An adrenal mass (adrenal incidentaloma) is a lesion of the adrenal gland discovered incidentally on imaging performed for another indication, affecting up to 5% of adults undergoing abdominal imaging. The sonographic differential includes benign adrenal adenoma (the most common, typically small, homogeneous, and hypoechoic), adrenocortical carcinoma (large, heterogeneous, with possible calcifications or necrosis), pheochromocytoma (variable echogenicity, often hyperechoic), myelolipoma (hyperechoic due to fat content), and metastases. Ultrasound characterizes size, echogenicity, and internal structure. Further evaluation with CT adrenal protocol, MRI, or biochemical workup guides management, particularly distinguishing functioning from non-functioning lesions.
Associated Anatomy: Adrenal Glands
Signs & Symptoms: Often asymptomatic (incidentaloma); hypertension, weight gain, hormonal symptoms depending on lesion type
ICD-10: D35.0