What Is the Best Approach for the Evaluation and Management of
Endocrine Incidentalomas?   A 54-year-old man with a history of
hypertension treated with hydrocholorothiazide and Type 2
diabetes mellitus is admitted with abdominal pain and found to
have an incidental 2.1-cm left adrenal mass on CT scan of the
abdomen. He denies symptoms of headache, palpitations, weight
gain, or muscle weakness. His exam is significant for mildly
elevated blood pressure. What is the best approach for
evaluation and management of this incidental finding?
Incidentalomas are mass lesions that are inadvertently
discovered during radiolographic diagnostic testing or treatment
for other clinical conditions that are unrelated to the
incidental mass. In recent decades, improvements in radiographic
diagnostic techniques and sensitivity have led to increasing
discovery of incidental lesions that are often in the absence of
clinical signs or symptoms.1 Three commonly discovered lesions
by hospitalists are pituitary, thyroid, and adrena