An adrenal incidentaloma is an adrenal mass found in an imaging study performed for other reasons unrelated to adrenal disease and often accompanied by obesity, diabetes, or hypertension. The prevalence and incidence of adrenal incidentaloma increase with age and are also expected to rise due to the rapid development of imaging technology and frequent imaging studies. The Korean Endocrine Society is promoting an appropriate practice guideline to meet the rising incidence of adrenal incidentaloma, in cooperation with the Korean Adrenal Gland and Endocrine Hypertension Study Group. In this paper, we discuss important core issues in managing the patients with adrenal incidentaloma. After evaluating core proposition, we propose the most critical 20 recommendations from the initially organized 47 recommendations by Delphi technique.

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• The improvement of postoperative blood pressure and associated factors in patients with hormone‐negative adrenal adenoma and hypertension
  Jiaxing Sun, Yingchun Dong, Hanbo Wang, Xudong Guo, Ning Suo, Shangjian Li, Xiangbin Ren, Shaobo Jiang
  Journal of Surgical Oncology.2024; 129(6): 1073.     CrossRef
• Clinical features and treatment options for pediatric adrenal incidentalomas: a retrospective single center study
  Xiaojiang Zhu, Saisai Liu, Yimin Yuan, Nannan Gu, Jintong Sha, Yunfei Guo, Yongji Deng
  BMC Pediatrics.2024;[Epub]     CrossRef
• Characterizing incidental mass lesions in abdominal dual-energy CT compared to conventional contrast-enhanced CT
  Jack Junchi Xu, Peter Sommer Ulriksen, Camilla Wium Bjerrum, Michael Patrick Achiam, Timothy Andrew Resch, Lars Lönn, Kristoffer Lindskov Hansen
  Acta Radiologica.2023; 64(3): 945.     CrossRef
• Metastatic Adrenal PEComa: Case Report and Short Review of the Literature
  Enrico Battistella, Luca Pomba, Marica Mirabella, Michele Gregianin, Antonio Scapinello, Marco Volante, Antonio Toniato
  Medicina.2023; 59(1): 149.     CrossRef
• Surgical management and outcomes of spinal metastasis of malignant adrenal tumor: A retrospective study of six cases and literature review
  Xiangzhi Ni, Jing Wang, Jiashi Cao, Kun Zhang, Shuming Hou, Xing Huang, Yuanjin Song, Xin Gao, Jianru Xiao, Tielong Liu
  Frontiers in Oncology.2023;[Epub]     CrossRef
• An adrenal incidentaloma that had appeared to produce dehydroepiandrosterone-sulfate in excess before immunohistochemical study of the tumor
  Toshihide Yamamoto, Takuma Kimura, Yuki Kubo, Shin-ichi Nakatsuka, Hiromasa Harada, Takashi Suzuki, Hironobu Sasano
  Endocrine Journal.2023; 70(1): 43.     CrossRef
• Mortality Not Increased in Patients With Nonfunctional Adrenal Adenomas: A Matched Cohort Study
  Albin Kjellbom, Ola Lindgren, Malin Danielsson, Henrik Olsen, Magnus Löndahl
  The Journal of Clinical Endocrinology & Metabolism.2023; 108(8): e536.     CrossRef
• Construction of a novel clinical nomogram to predict cancer-specific survival in patients with primary malignant adrenal tumors: a large population-based retrospective study
  Mingzhen Li, Xiaoying Duan, Di You, Linlin Liu
  Frontiers in Medicine.2023;[Epub]     CrossRef
• Primary Aldosteronism Prevalence – An Unfolding Story
  Suranut Charoensri, Adina F. Turcu
  Experimental and Clinical Endocrinology & Diabetes.2023; 131(07/08): 394.     CrossRef
• Management of Adrenal Cortical Adenomas: Assessment of Bone Status in Patients with (Non-Functioning) Adrenal Incidentalomas
  Alexandra-Ioana Trandafir, Mihaela Stanciu, Simona Elena Albu, Vasile Razvan Stoian, Irina Ciofu, Cristian Persu, Claudiu Nistor, Mara Carsote
  Journal of Clinical Medicine.2023; 12(13): 4244.     CrossRef
• Clinical manifestations of functionally autonomous cortisol secretion in patients with adrenal masse
  T. R. Chzhen, T. P. Kiseleva
  Ural Medical Journal.2023; 22(3): 13.     CrossRef
• Tumor enlargement in adrenal incidentaloma is related to glaucoma: a new prognostic feature?
  M. Caputo, T. Daffara, A. Ferrero, M. Romanisio, E. Monti, C. Mele, M. Zavattaro, S. Tricca, A. Siani, A. Clemente, C. Palumbo, S. De Cillà, A. Carriero, A. Volpe, P. Marzullo, G. Aimaretti, F. Prodam
  Journal of Endocrinological Investigation.2023; 47(2): 377.     CrossRef
• Adrenal ganglioneuroma: Features and outcomes of cases series
  Pei Li, Rongchang Zhang, Guang Wang, Jiongming Li
  Asian Journal of Surgery.2023; 46(11): 5272.     CrossRef
• Recent Updates on the Management of Adrenal Incidentalomas
  Seung Shin Park, Jung Hee Kim
  Endocrinology and Metabolism.2023; 38(4): 373.     CrossRef
• Adrenal malakoplakia a rare lesion that mimics a neoplasm
  Orión Erenhú Rodríguez González, Jesus Eduardo Osorio, Edgar Iván Bravo Castro
  Urology Case Reports.2023; 51: 102568.     CrossRef
• LC-MS based simultaneous profiling of adrenal hormones of steroids, catecholamines, and metanephrines
  Jongsung Noh, Chaelin Lee, Jung Hee Kim, Seung Woon Myung, Man Ho Choi
  Journal of Lipid Research.2023; 64(11): 100453.     CrossRef
• Incidentaloma adrenal. Del hallazgo casual al diagnóstico definitivo
  Mercedes Retamal Ortíz, Ana Belén Vicario Parada, Elena Vázquez Jarén
  Actualización en Medicina de Familia.2023;[Epub]     CrossRef
• Diagnosis and management of adrenal incidentaloma: use of clinical judgment and evidence in dialog with the patient
  Yusaku Yoshida, Kiyomi Horiuchi, Michio Otsuki, Takahiro Okamoto
  Surgery Today.2023;[Epub]     CrossRef
• Can MDCT Enhancement Patterns Be Helpful in Differentiating Secretory from Non-Functional Adrenal Adenoma?
  Svetlana Kocic, Vladimir Vukomanovic, Aleksandar Djukic, Jovica Saponjski, Dusan Saponjski, Vuk Aleksic, Vesna Ignjatovic, Katarina Vuleta Nedic, Vladan Markovic, Radisa Vojinovic
  Medicina.2023; 60(1): 72.     CrossRef
• Computer-assisted Reporting and Decision Support Increases Compliance with Follow-up Imaging and Hormonal Screening of Adrenal Incidentalomas
  Renata R. Almeida, Bernardo C. Bizzo, Ramandeep Singh, Katherine P. Andriole, Tarik K. Alkasab
  Academic Radiology.2022; 29(2): 236.     CrossRef
• Incidental Adrenal Masses: Adherence to Guidelines and Methods to Improve Initial Follow-Up: A Systematic Review
  Timothy Feeney, Andrea Madiedo, Philip E. Knapp, Avneesh Gupta, David McAneny, Frederick Thurston Drake
  Journal of Surgical Research.2022; 269: 18.     CrossRef
• Incidental Adrenal Lesions May Not Always Require Further Imaging Work-up
  Deborah A. Baumgarten
  Radiology.2022; 302(1): 138.     CrossRef
• Adrenal Nodules Detected at Staging CT in Patients with Resectable Gastric Cancers Have a Low Incidence of Malignancy
  Hae Young Kim, Won Chang, Yoon Jin Lee, Ji Hoon Park, Jungheum Cho, Hee Young Na, Hyungwoo Ahn, Sung Il Hwang, Hak Jong Lee, Young Hoon Kim, Kyoung Ho Lee
  Radiology.2022; 302(1): 129.     CrossRef
• Management of incidental adrenal nodules: a survey of abdominal radiologists conducted by the Society of Abdominal Radiology Disease-Focused Panel on Adrenal Neoplasms
  Michael T. Corwin, Nicola Schieda, Erick M. Remer, Elaine M. Caoili
  Abdominal Radiology.2022; 47(4): 1360.     CrossRef
• Primary hyperaldosteronism: indications for screening
  Novella M. Chikhladze
  Terapevticheskii arkhiv.2022; 94(1): 107.     CrossRef
• Pathophysiological Link between Insulin Resistance and Adrenal Incidentalomas
  Jordan A. Higgs, Alyssa P. Quinn, Kevin D. Seely, Zeke Richards, Shad P. Mortensen, Cody S. Crandall, Amanda E. Brooks
  International Journal of Molecular Sciences.2022; 23(8): 4340.     CrossRef
• Can Radiomics Provide Additional Diagnostic Value for Identifying Adrenal Lipid-Poor Adenomas From Non-Adenomas on Unenhanced CT?
  Binhao Zhang, Huangqi Zhang, Xin Li, Shengze Jin, Jiawen Yang, Wenting Pan, Xue Dong, Jin Chen, Wenbin Ji
  Frontiers in Oncology.2022;[Epub]     CrossRef
• Adrenal Surgery in the Era of Multidisciplinary Endocrine Tumor Boards
  Costanza Chiapponi, Daniel Pinto Dos Santos, Milan Janis Michael Hartmann, Matthias Schmidt, Michael Faust, Roger Wahba, Christiane Josephine Bruns, Anne Maria Schultheis, Hakan Alakus
  Hormone and Metabolic Research.2022; 54(05): 294.     CrossRef
• Optimal and novel imaging of the adrenal glands
  Patrick J. Navin, Michael R. Moynagh
  Current Opinion in Endocrinology, Diabetes & Obesity.2022; 29(3): 253.     CrossRef
• Adrenal Tumors in Young Adults: Case Reports and Literature Review
  Małgorzata Zdrojewska, Emilia Mech-Siebieszuk, Renata Świątkowska-Stodulska, Bartosz Regent, Michał Kunc, Łukasz Zdrojewski, Krzysztof Sworczak
  Medicina.2022; 58(6): 746.     CrossRef
• Incidence of malignancy in adrenal nodules detected on staging CTs of patients with potentially resectable colorectal cancer
  Hae Young Kim, Yoon Jin Lee, Won Chang, Ji Hoon Park, Jungheum Cho, Hyeon Jeong Oh, Young Hoon Kim, Kyoung Ho Lee
  European Radiology.2022; 32(12): 8560.     CrossRef
• Appendiceal Incidentalomas: Prevalence, Radiographic Characteristics, Management, and Outcomes
  Adam Kelly, Stacy O’Connor, Diana Kane, Chiang-Ching Huang, Harveshp Mogal
  Annals of Surgical Oncology.2022; 29(13): 8265.     CrossRef
• Laparoscopic large adrenal mass resection: why we should be more careful?
  Mohsen Varyani, Mahmood Parvin, Hamidreza Akbari Gilani
  African Journal of Urology.2022;[Epub]     CrossRef
• Serum Visfatin/NAMPT as a Potential Risk Predictor for Malignancy of Adrenal Tumors
  Nadia Sawicka-Gutaj, Hanna Komarowska, Dawid Gruszczyński, Aleksandra Derwich, Anna Klimont, Marek Ruchała
  Journal of Clinical Medicine.2022; 11(19): 5563.     CrossRef
• Application of radiomics in adrenal incidentaloma: a literature review
  Cheng Li, Yan Fu, Xiaoping Yi, Xiao Guan, Longfei Liu, Bihong T. Chen
  Discover Oncology.2022;[Epub]     CrossRef
• Hormone-inactive adrenal tumors in clinician’s practice
  T. R. Chzhen, T. P. Kiseleva
  Perm Medical Journal.2022; 39(5): 48.     CrossRef
• The diagnostic value of salivary cortisol and salivary cortisone in patients with suspected hypercortisolism
  Vendela Berndt, Per Dahlqvist, Jennie de Verdier, Henrik Ryberg, Oskar Ragnarsson
  Frontiers in Endocrinology.2022;[Epub]     CrossRef
• The Role of Intraoperative Indocyanine Green (ICG) and Preoperative 3-Dimensional (3D) Reconstruction in Laparoscopic Adrenalectomy: A Propensity Score-matched Analysis
  Giuseppe Palomba, Vincenza Paola Dinuzzi, Francesca Pegoraro, Roberto Ivan Troisi, Roberto Montalti, Giovanni Domenico De Palma, Giovanni Aprea
  Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2022; 32(6): 643.     CrossRef
• The Etiological Profile of Adrenal Incidentalomas
  Fatima-Zahra Lahmamssi, Loubna Saadaoui, Hayat Aynaou, Houda Salhi, Hanan El Ouahabi
  Cureus.2022;[Epub]     CrossRef
• Forty Years Together, New Leap Forward! The 40th Anniversary of the Korean Endocrine Society
  Jong Chul Won, Ki-Hyun Baek
  Endocrinology and Metabolism.2022; 37(6): 851.     CrossRef
• Conduite à tenir face à un fortuitome surrénalien chez le chien ou le chat
  Diane Pichard, Ghita Benckekroun
  Le Nouveau Praticien Vétérinaire canine & féline.2022; 19(82): 40.     CrossRef
• Laparoscopic transperitoneal adrenalectomy: a comparative study of different techniques for vessel sealing
  Luca Cardinali, Edlira Skrami, Elisa Catani, Flavia Carle, Monica Ortenzi, Andrea Balla, Mario Guerrieri
  Surgical Endoscopy.2021; 35(2): 673.     CrossRef
• Epidemiology and Comorbidity of Adrenal Cushing Syndrome: A Nationwide Cohort Study
  Chang Ho Ahn, Jung Hee Kim, Man Young Park, Sang Wan Kim
  The Journal of Clinical Endocrinology & Metabolism.2021; 106(3): e1362.     CrossRef
• Urine steroid profile as a new promising tool for the evaluation of adrenal tumors. Literature review
  Marta Araujo-Castro, Pablo Valderrábano, Héctor F. Escobar-Morreale, Felicia A. Hanzu, Gregori Casals
  Endocrine.2021; 72(1): 40.     CrossRef
• A Rare Neoplasm: Primary Adrenal Leiomyosarcoma
  Jack T. Barnett, Christine W. Liaw, Reza Mehrazin
  Urology.2021; 148: e11.     CrossRef
• Adrenal Ganglioneuroma Presenting as an Incidentaloma in an Adolescent Patient
  Sonia G. Sharma, Steven N. Levine, Xin Gu
  AACE Clinical Case Reports.2021; 7(1): 61.     CrossRef
• Feasibility of Iodine-131 6β-Methyl-Iodo-19 Norcholesterol (NP-59) Scintigraphy to Complement Adrenal Venous Sampling in Management of Primary Aldosteronism: A Case Series
  Jeongmin Lee, Jeonghoon Ha, Sang-Kuon Lee, Hye Lim Park, Sung-Hoon Kim, Dong-Jun Lim, Jung Min Lee, Sang-Ah Chang, Moo Il Kang, Min-Hee Kim
  International Journal of General Medicine.2021; Volume 14: 673.     CrossRef
• Best Achievements in Pituitary and Adrenal Diseases in 2020
  Chang Ho Ahn, Jung Hee Kim
  Endocrinology and Metabolism.2021; 36(1): 51.     CrossRef
• Adrenal surgery: Review of 35 years experience in a single centre
  Enrico Battistella, Stefania Ferrari, Luca Pomba, Antonio Toniato
  Surgical Oncology.2021; 37: 101554.     CrossRef
• Adrenocortical Carcinoma: A Case of Missed Diagnosis
  Yusef Hazimeh, Carlie Sigel, Carsello Carie, Mathew Leinung, Zaynab Khalaf
  Cureus.2021;[Epub]     CrossRef
• Imagerie fonctionnelle en endocrinologie : nouveaux paradigmes à l’horizon 2020
  E. Marchal
  Médecine Nucléaire.2021; 45(3): 158.     CrossRef
• Adrenal Incidentaloma
  Caren G. Solomon, Electron Kebebew
  New England Journal of Medicine.2021; 384(16): 1542.     CrossRef
• Can Hematological Parameters Play a Role in the Differential Diagnosis of Adrenal Tumors?
  Mehmet Gürkan Arıkan, Göktan Altuğ Öz, Nur Gülce İşkan, Necdet Süt, İlkan Yüksel, Ersan Arda
  Uro.2021; 1(2): 39.     CrossRef
• Incidental Adrenal Nodules
  Daniel I. Glazer, Michael T. Corwin, William W. Mayo-Smith
  Radiologic Clinics of North America.2021; 59(4): 591.     CrossRef
• Antioxidant Barrier and Oxidative Damage to Proteins, Lipids, and DNA/RNA in Adrenal Tumor Patients
  Barbara Choromańska, Piotr Myśliwiec, Tomasz Kozłowski, Magdalena Łuba, Piotr Wojskowicz, Jacek Dadan, Hanna Myśliwiec, Katarzyna Choromańska, Anna Gibała, Anna Starzyńska, Małgorzata Żendzian-Piotrowska, Anna Zalewska, Mateusz Maciejczyk, Jos L. Quiles
  Oxidative Medicine and Cellular Longevity.2021; 2021: 1.     CrossRef
• Laparoscopic Retroperitoneoscopic Removal of an Adrenal Hemangioma: a Case Report
  Kristin McCoy, Katherine Howe, Daniel Tershak
  Journal of Endocrine Surgery.2021; 21(3): 70.     CrossRef
• Metabolic Subtyping of Adrenal Tumors: Prospective Multi-Center Cohort Study in Korea
  Eu Jeong Ku, Chaelin Lee, Jaeyoon Shim, Sihoon Lee, Kyoung-Ah Kim, Sang Wan Kim, Yumie Rhee, Hyo-Jeong Kim, Jung Soo Lim, Choon Hee Chung, Sung Wan Chun, Soon-Jib Yoo, Ohk-Hyun Ryu, Ho Chan Cho, A Ram Hong, Chang Ho Ahn, Jung Hee Kim, Man Ho Choi
  Endocrinology and Metabolism.2021; 36(5): 1131.     CrossRef
• Cross-Talk Between Nitrosative Stress, Inflammation and Hypoxia-Inducible Factor in Patients with Adrenal Masses
  Barbara Choromańska, Piotr Myśliwiec, Tomasz Kozłowski, Magdalena Łuba, Piotr Wojskowicz, Jacek Dadan, Hanna Myśliwiec, Katarzyna Choromańska, Katarzyna Makarewicz, Anna Zalewska, Mateusz Maciejczyk
  Journal of Inflammation Research.2021; Volume 14: 6317.     CrossRef
• Cirugía laparoscópica en incidentaloma suprarrenal para el cirujano general: serie de casos
  Martín Adrián Bolívar-Rodríguez, Marcel Antonio Cázarez-Aguilar, Pedro Alejandro Magaña-Zavala, Francisco Magaña-Olivas, José Martín Niebla-Moreno
  Revista Mexicana de Cirugía Endoscópica.2021; 22(1): 8.     CrossRef
• Adrenal adenomas: what to do with them? Review 2
  S. Rybakov
  INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2021; 17(3): 241.     CrossRef
• Is Follow-up of Adrenal Incidentalomas Always Mandatory?
  Giuseppe Reimondo, Alessandra Muller, Elisa Ingargiola, Soraya Puglisi, Massimo Terzolo
  Endocrinology and Metabolism.2020; 35(1): 26.     CrossRef
• Imaging Findings of Primary Adrenal Leiomyosarcoma: A Case Report
  Hye Ran Yoon, Dong Hee Park
  Journal of the Korean Society of Radiology.2020; 81(2): 459.     CrossRef
• WFUMB position paper on the management incidental findings: adrenal incidentaloma
  Christoph F. Dietrich, Jean Michel Correas, Yi Dong, Christian Nolsoe, Susan Campbell Westerway, Christian Jenssen
  Ultrasonography.2020; 39(1): 11.     CrossRef
• A nationwide survey of adrenal incidentalomas in Japan: the first report of clinical and epidemiological features
  Takamasa Ichijo, Hajime Ueshiba, Hajime Nawata, Toshihiko Yanase
  Endocrine Journal.2020; 67(2): 141.     CrossRef
• Mimics, pitfalls, and misdiagnoses of adrenal masses on CT and MRI
  Khaled M. Elsayes, Mohab M. Elmohr, Sanaz Javadi, Christine O. Menias, Erick M. Remer, Ajaykumar C. Morani, Akram M. Shaaban
  Abdominal Radiology.2020; 45(4): 982.     CrossRef
• Adrenal Incidentaloma
  Mark Sherlock, Andrew Scarsbrook, Afroze Abbas, Sheila Fraser, Padiporn Limumpornpetch, Rosemary Dineen, Paul M Stewart
  Endocrine Reviews.2020; 41(6): 775.     CrossRef
• A Web Application for Adrenal Incidentaloma Identification, Tracking, and Management Using Machine Learning
  Wasif Bala, Jackson Steinkamp, Timothy Feeney, Avneesh Gupta, Abhinav Sharma, Jake Kantrowitz, Nicholas Cordella, James Moses, Frederick Thurston Drake
  Applied Clinical Informatics.2020; 11(04): 606.     CrossRef
• Presentation and outcome of patients with an adrenal mass: A retrospective observational study
  Nadeema Rafiq, Tauseef Nabi, SajadAhmad Dar, Shahnawaz Rasool
  Clinical Cancer Investigation Journal.2020; 9(5): 198.     CrossRef
• Evaluation of Functionality and Growth Rates in Adrenal Incidentalomas: Single Center Experience
  Suna AVCI, Yüksel Aslı OZTURKMEN, Sayid ZUHUR, Gulkan OZKAN, Elif GUVEN, Nazan DEMİR, Yuksel ALTUNTAS
  Phoenix Medical Journal.2020; 2(3): 125.     CrossRef
• Percutaneous Adrenal Radiofrequency Ablation: A Short Review for Endocrinologists
  Byung Kwan Park
  Endocrinology and Metabolism.2020; 35(4): 750.     CrossRef
• Autonomous cortisol secretion in adrenal incidentalomas
  Marta Araujo-Castro, Miguel Antonio Sampedro Núñez, Mónica Marazuela
  Endocrine.2019; 64(1): 1.     CrossRef
• Primary adrenal schwannoma: a series of 31 cases emphasizing their clinicopathologic features and favorable prognosis
  Jun Zhou, Dandan Zhang, Wencai Li, Luting Zhou, Haimin Xu, Saifang Zheng, Chaofu Wang
  Endocrine.2019; 65(3): 662.     CrossRef
• Challenging risk factors for right and left laparoscopic adrenalectomy: A single centre experience with 272 cases
  Kadir Omur Gunseren, Mehmet Cagatay Cicek, Hakan Vuruskan, Yakup Kordan, Ismet Yavascaoglu
  International braz j urol.2019; 45(4): 747.     CrossRef
• A case report on 111In chloride bone marrow scintigraphy in management of adrenal myelolipoma
  Tatsuya Yamamoto, Mitsuru Koizumi, Atsushi Kohno, Noboru Numao, Kentaro Inamura
  Medicine.2019; 98(8): e14625.     CrossRef
• PRACTICAL ASPECTS OF LAPAROSCOPIC ADRENALECTOMY IN CHILDREN WITH BENIGN ADRENAL TUMORS
  I. V. Poddubny, R. S. Oganesyan, K. N. Tolstov, M. A. Kareva
  Russian Journal of Pediatric Surgery.2019; 23(5): 248.     CrossRef
• Incidental neuroblastoma with bilateral retinoblastoma: what are the chances?
  Kelsey Roelofs, Furqan Shaikh, William Astle, Brenda L. Gallie, Sameh E. Soliman
  Ophthalmic Genetics.2018; 39(3): 410.     CrossRef
• Surgical Considerations in Subclinical Cushing’s Syndrome. When is it Time to Operate?
  Alexander M. Nixon, C Aggeli, C Tserkezis, GN Zografos
  Hellenic Journal of Surgery.2018; 90(1): 27.     CrossRef
• Adrenal incidentaloma – diagnostic and treating problem – own experience
  Ryszard Pogorzelski, Krzysztof Celejewski, Sadegh Toutounchi, Ewa Krajewska, Tomasz Wołoszko, Małgorzata Szostek, Wawrzyniec Jakuczun, Patryk Fiszer, Małgorzata Legocka, Zbigniew Gałązka
  Open Medicine.2018; 13(1): 281.     CrossRef