Pituitary, adrenal and thyroid incidentalomas

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Abstract
Introduction The use of increasingly sophisticated imaging techniques has produced a new clinical problem: namely the evaluation and management of the serendipitously discovered mass-‘incidentaloma’. In the last 50 years of endocrinology, these lesions have been described mainly in the adrenal and pituitary glands by pathologists on the basis of autopsy series of patients assumed to have been asymptomatic. The current challenge is the investigation of these common lesions which are now more commonly detected during life, to allow not only the correct identification and investigation of those with a hypersecretory syndrome whether it be clinically apparent or subclinical, but also the correct identification of those masses which are malignant and which may therefore produce significant problems in the future. As more experience is gained on the natural history of the true incidentaloma, appropriate follow-up and treatment can be instigated as necessary. The rationale of investigations therefore should be to evaluate most accurately and cost-effectively which patients do not have an incidentaloma, but a lesion that requires further active treatment.

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