. Author manuscript; available in PMC: 2021 Apr 21.

Published in final edited form as: Endocr Pract. 2020 Dec 14;26(11):1366–1383. doi: 10.4158/DSCR-2020-0567

Table 2.

Diagnostic Evaluation in Patients With Adrenal Mass Suspicions for ACC

Diagnostic Evaluation	Essential for Clinical Care	Non-Essential, but Potentially Informative
Evaluation for Autonomous Adrenal Cortical Hormone Excess	History and Physical Examination Blood Pressure Measurement Serum Potassium 1 mg dexamethasone suppression test and/or 24-h urinary free cortisol Morning ACTH level Aldosterone-to-renin ratio Total testosterone and DHEA-S	Plasma glucose Glycated hemoglobin 24-h urine steroid profiling Androstnedione 11-deoxycortisol 17-beta-estradiol 17-hydroxyprogesterone
Exclusion of Pheochromocytoma	Plasma metanephrines	24-hour urinary fractionated metanephrines
Diagnostic Imaging	Abdominal CT or MRI	FDG-PET
Staging Imaging	Chest CT	FDG-PET

Abbreviations: ACC = adrenocortical carcinoma; ACTH = adrenocorticotropic hormone; CT = computed tomography; DHEA-S = dehydroepiandrosterone sulfate; FDG-PET = fluorodeoxyglucose positron emission tomography; MRI = magnetic resonance imaging.