90 calendar days)
    • Adrenal incidentaloma with no suspicious features for malignancy or production of excess cortisol, aldosterone, catecholamines or androgens
  • Category 3
    (appointment within 365 calendar days)
    • No category 3 criteria

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Advise presence of hypertension or hypokalaemia
  • For incidental adrenal lesion: ELFT, plasma free metadrenaline and normetadrenaline, morning (08:00-09:00) ACTH, aldosterone and renin, DHEAs
  • Current and previous CT or other imaging preferred with dedicated adrenal protocol

3. Additional referral information Useful for processing the referral

  • Relevant investigations - any relevant imaging studies
  • If suspicion of Cushing's syndrome, then 1mg dexamethasone suppression test

4. Request

Last updated: 13 June 2023