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Adrenal Incidentaloma

Adrenal masses incidentally detected 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 refers to adrenal masses larger than 1 cm incidentally detected on abdominal imaging (CT, MRI, US) performed for reasons other than adrenal disease. Frequency increases with age and can rise to 7% in those over 60 years.

Most incidentalomas are benign non-functional adrenocortical adenomas. However, hormone-secreting adenomas (subclinical Cushing, pheochromocytoma, aldosteronoma), adrenal cancer, metastasis, and lesions such as myelolipoma may also be present. Lesion size, imaging features, and hormonal activity determine management.

Two basic questions are answered in evaluation: is the mass functional and is it malignant? Hormonal screening (1 mg overnight dexamethasone suppression test, plasma metanephrines, aldosterone/renin ratio) and diagnostic imaging features (<10 HU, washout >50%) are considered.

Symptoms

Usually asymptomatic
Subclinical Cushing findings
Paroxysmal hypertension (pheochromocytoma)
Hypokalemia and hypertension (aldosteronoma)
Weight loss and flank pain (cancer suspicion)
Mass-related compression symptoms
Metastasis in those with malignancy history
Hirsutism or virilization (rare)

Risk Factors

Being over 60 years old
History of malignancy
Hypertension and diabetes
Family history of endocrine neoplasia
Smoking
Obesity
Frequent imaging for chronic diseases
Genetic syndromes (MEN, VHL)

When to See a Doctor?

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

  • Adrenal mass detected on imaging
  • Hypertension and hypokalemia
  • Paroxysmal palpitations and sweating
  • Weight gain and Cushingoid appearance
  • Unexplained muscle weakness
  • Previously known cancer history

Treatment Methods

01
Hormonal screening tests (in all patients)
02
Pheochromocytoma exclusion mandatory before biopsy
03
Adrenalectomy in functional masses
04
Surgery for masses larger than 4 cm or suspicious
05
Follow-up in benign non-functional masses
06
Oncological approach in malignancy suspicion
07
Laparoscopic adrenalectomy (when possible)
08
Regular hormonal and imaging 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.