Endocrine Abstracts

Aim: To describe the follow-up of adrenal incidentalomas (AI) classified as non-functioning and no suspicious for malignancy in the first approach.

Patients and methods: Observational retrospective study of a cohort of patients who consulted in the Endocrinology service between 2005 and 2015 because of an AI. Statistical analysis performed with SPSS 19th version.

Results: Two hundred and one patients with IA were firstly evaluated. Thirty two of them (15.92%) underwent surgery after the initial evaluation. One hundred and twenty four patients out of the 169 who didn’t undergo surgery (73.37%) were followed: 97 unilateral AI and 27 bilateral AI. Age: 58.48±11.84 years. Size: 26.36±14.14 mm. 57.3% Women. Repeated measurement of plasma metanephrines in 26 patients (20.97%): 21 unilateral AI (21.65%) and five bilateral AI (18.52%). No catecholamine production in any AI. Median follow-up: 4.12±3.44 years. Ninety eight patients (79.03%) underwent a 1 mg dexamethasone suppression test to screen the cortisol autonomous production: 76 unilateral AI (78.35%) and 22 (81.48%) bilateral AI. Follow-up: 2.83±2.67 years. 10 patients (10.20%) diagnosed with subclinical Cushing not present in the first evaluation. The rest of them showed no autonomous cortisol production. A follow-up imaging study was performed in 103 patients (83.06%): 80 with unilateral AI (82.47%) and 23 with bilateral AI (85.19%). Median follow-up: 2.77±2.70 years. In four patients (5%) with unilateral AI there was a significant growth (28.85±15.63 mm), so they underwent surgery to remove them. None of them were malignant.

Conclusions: There wasn’t any patient with new cathecolamine production in the follow-up. In 10.20% of patients we discovered a subclinical Cushing. Our findings agree with previously published studies. There was a significant AI growth in 5% of the patients so they were operated upon. Pathological diagnosis didn’t show malignancy in any case, which is consistent with the available scientific evidence.