Adrenal Incidentaloma: An Update

Adrenal incidentalomas, which are most often benign adenomas, pose diagnostic challenges due to overlapping imaging appearances between adenomas and other pathologies. Current imaging techniques, such as unenhanced CT and chemical shift MR imaging, reliably identify benign lipid-rich adenomas, while recent studies reveal limitations in CT washout. Recent studies and guidelines have continued to refine diagnostic criteria, emphasizing size, attenuation, and growth patterns, with heterogeneity, growth rate, macroscopic fat, cystic areas, and enhancement providing key diagnostic clues to diagnosis.