the Management of Adrenal Lesions

Adrenal incidentalomas are adrenal masses detected on imaging performed for reasons other than suspected adrenal disease. In most cases, adrenal incidentalomas are nonfunctioning adrenocortical adenomas but may also require therapeutic intervention including that for adrenocortical carcinoma, pheochromocytoma, hormone-producing adenoma, or metastases, ⁽¹⁾.
In recent years, several studies have investigated steroid profiling as a tool to discriminate benign from malignant adrenal tumors, ⁽²⁾.
For the differentiation of malignant from benign adrenal tumors there are still 3 main imaging techniques in mainstream clinical use: CT, MRI, and Pet/CT, ^{(3 &4)}. The conservative treatments for the group of patients ranged from pharmacotherapeutic interventions for comorbidities to watchful waiting only were studied. The quality of evidence from these cohort studies is low to very low, mainly due to confounding and the lack of a standardized protocol, ⁽⁵⁾.
Etiology of adrenal tumors presented as adrenal incidentaloma, is summarized in table 1.
Minimally invasive surgery was comparable to open surgery in most of the studies, ⁽⁶⁾.