title: Current status and controversies in adrenal incidentalomas.
abstract: Adrenal incidentalomas (AI) are serendipitously discovered lesions during abdominal imaging studies that need to be investigated for evidence of hormonal hypersecretion and/or malignancy. Because imaging modalities can reliably identify lesions that carry a high risk of malignancy, we focus on the identification of hypersecretory lesions and those with subclinical activity, particularly Cushing syndrome. Because diverse diagnostic tests and cut-offs are employed, the prevalence of hypersecretory AI varies widely, and there is controversy regarding their long-term sequelae. In this article we provide information regarding current radiological means to define the nature of AI, and the most appropriate biochemical tests for delineating hypersecretory states. We also discuss the duration and intensity of AI follow-up as well as the identification of AI that require specific therapeutic intervention.
authors.affiliation: Department of Pathophysiology, National University of Athens, Mikras Asias 75, 11527, Greece. gkaltsas@endo.gr
authors.forename: Gregory
authors.initials: G
authors.lastname: Kaltsas
authors.forename: Alexandra
authors.initials: A
authors.lastname: Chrisoulidou
authors.forename: Georgios
authors.initials: G
authors.lastname: Piaditis
authors.forename: Eva
authors.initials: E
authors.lastname: Kassi
authors.forename: George
authors.initials: G
authors.lastname: Chrousos
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D018246:Adrenocortical Adenoma / Q000175:diagnosis; D003480:Cushing Syndrome / Q000175:diagnosis; D003907:Dexamethasone; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D033162:Incidental Findings; D024821:Metabolic Syndrome / Q000150:complications; D014057:Tomography, X-Ray Computed
chemical_list: D003907:Dexamethasone; D006854:Hydrocortisone