Endocrine Abstracts (2017) 49 EP81 | DOI: 10.1530/endoabs.49.EP81

Long term follow up of patients with adrenal incidentaloma and 'autonomous cortisol secretion'

Ivana Kraljevic1, Mirsala Solak1, Tina Dusek1,2, Tanja Skoric Polovina1, Annemarie Balasko1 & Darko Kastelan1,2


1University Hospital Center Zagreb, Zagreb, Croatia; 2ZAgreb University School of Medicine, Zagreb, Croatia.


The aim of this study was to compare the long-term co-morbidities and biochemical data between patients with adrenal incidentaloma and ‘autonomous cortisol secretion’ who were treated surgically and conservatively.

Methods: The research of the database of the patients with adrenal incidentaloma diagnosed between 2007 and 2014 was performed. Among them, 43 patients with ‘autonomous cortisol secretion’ were identified and invited for a follow-up visit. Diagnostic criteria for ‘autonomous cortisol secretion’ were: cortisol>83 nmol/l after 1 mg dexamethasone suppression test plus one additional criteria (suppressed ACTH secretion or elevated urinary free cortisol). At follow-up visit the anthropometric as well as biochemical data were collected (blood glucose, lipid panel test, HOMA index, cortisol after 1 mg dexamethasone, urinary free cortisol, and ACTH). All patients were evaluated for hypertension, dyslipidemia, osteoporosis and diabetes mellitus/impaired glucose tolerance.

Results: Of the 43 invited patients, 26 patients performed follow up visit (4 males). Among them, 17 patients were treated surgically and 9 were treated conservatively. Median follow-up was 6 years (range 2–16), median age at follow-up was 62 years (range 41–76). There was no difference in BMI at baseline and at follow up in both groups. In the group of surgically treated patients, during follow-up period one patient was diagnosed with arterial hypertension, 4 with hyperlipidemia, and one with diabetes mellitus. Nevertheless, nine out of 12 patients with hypertension in the surgical group reported improvement/disappearance of arterial hypertension at the follow-up visit. Among conservatively treated patients, six out of nine patients had no difference in co-morbidities, one was newly diagnosed with osteoporosis, one with arterial hypertension and one with renal insufficiency. Conclusion: Patient who underwent surgery for ‘autonomous cortisol secretion’ experienced improvement in the regulation of hypertension after medium follow-up of 6 years. No other significant differences were found in the prevalence of comorbidities between conservatively versus surgically treated patients.

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