Evaluation of incidental adrenal mass

Last reviewed: 9 Apr 2025
Last updated: 12 Dec 2024

Summary

Differentials

Common

  • Nonsecretory adrenal adenomas
Full details

Uncommon

  • Cushing syndrome
  • Pheochromocytoma
  • Primary hyperaldosteronism
  • Adrenal cysts
  • Adrenal myelolipomas
  • Adrenal hemangiomas
  • Adrenal ganglioneuroma
  • Granulomatous infiltrative adrenal lesions
  • Adrenocortical carcinoma
  • Adrenal metastases
  • Adrenal malignant melanoma
Full details

Contributors

Authors

Benjamin Viglianti, MD, PhD

Associate Professor

Division of Nuclear Medicine

Department of Radiology

University of Michigan

Ann Arbor

MI

Disclosures

BV declares that he has no competing interests.

Mitchel Muhleman, MD

Assistant Professor

Division of Nuclear Medicine

Department of Radiology

University of Michigan

Ann Arbor

MI

Disclosures

MM declares that he has no competing interests.

Daniel Wale, DO

Associate Professor

Division of Nuclear Medicine

Department of Radiology

University of Michigan

Ann Arbor

MI

Disclosures

DW declares that he has no competing interests.

Ka Kit Wong, MBBS

Associate Professor

Division of Nuclear Medicine

Department of Radiology

University of Michigan

Ann Arbor

MI

Disclosures

KKW declares that he has no competing interests.

Acknowledgements

Dr Benjamin Viglianti, Dr Mitchel Muhleman, Dr Daniel Wale, and Dr Ka Kit Wong would like to gratefully acknowledge Dr Milton D. Gross and Dr Anca M. Avram, the previous contributors to this topic.

Disclosures

MDG is an author of references cited in this topic. AMA declares that he has no competing interests.

Peer reviewers

Shehzad Basaria, MD

Assistant Professor

Johns Hopkins University School of Medicine

Baltimore

MD

Disclosures

SB declares that he has no competing interests.

Lawrence S. Kirschner, MD, PhD

Associate Professor of Medicine

Ohio State University

Columbus

OH

Disclosures

LSK declares that he has no competing interests.

References

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Key articles

Grumbach MM, Biller BM, Braunstein GD, et al. Management of the clinically inapparent adrenal mass ("incidentaloma"). Ann Intern Med. 2003 Mar 4;138(5):424-9.Full text  Abstract

Young WF Jr. Clinical practice. The incidentally discovered adrenal mass. N Engl J Med. 2007;356:601-10. Abstract

Fassnacht M, Tsagarakis S, Terzolo M, et al. European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2023 Jul 20;189(1):G1-42.Full text  Abstract

Zeiger MA, Thompson GB, Duh QY, et al. The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas. Endocr Pract. 2009 Jul-Aug;15(suppl 1):1-20.Full text  Abstract

Expert Panel on Urological Imaging., Mody RN, Remer EM, et al. ACR Appropriateness Criteria® Adrenal Mass Evaluation: 2021 Update. J Am Coll Radiol. 2021 Nov;18(11s):S251-S267.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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