ABSTRACT
The majority of coincidental adrenal masses are benign adrenocortical adenomas with a considerable low probability of malignancy. Occasionally, other lesions might present as adrenal incidentalomas. The first step in the investigation of an incidentally discovered adrenal mass is the characterization of its imaging phenotype. Radiological and scintigraphic techniques are able to discriminate between benign and malignant lesions and/or provide insight on the nature of the underlying lesion. The imaging phenotype of the mass, using imaging techniques, determines with much more accuracy the nature of the adrenal lesion. The recommended hormonal evaluation in patients with a coincidental adrenal mass includes testing for catecholamine, aldosterone, and cortisol excess. The majority of coincidental adrenal masses demonstrate an imaging phenotype consistent with a benign adrenocortical adenoma. Adrenal incidentalomas are lesions discovered coincidentally during abdominal imaging for reasons unrelated to adrenal disease. Modern imaging techniques can usually distinguish between benign and malignant lesions.
