An incidentaloma is a radiological neologism to denote a lesion found incidentally and of dubious clinical significance. Although it can refer to any incidental lesion (e.g. pituitary 3, thyroid 4), it is most often used to denote an incidental adrenal lesion, which is commonly an adrenal adenoma 1. Colloquially, some radiologists use the term interchangeably with adrenal adenoma, although clearly its use in a report would be confusing, and should be avoided. Most incidentalomas are asymptomatic.
If an adrenal adenoma is found incidentally, please refer to the Management of incidental adrenal masses: American College of Radiology white paper.
The likelihood of an incidental adrenal lesion being malignant is most strongly determined by the presence or absence of a malignancy elsewhere. In cases where a malignancy is present up to 27% of incidental adrenal lesions represent adrenal metastases 6.
- 1. Dunnick NR, Korobkin M. Imaging of adrenal incidentalomas: current status. AJR Am J Roentgenol. 2002;179 (3): 559-68. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Roppolo HM, Latchaw RE, Meyer JD et-al. Normal pituitary gland: 1. Macroscopic anatomy-CT correlation. AJNR Am J Neuroradiol. 4 (4): 927-35. AJNR Am J Neuroradiol (abstract) - Pubmed citation
- 3. Reincke M, Allolio B, Saeger W et-al. The 'incidentaloma' of the pituitary gland. Is neurosurgery required? JAMA. 263 (20): 2772-6. doi:10.1001/jama.1990.03440200076026 - Pubmed citation
- 4. Kwak JY, Kim EK, Yun M et-al. Thyroid incidentalomas identified by 18F-FDG PET: sonographic correlation. AJR Am J Roentgenol. 2008;191 (2): 598-603. doi:10.2214/AJR.07.3443 - Pubmed citation
- 5 Choyke PL. Commentary on "Computed tomography in the diagnosis of adrenal disease" and "Nonfunctioning adrenal masses: incidental discovery on computed tomography". AJR Am J Roentgenol. 2009;192 (3): 568-70. doi:10.2214/AJR.08.1718 - Pubmed citation
- 6. Blake MA, Holalkere NS, Boland GW. Imaging techniques for adrenal lesion characterization. Radiol. Clin. North Am. 2008;46 (1): 65-78, vi. doi:10.1016/j.rcl.2008.01.003 - Pubmed citation
- 7. Mayo-Smith WW, Song JH, Boland GL, Francis IR, Israel GM, Mazzaglia PJ, Berland LL, Pandharipande PV. Management of Incidental Adrenal Masses: A White Paper of the ACR Incidental Findings Committee. (2017) Journal of the American College of Radiology : JACR. 14 (8): 1038-1044. doi:10.1016/j.jacr.2017.05.001 - Pubmed