An adrenal mass discovered in testing for another condition (an ¡°incidentaloma¡±) warrants biochemical tests to detect pheochromocytoma, excess cortisol, and, in a patient with hypertension, primary hyperaldosteronism. Imaging may distinguish benign from malignant lesions. Small nonfunctioning adrenal tumors with low CT attenuation generally do not warrant intervention or long-term follow-up.
Funding and Disclosures
Disclosure forms provided by the author are available with the full text of this article at NEJM.org.
No potential conflict of interest relevant to this article was reported.
I thank Ms. Rebecca Gaw (Stanford University) for her help with drafting and organizing an earlier version of the manuscript, Dr. Ryan L. Brunsing (Department of Radiology, Stanford University) for the analysis of the imaging features, and Drs. Andr¨¦ Lacroix (Centre Hospitalier de l¡¯Universit¨¦ de Montr¨¦al) and Quan-yang Duh (University of California, San Francisco) for their helpful comments on the initial draft of the manuscript.
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