Adrenal incidentaloma

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Do I need a biopsy?

One common mistake is to perform a biopsy when an adrenal "incidentaloma" is discovered. This can be disastrous if the tumor is a pheochromocytomaPheochromocytoma - a disease where too much adrenaline is being made by an adrenal tumor.⁹ Adrenal masses should never be biopsied unless a pheochromocytoma has been ruled out with biochemical tests. Even then, a biopsy is rarely helpful or necessary. The main reason to biopsy an adrenal mass is to make a diagnosis of an adrenal metastasis in someone with another type of cancer for whom the physician is deciding between systemic therapy and an operation. An example of this is someone with lung cancer and an adrenal tumor. If the adrenal tumor is a metastatic lung cancer, the patient will likely get chemotherapy and not an operation to remove the lung cancer.