Figure 1. Algorithm for the Evaluation of Patients with an Adrenal Incidentaloma. The algorithm should be individualized according to the clinical circumstance, the imaging phenotype of the mass, the patient's age, and the patient's preferences. Given the strong association between the imaging features and pheochromocytoma, some advocate treatment with {alpha}- and beta-adrenergic blockade and tumor resection in patients with this imaging phenotype, even when the results of biochemical testing for pheochromocytoma are normal. The dashed line indicates that for some patients, on the basis of the physician's clinical judgment, serial imaging and hormonal testing may be an alternative approach.