Skip to main content

Incidentaloma

  • Chapter
  • First Online:
Endocrine Surgery

Part of the book series: Springer Specialist Surgery Series ((SPECIALIST))

  • 1716 Accesses

Historically the adrenal tumor discovered incidentally, usually during an imaging procedure (CT, MRI, ultrasound) for symptoms unrelated to adrenal disease (e.g., back pain), is called an incidentaloma [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Copeland PM. The incidentally discovered adrenal mass. Ann Surg. 1984;199:116–122.

    Article  PubMed  CAS  Google Scholar 

  2. Linos D. Adrenaloma: a better term than incidentaloma. Surgery. 1989;105:456.

    PubMed  CAS  Google Scholar 

  3. Grumbach M, Biller B, Braunstein G, et al. Management of the clinically inapparent adrenal mass (“incidentaloma”). Ann Intern Med. 2003;138(5):424–29.

    PubMed  Google Scholar 

  4. Young AE, Smellie WD. The adrenal glands in endocrine surgery, 2nd ed. In: Farndon JR, editor. London: WB Saunders; 2001. 123–4.

    Google Scholar 

  5. Ross NS, Aron DC. Hormonal evaluation of the patient with an incidentally discovered adrenal mass. N Engl J Med. 1990;323:1401.

    Article  PubMed  CAS  Google Scholar 

  6. Mantero F, Terzolo M, Arnaldi G, Osella G, Masini AM, et al. A survey on adrenal incidentaloma in Italy. J Clin Endocrinol Metab. 2000;85(2):637–44.

    Article  PubMed  CAS  Google Scholar 

  7. Shen WT, Sturgeon C, Duh QY. From incidentaloma to adrenocortical carcinoma: the surgical management of adrenal tumors. J Surg Oncol. 2005;89(3):186–92.

    Article  PubMed  Google Scholar 

  8. Terzolo M, Bossoni S, Ali A, Doga M, Reimondo G, Milani G, Peretti P, Manelli F, Angeli A, Guistina A. Growth hormone (GH) responses to GH-releasing hormone alone or combined with arginine in patients with adrenal incidentaloma: evidence for enhanced somatostatinergic tone. J Clin Endocrinol Metab. 2000;85(3):1310–5.

    Article  PubMed  CAS  Google Scholar 

  9. Terzolo M, Pia A, Ali A, Osella G, et al. Adrenal incidentaloma: a new cause of the metabolic syndrome. J Clin Endocrinol Metab. 2002;87(3):998–1003.

    Article  PubMed  CAS  Google Scholar 

  10. Rossi R, Tauchmanova L, Luciano A, Di Martino M, Battista C, Del Viscovo L, Nuzzo V, Lombardi G. Subclinical Cushing’s syndrome in patients with adrenal incidentaloma: clinical and biochemical features. J Clin Endocrinol Metab. 2000;85(4):1440–8.

    Article  PubMed  CAS  Google Scholar 

  11. Midorikawa S, Sanada H, Hashimoto S, Suzuki T, Watanabe T. The improvement of insulin resistance in patients with adrenal incidentaloma by surgical resection. Clinical Endocrinology. 2001;54(6):797–804.

    Article  PubMed  CAS  Google Scholar 

  12. Fernadez-Real JM, Engel WR, Simon R, et al. Study of glucose tolerance in consecutive patients harbouring incidental adrenal tumours: Study Group of Incidental Adrenal Adenoma. Clin Endocrinol (Oxf). 1998;49:53.

    Article  Google Scholar 

  13. Garrapa GGM, Pantanetti P, Arnaldi G, Mantero F, Faloia E. Body composition and metabolic features in women with adrenal incidentaloma or Cushing’s syndrome. J Clin Endocrinol Metab. 2001;86(11):5301–6.

    Article  PubMed  CAS  Google Scholar 

  14. Chiodini I, Torlontano M, Carnevale V, Guglielmi G, Cammisa M, Trischitta V, Scillitani A. Bone loss rate in adrenal incidentalomas: a longtitudinal study. J Clin Endocrinol Metab. 2001;86(11):5337–41.

    Article  PubMed  CAS  Google Scholar 

  15. Young WF. Management approaches to adrenal incidentalomas. A view from Rochester, Minnesota. Endocrinol Metab Clin North Am. 2000;29(1):159–85.

    Article  PubMed  Google Scholar 

  16. Abecassis M, McLoughlin MJ, Langer B, et al. Serendipitous adrenal masses: Prevalence, significance and management. Am J Surg. 1985;149:783.

    Article  PubMed  CAS  Google Scholar 

  17. Herrera MF, Grant CS, van Heerden JA, et al. Incidentally discovered adrenal tumors: an institutional perspective. Surgery. 1991;110:1014.

    PubMed  CAS  Google Scholar 

  18. Caplan RH, Srutt PJ, Wickus G. Subclinical hormone secretion by incidentally discovered adrenal masses. Arch Surg. 1994;129:291

    PubMed  CAS  Google Scholar 

  19. Bovio S, Cataldi A, Reimondo G, Sperone P, Novello S, Berruti A, Borasio P, Fava C, Dogliotti L, Scagliotti GV, Angeli A, Terzolo M. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest. 2006;29(4):298–302.

    PubMed  CAS  Google Scholar 

  20. Guerrieri M, De Sanctis A, Crosta F, Arnaldi G, Boscaro M, Lezoche G, Campagnacci R. Adrenal incidentaloma: surgical update. J Endocrinol Invest. 2007;30(3):200–4.

    PubMed  CAS  Google Scholar 

  21. Belldegrun A, Hussain S, Seltzer SE, et al. Incidentally discovered mass of the adrenal gland. Surg Gynecol Obstet. 1986;163:203.

    PubMed  CAS  Google Scholar 

  22. Mantero F, Masini AM, Opocher G, et al. Adrenal incidentaloma: an overview of hormonal data from the National Italian Study Group. Horm Res. 1997;47:284.

    Article  PubMed  CAS  Google Scholar 

  23. Linos DA, Stylopoulos N, Raptis SA. Adrenaloma: a call for more aggressive management. World J Surg. 1996;20:788.

    Article  PubMed  CAS  Google Scholar 

  24. Bitter DA, Ross DS. Incidentally discovered adrenal masses. Am J Surg. 1989;158:159.

    Article  PubMed  CAS  Google Scholar 

  25. Caplan RH, Kisken WA, Huiras CM. Incidentally discovered adrenal masses. Minn Med. 1991;74:23.

    PubMed  CAS  Google Scholar 

  26. Cajraj H, Young AE. Adrenal incidentaloma. Br J Surg. 1993;80:422.

    Article  Google Scholar 

  27. Geelhoed GW, Druy EM. Management of the adrenal “incidentaloma”. Surgery. 1992;92:866.

    Google Scholar 

  28. Didolkar MS, Bescher RA, Elias EG, et al. Natural history of adrenal cortical carcinoma: a clinicopathologic study of 42 patients. Cancer. 1984;47:2153.

    Article  Google Scholar 

  29. Sutton MG, Sheps SG, Lie JT. Prevalence of clinically unsuspected pheochromocytoma: review of a 50-year autopsy series. Mayo Clin Proc. 1981;56:354.

    PubMed  CAS  Google Scholar 

  30. Proye C, Fossati P, Fontaine P, et al. Dopamine secreting pheochromocytoma: an unrecognised entity? Classification of pheochromocytomas according to their type of secretion. Surgery. 1986;100:1154.

    PubMed  CAS  Google Scholar 

  31. Kebebew E, Siperstein AE, Clark OH, Duh QY. Results of laparoscopic adrenalectomy for suspected and unsuspected malignant adrenal neoplasms. Arch Surg. 2002;137(8): 948–53.

    Article  PubMed  Google Scholar 

  32. Aso Y, Homma Y. A survey on incidental adrenal tumors in Japan. J Urol. 1992;147:1478.

    PubMed  CAS  Google Scholar 

  33. Ito T, Imai T, Kikumori T, Shibata A, Horiba T, Kobayashi H, Sawaki M, Watanabe R, Nakao A, Kiuchi T. Adrenal incidentaloma: review of 197 patients and report of a drug-related false-positive urinary normetanephrine result. Surg Today. 2006;36(11):961–5.

    Article  PubMed  Google Scholar 

  34. Terzolo M, Ali A, Osella G, et al. Prevalence of adrenal carcinoma among incidentally discovered adrenal masses: a retrospective study from 1989 to 1994. Gruppo Piemontese Incidentalomi Surrenalici. Arch Surg. 1997;132:8, 14.

    Google Scholar 

  35. Yamakita N, Saitoh M, Mercado-Asis LB, et al. Asymptomatic adrenal tumor: 38 cases in Japan including seven of our own. Endocrinol Jpn. 1990;37:671.

    PubMed  CAS  Google Scholar 

  36. Fernadez-Real JM, Gonzalbez J, Ricart W. Metabolic abnormalities in patients with adrenal incidentaloma [Letter to the Editor]. J Clin Endocrinol Metab. 2001;86(2): 950–1.

    Article  Google Scholar 

  37. Terzolo M, Osella G, Ali A, et al. Subclinical Cushing’s syndrome in adrenal incidentaloma. Clin Endocrinol (Oxf). 1998;48:89.

    Article  CAS  Google Scholar 

  38. Chidiac RM, Aron DC. Incidentalomas: a disease of modern technology. Endocrinol Metab Clin North Am. 1997;26:233.

    Article  PubMed  CAS  Google Scholar 

  39. Beuschlein F, Borgemeister M, Schirra J, Goke B, Fassnacht M, Arlt W, Allolio B, Reincke M. Oral glucose tolerance testing but not intravenous glucose administration uncovers hyper-responsiveness of hypothalamo-pituitary-adrenal axis in patients with adrenal incidentalomas. Clin Endocrinol. 2000;52(5): 617–23.

    Article  CAS  Google Scholar 

  40. Barzon L, Scaroni C, Sonino N, et al. Incidentally discovered adrenal tumors: endocrine and scintigraphic correlates. J Clin Endocrinol Metab. 1998;83:55.

    Article  PubMed  CAS  Google Scholar 

  41. Ito Y, Obara T, Okamoto T et al. Efficacy of single-voided urine metanephrine and normetahephrine assay for diagnosing pheochromocytoma. World J Surg. 1998;22:684.

    Article  PubMed  CAS  Google Scholar 

  42. Lee JA, Zarnegar R, Shen WT, Kebebew E, Clark OH, Duh QY. Adrenal incidentaloma, borderline elevations of urine or plasma metanephrine levels, and the “subclinical” pheochromocytoma. Arch Surg. 2007;142(9):870–4.

    Article  PubMed  CAS  Google Scholar 

  43. Linos DA. Management Approaches to adrenal incidentalomas (adrenalomas). A view from Athens, Greece. Endocrinol Metab Clin North Am. 2000;29(1):141–57.

    Article  PubMed  CAS  Google Scholar 

  44. Gordon RD, Ziesak MD, Tunny TJ, et al. Evidence that primary aldosteronism may not be uncommon: 12% incidence among antihypertensive drug trial volunteers. Clin Exp Pharmacol Physiol. 1993;20:296.

    Article  PubMed  CAS  Google Scholar 

  45. Gordon R, Stowasser M, Rutherford J. Primary Aldosteronism: are we diagnosing and operating on too few patients? World J Surgery. 2001;25:941–7.

    Article  CAS  Google Scholar 

  46. Mansmann G, Lau J, Balk E, Rothberg M, Miyachi Y, Bornstein SR. The clinically inapparent adrenal mass: update in diagnosis and management. Endocr Rev. 2004;25(2):309–40.

    Article  PubMed  Google Scholar 

  47. Schteingart DE. Management approaches to adrenal incidentalomas. A view from Ann Arbour, Michigan. Endocrinol and Metab Clin North Am. 2000;29(1):127–39.

    Article  CAS  Google Scholar 

  48. Linos DA, Avlonitis VS, Iliadis K. Laparoscopic resection of solitary adrenal metastasis from lung carcinoma: a case report. J Soc Laparoendoscopic Surg. 1998;2:291.

    CAS  Google Scholar 

  49. Linos DA, Stylopoulos N. How accurate is computed tomography in predicting the real size of adrenal tumors? Arch Surg. 1997;132:740.

    PubMed  CAS  Google Scholar 

  50. Fajardo R, Montalvo J, Velázquez D, Arch J, Bezaury P, Gamino R, Herrera MF. Correlation between radiologic and pathologic dimensions of adrenal masses. World J Surg. 2004;28(5):494–7.

    Article  PubMed  Google Scholar 

  51. Yun M, Kim W, Alnafisi N, Lacorte L, Jang S, Alavi A. 18 F-FDG PET in characterizing adrenal lesions detected on CT or MRI. J Nucl Med. 2001;42(12):1795–9.

    PubMed  CAS  Google Scholar 

  52. Frilling A, Tecklenborg K, Weber F, Kühl H, Müller S, Stamatis G, Broelsch C. Importance of adrenal incidentaloma in patients with a history of malignancy. Surgery. 2004;136(6):1289–96.

    Article  PubMed  Google Scholar 

  53. Silverman SG, Mueller PR, Pinkey LP, et al. Predictive value of image-guided adrenal biopsy: Analysis and results of 101 biopsies. Radiology. 1993;187:715.

    PubMed  CAS  Google Scholar 

  54. Wachenfeld C, Beuschlein F, Swermann O, Mora P, Fassnacht M, Allolio B, Reincke M. Discerning malignancy in adrenocortical tumors: are molecular markers useful? Eur J Endocrinology. 2001;145: 335–41.

    Article  CAS  Google Scholar 

  55. Libè R, Fratticci A, Bertherat J. Adrenocortical cancer: pathophysiology and clinical management. Endocr Relat Cancer. 2007;14(1):13–28.

    Article  PubMed  Google Scholar 

  56. Reincke M, Beuschlein F, Slawik M, Borm K. Molecular adrenocortical tumourgenesis. Eur J Clin Invest. 2000;30(53):63–68.

    Article  PubMed  CAS  Google Scholar 

  57. Bülow B, Jansson S, Juhlin C, Steen L, Thorén M, Wahrenberg H, Valdemarsson S, Wängberg B, Ahrén B. Adrenal incidentaloma – follow-up results from a Swedish prospective study. Eur J Endocrinol. 2006;154(3):419–23.

    Article  PubMed  Google Scholar 

  58. Nawar R, Aron D. Adrenal incidentalomas – a continuing management dilemma. Endocr Relat Cancer. 2005;12(3):585–98.

    Article  PubMed  CAS  Google Scholar 

  59. Brunaud L, Kebebew E, Sebag F, Zarnegar R, Clark OH, Duh QY. Observation or laparoscopic adrenalectomy for adrenal incidentaloma? A surgical decision analysis. Med Sci Monit. 2006;12(9):CR355–62.

    PubMed  Google Scholar 

  60. Barzon L, Scaroni C, Sonino, et al. Risk factors and long-term follow-up of adrenal incidentalomas. J Clin Endocrinol Metab. 1999;84:520.

    Article  PubMed  CAS  Google Scholar 

  61. Grossrubatscher E, Vignati F, Posso M, Lohi P. The natural history of incidentally discovered adrenocortical adenomas: a retrospective evaluation. J Endocrinol Invest. 2001;24(11):846–55.

    PubMed  CAS  Google Scholar 

  62. Linos DA. Surgical approach to the adrenal gland. In: van Heerden JA, editor. Common problems in endocrine surgery: recommendations of the experts. St. Louis: Year Book Medical; 1989. 349–55.

    Google Scholar 

  63. Linos DA, Stylopoulos N, Boukis M, et al. Anterior, posterior or laparoscopic approach for the management of adrenal diseases? Am J Surg. 1997;173:120.

    Article  PubMed  CAS  Google Scholar 

  64. Gagner M, Pomp A, Heniford BT, et al. Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures. Ann Surg. 1997;226:238.

    Article  PubMed  CAS  Google Scholar 

  65. Lanzi R, Montorsi F, Losa M, et al. Laparoscopic bilateral adrenalectomy for persistent Cushing’s disease after transsphenoidal surgery. Surgery. 1998;123:144.

    Article  PubMed  CAS  Google Scholar 

  66. Miccoli P, Raffaelli M, Berti P, Materazzi G, Massi M, Bernini G. Adrenal surgery before and after the introduction of laparoscopic adrenalectomy. Br J Surg. 2002;89(6):779–82.

    Article  PubMed  CAS  Google Scholar 

  67. Waltz MK, Alesina PF, Wenger FA, Deligiannis A, Szuczik E, Peterson S, et al. Posterior retroperitoneoscopic adrenalectomy-results of 560 procedures in 520 patients. Surgery. 2006;140(6):943–948.

    Google Scholar 

  68. Walz MK, Gwosdz R, Levin SL, Alesina PF, Suttorp AC, Metz KA, et al. Retroperitoneoscopic adrenalectomy in Conn’s syndrome caused by adrenal adenomas or nodular hyperplasia. World S Surg. 2008;32(5):847–53.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag London Limited

About this chapter

Cite this chapter

Linos, D.A. (2009). Incidentaloma. In: Hubbard, J., Inabnet, W., Lo, CY. (eds) Endocrine Surgery. Springer Specialist Surgery Series. Springer, London. https://doi.org/10.1007/978-1-84628-881-4_31

Download citation

  • DOI: https://doi.org/10.1007/978-1-84628-881-4_31

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-880-7

  • Online ISBN: 978-1-84628-881-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics