Current status and controversies in adrenal incidentalomas.

[adrenal incidentaloma]

Adrenal incidentalomas (AI ) are serendipitously discovered lesions during abdominal imaging studies that need to be investigated for evidence of hormonal hypersecretion and /or malignancy . Because imaging modalities can reliably identify lesions that carry a high risk of malignancy , we focus on the identification of hypersecretory lesions and those with subclinical activity , particularly Cushing syndrome . Because diverse diagnostic tests and cut-offs are employed , the prevalence of hypersecretory AI varies widely , and there is controversy regarding their long -term sequelae . In this article we provide information regarding current radiological means to define the nature of AI , and the most appropriate biochemical tests for delineating hypersecretory states . We also discuss the duration and intensity of AI follow-up as well as the identification of AI that require specific therapeutic intervention .