Mirica Alexandra, Tilici Dana-Mihaela, Paun Diana Loreta, Arnautu Ana Maria, Nimigean Victor, Paun Sorin
Endocrinologie, CHU Brugmann, 1020 Bruxelles, Belgium.
Doctoral School of "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Biomedicines. 2025 Sep 19;13(9):2298. doi: 10.3390/biomedicines13092298.
The widespread use of advanced imaging techniques has led to a rising incidence of adrenal incidentalomas (AIs), asymptomatic adrenal masses discovered during imaging for non-adrenal-related conditions. AIs represent a diagnostic and therapeutic challenge due to their varied etiology, secretory potential, and potential for malignancy. This review aims to provide a comprehensive overview of the current knowledge on adrenal incidentalomas, focusing on their pathogenesis, diagnostic work-up, imaging features, hormonal evaluation, and evidence-based management, with a special emphasis on autonomous cortisol secretion (ACS). A thorough narrative review of the literature from the past two decades was conducted, synthesizing data from key international guidelines (ESE/ENSAT), observational studies, meta-analyses, and case series regarding the evaluation and treatment of AI. AI represents an increasingly relevant clinical condition requiring a multidisciplinary, personalized approach. Prompt endocrine and radiological evaluation is essential to identify hormonally active or potentially malignant tumors. The complexity of the natural history of AI and the evolving understanding of ACS underline the need for tailored follow-up and management strategies.
先进成像技术的广泛应用导致肾上腺偶发瘤（AI）的发病率不断上升，肾上腺偶发瘤是在针对非肾上腺相关疾病进行成像检查时发现的无症状肾上腺肿块。由于其病因多样、分泌潜能以及恶变可能性，肾上腺偶发瘤带来了诊断和治疗方面的挑战。本综述旨在全面概述目前关于肾上腺偶发瘤的知识，重点关注其发病机制、诊断检查、影像学特征、激素评估以及循证管理，特别强调自主性皮质醇分泌（ACS）。对过去二十年的文献进行了全面的叙述性综述，综合了来自关键国际指南（ESE/ENSAT）、观察性研究、荟萃分析以及关于肾上腺偶发瘤评估和治疗的病例系列的数据。肾上腺偶发瘤是一种越来越重要的临床病症，需要多学科、个性化的方法。及时进行内分泌和放射学评估对于识别有激素活性或潜在恶性肿瘤至关重要。肾上腺偶发瘤自然病史的复杂性以及对自主性皮质醇分泌不断演变的认识凸显了制定个性化随访和管理策略的必要性。
