Molecular Incidentaloma: Proposal for a New Conceptual Term in Omics-Driven Medicine

Proposal of the term "molecular incidentaloma" to describe any omics-derived finding — from liquid biopsy (cfDNA, ctDNA, CTCs), proteomics, metabolomics, or multi-omics platforms — detected incidentally during a clinically indicated assay, carrying uncertain or unsolicited clinical significance, and triggering an unplanned cascade of diagnostic, therapeutic, and ethical decisions at the individual patient level. The term is conceptually distinct from the established "incidentalome" (Kohane et al., 2006), which describes the aggregate statistical burden of secondary findings in population-level genomic sequencing. The molecular incidentaloma is a singular, patient-level clinical event with immediate consequences. This document provides the operational definition, biological phenomenology, ethical implications, and the epistemological argument for naming this phenomenon. Deposited to establish formal, citable, and dated authorship of the conceptual term.