Endocrine Abstracts

Objective

In this retrospective study we investigated the clinical and radiological characteristics, hormonal status and metabolic components of the patients with adrenal incidentaloma(AI). Additionally, we investigated whether tumor size or hormonal status changes during long-term follow-up and the effect of these on metabolic parameters.

Methods: The data of 384 patients who were followed up with the diagnosis of AI between 2010 and 2020 were retrospectively analyzed. All patients underwent radiological, hormonal and metabolic evaluation and prospective follow-up.

Results: 374 patients (248 female (%64)) enrolled to this study. 348(%90.6) of them were reported as adenomas and 31(%8.07) of them as non-adenomas and 4(%1.04) of them were indeterminate. The mean adenoma diameter was approximately 2 centimeters and was mostly detected on the left (%48.9). %13,81 of the subjects(n=53) were functioning and among functional adenomas 9 subjects(%2.34) have autonomous cortisol secretion(ACS), 7 subjects(%1.82) have primary hyperaldosteronism, 4 subjects(%1.04) have pheochromocytomas, and 39 subjects(%10.1) have possible autonomous cortisol secretion. In patients with bilateral incidentalomas, the mean diameter of adenomas was higher than unilateral incidentalomas with a diameter of 24.22 mm in comparison to 20.36 mm. Similarly, in patients with bilateral incidentalomas, systolic and diastolic blood pressure was higher than unilateral incidentalomas (135.83±20.27,130.02±18.84% and 79.25±11.56, 78.52±10.11, respectively). Moreover, our study revealed that the frequency of diabetes, hypertension and hyperlipidemia in patients with possible autonomous cortisol secretion was %37, %63, %22.2, respectively. Of 384 patients, 9.11% (n=35) underwent surgery. The most common pathological finding was adrenocortical adenoma (n=19, %54). The median follow-up duration of patients was 48.91 months. Of 384 patients, %44.7 (n=172) were followed up regularly with CT/MRI. During the follow-ups, the diameter of adenomas (%11.6) has increased by more than 10 mm. Of 384 subjects, %56.7 (n=218) were followed with hormonal evaluation and 6 patients have developed possible autonomous cortisol secretion and 3 patients have developed autonomous cortisol secretion. Moreover, 1 subject has been developed primary hyperaldosteronism.

Conclusions: The main findings of the present study are that there was no relevant tumor growth after 5 years of follow-up and that the conversion rate to subclinical or clinical hypercortisolism was low and there were no new cases of pheochromocytoma. Only one subject has shown the development of primary hyperaldosteronism. Our study revealed a significantly increased risk of developing DM, HT and HL in patients with possible autonomous cortisol secretion.