Ivica Lazúrová
The clinically inapparent adrenal masses, i.e. adrenal incidentalomas, currently represent one of the most prevalent of all tumours in human pathology ever. In abdominal examination the prevalence ranges from 2 to 4.4 % depending on the age of the examined population. With respect to differential diagnostics of adrenal incidentalomas the two questions must be answered: if a tumour is benign or malignant and if it is hormonally active. Considering diagnostics of hormonal activity it is essential to rule out mainly subclinical glucocorticoid overproduction, primary hyperaldosteronism, catecholamine overproduction and finally androgen overproduction. The imaging methods CT and MRI in particular serve for assessing malignancy or benignity. Adrenalectomy is indicated after confirming hormonal overproduction and afunctional lesions associated with CT signs of malignancy, i.e. tumour > 6 cm in size. Currently the criteria for diagnosis of subclinical glucocorticoid overproduction as well as the indications for adrenalectomy are not clear. From this point of view large prospective multicentre studies are needed for assessing cardiovascular morbidity and mortality in patients with subclinical hypercortisolism.