Endocrine Abstracts

Introduction: Adrenal incidentaloma refers to an adrenal mass discovered incidentally during imaging for another indication, most commonly through a CT scan. The discovery of an adrenal incidentaloma has become frequent with the use of imaging studies. CT scans play a crucial role in characterizing adrenal incidentalomas, allowing for better management. The aim of the study is to determine the contribution of CT scans in exploring adrenal incidentalomas in patients followed in the endocrinology department.

Patients and Methods: A retrospective descriptive and analytical study was conducted, including all patients seen in consultation or hospitalized in the endocrinology department with adrenal incidentalomas over a period of 5 years (2017-2022). Criteria for determining the nature of the adrenal incidentaloma included histology and the absence of size progression after one year of follow-up. CT scan characteristics for the diagnosis of adrenal incidentalomas included size, spontaneous density (SD), absolute washout (AW), and relative washout (RW). Statistical analysis was performed using Excel 2017.

Results: The study included 43 patients, of whom 59% were women, with a mean age of 48 years. All patients underwent endocrine hormonal assays for adrenal incidentalomas. The size of the mass was less than 40mm in 32 patients and greater than or equal to 40mm in 11 patients. Adrenalectomy was performed in 20 patients, and 23 non-operated patients underwent medical follow-up. Histology revealed adenoma in 11 cases, pheochromocytoma in 2 cases, myelolipoma in 3 cases, lymphoma in 2 cases, and adrenal hyperplasia in 1 case. Adenoma was confirmed histologically, and the size did not change after one year of follow-up in non-operated cases, in 92.4% of adrenal incidentalomas with a size <40 mm, SD ≤15 HU, RW ≥40%, and AW >60%.

Conclusions: Characterizing adrenal incidentalomas with CT scans is a crucial step in the management of these incidentalomas.