Adrenal incidentaloma.

[adrenal incidentaloma]

Adrenal incidentaloma is a common clinical problem and its prevalence , in radiological studies , comes close to that of autoptic data as a result of imaging technological advances . The diagnostic challenge is to distinguish the majority of benign lesions from other masses , either malignant or hormone secreting , which require further therapy . The imaging evaluation (unenhanced CT and MRI ) can differentiate malignant to benign lesions because the benign lesions have high lipid content . All patients should be tested for hypercortisolism and pheochromocytoma whereas aldosteronism should be tested in hypertensive patients only . The optimal diagnostic management for adrenal incidentaloma is still controversial , and the endocrinologist must devise a cost-effective approach taking into account the extensive endocrine work-up and imaging investigations that may be necessary . A tailored strategy may be based on the selection of patients at increased risk who require a careful and extensive follow-up among the vast majority of patients who require a simplified follow-up .