Endocrine Abstracts

Background

The term adrenal incidentaloma (AI) refers to the existence of an asymptomatic adrenal mass that was detected at random in an imaging test performed not in order to evaluate the adrenal glands. In recent years, the use of imaging tests has increased, and the resolution of the imaging studies has been improved. This trend may affect the characteristics of AIs at the time of diagnosis.

Objective

Investigating the demographic, clinical, imaging and laboratory characteristics of patients with AI who were referred to the Endocrine Institute at the Rabin Medical Center in the recent years and comparing the findings with data collected from consecutive patients referred to the same institute between 1995 and 2005.

Research Methods

The research was conducted at the Endocrine Institute at Rabin Medical Center. The study’s design is retrospective-comparative. Demographic, clinical, imaging and laboratory features of 191 consecutive patients who were referred to the Endocrine Institute with AI over the years 2005–2016 years were retrieved from the computerized files, analyzed and compared with 100 patients referred for investigation between 1995 and 2005.

Results

The patients’ average age at diagnosis was 61.6 (median 62), and female patients constituted 62.3% of the cohort (119/191). The average size of the mass at presentation was 23 ± 12.2 mm (mean 20). Most patients (169/191, 88.5%) underwent an additional imaging test during a follow-up of 4.5 ± 3.3 years. In 52 patients (27.2%), a change in the diameter of the mass at the end of the follow-up period was reported. The Incidence of left AIs was higher more than twice than right adrenal masses (59.1% vs. 28.3%) and bilateral masses were demonstrated in 12.5%. The rate of functional tumors was 14.6% and most of them (25/28, 89%) were cortisol-secreting. A known diagnosis of a malignancy at time of the detection of AI was present in 29.3% of the patients, diabetes in 35.6%, hypertension in 59.1% and obesity in 30.9%. Adrenalectomy was performed in 17 patients (8.9%) of whom a primary adrenal malignancy was diagnosed in two. In comparison to the results from the previous study on patients diagnosed with AI during the years 1995–2005, we did not find differences in the age of the patients and their underlying conditions or the characteristics of the adrenal mass.

Conclusion

The clinical features of patients diagnosed with AI and the imaging characteristics of the adrenal mass have not been changed significantly in recent years.