Endocrine Abstracts

The management of nonfunctioning adrenal masses is controversial. The size is usually the only criterion for surgical treatment. The objective was to study the progression of the tumor size and the follow-up of several cardiovascular risk parameters in patients with nonsurgical nonfunctioning adrenal masses.

Retrospective longitudinal observational study of 24 patients (54.2% men) with nonfunctioning adenomas followed for five years without surgical treatment. Age, sex, size and location of tumor, blood pressure (BP), body mass index (BMI), lipids, fasting glucose, ions (Na and K), cortisol levels, 24 hours cortisoluria, ACTH, S-DHEAS, aldosterone, urine catecholamines and metanephrines, were analyzed at the time of diagnosis and after five years. LDL and TG were classified according to ATP -III criteria, and diabetes or prediabetes were diagnosed according to the ADA criteria. Adrenal CT was performed every 6 months. Data are presented as mean (standard deviation) and percentage.

At baseline, mean age was 55.5 (11.8) years, BMI 30.1 (5.3) kg/m². The adenoma’s size was 2.1 (0.9) cm. There was hypertension in 50% of patients, hypercholesterolemia in 29.2%, hypertriglyceridemia in 8.3%, mixed dyslipidemia in 12.5%, prediabetes in 29.2% and diabetes in 4.2%.

The mean tumor growth at 5 years was 0.4 (0.5) cm. 45.8% of patients showed a deterioration on the LDL levels, 37.5% worsened the TG levels, and 37.5% aggravated their carbohydrate metabolism. 29.2% of patients required to increase the antihypertensive treatment and 12.5% of nonhypertensive patients developed hypertension (P<0.01). Only one of the adenomas became functioning (hipercortisoluria, lack of cortisol suppression with dexamethasone), confirmed by biopsy after surgery.

In our serie, the growth of nonfunctioning adrenal adenomas is stable after 5 years since diagnosis. However, there is a tendency to a deterioration of BP, carbohydrate metabolism and lipid profile.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.