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HelpTest ID ACC Adrenal Mass Panel, 24 Hour, Urine
Shipping Instructions
Ship specimens frozen.
Necessary Information
The following information is required. Testing cannot proceed without this information (NA or Not Applicable are not acceptable responses).
-Age at diagnosis (Years, not offered for pediatric patients)
-Gender (Male, Female)
-Mode of discovery (incidental, cancer staging, other)
-Tumor diameter (mm)
-Unenhanced computerized tomography (CT) (Hounsfield units)
-Hormonal excess (Yes = Present, No=Absent)
-Collection duration and 24-hour volume
If information is not provided within 5 days of specimen receipt at MCL, testing may be delayed or canceled.
If not ordering electronically, Adrenal Mass Panel Patient Information is required.
Specimen Required
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Container/Tube: Plastic urine tube
Specimen Volume: 4 mL
Collection Instructions:
1. Collect urine for a full 24 hours (required) and record the total volume.
2. Do not add preservatives. Specimens containing preservatives will be canceled.
3. Entire 24 hour collection must be mixed well prior to aliquoting into a 5 mL plastic tube.
Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.
Forms
Adrenal Mass Panel Patient Information is required if not ordering electronically.
Useful For
Aiding in assessing malignancy in adrenal masses
May aid in improving diagnostic and prognostic prediction and dissect disease mechanisms for the following applications:
-Diagnostic assessment and follow up of adrenal cortical carcinoma (ACC)
-Differential diagnostic assessment of adrenal tumors
-Additional assessment related to Cushing syndrome, mild autonomous cortisol secretion, primary aldosteronism, inborn errors of steroidogenesis, polycystic ovary syndrome
This test is not useful for establishing eligibility for a specific treatment as results must be interpreted in conjunction with the clinical status of the patient.
Testing Algorithm
Testing begins with a clinical risk assessment based on clinical data before integration with biochemical steroid data to assess the probability of a malignant adrenal cortical carcinoma (ACC) or other malignancy (sarcoma, lymphoma, other) as well as the probability of a benign mass (adenoma, myelolipoma, cyst, other).
Clinical data includes age at diagnosis, gender, mode of discovery and hormonal status along with tumor diameter and an unenhanced computerized tomography (CT) scan density measurement of the tumor (in Hounsfield units).
Steroids and their metabolites are extracted, analyzed, quantitated, and reported. Each reported analyte also includes a Z-score. An integrated risk assessment based on clinical data in combination with biochemical steroid data is reported to assess the probability of a malignant ACC or other malignancy as well as the probability of a benign mass.
For more information, see Adrenal Mass Panel Clinical Data Definition of Malignancy Predictors.
Special Instructions
Method Name
Liquid Chromatography-Tandem Mass Spectrometry, High-Resolution Accurate Mass (LC-MS/MS HRAM)
Reporting Name
Adrenal Mass Panel, 24 Hr, USpecimen Type
UrineSpecimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Frozen (preferred) | 90 days | |
| Refrigerated | 14 days |
Reference Values
Note: Due to the wide range of urine steroid metabolite concentrations seen in healthy individuals and their skewed distribution, the reference values are based on the back calculated ± 3SD of log transformed data.
Males 18-49 years:
Androsterone: 182-29,212 mcg/24 hour
Etiocholanolone: 133-23,272 mcg/24 hour
Dehydroepiandrosterone: <5-81,554 mcg/24 hour
16a-OH-Dehydroepiandrosterone: 13-29,945 mcg/24 hour
5-Pregnenetriol: 23-7,328 mcg/24 hour
5-Pregnenediol: 13-2,823 mcg/24 hour
Tetrahydro-11-Corticosterone: 8-1,961 mcg/24 hour
Tetrahydro-11-Deoxycorticosterone: <5-316 mcg/24 hour
Pregnanediol: 12-3,812 mcg/24 hour
17a-OH-Pregnanolone: 15-2,466 mcg/24 hour
Pregnanetriol: 66-9,409 mcg/24 hour
Pregnanetriolone: <5-550 mcg/24 hour
Tetrahydrodeoxycortisol: 7-1520 mcg/24 hour
Cortisol: <5-903 mcg/24 hour
6B-OH-Cortisol: 13-2,303 mcg/24 hour
Tetrahydrocortisol: 152-22,723 mcg/24 hour
5a-Tetrahydrocortisol: 157-24,059 mcg/24 hour
B-Cortol: 30-5,115 mcg/24 hour
11B-OH-Androsterone: 108-11,987 mcg/24 hour
11B-OH-Etiocholanolone: 22-8,312 mcg/24 hour
Cortisone: 12-842 mcg/24 hour
Tetrahydrocortisone: 271-44,355 mcg/24 hour
a-Cortolone: 140-14,885 mcg/24 hour
B-Cortolone: 72-9,740 mcg/24 hour
11-Oxoetiocholanolone: 70-8,446 mcg/24 hour
Males ≥50 years:
Androsterone: 118-25,389 mcg/24 hour
Etiocholanolone: 127-15,640 mcg/24 hour
Dehydroepiandrosterone: 7-4,260 mcg/24 hour
16a-OH-Dehydroepiandrosterone: 11-6,183 mcg/24 hour
5-Pregnenetriol: 24-2,162 mcg/24 hour
5-Pregnenediol: 17-1,296 mcg/24 hour
Tetrahydro-11-Corticosterone: 16-1,674 mcg/24 hour
Tetrahydro-11-Deoxycorticosterone: <5-297 mcg/24 hour
Pregnanediol: 23-1,846 mcg/24 hour
17a-OH-Pregnanolone: 18-1,747 mcg/24 hour
Pregnanetriol: 115-5,432 mcg/24 hour
Pregnanetriolone: 5-221 mcg/24 hour
Tetrahydrodeoxycortisol: 12-1,277 mcg/24 hour
Cortisol: 12-597 mcg/24 hour
6B-OH-Cortisol: 22-2,406 mcg/24 hour
Tetrahydrocortisol: 331-19,009 mcg/24 hour
5a-Tetrahydrocortisol: 155-35,266 mcg/24 hour
B-Cortol: 56-3,541 mcg/24 hour
11B-OH-Androsterone: 142-13,135 mcg/24 hour
11B-OH-Etiocholanolone: 69-6,805 mcg/24 hour
Cortisone: 24-732 mcg/24 hour
Tetrahydrocortisone: 454-34,576 mcg/24 hour
a-Cortolone: 211-17,591 mcg/24 hour
B-Cortolone: 114-8,434 mcg/24 hour
11-Oxoetiocholanolone: 155-7,174 mcg/24 hour
Females 18-49 years:
Androsterone: 90-29,625 mcg/24 hour
Etiocholanolone: 127-24,568 mcg/24 hour
Dehydroepiandrosterone: <5-12,317 mcg/24 hour
16a-OH-Dehydroepiandrosterone: 5-31,248 mcg/24 hour
5-Pregnenetriol: 17-4,166 mcg/24 hour
5-Pregnenediol: 6-2,900 mcg/24 hour
Tetrahydro-11-Corticosterone: 13-1,548 mcg/24 hour
Tetrahydro-11-Deoxycorticosterone: <5-833 mcg/24 hour
Pregnanediol: 8-44,760 mcg/24 hour
17a-OH-Pregnanolone: 7-3,208 mcg/24 hour
Pregnanetriol: 50-9,768 mcg/24 hour
Pregnanetriolone: <5-139 mcg/24 hour
Tetrahydrodeoxycortisol: 7-1,047 mcg/24 hour
Cortisol: 11-642 mcg/24 hour
6B-OH-Cortisol: 22-2,061 mcg/24 hour
Tetrahydrocortisol: 185-16,515 mcg/24 hour
5a-Tetrahydrocortisol: 45-22,591 mcg/24 hour
B-Cortol: 28-4260 mcg/24 hour
11B-OH-Androsterone: 59-12,462 mcg/24 hour
11B-OH-Etiocholanolone: 32-6,354 mcg/24 hour
Cortisone: 19-749 mcg/24 hour
Tetrahydrocortisone: 262-32,461 mcg/24 hour
a-Cortolone: 207-13,931 mcg/24 hour
B-Cortolone: 63-7,489 mcg/24 hour
11-Oxoetiocholanolone: 63-7,449 mcg/24 hour
Females ≥50 years:
Androsterone: 32-10,134 mcg/24 hour
Etiocholanolone: 52-10,946 mcg/24 hour
Dehydroepiandrosterone: <5-10,046 mcg/24 hour
16a-OH-Dehydroepiandrosterone: <5-9,982 mcg/24 hour
5-Pregnenetriol: 10-1,901 mcg/24 hour
5-Pregnenediol: <5-2,732 mcg/24 hour
Tetrahydro-11-Corticosterone: 14-1,229 mcg/24 hour
Tetrahydro-11-Deoxycorticosterone: <5-123 mcg/24 hour
Pregnanediol: 8-2,138 mcg/24 hour
17a-OH-Pregnanolone: <5-571 mcg/24 hour
Pregnanetriol: 26-3,444 mcg/24 hour
Pregnanetriolone: <5-348 mcg/24 hour
Tetrahydrodeoxycortisol: 8-801 mcg/24 hour
Cortisol: 9-336 mcg/24 hour
6B-OH-Cortisol: 25-1,365 mcg/24 hour
Tetrahydrocortisol: 237-14,050 mcg/24 hour
5a-Tetrahydrocortisol: 92-12,604 mcg/24 hour
B-Cortol: 29-3289 mcg/24 hour
11B-OH-Androsterone: 86-9,280 mcg/24 hour
11B-OH-Etiocholanolone: 40-7,002 mcg/24 hour
Cortisone: 15-555 mcg/24 hour
Tetrahydrocortisone: 359-24,320 mcg/24 hour
a-Cortolone: 125-17,472 mcg/24 hour
B-Cortolone: 82-5,784 mcg/24 hour
11-Oxoetiocholanolone: 78-6,571 mcg/24 hour
Reference values have not been established for patients who are younger than 18 years of age.
Day(s) Performed
Monday
Report Available
7 to 17 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
0015M
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ACC | Adrenal Mass Panel, 24 Hr, U | 95556-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 607276 | ACC - Clinical Risk | 95787-8 |
| 607277 | Other Malignancy - Clinical Risk | 95788-6 |
| 607278 | Benign Mass - Clinical Risk | 95789-4 |
| 607279 | ACC - Integrated Risk | 95790-2 |
| 607280 | Other Malignancy - Integrated Risk | 95791-0 |
| 607281 | Benign Mass - Integrated Risk | 95792-8 |
| 607282 | Interpretation | 73884-9 |
| 607333 | Comment | 77202-0 |
| AC1AG | Age at Diagnosis | 63932-8 |
| AC2GD | Gender | 76691-5 |
| AC3MD | Mode of Discovery | 95557-5 |
| AC4TZ | Tumor Diameter (mm) | 21889-1 |
| AC5HX | Unenhanced CT (Hounsfield Units) | 95558-3 |
| AC6HM | Hormonal Excess | 95559-1 |
| TM66 | Collection Duration | 13362-9 |
| VL66 | Urine Volume | 3167-4 |
| 607283 | Androsterone | 6705-8 |
| 607284 | Androsterone Z-score | 95560-9 |
| 607285 | Etiocholanolone | 2268-1 |
| 607286 | Etiocholanolone Z-score | 95561-7 |
| 607287 | Dehydroepiandrosterone | 13612-7 |
| 607288 | Dehydroepiandrosterone Z-score | 95562-5 |
| 607289 | 16a-OH-Dehydroepiandrosterone | 95563-3 |
| 607290 | 16a-OH-DHEA Z-score | 95564-1 |
| 607291 | 5-Pregnenetriol | 95565-8 |
| 607292 | 5-Pregnenetriol Z-score | 95566-6 |
| 607293 | 5-Pregnenediol | 95567-4 |
| 607294 | 5-Pregnenediol Z-score | 95568-2 |
| 607295 | Tetrahydro-11-Corticosterone | 95569-0 |
| 607296 | TH-11-Corticosterone Z-score | 95570-8 |
| 607297 | Tetrahydro-11-Deoxycorticosterone | 95571-6 |
| 607298 | TH-11-Deoxycorticosterone Z-score | 95572-4 |
| 607299 | Pregnanediol | 2834-0 |
| 607300 | Pregnanediol Z-score | 95573-2 |
| 607301 | 17a-OH-Pregnanolone | 95574-0 |
| 607302 | 17a-OH-Pregnanolone Z-score | 95575-7 |
| 607303 | Pregnanetriol | 2836-5 |
| 607304 | Pregnanetriol Z-score | 95576-5 |
| 607305 | Pregnanetriolone | 50643-6 |
| 607306 | Pregnanetriolone Z-score | 95577-3 |
| 607307 | Tetrahydrodeoxycortisol | 2996-7 |
| 607308 | Tetrahydrodeoxycortisol Z-score | 95578-1 |
| 607309 | Cortisol | 14158-0 |
| 607310 | Cortisol Z-score | 95579-9 |
| 607311 | 6B-OH-Cortisol | 13611-9 |
| 607312 | 6B-OH-Cortisol Z-score | 95580-7 |
| 607313 | Tetrahydrocortisol | 2995-9 |
| 607314 | Tetrahydrocortisol Z-score | 95581-5 |
| 607315 | 5a-Tetrahydrocortisol | 21044-3 |
| 607316 | 5a-Tetrahydrocortisol Z-score | 95582-3 |
| 607317 | B-Cortol | 53634-2 |
| 607318 | B-Cortol Z-score | 95583-1 |
| 607319 | 11B-OH-Androsterone | 6701-7 |
| 607320 | 11B-OH-Androsterone Z-score | 95584-9 |
| 607321 | 11B-OH-Etiocholanolone | 6700-9 |
| 607322 | 11B-OH-Etiocholanolone Z-score | 95585-6 |
| 607323 | Cortisone | 14044-2 |
| 607324 | Cortisone Z-score | 95586-4 |
| 607325 | Tetrahydrocortisone | 16116-6 |
| 607326 | Tetrahydrocortisone Z-score | 95587-2 |
| 607327 | a-Cortolone | 55906-2 |
| 607328 | a-Cortolone Z-score | 95588-0 |
| 607329 | B-Cortolone | 95589-8 |
| 607330 | B-Cortolone Z-score | 95590-6 |
| 607331 | 11-Oxoetiocholanolone | 6703-3 |
| 607332 | 11-Oxoetiocholanolone Z-score | 95591-4 |