The Spectrum of Adrenal Lesions in a Tertiary Referral Center
Carmen Sorina Martin,
Marian Andrei,
Bianca Alina Voicu,
Miruna Alexandra Riță,
Ana Alice Taralunga,
Anca Elena Sîrbu,
Luminita Nicoleta Cima,
Iulia Stoian,
Carmen Gabriela Barbu,
Valentin Calu,
Adrian Miron,
Simona Fica
Affiliations
Carmen Sorina Martin
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Marian Andrei
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Bianca Alina Voicu
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Miruna Alexandra Riță
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Ana Alice Taralunga
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Anca Elena Sîrbu
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Luminita Nicoleta Cima
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Iulia Stoian
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Carmen Gabriela Barbu
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Valentin Calu
Department of Surgery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Adrian Miron
Department of Surgery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Simona Fica
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Background: Adrenal tumors are a common finding in clinical practice, and only detailed evaluation may reveal secretory and metabolic abnormalities or their malignant character. We aimed to highlight epidemiological data, rates of malignancy, clinical or secretory characteristics, and the cardiometabolic implications of adrenal masses. Methods: We conducted a retrospective analysis using data from the medical files of 474 patients with adrenal pathology hospitalized between January 2007 and January 2020, before the COVID-19 pandemic, using the ICD-10 codes. After applying inclusion and exclusion criteria, a total of 264 patients with adrenal tumors were enrolled in the study. Patients underwent clinical examination, abdominal imaging, and hormonal evaluation, and some of them underwent a pathological exam after adrenalectomy. Results: Median age at diagnosis was 56 (17) years, with 81.06% of patients being female. The median follow-up period was 41.5 (70) months, ranging from 6 months to 13 years. Adrenal tumors were most frequently seen in older female patients, with 83.47% of them being over 40 years old. The malignancy rate was 4.54%. Hormonally nonfunctioning tumors (71.95%) predominated, and overt hypercortisolism was present in 10.61% of patients, as was mild autonomous cortisol secretion in 5.31% of patients, primary hyperaldosteronism in 8.71% of patients, and adrenal paraganglioma in 3.41% of patients. Cardiometabolic comorbid conditions were similar in patients with functioning and nonfunctioning tumors. Conclusions: All patients with adrenal tumors should receive a complete hormonal workup and detailed malignancy risk assessment. Even though a hormonally active tumor predisposes to cardiometabolic comorbid conditions, a nonfunctioning lesion may also be associated with such disorders and needs thorough assessment.
