Structured evaluation of adrenal gland tumors found incidentally during imaging studies.

The standard diagnostic work-up for adrenal incidentaloma (AI) consists of biochemical analysis to detect hormonal hypersecretion and repeat CT-scanning as the primary diagnostic tool to demonstrate the presence of an adrenocortical carcinoma (ACC). However, prospective data describing the diagnostic yield and cost-effectiveness of repeat CT-scanning are limited. SERENDIPITY represents the largest prospective study on AI management thus far and aims to improve the cost-effectiveness of the diagnostic strategy by the application of a
single baseline urinary steroid profiling (USP). In retrospective studies, it has been shown that USP distinguishes benign AI from ACC with high
sensitivity and high specificity. If these promising results are to be confirmed in our study, then USP would offer a safe, patient-friendly and inexpensive alternative to repeat CT- scanning. In addition, we aim to examine the psychological impact for patients with AI being currently subjected to repeated laboratory tests and CT-scanning during several years.

We hypothesize that urinary steroid profiling is cost-effective compared to repeat CT-scanning in patients with adrenal incidentalomas.

•December 2014 – June, 2016: patient recruitment.


•December, 2014 – June, 2018: patient evaluation according to study algorithm, data collection and data entry.


•June, 2018 – December, 2018: data analysis and reporting.

Not applicable.



This is not an interventional study per se, as patients with an adrenal incidentaloma are evaluated according to current management guidelines.

The diagnostic value of urinary steroid profiling will be assessed at the end of the study. Thus, the results of urinary steroid profiling will not affect the clinical management of participants with adrenal incidentaloma.