Tumors larger than 6 cm have a high rate of malignancy and should be surgically excised.
The National Institutes of Health consensus statement makes no specific size recommendations for surgical excision. The statement notes that tumors larger than 6 cm are usually excised; however, no recommendations are made regarding surgery versus observation based on size criteria alone.5
REFERENCE 5. Management of the clinically inapparent adrenal mass (incidentaloma). NIH Consens Statement Online 2002;19:1-23. Available at www.guideline.gov/summary/
summary.aspx?doc_id=6109. Accessed 21 Feb 2007.