Adrenal incidentalomas

An adrenal incidentaloma is an adrenal gland mass discovered incidentally during an imaging examination performed for another reason (e.g., a CT scan of the abdomen for back pain). Most of these findings are benign and non-hormone-producing, though some may be functional (hormone-producing) or, rarely, malignant.

What is an adrenal incidentaloma?

  • An unexpected finding of an adrenal gland mass larger than 1 cm.
  • These are most often non-functional benign adenomas.
  • In a smaller percentage of cases, it may be a hormone-secreting tumor or cancer.

What types of tumors could this finding represent?

Following the discovery, two key questions are always evaluated:

  1. Is the tumor hormonally active?
    (e.g., cortisol — Cushing syndrome, aldosterone — Conn syndrome, catecholamines/metanephrines — pheochromocytoma)
  2. Is the tumor potentially malignant?
    (size, appearance, growth over time, and findings on CT, MRI, or PET scans)
  • Hormonal testing — blood and urine tests for cortisol (including the dexamethasone suppression test), aldosterone, renin, and metanephrines.
  • Imaging methods — CT/MRI to assess structure and risk factors (e.g., size over 4 cm, irregular margins).
  • Follow-up — for small, non-functional findings, a repeat imaging examination is recommended after 6–12 months.

Not sure how to proceed?

Every health problem has its own context. If you are hesitant about what is best for you, arrange a consultation. Our doctors will walk you through the situation and recommend a course of action that makes sense — professionally, sensitively, without unnecessary stress.

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When is tumor removal necessary?

Surgical removal is recommended:

  • If the finding is hormonally active
  • If the tumor is larger than 4–5 cm and shows specific characteristics on a CT or MRI scan
  • If the tumor increases in size during monitoring or shows suspicious signs

How is monitoring conducted?

  • For small, inactive findings, we recommend:
    • Hormone testing after 1 year, with the possibility of repeating it once more the following year
    • Follow-up imaging in 6–12 months
    • Long-term follow-up is not always necessary if the finding remains stable

Patient support

Our team at the Adrenal Endocrine Tumor Center offers patients with incidentally discovered findings:

  • Evaluation of all necessary tests
  • Clear recommendations for further steps
  • Explanation of risks and options

Other diseases

Very rare adrenal tumors

Very rare adrenal tumors

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Adrenal tumors in children

Adrenal tumors in children

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Pheochromocytomas and paragangliomas

Pheochromocytomas and paragangliomas

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