Endocrine Abstracts

Introduction: With the wider availability of imaging techniques there is an increasing number of newly diagnosed, accidentally found pathological formations in the adrenal glands known as adrenal incidentaloma (AI). Currently, the professional consensus is that hormonally active incidentalomas and those suspicious of malignancy should be indicated for surgery.

Methods: In our retrospective study, we analyzed data of 141 patients with a total of 160 AIs, who were followed up in 2001–2011 by the Outpatient Endocrinology Department of the Military University Hospital in Prague. Most AIs were up to 3 cm in size (77.5%), 11.25% had a size of 4–6 cm, and 11.25% were above 6 cm in size. Adrenalectomy was primarily indicated in all patients with AI greater than 6 cm. During the follow-up period, 12 AIs increased in size by 1 cm and four AIs by 2 cm or more. Hormonal activity was examined in all patients. Pathological hormonal overproduction was detected in 24 patients. During the 10-year follow-up period, a total of 36 patients underwent surgery, 21 because of the size of AI, nine for endocrine activity of the AI and three patients due to size progression of the AI. The result of postoperative histology was available for 21 incidentalomas. Malignant tumours accounted for 28.5%. All were larger than 6 cm and four were found to be hormonally active.

Results: All malignant tumours were larger than 6 cm. There is no doubt about the need to indicate adrenalectomy in these patients. Size progression of the AI had always been recorded already during the first 2 years of the follow-up. In patients with growth progression, detected hormonal activity or size 4–6 cm we use an individual approach and long-term follow-up.