Endocrine Abstracts

Introduction: Due to the widespread use of imaging studies performed in hospitalised patients for other indications, adrenal incidentalomas (AI) are frequent findings in the everyday clinical practice. The objective of this research is to describe the prevalence of hormonally active and malignant AI.

Patients and methods: Observational retrospective study of a cohort of patients who consulted in the Endocrinology service between 2005 and 2015 because of an AI. The statistical analysis was performed with SPSS 19th version for Windows.

Results: Two hundred and one patients presented with an AI. Seventy four of them had multiple AI so that the number of AI analysed was 239. The median age of the patients was 58.85±11.55 years, 74.1% of which were older than 50. 56.9% of them were women.

Imaging study where the AI was found: 73.6% CT scan, 40% abdominal ultrasonography, 7.1% MRI, 0.8% PET and 0.4% surgical finding. Size: 29.36±20.96 mm. 54.4% of the masses were located in the left adrenal gland. After the biochemical testing for hormone production and radiology study were conducted, 71.6% of the AI were non-functioning, 14.4% subclinical Cushing’s syndrome 6.8% myelolipoma, 3.2% Cushing’s syndrome, 1.4% pheochromocytoma, 1.4% adrenal cancer, 0.9% hematoma, 0.5% metastatic masses. Surgical treatment was performed in 37 patients (15.5%). The size of the mass was the most frequent reason for the intervention (36.7% of the AI removed), followed by radiological findings suggestive of malignancy (26.7%), growing AI (13.3%), Cushing’s syndrome (13.3%), pheochromocytoma (6.7%) and history of previous malignancy (3.3%).

Conclusions: The AI is more frequent in women and in patients in the fifth decade of life. In our study, the predominant location was the left adrenal gland. Most of the AI studied were non-functional, being the percentage of hormonally active masses found similar as previous and larger studies.