Dear Colleagues,

The detection of adrenal lesions, both unilateral and bilateral, during radiological examinations for unrelated diseases, is an emerging condition and requires extensive and adequate evaluation. Indeed, the term adrenal incidentaloma includes a wide range of lesions that are, frequently, although not always, benign. Primitive, rare, or secondary malignancy has to be excluded, as well as the presence of pheochromocytoma, infiltrative diseases, or congenital enzymatic mutations if bilateral. New radiological algorithms and metabolomics have been proposed so as to better characterize suspicious lesions; however, areas of uncertainty remain. Although the majority of adrenocortical masses are nonfunctioning adenomas, hormone-secreting tumours may cause Cushing's syndrome, primary aldosteronism, or virilisation. Clinical presentations vary in relation to the degree of steroid secretion, which are frequently mild. One of the main challenges is to identify patients with adrenal incidentaloma that present an increased risk of developing cardiovascular or bone complications, thus limiting unnecessary assessments. The adequate treatment of adrenal incidentaloma still needs to be defined—new drugs could be helpful when surgical excision is not feasible, for example in secreting cases.

This Special Issue will focus on all of these aspects, in particular the pathophysiology and preclinical approach of adrenocortical lesions, differential diagnosis, clinical consequences of mild hypersecretion, the role of new steroid measurement techniques, and biochemical inflammation markers in this setting, as well as possible therapeutic approaches. Both original research and review articles are welcome.

Dr. Valentina Morelli
Guest Editor

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• adrenal incidentalomas
• differential diagnosis of adrenal masses
• subclinical hypercortisolism
• genetics of adrenal tumours
• adrenalectomy
• steroidogenesis inhibitors
• cardiovascular risk factors
• secondary osteoporosis and vertebral fractures
• biochemical markers
• metabolomics