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Adrenal Incidentaloma

An adrenal mass discovered incidentally on imaging performed for another reason.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Adrenal Incidentaloma?

Adrenal incidentaloma is an adrenal mass ≥1 cm detected incidentally on imaging (CT, MRI, ultrasound) performed for indications unrelated to adrenal pathology. Its prevalence on abdominal CT is 4–6% and increases with age.

Two key questions must be answered during evaluation: (1) Is the mass hormone-secreting? (pheochromocytoma, subclinical Cushing, primary hyperaldosteronism), and (2) Is it malignant? (adrenocortical carcinoma, metastasis). Benign adrenal adenoma represents the vast majority of cases.

On imaging, lipid-rich adenoma (Hounsfield units ≤10 HU) appears benign; non-lipid-containing masses and large masses (>4 cm) require more comprehensive evaluation.

Symptoms

Most cases are asymptomatic (incidentally detected)
Pheochromocytoma component: hypertensive episodes, sweating, palpitations
In subclinical Cushing: weight gain, skin changes, hypertension
In hyperaldosteronism: hard-to-control hypertension, low potassium
In large masses, abdominal pain or fullness

Risk Factors

Advanced age
Hypertension and diabetes (Cushing risk)
Known extra-adrenal cancer (metastasis risk)
Family history of adrenal disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • For endocrinology evaluation when an adrenal mass is reported on imaging
  • If hypertension, low potassium or Cushing symptoms are accompanying
  • If the mass is >4 cm or has suspicious imaging features

Treatment Methods

01
Hormonal evaluation: 1 mg DEX suppression test, urine/plasma metanephrines, aldosterone/renin ratio
02
Functional adenoma: surgical or medical treatment depending on the hormone involved
03
Non-functional ≤4 cm benign-appearing: 6–12 months CT follow-up, then intermittent monitoring if no growth
04
Non-functional >4 cm or with suspicious appearance: laparoscopic adrenalectomy
05
When adrenocortical carcinoma is suspected: surgery and oncology evaluation
06
Treatment plan updated if growth or hormone activation develops during follow-up

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.