Indeterminate Adrenal Mass in a Child, Adolescent, Adult Under 40, or Pregnant Woman

When adrenal imaging returns an indeterminate result, clinical context matters. In younger patients and during pregnancy, the threshold for action is lower because the risk profile differs substantially from that of older adults.

Clinical scenario

An adrenal mass that is indeterminate on imaging, identified in a child, adolescent, or adult younger than 40 years of age, or in a pregnant woman. These populations warrant urgent evaluation given a higher likelihood of malignancy and clinically significant hormone excess.

Management approach

Current guidance supports a surgical approach in this scenario. The complete protocol details the evaluation pathway, timing considerations, and the full management algorithm — including how pregnancy status and patient age shape the decision.

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References

DOI: 10.1093/ejendo/lvad066

We suggest surgical resection if an adrenal mass is indeterminate on imaging in children, adolescents, pregnant women, and adults < 40 years of age.

We recommend urgent assessment of an adrenal mass in pregnant women and individuals <40 years of age because of a higher likelihood of malignancy as well as and clinically significant hormone excess.

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