Incidentalomas? (Incidental findings found on imaging tests)  What’s the chance…?  Recently 20 systematic reviews of observational studies were combined to show which imaging test/region reports the greatest number of incidental findings?  And, of these findings, what are the chances that the incidental findings were cancer.

flickr.com/ photos/ lynnfriedman/ 8703242835

We, physicians, are often concerned about going on a “fishing expedition” which may not show what we are looking for and instead may show a result which leads to patient anxiety, further testing and possibly overtreatment.

Here are the results of the % of incidental findings found with a specific test

• CT chest 45%
• CT colonoscopy 38%
• cardiac MRI 34%

The rate of the incidentalomas being a cancer was dependent on the part of the body the incidental finding was found

• breast 42%
• ovary 28%
• prostate and colon 10-20%,
• brain < 5%,
• parotid gland < 5%,
• adrenal gland (a small gland found on the top part of each kidney) < 5%.

We all know of people who found malignant “incidentalomas” that are still alive due to the serendipitous finding and prompt treatment.  I also imagine that we know many others who had a scare only to find out after additional testing (or procedures) that it was benign.  We, physicians, are trying to find the important things and not the unimportant ones.  Do no harm, right?!

I hope this helps.