<prompt> Surgical removal of adrenal adenoma is indicated when their size is more than:2 cm4 cm6 cm10 cm  <response>: Ans. B. 4 cm. Ref. LB 25th pg. 811; Harrison 17thpg. 2259; FIGURE 336-9H-l7thpg. 2258:Features suggestive of malignancy include: large size 4-6 cm, irregular margins and tumor inhomogeneity, soft tissue calcifications visible on CT, and high unenhanced CT attenuation values 10 HU. Similar findings characteristic of malignancy are seen on chemical-shift MRI. In contrast, the common benign adrenocortical adenoma is characterized by diameter 4 cm and tumor homogeneity with sharp margins and low CT values 10 HU.Indications for Surgical Removal of Adrenal Glands include: Tumors of the adrenal cortex which overproduce hormones. .- Tumors of the adrenal medulla which overproduce adrenaline pheochromocytoma.- Most solid tumors of the adrenal gland which are greater than 4 cm 2 inches regardless of whether they produce hormone or not to rule out malignancy.- Primary cancers of the adrenal. Any size adrenal mass which causes symptoms such as flank pain or tenderness.Note: Some books mention, size more than 5 cm favor adrenal carcinoma and should be criteria for surgical resection, while few books also have mentioned as more than 6 cm adenoma favor adrenal carcinoma and should be an indication for resection. 