Abstract:

Adrenal tumors originate from the medulla or cortex of the adrenal gland and may be benign or malignant, functional or non-functional. Adrenal tumors discovered during imaging for non-adrenal indications are called incidentalomas and are more common than non-incidental masses. Most incidentalomas are hormonally inactive and benign. Adrenal masses are approximately 30-35 mm in diameter at the time of diagnosis. While masses less than 4 cm are generally considered to be small masses, they are at lower risk for malignancy than adrenal masses larger than 4 cm. An incidentally detected adrenal mass should be investigated for malignancy and functional activity. Hormonal activity or malignancy of the adrenal mass are indications for surgery. Laparoscopic surgery for adrenal adenomas is the gold standard. Evaluation is important to determine the treatment and follow-up process. Although the frequency of benign small adrenal masses increase with age, even if the mass size is <4 cm in young patients, because of their rarity at this age, a closer follow-up is required. The ideal follow-up schedule for these small masses <4 cm in diameter has not been precisely defined. However, clinical guidelines recommend clinical and hormonal follow-up for at least 4 years, and follow-up imaging [computed tomography (CT), magnetic resonance imaging] 6-12-24 months after the first CT. If the size increase in a followed mass is >0.8 cm/year, surgery is recommended, but the malignancy rate is low in these masses.

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