[Imaging of adrenal tumors]

Adrenal masses may be discovered incidentally by sonography. Nevertheless, CT is the modality of choice for the detection of adrenal mass when primary or secondary neoplasm is suspected. The distinction between benign and metastatic lesions relies mainly on the relatively high lipid content of most of the adenomas. CT (evaluation of non-enhanced attenuation) and MRI (chemical shift imaging) have comparable performances in the evaluation of lipid content. Lipid-poor adenomas benefit from the evaluation of tumoral wash-out, and, if necessary, CT-guided biopsy. Primary neoplasms are uncommon, reliability of biopsy is poor and surgical resection is generally performed.