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Quality in Sport

Current guidelines for the management of adrenal incidentalomas in European countries
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Current guidelines for the management of adrenal incidentalomas in European countries

Authors

  • Julia Ząber 5 Military Clinical Hospital with Polyclinic SPZOZ, Wrocławska 1-3, 30-901 Kraków https://orcid.org/0009-0005-2687-566X
  • Zuzanna Wyleciał The University Hospital in Krakow, Macieja Jakubowskiego 2, 30-688 Kraków https://orcid.org/0009-0001-2984-7091
  • Patryk Dąbrowski The University Hospital in Krakow, Macieja Jakubowskiego 2, 30-688 Kraków https://orcid.org/0009-0004-5388-8581
  • Marcelina Guzik The University Hospital in Krakow, Macieja Jakubowskiego 2, 30-688 Kraków https://orcid.org/0009-0001-4882-8494
  • Eliza Pyla District Hospital in Dębica, Krakowska 91, 39-200 Dębica https://orcid.org/0009-0002-3345-1572

DOI:

https://doi.org/10.12775/QS.2025.42.60528

Keywords

incidentaloma, adrenal glands, hormonal activity, malignancy

Abstract

Introduction and purpose:

Adrenal incidentalomas are increasingly detected due to the widespread use of advanced imaging techniques, presenting a growing clinical challenge. These adrenal masses, often discovered unintentionally, necessitate careful evaluation to differentiate between benign and malignant lesions, as well as hormonally active and inactive tumors. Despite a shared clinical concern, the management of adrenal incidentalomas varies across European countries, reflecting differences in healthcare systems, access to resources, and interpretation of evidence-based practices. This article aims to provide an overview of the current guidelines adopted by various European nations, highlighting areas of consensus and divergence, and exploring their implications for clinical practice and patient outcomes.

Materials and methods:

A literature search was conducted by analysing scientific articles published in Google Scholar, PubMed, and UpToDate using keywords included: incidentaloma, adrenal glands, hormonal activity, malignancy. We also searched current recommendations of The Endocrine Society Clinical Practice Guidelines.  

Description of the state of knowledge:

Adrenal incidentalomas are asymptomatic adrenal masses detected incidentally during imaging studies performed for unrelated reasons. The clinical importance of these lesions lies in their potential for hormonal activity and malignancy. This article aims to evaluate the current strategies and guidelines for hormonal assessment in patients with adrenal incidentalomas. A systematic hormonal workup is essential to identify subclinical hormone secretion, particularly autonomous cortisol secretion, pheochromocytoma, and primary aldosteronism.

Conclusion:

Timely and accurate hormonal evaluation is crucial for risk stratification and guiding management decisions, including surveillance or surgical intervention. This assessment is key to preventing potential complications and improving patient outcomes.

References

1. Sherlock M, Scarsbrook A, Abbas A, Fraser S, Limumpornpetch P, Dineen R, Stewart PM. Adrenal Incidentaloma. Endocr Rev. 2020 Dec 1;41(6):775–820. doi: 10.1210/endrev/bnaa008. PMID: 32266384; PMCID: PMC7431180.

2. Fassnacht M, Tsagarakis S, Terzolo M, Tabarin A, Sahdev A, Newell-Price J, Pelsma I, Marina L, Lorenz K, Bancos I, Arlt W, Dekkers OM. European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2023 Jul 20;189(1):G1-G42. doi: 10.1093/ejendo/lvad066. PMID: 37318239.

3. Chatzellis E, Kaltsas G. Adrenal Incidentaloma. 2024 May 28. In: Feingold KR, Ahmed SF, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hofland J, Kalra S, Kaltsas G, Kapoor N, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, Muzumdar R, Purnell J, Rey R, Sahay R, Shah AS, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. PMID: 25905250.

4. Okroj D, Rzepecka A, Kłosowski P, Babińska A, Sworczak K. Review of Diagnostic Modalities for Adrenal Incidentaloma. J Clin Med. 2023 May 29;12(11):3739. doi: 10.3390/jcm12113739. PMID: 37297933; PMCID: PMC10254053.

5. Bernardi S, Calabrò V, Cavallaro M, Lovriha S, Eramo R, Fabris B, de Manzini N, Dobrinja C. Is the Adrenal Incidentaloma Functionally Active? An Approach-To-The-Patient-Based Review. J Clin Med. 2022 Jul 14;11(14):4064. doi: 10.3390/jcm11144064. PMID: 35887828; PMCID: PMC9323753.

6. Voltan G, Boscaro M, Armanini D, Scaroni C, Ceccato F. A multidisciplinary approach to the management of adrenal incidentaloma. Expert Rev Endocrinol Metab. 2021 Jul;16(4):201-212. doi: 10.1080/17446651.2021.1948327. Epub 2021 Jul 9. PMID: 34240680.

7. Szychlińska M, Baranowska-Jurkun A, Matuszewski W, Wołos-Kłosowicz K, Bandurska-Stankiewicz E. Markers of Subclinical Cardiovascular Disease in Patients with Adrenal Incidentaloma. Medicina (Kaunas). 2020 Feb 10;56(2):69. doi: 10.3390/medicina56020069. PMID: 32050625; PMCID: PMC7074127.

8. Łebek-Szatańska A, Januszewicz A, Kołodziejczyk-Kruk S, Kabat M, Śpiewak M, Januszewicz M. How to manage adrenal incidentaloma in a hypertensive patient? Pol Arch Intern Med. 2025 Feb 27;135(2):16949. doi: 10.20452/pamw.16949. Epub 2025 Feb 7. PMID: 39918042.

9. Remde H, Kimpel O, Fassnacht M. Nebennieren-Inzidentalom – Differenzial diagnose und Management [Adrenal incidentaloma - differential diagnosis and management]. Dtsch Med Wochenschr. 2022 Jan;147(3):85-91. German. doi: 10.1055/a-1370-6005. Epub 2022 Jan 31. PMID: 35100640.

10. Ceccato F, Barbot M, Scaroni C, Boscaro M. Frequently asked questions and answers (if any) in patients with adrenal incidentaloma. J Endocrinol Invest. 2021 Dec;44(12):2749-2763. doi: 10.1007/s40618-021-01615-3. Epub 2021 Jun 23. PMID: 34160793; PMCID: PMC8572215.

11. Yoshida Y, Horiuchi K, Otsuki M, Okamoto T. Diagnosis and management of adrenal incidentaloma: use of clinical judgment and evidence in dialog with the patient. Surg Today. 2024 Dec;54(12):1417-1427. doi: 10.1007/s00595-023-02781-y. Epub 2023 Dec 13. PMID: 38091063; PMCID: PMC11582175.

12. Müller A, Ingargiola E, Solitro F, Bollito E, Puglisi S, Terzolo M, Pia A, Reimondo G. May an adrenal incidentaloma change its nature? J Endocrinol Invest. 2020 Sep;43(9):1301-1307. doi: 10.1007/s40618-020-01219-3. Epub 2020 Mar 16. PMID: 32180166.

13. Janiak K, Józwik-Plebanek K, Kamiński G. Recent guidelines for diagnostic and therapeutic management of accidentally detected adrenal tumours (incidentaloma) in adults. Endokrynol Pol. 2024;75(4):385-394. doi: 10.5603/ep.100278. PMID: 39279307.

14. Watari J, Vekaria S, Lin Y, Patel M, Kim H, Kang F, Lubitz S, Beninato T, Laird AM. Radiology report language positively influences adrenal incidentaloma guideline adherence. Am J Surg. 2022 Feb;223(2):231-236. doi: 10.1016/j.amjsurg.2021.06.015. Epub 2021 Jun 29. PMID: 34243951.

15. Hanna FWF, Hancock S, George C, Clark A, Sim J, Issa BG, Powner G, Waldron J, Duff CJ, Lea SC, Golash A, Sathiavageeswaran M, Heald AH, Fryer AA. Adrenal Incidentaloma: Prevalence and Referral Patterns From Routine Practice in a Large UK University Teaching Hospital. J Endocr Soc. 2021 Dec 16;6(1):bvab180. doi: 10.1210/jendso/bvab180. PMID: 34988349; PMCID: PMC8694520.

16. Pelsma ICM, Fassnacht M, Tsagarakis S, Terzolo M, Tabarin A, Sahdev A, Newell-Price J, Marina L, Lorenz K, Bancos I, Arlt W, Dekkers OM. Comorbidities in mild autonomous cortisol secretion and the effect of treatment: systematic review and meta-analysis. Eur J Endocrinol. 2023 Oct 17;189(4):S88-S101. doi: 10.1093/ejendo/lvad134. PMID: 37801655.

17. Sconfienza E, Tetti M, Forestiero V, Veglio F, Mulatero P, Monticone S. Prevalence of Functioning Adrenal Incidentalomas: A Systematic Review and Meta-analysis. J Clin Endocrinol Metab. 2023 Jun 16;108(7):1813-1823. doi: 10.1210/clinem/dgad044. PMID: 36718682.

18. Al-Waeli DK, Mansour AA, Haddad NS. Reliability of adrenal computed tomography in predicting the functionality of adrenal incidentaloma. Niger Postgrad Med J. 2020 Apr-Jun;27(2):101-107. doi: 10.4103/npmj.npmj_156_19. PMID: 32295940.

19. Allahwasaya A, Akhund R, Balachandra S, McLeod C, Lindeman B, Fazendin J, Gillis A, Zmijewski P, Chen H. Adrenal Referral Pattern: Management of Patients With an Adrenal Incidentaloma. J Surg Res. 2024 Oct;302:144-149. doi: 10.1016/j.jss.2024.07.051. Epub 2024 Aug 2. PMID: 39096742; PMCID: PMC11490361.

20. Wang J, Zhu Y, Wang Z, Liu C, Liu S, Li X, Chen R, Zhan Y, Wang S, Zeng X. Hypertension Resolution after Laparoscopic Adrenal Tumor Resection in Patients of Adrenal Incidentaloma with Normal Hormone Levels. Urol Int. 2023;107(2):193-201. doi: 10.1159/000524803. Epub 2022 Jun 7. PMID: 35671712.

Quality in Sport

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Published

2025-06-03

How to Cite

1.
ZĄBER, Julia, WYLECIAŁ, Zuzanna, DĄBROWSKI, Patryk, GUZIK, Marcelina and PYLA, Eliza. Current guidelines for the management of adrenal incidentalomas in European countries. Quality in Sport. Online. 3 June 2025. Vol. 42, p. 60528. [Accessed 7 July 2025]. DOI 10.12775/QS.2025.42.60528.
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Vol. 42 (2025)

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Medical Sciences

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Copyright (c) 2025 Julia Ząber, Zuzanna Wyleciał, Patryk Dąbrowski, Marcelina Guzik, Eliza Pyla

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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