Endocrine Abstracts

Background and aim: Incidence of adrenal incidentaloma is increasing proportionally to the use of radiographic imaging and there were two questions that whether malignant or functional. We aimed to evaluate patients with adrenal incidentalomas in terms of malignancy.

Subjects and methods: This study was performed between 2010 and 2013. From 320 patients with adrenal incidentaloma, total 52 patients who underwent surgical intervetion were evaluated. Indications for surgery were tumor size >4 cm and adrenal hyperfunction. All data were shown as mean±S.D. χ² and Pearson’s correlation methods were used and values P<0.05 as accepted statistical meaningful.

Results: Of 320 patients 52 underwent (16.2%) to surgical intervention (19 non-functional adrenal incidentaloma >4 cm), 15 subclinical Cushing’s syndrome (SCS), and 18 pheochromocytoma). Malignancy was determined in only 12 of total 320 (3.75%). In remained 40 patients (76.9%), benign histopathology was determined (14 non-functional, 14 SCS and 12 pheochromocytoma. In the evaluation of cases with malignancy; total five malignacy were determined in non-functional patients (leiomyosarkom, liposarkom ve renal cell carcinoma, lymphoma and metastasis of small cell lung carcinoma). Malignancy was found in only one case (metastasis of renal cell carcinoma) in SCS patients and six in patients with pheochromocytoma.

We evaluated all malignant cases in terms of tumor size and found that; there was a correlation between tumor size and malignancy. In patiens with tumor size ≤60 mm; malignancy were determined only two patients (2/29, 6.9%), whereas malignancy were found in ten patients (43.5%) in tumor size >60 mm group. We could not determine any malignancy in pateints whose tumor size <4 cm and 4–6 cm. There was no meaningful difference between gender and age of the patients.

Discussion: Malignancy incidence is low in adrenal incidantalomas and tumor size is important in the prediction of tumor behaviour.