Incidental Adrenal Mass
Walk the decision tree step by step, see it as a flowchart, or view the whole algorithm at once.
ACR IFC 2017·reviewed 2026-07-01
- •Applies to incidentally detected adrenal masses ≥1 cm in patients ≥18 years old. Masses <1 cm generally require no workup.
- •Consider biochemical evaluation to exclude subclinical hyperfunction (cortisol excess, pheochromocytoma; aldosterone if hypertensive) for indeterminate masses and before any resection or biopsy.
- •Suspicious morphology at any size — heterogeneity, necrosis, irregular margins — should prompt workup regardless of the size branch.
Does the mass have diagnostic benign features?
Unenhanced attenuation ≤10 HU (lipid-rich adenoma), macroscopic fat (myelolipoma), an unequivocal simple cyst, or pure hemorrhage with no underlying enhancing mass.
Tip: press 1–2 to choose, Backspace to go back.
Sources
- Mayo-Smith WW, et al. Management of Incidental Adrenal Masses: A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 2017;14(8):1038-1044.source
Educational reference for clinicians — not medical advice. Verify against the primary source before acting on it; guidelines change. Final decisions rest with the interpreting physician and your institution's protocols.