SFEBES2023 Poster Presentations Adrenal and Cardiovascular (78 abstracts)
Hormonal secretion pattern in patients with adrenal tumours referred to a UK tertiary care centre
Sumedha Mandal 1 , Pratyusha Saha 1 , Onnicha Suntornlohanakul 1 , Shadman Ahmed 1 , Jessica Parkin-Crawshaw 1 , Miriam Asia 2 , Wiebke Arlt 3 , Yasir Elhassan 2 , Alessandro Prete 1 & Cristina Ronchi 1
1University of Birmingham, Birmingham, United Kingdom. 2Queen Elizabeth Hospital, Birmingham, United Kingdom. 3Medical Research Council London Institute of Medical Sciences, London, United Kingdom
Introduction: Up to 3-7% of adults have an adrenal incidentaloma. These are most frequently non-functioning adenomas (NFA) but can be associated with adrenal hormone excess. According to the ESE-ENSAT guidelines on adrenal incidentalomas (2016), an accurate endocrine work-up is recommended.
Methods: We provide an extensive retrospective analysis of patients with adrenal tumours referred to a large UK tertiary centre between 1998 and 2022, with focus on non-aldosterone producing adrenocortical adenomas (NAPACA) and the relationship between hormonal secretion patterns and demographic characteristics.
Results: Our cohort consisted of 1398 patients (56% women, median age at diagnosis: 60 years [IQR 49-70]). Adrenocortical adenomas (ACA) accounted for majority of tumours (56%, n=782); of these, 90% (n=706) underwent full endocrine work-up including overnight dexamethasone suppression test. While most patients had NFA (51%), the others most frequently had mild autonomous cortisol secretion (MACS, 32%), followed by primary aldosteronism (10%) and Cushing’s syndrome (CS, 4%). Most patients with NAPACA were women, with a higher proportion among those with CS (61% in NFA, 60% in MACS, 87% in CS, P<0.05). Moreover, patients with CS were younger (NFA median 60 years [IQR 51.5-68], MACS 67 years [IQR 58-74], CS 44 years [IQR 30.5-54.5], P<0.05). There was no significant difference in availability of endocrine work-up or proportion of diagnosed autonomous cortisol secretion between patients referred before (1998-2015) or after the publication of the ESE-ENSAT guidelines (2016-2022).
Conclusion: In our large cohort of patients referred for adrenal tumours, full endocrine work up was available in 90% of ACAs and showed presence of autonomous cortisol secretion in 36% of cases. Patients with CS were more frequently younger females. These figures did not change after the implementation of the 2016 guidelines.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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