Endocrine Abstracts

Introduction: The adrenal incidentaloma is an asymptomatic tumor measuring at least one cm, discovered incidentally during a medical imaging examination. The adrenal incidentaloma continues to grow with technological advances and improved radiological examinations. Any adrenal incidentaloma involves the search for a secretion or malignant character. The objective of our study is to study the clinical, biological and etiological aspects of adrenal incidentalomas.

Patients and Methods: This was a retrospective, descriptive study carried out in an Endocrinology department, on records of patients in whom an adrenal incidentaloma has been discovered. The following parameters were identified: Clinical and biological presentation, etiological profile, diagnosis and therapeutic means.

Results: Our study covered 22 patients: 2 men and 20 women, aged between 29 years and 76 years with an average of 52±14 years. Family history in these patients was familial hypertension in 18 patients (81.8%), 3 had a history of early stroke and 1 had a history of myocardial infarction. Beyond them, 6 patients had type 2 diabetes with an average duration of 4±3 months. Only one patient was smoking and only one was dyslipidemic under statin. Hypertension was found in 12 patients (54.5. Of these patients, 4 had a refractory hypertension (18.2%), 2 had a malignant hypertension (9.1%). The mean systolic blood pressure was 16.1±2.1 mmHg and the average diastolic blood pressure was 9.1±1.3 mmHg. The mean weight of the population was 79.8±15.06 Kg, the mean size of 159.19±7.6 cm, an average BMI of 31.13 kg/m²; and an average waist of 105±26.6 cm. Biologically, the mean blood glucose was 6.57 mmol/l, the mean serum potassium level was 3.8±0.57 mmol/l. 10 patients had proven hypokalemia. An adrenal-centered scan showed an incidentaloma of an average size of 21.5±19.21 mm. The etiologic diagnosis was a pheochromocytoma in 7 patients (31.8%) attested by an elevation of the metanephrine blocks, clinical and biological hypercorticism in 9 cases (27.3%) including 6 adenomas, 1 case Of adrenal cortex and 2 cases of bilateral adrenal hyperplasia, 4 cases of primary hyperaldosteronism (18.2%). 2 patients had no hormonal secretion. For etiological treatment, 18 patients had unilateral adrenalectomy in (81.8%). 4 patients received medical treatment (18.2%).

Conclusion: The adrenal incidentaloma continues to grow with technological advances and increased abdominal radiological examinations. In the majority of cases, it will be a non-secreting benign adenoma. However, the clinician must ensure that there is no disease requiring specific management by performing a baseline hormonal assessment.