Endocrine Abstracts

Introduction: Adrenal incidentalomas (AIs) constitute an emerging clinical entity due to the increased use of abdominal imaging for diagnostic purposes.

Objective: To investigate the morphological and hormonal alterations of AIs in a cohort of patients, who were followed-up in a single centre.

Methods: Sixty-four patients (22 males and 42 females; mean age 61.6±1.2 years), with AIs and follow-up of 3.1±0.4 years (range 0–19) were retrospectively evaluated. The patients underwent basal and dynamic evaluation of the hypothalamic–pituitary–adrenal axis, renin–angiotensin–aldosterone system and adrenomedullary function. Mass enlargement and adrenal hyperfunction were estimated at yearly intervals.

Results: Adrenalectomy was performed in five patients (four benign cortical adenomas and one pheochromocytoma). Abnormal manifestation, based on clinical, laboratory and histological evaluation, was observed in four patients (one (1.56%) with SCS, two (3.12%) with pheochromocytoma and one (1.56%) with aldosteronoma), three of which were diagnosed at their initial evaluation and 1 at the 3rd year of follow-up. The remainders (60 patients (93.75%)) were harbouring a nonsecretory mass (eight potential myelolipomas, eight nodular hyperplasias, three cystic lesions). Eleven patients (17.2%) had bilateral AIs. Mass enlargement (5–13 mm) was observed in nine patients (14%), ≥10 mm four (6.25%), while mass shrinkage (5–19 mm) in three (4.7%) during follow-up. No hormonal evolution was noticed.

Conclusions: AIs present usually as benign, non-secretory lesions. Criteria for surgical intervention were met at initial assessment for the majority of AIs. Size alterations during follow-up are uncommon and functional evolution is rare.