Endocrine Abstracts

Introduction: Incidentally discovered adrenal incidentalomas has been reported to be as high as 5% of abdominal cross-sectional imaging performed for reasons unrelated to the adrenal gland. Although the management of bilateral and unilateral incidentalomas is the same, some studies suggest differences between the two groups.

Patients and Methods: Retrospective study including 91 patients with adrenal incidentaloma at the Department of Endocrinology, Charles Nicolle hospital.

Results: Comparing the group of bilateral incidentaloma (23 patients) to the group of unilateral incidentaloma (68 patients) we found high sex ratio for the first group (1.55 vs 0.94). The average age was the same for the 2 groups (61 years old). The first group showed more diabetes (47% vs 37%) and less hypertension and dyslipidemia (43% vs 65%). Incidentalomas were revealed more often for the first group with CT scan and less often with Ultrasound and MRI (34% vs 41%). Tumors diameter on average was less in the bilateral incidentaloma group (18.8 mm vs 23.3 mm). Bilateral incidentalomas were associated with a significantly higher prevalence of subclinical Cushing syndrome (26% vs 10%) and a lower prevalence of hyperaldosteronism (17% vs 30%), compared with unilateral lesions, while rates of pheochromocytoma were similar in both groups (4%). Only one patient with bilateral incidentaloma underwent adrenal surgery versus 5 patients with unilateral lesion.

Conclusion: Although patients with bilateral incidentalomas undergo the same management as the patients with unilateral lesions, bilateral incidentalomas are more likely to be associated with subclinical Cushing syndrome and less likely to be hyperaldosteronism.