Table 5.

Differences between benign adrenal cysts, cystic pheochromocytomas, and cystic adrenal malignancies. Data are presented as n (%) or as median (range).

Variable	Benign adrenal cyst$	Cystic pheochromocytoma#	Cystic adrenal malignancy*
n	92	21	7
Mode of discovery, %
Incidental	90	60	86
Abdominal mass effect	10	25	-
Symptoms of hormone excess	0	10	-
Genetic screening	0	5	-
Type B symptoms	-	-	14
Tumor laterality, %	98% Unilateral	100% Unilateral	86% Unilateral
Tumor size, cm	4.8 (0.5–20)	6.4 (3–19)	6.7 (3.6–28)
Unenhanced CT, HU	19 (0–83)
Cystic component		18 (13–30)	19 (14–22)
Solid component		40 (22–50)	38 (28–44)
Contrast enhancement	Rare
Cystic component		No	No
Solid component		Yes	Yes
Heterogeneous appearance, %	10–15	85	100
Calcifications,%	64	15	0
Hormonal			Adrenocortical cancer (n=1): incomplete work up (negative for aldosterone and androgen excess); Adrenal metastases (n=6): not applicable
Overt hormone excess, %	0	100
Mild hormone excess, %	12	0
Hormonally inactive, %	88	0
Management	Conservative; adrenalectomy if symptoms of mass effect	Adrenalectomy after adequate alpha-blockade	Depending on primary etiology (adrenalectomy, ablation, chemotherapy)

Abbreviations used: CT = computed tomography; HU = Hounsfield units

^$Current study

^#Dogra P, Navin PJ, McKenzie TJ, Foster T, Dy B, Lyden M, Young WF, Jr., Bancos I. Clinical, imaging and biochemical presentation of cystic pheochromocytomas. Clin Endocrinol (Oxf). 2022.

^*Unpublished data from the Mayo Clinic Adrenal Database