Med. praxi. 2026;23(1):28-32 | DOI: 10.36290/med.2025.072
Adrenal incidentalomas: management approach
- Centrum pro výzkum, diagnostiku a léčbu arteriální hypertenze
- III. interní klinika VFN a 1. LF UK v Praze
Incidentalomas are adrenal masses detected on imaging performer for reasons other than suspected adrenal disease. They include a wide spectrum of diagnoses from completely benign and insignificant findings to hormonally active tumors, to possible rare adrenal cortex carcinoma or metastatic disease. The following article contains a basic diagnostic and therapeutic approach considering currently valid European guidelines on management of adrenal incidentalomas. It includes several basic considerations, namely when to think about malignancy and hormonally active form, when to operate and how follow up the patient.
Keywords: adrenal incidentaloma, pheochromocytoma, primary hyperaldosteronism, hypercortisolism, MACS, adenoma, adrenal cortex carcinoma, myelolipoma.
Received: April 8, 2025; Revised: September 18, 2025; Accepted: October 3, 2025; Published: March 3, 2026 Show citation
References
- 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. Jul 20 2023;189(1):G1-G42. doi:10.1093/ejendo/lvad066.
Go to original source... 
Go to PubMed... - Lenders JWM, Kerstens MN, Amar L, et al. Genetics, diagnosis, management and future directions of research of phaeochromocytoma and paraganglioma: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension. J Hypertens. Aug 2020;38(8):1443-1456. doi:10.1097/HJH.0000000000002438. Go to original source... Go to PubMed...
- Mulatero P, Monticone S, Deinum J, et al. Genetics, prevalence, screening and confirmation of primary aldosteronism: a position statement and consensus of the Working Group on Endocrine Hypertension of The European Society of Hypertension. J Hypertens. Oct 2020;38(10):1919-1928. doi:10.1097/HJH.0000000000002510. Go to original source... Go to PubMed...
- Deutschbein T, Reimondo G, Di Dalmazi G, et al. Age-dependent and sex-dependent disparity in mortality in patients with adrenal incidentalomas and autonomous cortisol secretion: an international, retrospective, cohort study. Lancet Diabetes Endocrinol. Jul 2022;10(7):499-508. doi:10.1016/S2213-8587(22)00100-0. Go to original source... Go to PubMed...