Endocrine Abstracts (2012) 28 P67

Adrenal incidentalomas outside the Endocrinology clinic

Adaugo Amajuoyi1, Aikaterini Theodoraki1, Jody MacLachlan2, Pierre-Marc Bouloux1 & Bernard Khoo1

1Endocrinology Department, Royal Free Hospital, London, United Kingdom; 2Radiology Department, Royal Free Hospital, London, United Kingdom.

Adrenal masses discovered incidentally during imaging (adrenal incidentalomas) are common and constitute a common reason for referral in the Endocrinology clinic. Our aim was to audit the prevalence of adrenal masses discovered in all computerised tomography (CT) abdominal imaging done over one calendar month in our centre. A secondary aim was to identify the underlying diagnosis and fate of the discovered adrenal nodules. All 690 CT scans done in March 2011 in our centre that included the adrenal glands were reviewed by two trainees; 32 patients (4.64%) were identified with adrenal lesions. Twenty patients (2.9%) had known adrenal pathology, while 12 (1.74%) had newly found adrenal masses (figure 1). Overall, 37.5% (12/32) of all patients with adrenal lesions had another malignancy or adrenal metastasis and all but one were followed-up under the Oncology department, while another 15.6% (5/32) were seen in the Endocrinology clinic. After excluding these 17 patients, 15 patients (n=8 with newly found lesions , n=7 with known lesions) were identified with benign adrenal nodules on imaging criteria. Reviewing all pathology records, none of these 15 patients had any investigations done in order to exclude a functional adrenal lesion. We conclude that the patients seen in the Endocrinology clinic with an incidentaloma represent only a small fraction of the patients bearing a potentially functional adrenal nodule. We are in the process of introducing an investigation and referral pathway to ensure that these patients are properly investigated and managed.

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.

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