Initial Diagnostic Workflow

ACC overview

The first-pass ACC workup is easier to follow when it is split into immediate adrenal-mass triage, staging and referral decisions, and the narrow set of situations where biopsy is considered.¹²³

Clinical Map

Evaluating an Adrenal Mass When ACC Is Possible

This note covers the earliest diagnostic branch point: which imaging and endocrine tests matter immediately when a large or suspicious adrenal mass is found.¹²³

Grouped note: Evaluating an Adrenal Mass When ACC Is Possible

Staging and Referral Triage in Suspected ACC

These articles cover chest staging, metastatic assessment, referral-center pathways, and the threshold for early surgical oncology involvement.¹²³

Grouped note: Staging and Referral Triage in Suspected ACC

When Biopsy Helps or Harms in ACC

This cluster focuses on why biopsy is usually avoided in suspected ACC, plus the exceptions where tissue diagnosis is needed.¹²³

Grouped note: When Biopsy Helps or Harms in ACC

How to Read This Literature

The grouped notes below organize the literature by the questions a clinician faces in the first days of evaluation, not by specialty.¹²³

See Also

• anatomic_imaging
• hormonal_evaluation
• practical_care_model

References

Footnotes

1. Adrenocortical carcinomas and malignant phaeochromocytomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020. PMID: 32861807. Local full text: 32861807.md ↩ ↩² ↩³ ↩⁴ ↩⁵

2. Adrenocortical carcinoma: a practical guide for clinicians. Lancet Diabetes Endocrinol. 2025. PMID: 40086465. Local full text: 40086465.md ↩ ↩² ↩³ ↩⁴ ↩⁵

3. Impact of 18F-FDG PET/CT on the management of adrenocortical carcinoma: analysis of 106 patients. Eur J Nucl Med Mol Imaging. 2014. PMID: 24990404. Local full text: 24990404.md ↩ ↩² ↩³ ↩⁴ ↩⁵