Evaluation of the Adrenal Mass in Urologic Practice

Adrenal masses are commonly encountered as incidental findings in urologic practice. Many of these lesions do not undergo appropriate testing, likely because guidelines have historically been complex and contradictory. However, the workup for the vast majority of these lesions is actually straightforward. Here we present a practical, guidelines-based approach to the workup of adrenal lesions. We focus on distinguishing between benign, nonhormonally active adenomas (which require no further imaging or intervention) from those which are concerning for malignancy or are hormonally active.