Endocrine Abstracts

Background: The incidental adrenal lesion, coined ‘incidentaloma’, is a common radiological finding, necessary of further investigation and diagnosis

Aims: This is a retrospective observational study which aims to identify the prevalence of incidentaloma in CT scans of the abdomen and pelvis in the Brighton & Sussex University Hospital’s Trust. Our additional objective is to assess the adequacy of incidentaloma management through adherence to current guidelines.

Materials and methods: 1169 CT scans involving the abdomen and pelvis were reviewed for the presence of adrenal incidentaloma between 1 January 2015 and 31 January 2015. Patients identified to have an incidentaloma then had their clinical records reviewed.

Results: Only 28.14% of all radiologist reports reviewed contained a comment on adrenal appearance and 39 individuals (3.34%) were found to have an incidentaloma. Excluding patients who had since passed away, had cancer of another organ or were otherwise too frail, 4 of a possible 15 (26.67%) were followed up in some capacity. 20% were reviewed in clinic, 20% were assessed for hypercortisolism and 20% were assessed for pheochromocytoma.

Conclusion: The prevalence of adrenal incidentaloma is statistically similar to audits of a similar nature. However, management of incidentaloma in the trust shows poor adherence to existing clinical practise guidelines as not all incidentaloma patients were referred to the endocrinology department. We therefore recommend improved consistency in radiologist reports on the adrenals through the implementation of adrenal ‘autotext’ and to ensure trust doctors are aware that every incidentaloma is necessary of endocrine referral.