Adrenal: incidentaloma: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Adrenal: incidentaloma

Sample item

A CT performed for renal colic in a 55-year-old man shows a homogeneous 3 cm right adrenal mass with an unenhanced attenuation of 6 Hounsfield units. Which interpretation is correct?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. A benign lipid-rich adenoma

An unenhanced attenuation under 10 HU indicates intracellular lipid and is highly specific for a benign adenoma. All incidentalomas still need a hormonal screen, including a dexamethasone suppression test, and metanephrines if attenuation is above 10 HU. Malignant masses are usually heterogeneous, larger than 4 cm and of higher attenuation.

Option by option

  • A. Phaeochromocytoma, which excludes further tests

    Phaeochromocytomas are typically over 10 HU and enhance avidly.

  • B. Adrenal metastasis

    Metastases are lipid-poor and have higher attenuation.

  • C. Adrenocortical carcinoma needing urgent resection

    Carcinoma is heterogeneous and of higher attenuation, usually over 4 cm.

  • D. A benign lipid-rich adenoma (correct)

    Correct. Low attenuation reflects lipid content and is typical of an adenoma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, A benign lipid-rich adenoma. An unenhanced attenuation under 10 HU indicates intracellular lipid and is highly specific for a benign adenoma.

Why is "Phaeochromocytoma, which excludes further tests" not the answer?

Phaeochromocytomas are typically over 10 HU and enhance avidly.

Why is "Adrenal metastasis" not the answer?

Metastases are lipid-poor and have higher attenuation.

Why is "Adrenocortical carcinoma needing urgent resection" not the answer?

Carcinoma is heterogeneous and of higher attenuation, usually over 4 cm.

What concept does this question test?

It tests Adrenal: incidentaloma in General Surgery. All incidentalomas still need a hormonal screen, including a dexamethasone suppression test, and metanephrines if attenuation is above 10 HU. Malignant masses are usually heterogeneous, larger than 4 cm and of higher attenuation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Adrenal: incidentaloma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.