MEN1 with Adrenal Tumour Larger Than 4 cm — When Is Intervention Indicated?

Clinical scenario: A patient with known Multiple endocrine neoplasia type 1 (MEN1) is found to have an adrenal tumour that is larger than 4 cm in diameter, or an adrenal lesion of 1–4 cm with atypical or suspicious radiological features (such as increased Hounsfield units on unenhanced CT), or a lesion of any qualifying size demonstrating measurable growth over a 6-month interval.

Treatment approach

In this scenario, a surgical approach to the adrenal tumour is indicated based on established criteria — size, radiological characteristics, and interval growth are each independent triggers.

The complete criteria thresholds, surgical considerations, and follow-up algorithm are available in the full structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/S2213-8587(25)00119-6

Surgery is recommended for adrenal tumours that are larger than 4 cm in diameter, have atypical or suspicious radiological features (eg, increased Hounsfield units on unenhanced CT) and are 1–4 cm in diameter, or show measurable growth over a 6-month interval.

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