Clinical Radiologıcal Assesment in Patients With Adrenal Incidentaloma

Abstract

INTRODUCTION: To evaluate the clinical and radiological results of adrenal masses of patients admitted to our center. METHODS: The demographic data of 139 patients admitted to Van YuzuncuYil University Dursun Odabasi Medikal Faculty Department of Endocrinology and Metabolism with adrenal incidental disease diagnosis from 01.01.2015 to 01.01.2017 were examined. The characteristics of adrenal incidentaloma, the right-left involvement, functional-nonfunctional hormones, and the pathology results and clinics of adrenalectomy patients were studied retrospectively. RESULTS: 69% of the cases were female (n: 95), 31% were male (n: 44). 99 of these patients were assessed with CT, 38 with MRI, and 2 with PET results. The surrenal involvement was in the right in 39.6%, in the left in 67.6% and bilateral in 7.2%. The mass diameter of adrenal incidentalomas was 1-90 mm. 23% of patients with adrenal insufficiency (n: 32) were operated. Incidentalomas according to pathology results were as follow: adrenal cortical adenoma in 14 (43.75%), pheochromocytoma in 8/139 (5,8%), bilateral adrenal hyperplasia in 4 (12,5%), adrenal cortical carcinoma in 2 (6,25%), lipomas in 1 (3,12%), mature cystic teratomas in 1 (3,12%), ganglioneuromas in 1 (3,12%) collision tumor in 1 (3,12%). Result of clinicopathological evaluation of patients with adrenal incidentaloma; there was hypertension in 46 of cases (33,1%), Diabetes Mellitus (along with hypertension) in 18 (12,9%), cushing syndrome (hypertension in 4, diabetes and hypertension in 3) in 16 (11,5%), pheochromocytoma in 8 (5,8%), hyperaldosteronism due to adrenal hyperplasia in 5 (3,5%) and Conn syndrome in 3 (2,1%). 2 of the 4 patients with cortical adrenal hyperplasia were diagnosed with Cushing's syndrome and one with primary hyperaldosteronism. 85.7% of patients with adrenal cortical adenoma were hormonally active. The lesion diameter of 18 patients with functional adrenal mass was less than 40 mm, and the mean diameter was 23,1 mm. The lesion diameters of the others were 44 mm and 60 mm. A 11-mm lesion with Conn's syndrome was detected as calcific on imaging. The diameters of the 2 nonfunctional cortical adenomas were 40 mm and 90 mm. Imaging revealed calcification in 4 patients. 2 of these patients were operated. As a result of pathology one was adenoma, the other was adrenal cancer. DISCUSSION AND CONCLUSION: Most of the adrenal incidental cases in our series are nonfunctional adenomas. Among the functional adenomas, Cushing's syndrome was the most common and the second was hyperaldosteronism. The factors that lead to the operation of the masses are function and size.

Keywords

• adrenal incidentaloma
• functional
• non-functional