Inclusion Criteria:  age ≥18 years adrenal incidentaloma (≥ 1cm) detected by cross-sectional imaging between January 1, 1996 and December 31, 2015 imaging characteristics suggestive for an adrenal adenoma or excluded malignancy by follow-up imaging availability of a 1 mg dexamethasone test result follow-up data on living status and occurrence of cardiovascular events follow-up duration of at least 36 months.  Exclusion Criteria:  proven pheochromocytoma, primary hyperaldosteronism or adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome clinical features suggestive for overt Cushing's syndrome; urinary free cortisol (UFC) ≥ 2-fold higher than the upper limit of normal of the local assay any active malignancy (including adrenocortical cancer) at the time of primary diagnosis