Overview
Introduction
An adrenal incidentaloma is an adrenal mass, generally at least 1 cm, found on imaging performed for an unrelated reason.
An adrenal incidentaloma is an adrenal mass, generally at least 1 cm, found on imaging performed for an unrelated reason. It is a finding, not a diagnosis. A lesion that appears benign may still secrete cortisol, while a hormonally silent lesion may still be malignant. The NP keeps two questions moving in parallel: Does the mass produce hormones? and Could it be malignant? Dedicated adrenal imaging answers the first structural question; biochemical testing identifies clinically important hormone excess. The results determine whether the patient needs reassurance, surveillance, endocrine assessment, or prompt review by a multidisciplinary adrenal team. Procedural safety comes before tissue sampling or surgery: an unrecognised pheochromocytoma can release large amounts of catecholamines when manipulated.