CT of adrenal incidentalomas

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Author: Mikael Häggström [notes 1]

Axial slice of CT without contrast, showing an adenoma. It has low attenuation, and well-defined margins.


Adrenal masses discovered incidentally ("incidentalomas") have the following workup by Swedish national guidelines:[1]

Features Workup
Size < 1 cm No radiologic workup needed (but biochemical screening may be indicated if clinical suspicion of being hormonally active)
Size 1 to 4 cm Attenuation ≤10 HU (adenoma)
Attenuation >10 HU Without IV contrast CT after 6 months, then stop if size is unchanged
On contrast CT CT without contrast as either:
  • Within 1 month for attenuation value
  • After 6 months for size control


  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.