Adrenal incidentalomas are incidentally discovered adrenal tumors by imaging methods without any prior suspicions of adrenal disease. Most of these tumors are functionally inactive but thorough investigations can reveal discrete hormone excess. Chromogranin A(CgA) is expressed in neuroendocrine cells throughout the body, including large and small intestine, adrenal medulla and pancreatic islets. It is a marker for carcinoid tumors, paragangliomas, and other neuroendocrine tumors. As a member of granin family, it was used in some studies as a marker of pheochromocytoma among patients with adrenal incidentaloma. The aim of this study was to determine CgA in patients with adrenal incidentaloma. We have evaluated 35 patients (28 female and 7 male) with adrenal incidentaloma, mean age 52.42±13.62 years. During inpatient testing blood was sampled and CgA was determined by commercial RIA kits with normal range: 19.498.1 ng/ml. In eleven patients, 31.42%, CgA were above upper normal level. Six of them had nonfunctional adrenal tumors with size under 3.5 cm and no other carcinoma and neuroendocrine tumor were detected. After endocrine testing five patients underwent surgical procedure and pathology confirmed two pheochromocytomas, one cortical adenoma, one macronodular adrenal hyperplasia and one secondary deposit of pancreatic carcinoma. In twenty four patients, 68.58%, CgA level was in normal range. Five of them, were surgically treated and one was MEN II b. Our study showed that CgA might be useful in endocrine testing in patient with adrenal incidentaloma since one third of tested patients had elevated values. Further investigations must be done to confirm it sensitivity and specificity.
01 - 05 Apr 2006
European Society of Endocrinology