ECE2017 Eposter Presentations: Adrenal and Neuroendocrine Tumours Adrenal cortex (to include Cushing's) (86 abstracts)
Clinical course of patients with adrenal incidentaloma: retrospective analysis of a single center
Ana Carolina Ruiz Serrano 1 , Ana Megia Colet 1, , Silvia Näf Cortes 1, , Joan Vendrell Ortega 1, , Inmaculada Simon Muela 1, , Esther Solano Fraile 1 & Theodora Michalopoulou Alevras 1
1Endocrinology and Nutrition Service University Hospital of Tarragona Joan XXIII, Tarragona, Spain; 2CIBERDEM, Tarragona, Spain.
In the adrenal incidentaloma (AI) it is fundamental to determine functionality and benignity. The aim of this study was to evaluated the clinical, radiological and hormonal evolution of AI and compare the frequency of autonomous cortisol secretion (ACS) between American and European Guidelines.
Methods: Retrospective evaluation of patients with AI referred to our service in the last 5 years.
Results: 140 patients were included, 50.9% were men. At diagnostic, the media of age was 66±11.2 years and the median of size was 20 mm. CT detected the 95% of AI and 80% had an adenoma-like appearance (49.3% left). Hormonal evaluation revealed that 54.3% were nonfunctional (NF), 38.6% possible autonomous cortisol secretion (PACS), 5.7% ACS, 5% Cushing’s syndrome (CS) and 1.4% pheochromocytoma (PCC). Considering American guidelines: 87.9% were NF, 9.3% subclinical Cushing’s syndrome and 0.7% CS. The majority of patients remained stable. None developed overt CS. The 13.6% showed growth, with a median of 6 mm. Median follow-up: 30 months. There were significant statistical differences (P<0.05) between the group of NF and PACS/CS in terms of size and between NF and CS in terms of growth. No differences were observed in terms of sex, age or cortisol-related comorbidities. Seven patients underwent surgery: one PACS, three ACS, two PCC and one adrenal carcinoma. The 4.3% died due to unrelated adrenal disease.
Conclusions: The AI’s are predominantly small, benign, nonfunctioning; stable in time, tumor size and hormonal production. The use of the diagnostic criteria for ASC according to European guidelines shows an increase in the frequency of PACS/ACS, therefore, ACTH determination should be considered in the diagnosis.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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