What are the NCCN recommendations for the treatment of adrenal incidentaloma?

Updated: Feb 12, 2019
  • Author: Cameron K Tebbi, MD; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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Answer

National Comprehensive Cancer Network (NCCN) guidelines for treatment of adrenal carcinoma include separate recommendations for localized and metastatic disease. [103] Recommendations for localized disease are as follows:

  • Resection of primary tumor and adjacent lymph nodes

  • Open adrenalectomy recommended

  • External-beam radiation therapy and adjuvant mitotane may be considered in patients at high risk for recurrence

NCCN treatment recommendations for metastatic disease are as follows:

  • Observation for clinically indolent disease with imaging and biomarkers (if functional) every 3 months

  • Resection of primary tumor and metastases if >90% removable, particularly if functional

  • Systemic therapy, preferably within a clinical trial


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