Etiology, morphology, and outcomes of adrenal calcifications in 540 adult patients - a retrospective single-centre study.

Sparse data are available on the etiology, morphology, clinical presentation and outcomes of adrenal calcification. In this single-center retrospective study of 540 consecutive patients (median age 65 years, 45% women) with adrenal calcification on computed tomography (12/2017-01/2021), most were discovered incidentally (472, 87%). The commonest etiology was idiopathic (389, 72%), followed by adrenal tumor (113, 21%), hemorrhage (29, 5%), and infiltrative disease (7,1%). Calcified adrenal tumors were predominantly benign (92, 81%) and primarily adenomas (63, 69%), whereas the most common calcified adrenal malignancy (16, 18%) was metastasis (12, 67%). Calcification (unilateral 94%, bilateral 6%) morphology varied from punctate (313, 58%) to coarse (165, 30%), linear/curvilinear (46, 9%), and rim-like (16, 3%). In summary, adrenal calcifications are usually incidentally discovered unilateral, punctate or coarse lesions of unclear etiology. Most calcified adrenal tumors are benign and <20% malignant or pheochromocytomas.