Endocrine Abstracts

Introduction: The improvement in imaging techniques has increased the number of incidentally discovered adrenal lesions. Current clinical recommendations are based on the NIH consensus statement (2002) and include: CT at 6,12 and 24 months plus annual hormone evaluation for 4 years.

The aim of this study was to describe the results of the application of the current guidelines in a cohort of consecutive patients whose initial diagnosis was non-functioning adrenal adenoma

Patients and methods: We reviewed the clinical records of the patients who followed the following inclusion criteria: incidental discovered adrenal mass; no extra-adrenal malignancy; no radiological suspicion of malignancy (apart from size). Annual hormone evaluation consisted in: 1 mg DXT, urine metanephrines and catecholamines, K and Renin/Aldo. Regular CT studies were also performed.

Results: Ninty-nine patients were included (54.5% females, mean age 59.8±11.3 years, BMI 28.8±4.9 kg/m²). Hypertension was present in 49.5% of the patients, dyslipidemia in 41.4%, type 2 DM in 25.3%.

Two patients underwent surgery because of sizeand in both cases the final diagnosis was cortical adenoma. Mean initial size was 21.6±9.5 mm and 14.4% of the patients had bilateral lesions. The median follow-up was 45.5 months.

At the baseline evaluation, hormonally active adenomas were diagnosed in 5 patients (2 hypercortisolism, 3 hyperaldosteronism). All the patients with an initial negative evaluation remained without alterations in the folowing hormonal tests. No significant increase in size (1.7±5.2 mm) was observed through the follow-up period.

Conclusion: The routine application of the current guidelines for the follow-up of adrenal incidentalomas whose initial diagnosis corresponds to non-functioning adenoma does not seem justified.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.