Management of the Incidental Adrenal Mass

Context: Incidentally discovered adrenal masses are becoming more common in clinical practice. Objective: To review the management of the incidental adrenal mass, including initial evaluation, surveillance, medical therapy, and surgical therapy. Evidence acquisition: A literature search of English-language publications that included the keywords adrenal incidentaloma and incidental adrenal mass was performed through July 2015 using PubMed. Relevant original articles and guidelines on the management of the incidental adrenal mass were ultimately selected for analysis, with the consensus of all authors. Evidence synthesis: Data from the manuscripts included in this review were synthesized, and findings were categorized into metabolic evaluation, imaging, biopsy, surgical considerations, and follow-up recommendations. Conclusions: Ideally, management of patients with adrenal incidentalomas should involve a multidisciplinary approach with experienced surgeons, radiologists, and endocrinologists to determine whether such lesions are benign or malignant and functional or nonfunctional and/or whether they require surgical resection. Patient summary: Management of patients with adrenal incidentalomas should involve a multidisciplinary approach with surgeons, radiologists, and endocrinologists to determine whether such lesions are benign or malignant and functional or nonfunctional and/or whether they require surgical resection. Management of patients with adrenal incidentalomas should involve a multidisciplinary approach with surgeons, radiologists, and endocrinologists to determining whether such lesions are benign or malignant and functional or nonfunctional. The vast majority of patients who need surgery can be managed with minimally invasive approaches by experienced surgeons.