ECE2015 Eposter Presentations Adrenal cortex (94 abstracts)
The clinical course of patients with adrenal incidentaloma: is it time to reconsider the current recommendations?
Darko Kastelan 1, , Ivana Kraljevic 2 , Tina Dusek 1, , Nikola Knezevic 2 , Mirsala Solak 2 , Bojana Gardijan 2 , Marko Kralik 2 , Tamara Poljicanin 3 , Tanja Skoric Polovina 2 & Zaljko Kastelan 1,
1Zagreb University School of Medicine, Zagreb, Croatia; 2University Hospital Center Zagreb, Zagreb, Croatia; 3Croatian National Institute of Public Health, Zagreb, Croatia.
Context: The current guidelines for the management of adrenal incidentaloma advise hormonal and radiological follow-up of the patients for 2–5 years after the initial diagnosis. However, a vast majority of adrenal incidentaloma are non-functional, benign cortical adenomas that require no treatment, so the routine application of the current strategies often results in a number of unnecessary biochemical and radiological investigations.
Objective: The aim of this study was to analyse the clinical course of patients with adrenal incidentaloma and to provide a critical review of the current management strategy of the disease. Design and setting: This was a retrospective study performed in the Croatian Referral Center for adrenal gland disorders. Patients: The study included 319 consecutive patients with adrenal incidentaloma 174 of which were followed for at least 24 months.
Results: A vast majority of patients were diagnosed with benign adrenal masses whereas in about 5% of them adrenal tumour corresponded to adrenal carcinoma or metastasis. Tumour density was found to be superior to tumour size in distinguishing benign adrenal masses from malignant tumors and pheochromocytomas. During the follow-up no patient demonstrated a clinically significant increase in tumour size. In addition, no changes, either in metanephrines and normetanephrines or in the activity of renin-aldosterone axis, were observed during the follow-up. Six patients developed SCS.
Conclusion: The study indicates that the risk of an adrenal mass initially diagnosed as benign and non-functional to become malignant or hormonally active is rather low. Therefore, the clinical management of those patients should be tailored on an individual basis in order to avoid unnecessary procedures.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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