ECE2007 Poster Presentations (1) (659 abstracts)
Adrenal incidentaloma, an oncological or endocrinological enigma? Clinical analysis of 1300 cases observed at a single endocrinological centre
Anna Kasperlik-Zaluska 1 , Elzbieta Roslonowska 1 , Jadwiga Slowinska-Srzednicka 1 , Wojciech Zgliczynski 1 , Wojciech Jeske 1 , Lucyna Papierska 1 , Maciej Otto 2 , Rafal Slapa 2 , Andrzej Cichocki 3 & Jaroslaw Cwikla 4
1Centre for Postgraduate Medical Education, Warsaw, Poland; 2Warsaw University of Medicine, Warsaw, Poland; 3Centre and Institute of Oncology, Warsaw, Poland; 4Hospital of MSWiA, Warsaw, Poland.
Objective: Incidentally found adrenal tumour (adrenal incidentaloma = AI) is the most frequent adrenal disorder. Every patient with AI has to be evaluated carefully to choose the best method of management. We present our experience with a group of 1300 patients with AI, registered at our department.
Material and methods: Material consisted of 1300 patients (female/male ratio 2.6, age 10–87 years) with AI ranging in size from 0.8 to 23.0 cm. Methods: clinical examination, biochemical assays, hormonal determinations (cortisol, androgens, ACTH, aldosterone, metanephrines), imaging studies (ultrasound scans, CT, MRI), histological/ immunocytochemical investigations in 420 patients treated by surgery.
Results: Basing on these examinations we diagnosed in our material 116 patients with adrenal cancer, 14 – with other primary malignant adrenal tumours, 48 – with metastatic tumours and 1122 with probably benign tumours. The most important criteria for surgery were imaging phenotype (mainly high density, over 20 HU in the I phase of CT), size (≧5 cm) rapid growth of the tumour and suspicion of a clinically silent chromaffin tumour (for fear of an unexpected metanephrines crisis). In some cases of adrenal cancer elevated levels of androgens have been noted. The most frequent form of subclinical hyperactivity has been pre-Cushing’s syndrome (6.5%).
Conclusions: 1/Malignant adrenal tumours were found in 178 patients (14%), in this number adrenal cancer in 9%. 2/ The oncological criteria for surgery were of primary importance in our material, with the elevated density in CT (I phase) as the main single indication.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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