Endocrine Abstracts

Introduction: CT renal tract is commonly requested by the urologists for suspected renal colic as it is recognized as the most accurate technique for the detection of ureteric stones. However, follow-up of adrenal incidentalomas identified on such scans could pose a challenge for the non-endocrinologist. We investigated the prevalence and follow-up of incidentally discovered adrenal masses after CT renal colic.

Methods: We looked through the reports of all CT renal tract during a 12-month period to identify adrenal incidentalomas. We then sought evidence of further investigations and follow-up.

Results: Eight hundred and sixty-three scans were identified. Nine patients (1%) were found to have adrenal incidentalomas. Median age was 60 years (range 40–75 years). Seventy-eight percent of the patients were male. In 2 cases malignancy with adrenal metastases was diagnosed on further contrast enhanced imaging. In a further case a contrast CT revealed no adrenal abnormality. One patient with a left sided 13 mm adrenal mass is awaiting further imaging and 1 with a 16 mm mass has had a negative screen for urinary catecholamines under the urologists but no other follow-up. The remaining 4 patients have not had any follow up arranged. Furthermore, the abnormal adrenal findings were not included in the discharge summaries. None of the 9 patients have been referred to the endocrine clinic.

Conclusion: The prevalence of adrenal incidentalomas varies according to inclusion criteria and patient populations studied. In our audit, we studied patients presenting with suspected renal colic and found a 1% prevalence of adrenal incidentalomas. This is relatively low, perhaps due to the young age of the subjects. None of the patients were referred for a specialist opinion and there was a lack of structured follow up, thus highlighting the need for a local protocol which will dictate appropriate further management of such cases.