Endocrine Abstracts

Background: Adrenal incidentalomas are detected in about 0.1% of general health screening with ultrasound, in 0.4–1.9% among patients evaluated for nonendocrinologic complaints, in ~4.4% among patients who have a previous cancer diagnosis. Majority are benign, but careful evaluation is warranted to rule out carcinoma and functional adenomas.

Aim: The purpose of presenting these cases is to highlight the importance of ultrasound examination in diagnostication and management of adrenal incidentalomas.

Materials and methods: We have prescribed six patients presenting in our clinic during a 3-year period, which resulted with adrenal incidentaloma in abdominal ultrasound. They underwent specific blood tests, depending on the clinical situation.

Results: Case 1 was a 41-year old male, presenting with hyperglycemia found to have Conns’ syndrome with aldosterone producing adenoma on routine ultrasound. Case 2 was a 21-year old boy, who had phaeochromocytoma misdiagnosed as anxiety disorders. Case 3 was a 49-year old female, presenting amenorrhoea which was mistaken as menopause, and minimal hirsutism which was mistaken as postmenopausal hirsutism. She resulted with adrenal androgen secreting adrenocortical carcinoma. Case 4 was a 59-year old hypertensive male, presenting with fever had phaeochromocytoma with catecholamine excess, producing fever. Case 5 was isolated adrenal tuberculosis, who presented with chronic diarrhea. Case 6 was a 43-year old female, presenting with drug-resistant hypertension and diabetes, found to have Cushing’s syndrome.

Conclusion: Adrenal incidentalomas are common, most are non-secreting adenomas. When a hormonal disorder is suspected clinically, specific blood tests for Cushing, Conn and/or pheaochromocytoma, are indicated.