Prevalence, Diagnosis and Management of Adrenal Incidentalomas

Abstract

Adrenal incidentalomas (AIs) are defined as adrenal masses incidentally discovered on imaging studies performed for unrelated reasons. AIs have become a common finding in clinical practice, particularly with the widespread application of high-resolution imaging techniques. While most AIs are nonfunctioning and benign, some cases can represent a clinical concern due to the risk of malignancy or hormone hyperfunction. The prevalence of AIs varies depending on the source of data and patient selection. The diagnosis of AIs relies on a combination of radiological, biochemical, and clinical evaluation to determine the functional status of the tumor and the potential for malignancy. The management of AIs remains a subject of controversy, with guidelines providing conflicting recommendations on the indications for surgical intervention and follow-up. Most AIs do not require surgical intervention, but appropriate follow-up is essential to detect any potential growth or functional changes. In cases where surgery is indicated, laparoscopic adrenalectomy is the gold standard, with open adrenalectomy reserved for masses highly suspicious for adrenal cortical carcinoma. A multidisciplinary approach involving endocrinologists, radiologists, and surgeons is crucial for optimal management of AIs.