Vnitr Lek 2024, 70(5):E9-E15 | DOI: 10.36290/vnl.2024.066

Adrenal incidentalomas

Ivana Ságová^{1, 2}

¹ Endokrinologické oddelenie, Národný endokrinologický a diabetologický ústav Ľubochňa

² 1. interná klinika UN a JLF UK Martin

Adrenal incidentalomas (AI) include all adrenal lesions ≥ 1 cm in diameter found incidentally during radiological examinations indicated for other than adrenal pathologies. Based on hormonal activity, AI are divided into hormonally non-functional and hormone active (functional). Nonfunctional AI and those with mild hormonal secretion can remain asymptomatic. However, AI that exhibit significant hormonal activity often present with characteristic symptoms of Cushing syndrome, primary hyperaldosteronism, or hyperandrogenism. Evaluation of AI requires a comprehensive approach involving hormonal examinations as well as imaging examinations to accurately determine the nature of the tumour. The most common etiology of AI is hormonally inactive adenoma of the adrenal cortex, but others can also be carcinoma of the adrenal cortex, pheochromocytoma, metastatic and infectious lesions, etc. Therapeutic management of AI (adrenalectomy/clinical observation) depends mainly on the nature of the lesion as well as its hormonal activity. The following article is a summary of etiology, clinical manifestations, diagnostic and therapeutic procedures of AI according to revised 2023 European Society of Endocrinology (ESE) guideline.

Keywords: adrenal incidentalomas, clinical symptomatology, diagnosis, etiology, treatment.

Accepted: August 28, 2024; Published: September 4, 2024  Show citation