An Adrenal Mass on a Scan: Why Biopsy Is Not the Routine Next Step

If a scan performed for another reason has identified an adrenal mass, you may want a tissue sample before you feel the finding has been explained. Ask the clinician what the assessment needs to establish and why the team recommends the next step.

Myth: a biopsy is the usual way to settle the finding

The leaflet says biopsy generally has no role in evaluating an adrenal mass. It may be considered in special circumstances, such as known malignant disease elsewhere or suspected infection.¹

Ask whether any such circumstance applies to your case. If biopsy has been proposed, request an explanation of the question it would answer and how the result could affect your treatment.

Do not cancel an arranged procedure or substitute your own interpretation of the scan report. Keep the clinician’s explanation with the referral details.

The assessment has two connected questions

ESE describes checking whether the mass produces excess hormones and whether its imaging features suggest it is benign or malignant. Assessment can involve symptoms, examination, blood or urine tests and imaging reviewed by a radiologist.¹

Ask your clinician to separate those questions when explaining the results. You could say: “What have the images clarified, and what do the hormone tests still need to establish?”

Bring the complete report and laboratory results. Ask the clinician to explain unfamiliar terms rather than assigning a risk category to a word or measurement yourself.

Different findings can lead to different plans

Imaging and hormone results guide management. Concerning features or hormone overproduction may need multidisciplinary review. Surgery or observation can be considered according to the findings and individual circumstances.¹

Ask which findings are driving your own recommendation. If several specialists are involved, confirm who coordinates the decision and who will explain it to you.

You could say: “What do we know now, what remains uncertain, and what would change the plan?” If surgery is discussed, ask for a separate explanation of its purpose, alternatives, risks and recovery before deciding with the team.

Put the next step in writing

Confirm which appointments or tests your clinician recommends and who arranges them. Ask how you will hear each result and whom to contact if the expected message does not arrive. Keep any existing appointments unless your team changes the plan.

Tell the clinician about symptoms you want assessed without assuming they all come from the scan finding. Request your own preparation and medicine instructions for any investigation, and ask the team to resolve conflicting directions before making changes.

My Body Changed. Now What? includes a Visit Brief. Use it to collect the scan questions, symptom concerns and next-step details you want discussed. Explore the menopause and hormones playbook.