Adrenal decision support

Incidental adrenal mass

Separate oncologic disease from a true incidentaloma, then select the least burdensome evidence-supported next step.

Current or previous extra-adrenal malignancy?

This answer deliberately comes first; oncologic lesions use a different pretest probability and pathway.

Change any answer above; the recommendation updates immediately.

Evidence register

Formal recommendations and emerging evidence.

Formal recommendations and emerging evidence are kept visibly separate. Source links must be rechecked before publication.

Noncontrast CT or MRI first; washout CT is conditional only when further imaging is required.

Primary detailed management, hormonal, oncologic, follow-up and special-population pathway.

Canadian definitions, multidisciplinary assessment and management context.

Evidence questioning washout CT and proposing a ≤20 HU / ≤4 cm no-follow-up category for true incidentalomas.