The adrenal incidentaloma Abstract. This article discusses the diagnostic workup of a patient with an incidentally discovered adrenal mass. Primarily, this situation raises two questions: Is the mass malignant? Is the mass hormonally active? The evaluation for malignancy is based on specific imaging characteristics ('imaging phenotype'). The evaluation for hormonal secretion is based on a targeted clinical examination and specific biochemical tests. In most cases, adrenal incidentalomas can be identified as benign, non-functioning adenomas. In unclear situations, patients should be referred for further evaluation.