Endocrine Abstracts

The objective of the research was to study clinical manifestations and characteristics of manifestations of adrenal tumors.

Material and Methods: We followed 282 patients with adrenal tumors, who received in and out-patient care in the Republican Specialized Scientific Practical Medical Center of Endocrinology of the Uzbekistan Public Healthcare Ministry within the period from 2000 till 2018. Among them there were 169(59.9%) women and 113 (40.1%) men. The age of the patients at the moment of the first application to doctor varied from 4 months to 74 years old, with average 39.8 ± 15.7. Male average age was 37.4 ± 16.7 years old, while female average age was 41.4 ± 14.9. Adrenal tumors were presented by the following nosological forms: 51(18.1%) pheochromocytoma, 45(16%) cortisol-secreting tumors,16(5.6%) aldosterone-secreting adenoma, 9(3.2%) androgen-secreting tumors, 5(1.8%) adrenal cortical cancer, 11(3.9%) adrenal metastases, and 145(51.4%) incidentaloma.

Results: Adrenal tumors were characterized by heterogeneous non-specific manifestations, such as lumbar pain 12.8%, gaining weight 7.8%, stomachache 5.7%, menstrual cycle disorders 5.7%, losing weight 2.8%, stroke 1.8%, polyuria 1.4%, headache 1.1%, pre-term maturation 1.1%, excessive hair growth 0.7%, cardialgia 0.7%, hypertonic crisis 0.7%, compression fractures 0.7%, neuromuscular disorders 0.4%, with prevalence of arterial hypertension (AH), which was observed in 52.5% of the cases. In 4.1% of the cases there were no symptoms. Taking into account heterogeneity of clinical symptoms, including AH, associated with tumors, most patients first applied to different specialist. Primarily, these patients were treated by other specialists, among them 17.7% of the patients applied first to cardiologist, 14.2% to physician, 8.9% to neuropathologist, 5.7% urologist, 3.5% to gynecologist, 1.8% to oncologist, 1.8% to pediatrician, 0.7% to traumatologist, 0.4% to rheumatologist, and only 18.8% of the patients initially applied to endocrinologist, while in 26.2% of the cases the diagnosis was established by functional diagnostics specialists. In the careful study of the history of the disease we revealed the following: 64.2% of the patients did not link the start of the disease with any reason, 22.7% associated it with stress, 4.6% with pregnancy, 2.8% related it to various surgical interventions, 2.1% with over-cooling, 1.1% with the start of climax period, 0.7% with delivery, infectious diseases, and application of hormonal agents, and, finally, 0.4% with abortions.

Conclusion: Heterogeneity of clinical symptoms, including AH, associated with tumors, inhibit in-time diagnostics due to initial application of patient to other specialists