Endocrine Abstracts

The objective was to study clinical aging peculiarities of manifestation period of cortisol secreting adrenal adenoma.

Materials and methods: Forty five patients with cortisol-secreting adrenal adenoma served the basis for the study. In that group of patients there were 11 (24.4%) men and 34 (75.6%) women, with the average age 27.5 ± 10.5 years old. Out of forty five patients 5 (11.2%) were children. All patients had common clinical, biochemical, hormonal, and instrumental tests.

Results: Cortisol-secreting adenoma were observed in young age from 18 to 44 years old (84.4%; χ² = 40.0; P < 0.0001); according to gender distribution it was more often observed in women, than in men (75.6% vs 24.4% respectively). among children and people above 44 these tumors were registered less often, in 5 (11.2%) and 2 (4.4%) cases, respectively. Only 11 (24.4%) patients were diagnosed within one years from the start of the disease, 26 (57.8%) patients needed from 1 to 5 years for the diagnosis, and 6 (13.3%) patients were correctly diagnosed in 5–10 years, and that, certainly affected the results of treatment. Finally, two (4.4%) patients spent more than 10 years before they were diagnosed. The most characteristic manifestation of cortisol-secreting adenoma was arterial hypertension (AH) observed in 18 (40%) patients. Average age of the patients in manifestation period of AH was 25.3 ± 10.2 years old. We observed positive direct correlation between the age at the moment of AH debut and systolic AP (r = 0.35; P = 0.03). Sexual dysfunctions (10–22.2%) and weight gaining (13–28.9%) had similar prevalence at the debut of the disease. Less often the pathology started with stomachache and changes in appearance. In one case cortisol-secreting adenoma diagnosis was established when patient with acute disorder of cerebral circulation was checked after long-term neuropathologist’s treatment of hypertonic disease. In the majority of cases when children suffered the disease its manifestations were non-specific, and displayed in weight gaining (100%), physical and mental retardation (60%), leading to the choice of observational strategy and absence of duly diagnostics and treatment.

Conclusion: Great number and variability of early clinical manifestations of cortisol-secreting adenoma cause difficulties in diagnostics reflected in the long duration of the disease, in other words time from appearance of initial symptoms till correct diagnosis. In children the basic symptom in manifestation of cortisol-secreting adenoma is gaining weight with no growth, which should urge pediatricians to perform targeted search for the disease.