The increment in the incidence of adrenal incidentaloma owing to the developments in imaging techniques increase the questioning regarding the choice of surgery concerning their treatment. Clinically silent adrenal masses can be functioning or non-functioning, and benign or malignant. Because of that all adrenal incidentalomas should be evaluated for malignancy and subclinical hormone production. It is suggested to operate cases with hormone over production, masses >4 cm and masses with radiological stigmata of malignancy. Others should be followed for subsequent changes in hormone production or size.
Keywords: Adrenal gland, incidentaloma, subclinical cushing's syndrome, cushing's syndrome, pheochromocytoma and adrenalectomy