Evaluating and managing adrenal incidentalomas

Adrenal masses that are found incidentally should be evaluated with both imaging and hormonal studies. The attenuation coefficient on noncontrast computed tomography (CT), expressed in Hounsfield units (HU), is better than tumor size in differentiating adrenal adenomas and hyperplastic lesions from nonadenomas. All patients should undergo hormonal evaluation for Cushing syndrome and pheochromocytoma. Those with hypertension should also be evaluated for hyperaldosteronism.