Long Term Follow-up of Patients with Adrenal Incidentalomas- A Single Center Experience and Review of the Literature
| Autor: | Zoe Efstathiadou, Konstantina Tsolakidou, Stergios A. Polyzos, Marina Kita, Panagiotis Anagnostis, Ioannis Litsas, Athanasios Panagiotou |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adenoma
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Adrenal Gland Neoplasm Adrenal Gland Neoplasms Pheochromocytoma Single Center Basal (phylogenetics) Cushing syndrome Endocrinology Prevalence Internal Medicine Humans Medicine Retrospective Studies Incidental Findings business.industry Adrenalectomy Incidentaloma Retrospective cohort study General Medicine Middle Aged medicine.disease Tumor Burden Surgery Disease Progression Female business Follow-Up Studies |
| Zdroj: | Experimental and Clinical Endocrinology & Diabetes. 118:610-616 |
| ISSN: | 1439-3646 0947-7349 |
| DOI: | 10.1055/s-0029-1237704 |
| Popis: | Introduction Adrenal incidentalomas (AIs) constitute an emerging clinical entity due to the increased use of abdominal imaging for diagnostic purposes. Most often it consists of benign-nonfunctioning lesions and an increase in size during follow-up is reported in about 9% (0-26%), whereas their functional evolution is rare. Materials and methods Sixty-four patients (22 males and 42 females; mean age 61.6 ± 1.2 years), with AIs and follow-up of 3.1 ± 0.4 years (range 0-19) were retrospectively evaluated. The patients underwent basal and dynamic evaluation of the hypothalamic-pituitary-adrenal axis, renin-angiotensin-aldosterone system and adrenomedullary function. Mass enlargement and adrenal hyperfunction were estimated at yearly intervals. Results Adrenalectomy was performed in 5 patients (4 benign cortical adenomas and 1 pheochromocytoma). Abnormal manifestation, based on clinical, laboratory and histological evaluation, was observed in 4 patients [1 (1.56%) with SCS, 2 (3.12%) with pheochromocytoma and 1 (1.56%) with aldosteronoma], 3 of which were diagnosed at their initial evaluation and 1 at the 3 (rd) year of follow-up. The remainders [60 patients (93.75%)] were harbouring a non-secretory mass (8 potential myelolipomas, 8 nodular hyperplasias, 3 cystic lesions). Eleven patients (17.2%) had bilateral AIs. Mass enlargement (5-13 mm) was observed in 9 patients (14%), ≥10 mm 4 (6.25%), while mass shrinkage (5-19 mm) in 3 (4.7%) during follow-up. No hormonal evolution was noticed. Conclusions AIs present usually as benign, non-secretory lesions. Criteria for surgical intervention were met at initial assessment for the majority of AIs. Size alterations during follow-up are uncommon and functional evolution is rare. |
| Databáze: | OpenAIRE |
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