Endocrine Abstracts

Introduction: Given their prevalence of up to 5% of the general population, A discovery of an asymptomatic adrenal mass (incidentaloma) during the investigation of an unrelated condition is relatively common. The issue of crucial importance is the histopathological differentiation between benign lesions and malignant tumours of the adrenal gland.

Objective: To evaluate the secretory or non-secretory profile and the benign and malignant nature of incidentalomas.

Patients and Methods: Retrospective study of 45 cases of CT-confirmed adrenal incidentalomas followed between 2010–2019 in the endocrinology department. Their clinical, radiologic, and histopathological evaluation were reported.

Results: The average age was 51.8 years with female predominance (Ratio H/F: 0.68). Eleven patients had masses in the adrenal gland discovered by abdominal ultrasonography (24.5%), 33 patients by abdominal CT (73,4%) and one patient by MRI (2.1%). The most common clinical abnormalities were abdominal pain (10 cases), chronic diarrhea (6 cases), weight loss with deterioration of the general state (6 cases), an unexplained ketosis in a type 2 diabetic (1 case), a chronic renal failure assessment (1 case). Incidentalomas were unilateral in 33 patients and bilateral in 12 patients. The size of the tumours ranged between 0.8 and 16.0 cm. The diagnosis was pheochromocytoma in 12 patients, metastasis in 5, adrenal carcinoma in 2, 2 lymphomas, 2 Conn adenomas, one adrenal cyst, 2 myelolipomas, and cortical adenomas in 19 patients. Management reposed on an adrenalectomy in 22 patients, followed up in 15 patients, 4 abstentions and 4 patients died before surgery (metastatic neoplasia).

Conclusion: In our series, 40% of the lesions were secreting and 20% malignant. In the vast majority of cases, the adrenal incidentaloma was a non-secreting benign adenoma. However, it is imperative to ensure the absence of malignancy requiring specific management.