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Management of adrenal incidentaloma.
[adrenal incidentaloma]
Improvements
in
medical
imaging
have
resulted
in
the
incidental
discovery
of
many
silent
and
unrecognized
adrenal
tumors
.
The
term
"
adrenal
incidentaloma
"
(
AI
)
is
applied
to
any
adrenal
mass
≥
1
cm
in
its
longest
axis
that
is
discovered
incidentally
during
abdominal
imaging
that
was
not
performed
to
specifically
evaluate
adrenal
pathology
.
These
incidentalomas
may
be
either
secretory
or
non-secretory
,
benign
or
malignant
.
Distinctive
characteristics
of
these
lesions
must
be
determined
by
the
clinician
to
determine
appropriate
management
.
Such
distinctions
are
based
on
laboratory
findings
and
imaging
,
principally
CT
with
and
without
contrast
injection
.
Investigations
must
be
carefully
chosen
to
avoid
ordering
unnecessary
and
expensive
tests
for
too
many
patients
while
,
at
the
same
time
,
avoiding
the
risk
of
failing
to
diagnose
a
secreting
malignant
or
tumor
.
These
examinations
will
determine
patient
care
:
surgery
or
surveillance
.
When
simple
surveillance
is
chosen
,
specific
criteria
must
be
met
with
regard
to
diagnostic
modalities
(
clinical
,
imaging
,
laboratory
testing
)
and
its
duration
.