[Adrenal incidentalomas]

Since the early 1980s, incidentally discovered adrenal masses have become a common clinical problem as a result of the more widespread use of abdominal imaging procedures. Once identified, an adrenal lesion must be characterized as to its functional status and malignant potential. The evaluation of these masses include clinical, hormonal, radiological and scintigraphic data. Optimal treatment of these patients require an agreement between endocrinologist, radiologist and surgeon. The presence of an hypersecretion will prompt a surgical intervention. In the vast majority of cases, the mass will be hormonally nonhypersecretory. Than the possibility of primary or metastatic malignancy must be excluded. The arguments for benign nonhypersecretory mass are mainly a enhanced CT attenuation coefficient of 0 HU or less, a small size (< or = 3 cm of diameter), typical feature of benign mass on CT scan. In the presence of those features non further investigation are necessary, and a reevaluation will be done regularly. We recommended surgery for adrenals at high risk of malignancy: 1. CT attenuation coefficient of more than 10 HU; 2. large (> 5 cm) diameter or increase in size at any reevaluation; 3. picture of intratumoral necrosis, hemorrhage or irregular margins.