[Incidentalomes surrénaliens].

ADRENAL INCIDENTALOMAS, MOST OFTEN BENIGN Adrenal incidentalomas are benign in their great majority, do not evolve towards malignity and do not secrete excess hormones. A dedicated CT scan without injection of contrast medium is the cornerstone investigation to characterize adrenal incidentalomas. The first-line biological work-up includes the search for pheochromocytoma (with the exception of typical adrenocortical adenomas at CT scan), a dexamethasone minute braking test and measurement of the plasma aldosterone/renin ratio in case of arterial hypertension. For bilateral incidentalomas, morning cortisol and ACTH measurements before and after synacthen injection are essential. Surgical removal can be indicated and the latest recommendations for follow-up of non-operated incidentalomas have been relaxed.