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'''Adrenal adenomas''' are small (1 – 5 cm), yellow, soft benign [[Adrenal tumour|adrenal tumours]]. Only a small percentage of them are functional (hormone-secreting), while the majority are non-functional.  
<section begin="radiology" />'''Adrenal adenomas''' are small (1 – 5 cm), yellow, soft benign [[Adrenal tumour|adrenal tumours]]. Only a small percentage of them are functional (hormone-secreting), while the majority are non-functional.  


Adrenal tumours are often discovered incidentally on [[CT]] imaging, giving them the nickname '''adrenal incidentaloma'''. In most cases, these incidentalomas are harmless non-functional adrenal adenomas. Incidentalomas are found on 0,3 – 5% of abdominal [[CT]] scans and are therefore quite common.
Adrenal tumours are often discovered incidentally on [[CT]] imaging, giving them the nickname '''adrenal incidentaloma'''. In most cases, these incidentalomas are harmless non-functional adrenal adenomas. Incidentalomas are found on 0,3 – 5% of abdominal [[CT]] scans and are therefore quite common.<section end="radiology" />


These tumours may grow or become malignant, and they may worsen other endocrine diseases like [[diabetes mellitus]], [[osteoporosis]], or [[hypertension]]. For these reasons, the patient must be evaluated for the likelihood for it being malignant and whether it’s hormonally active ([[Cushing syndrome]], [[phaeochromocytoma]], [[aldosteronoma]]).
<section begin="radiology" />
==Evaluation==
==Evaluation==
These tumours may grow or become malignant, and they may worsen other endocrine diseases like [[diabetes mellitus]], [[osteoporosis]], or [[hypertension]]. For these reasons, the patient must be evaluated for the likelihood for it being malignant and whether it’s hormonally active ([[Cushing syndrome]], [[phaeochromocytoma]], [[aldosteronoma]]).
Certain [[CT]] characteristics increase the risk of the incidentaloma being [[adrenal carcinoma]]. Benign findings include small size, low density (< 10 HU) due to containing mostly adipose tissue, smooth border, rapid contrast washout. Malignant findings include irregular shape, inhomogeneous density, and delayed contrast washout. MRI with in-phase and out-phase can also help distinguish it from carcinoma.  
 
<section end="radiology" />
Certain [[CT]] characteristics increase the risk of the incidentaloma being [[adrenal carcinoma]]. Benign findings include small size, smooth border, rapid contrast washout. Malignant findings include irregular shape, inhomogeneous density, and delayed contrast washout.
 
If phaeochromocytoma is suspected, 24-hour urinary metanephrines should be measured. Patients may undergo dexamethasone suppression test to detect subclinical Cushing syndrome.
If phaeochromocytoma is suspected, 24-hour urinary metanephrines should be measured. Patients may undergo dexamethasone suppression test to detect subclinical Cushing syndrome.