Endocrine Abstracts

Introduction: According to the latest recommendations, monitoring protocol for adrenal incidentalomas includes: hormonal determinations annually for 4 years and imaging at 6, 12 and 24 months. The objectives of this study are: i) to define the clinical features, natural history and clinical management of adrenal incidentaloma in our area, ii) to evaluate the performance of the current monitoring protocol.

Methods: Retrospective study including patients diagnosed with adrenal incidentaloma between 2007 and 2012 in our area. Epidemiological and clinical data were analyzed, as well as the morphological and functional characteristics at diagnosis and during follow-up.

Results: Ninety six patients were included (55,2% male, mean age 61,38±12,15 years). 74,3% were overweight or obese (mean BMI of 29,66±4,94 Kg/m²), 51% had hypertension, 32,3% dyslipidemia, 25% diabetes and 20,8% osteoporosis. 63,6% of the cases were detected by computed tomography, performed in most patients by digestive (21,1%) or genitourinary pathology (21%). 48,4% of adrenal incidentalomas were located in the left gland, 8,4% were bilateral and mean size at diagnosis was 26,6±20,2 mm. 2 cases of Cushing’s syndrome and two of pheochromocytoma were detected at the initial evaluation and six patients underwent surgery for larger than 40 mm incidentaloma. Biopsy confirmed a case of adrenal carcinoma. At two and four years of follow up, 98,86% maintained normal function (only one pheochromocytoma diagnosis at 6 months), and no significant changes in size were observed (mean resizing at two year evaluation was 0,56±2,3 mm, P=0,103).

Conclusions: In our area, no significant changes were detected in either the size or hormonal function in incidentalomas initially diagnosed as non-functioning; so the efficiency of systematic application of current protocol should be reassessed.