What are the indications for referring a patient with an adrenal incidentaloma to an endocrinologist?

The provided UK guidelines do not explicitly detail indications for referring a patient with an adrenal incidentaloma directly to an endocrinologist based solely on the incidentaloma itself.

However, if adrenal insufficiency is suspected, which may be a consideration in patients with adrenal findings, an 8 am to 9 am serum cortisol test is recommended for people aged 1 year and over ¹. For individuals aged 16 years and over, a serum cortisol level below 150 nmol/L indicates that adrenal insufficiency may be present, and referral to endocrinology is advised ¹. For children and young people between 1 year and under 16 years, a serum cortisol level below 150 nmol/L also warrants recognition of possible adrenal insufficiency and referral to endocrinology ¹.