Adrenal incidentaloma: A puzzle for clinician.

[adrenal incidentaloma]

An adrenal incidentaloma (AI ) is a puzzle for clinician . In the era of widespread use of CT and MRI , it is becoming an increasingly frequent diagnosis . A detailed list of investigations is ordered to diagnose pathology responsible for AI . Most likely etiology of AI is pathology of AI is benign non-functional adenoma . But looking to the need of specific preoperative preparation for functional adrenal adenoma and importance of early diagnosis in adrenal carcinoma , a complete workup is essential . CT scan of adrenals with contrast gives maximum information about nature of lesion . In general , a lesion more than 6 cm or a functioning AI or tumor signal intensity of more than 10 HU on unenhanced image , significant enhancement on contrast and deenhancement in signal intensity of less than 50 % is suggestive of carcinoma and must be removed . Those AI which are left for observation , also needs regular testing and if found functional on subsequent follow-up or if their size enlarge , they must be removed .