Diagnostics and treatment of adrenal tumors detected accidentally

Introduction: The adrenal glands are paired and located in the retroperitoneal space, above the upper pole of the kidney. Adrenal tumors depending on the histopathological structure, may be divided into: epithelial, mesenchymal, lymphoid and adrenal medulla tumors. Depending on the etiology, distinguishes between tumors, inflammatory tumors, true adrenal cysts, pseudocysts and parasitic adenomas and proliferative processes. The adrenal incydentaloma is a pathological tissue in the adrenal gland, with a diameter of ≥ 1 cm, diagnosed during diagnostics for reasons other than adrenal pathology. Aim: The work aims to discuss the latest available diagnostic and therapeutic methods of incidentalomas, which are an increasing clinical problem, due to the increasing availability of imaging ultrasonography and computed tomography. Material and methods: The paper was based on the available literature of the subject, magazines and the latest guidelines. Results and discussion: In diagnosing adrenal tumors, imaging diagnostics (ultrasonography, computed tomography, magnetic resonance, positron emission tomography, scintigraphy, fine needle aspiration biopsy), hormonal (ACTH, cortisol, dexamethasone suppression tests, diurnal excretion of free cortisol in urine and/or 17 hydroxycorthoroids, plasma renin activity, aldosterone, dehydroepiandrosterone sulphate, androstenedione, 17-alpha-hydroxyprogesterone, chromogranin A, metanephrins in plasma and excreted in urine and biochemic. Adrenal glands may have hormonal activity: a pheochromocytoma usually produces adrenaline and norepinephrine, and rarely dopamine; adrenocortical tumors that excessive produce cortisol cause ACTH-independent Cushing’s syndrome; adrenal tumors may also secrete excess aldosterone and androgens. Conclusions: Adrenal incydentaloma are common in everyday clinical practice and its treatment is established on the basis of interviews, physical examination, tumor phenotype in computed tomography and tumor hormonal activity