Pitfalls in diagnosis and treatment of adrenal diseases are frequent and not properly reported in literature. Among more than 51 adrenalectomies for incidentaloma performed during a 10.years period, we present 2 cases of diagnostic errors that a very formative opportunity in the approach to adrenal diseases. A precise and careful preoperative diagnosis is of utmost importance in the management of adrenal disease to avoid therapeutic pitfalls.