**Abstract**

In assisting a patient with adrenocortical tumors, the main concern is to establish whether the lesion consists of a malignant neoplasm and if there is any hormonal functioning, which are two instances that generally demand surgery. In distinguishing benign from malignant lesions, two aspects are particularly important: the size of the lesion and the image findings. In order to establish whether a lesion is hormonally functioning, it is necessary to carry out thorough clinical and endocrine assessments. The extension of such assessments is still controversial. This present chapter revises fundamental aspects of the propaedeutic of such tumors. Most guidelines agree that lesions smaller than 1 cm need not be investigated. The diagnostic and therapeutic approach of adrenocortical tumors imposes a difficult and challenging dilemma in terms of its approach, as it may be a benign finding or it may imply a high level of morbidity and mortality due to its hormonal activity or a possible malignant histology.

**Keywords:** adrenocortical tumors, adenoma, adrenal, Cushing's syndrome, aldosteronoma
