Endocrine Abstracts

Introduction: Adrenal incidentalomas (AI) are adrenal masses detected on imaging performed for reasons other than suspected adrenal disease. It is important to categorize whether the mass is a functioning or non-functioning incidentalomas to determine the appropriate management and follow-up. The aim of this study was to assess demographic, clinical, and paraclinical features of patients with AI.

Methods: This was a monocentric retrospective study including 155 patients with adrenal incidentaloma (AI) followed up at the department of endocrinology of la Rabta university hospital in Tunis between 2015 and 2022. Clinical and paraclinical data were collected from patients medical files. Patients with missing data were excluded.

Results: There were 103 women and 52 men with a sex-ratio of 1.98. The mean age at the diagnosis was 52 + 12.7 years (range: 20-84). Past medical history included obesity (8.8%), hypertension (53.5%), diabetes (11.8%), dyslipidemia (5.3%), and urolithiasis (4.1%). AI was unilateral in 80.6% of cases (56.2% on the right) and bilateral in 11.6% of cases. The mean initial size at diagnosis was 21.4 ± 16.8 mm (range: 7 – 130). The AI size was ≥ 40 mm in 7% of cases. AI were homogeneous in 80% of case. The mean spontaneous density value was 9.5 HU (interquartile interval: -2 and 14). Endocrine investigation revealed that 47.7 % of patients had nonfunctional tumors, 35.5% had primary hyperaldosteronism, 11.6% had Cushing’s syndrome, 4.5% had pheochromocytoma, and 0.6% had coexisting autonomous cortisol secretion and pheochromocytoma. Bilateral AI (17.6% vs 6.2%, P=0.027, Odds Ratio=3.23, 95%-confidence interval: 1.09-9.58) and heterogeneous tumors (26% vs 8.6%, P=0.004, Odds Ratio: 1.73, 95% confidence interval: 1.27-2.36) were more frequently functional than unilateral and homogeneous ones.

Conclusions: Our results showed that AI were more frequent in women than in men. They were unilateral, homogeneous, measuring less than 40 mm, and functional in the majority of cases. It is therefore important to explore all adrenal incidentalomas for an appropriate management.