Aim: This audit aims to access the compliance in management of adrenal incidentalomas with reference of European society of endocrinology guidelines.
Background: An adrenal incidentaloma is a mass lesion greater than 1 cm in diameter, serendipitously discovered on radiological examination. It is important to determine its malignant potential and functional status. European society of Endocrinology (ESE) has published its guidelines in 2016 for management of adrenal incidentalomas.
Methods: Patients with known adrenal incidentalomas were collected from Adrenal multidisciplinary team (MDT) meeting from October 2017 to February 2018. There were total 56 patients with 32 females and 24 males. As per ESE guidelines every patient should be evaluated for cortisol and catecholamines excess with overnight dexamethasone suppression test (ONDST) and urinary or plasma metanephrines. Aldosterone renin ratio (ARR) should only be performed in patients with known history of hypertension (HTN).
Results: ONDST and plasma/urinary metanephrines were not performed in 12 (21%) and 5 (8%) of patients respectively. Whereas Aldosterone renin ratio (ARR) was checked in 20 (35%) patients with no history of Hypertension (HTN).
Conclusion: This study demonstrates that ESE guidelines were largely followed but there is still need for better compliance.