Endocrine Abstracts

JOINT3790

Introduction: Bilateral incidental adrenal incidentaloma represent 10–23% of all incidental adrenal nodules. The general approach to these nodules follows the same premise as for unilateral incidental adrenal nodules however there are features unique to bilateral nodules including the differential diagnosis, the diagnostic approach as well as the management. The aim of our study is to describe the clinical and biological profile of bilateral AIs.

Methods: This was a retrospective, descriptive study carried out in an Endocrinology department, on records of patients in whom a bilateral AI has been discovered. The following parameters were identified: Clinical and biological presentation, etiological profile, diagnosis and therapeutic means.

Results: A total of 29 records were studied, 18 women and 11 men with a mean age of 57,2 years [26-80 years]. Of these patients, 10 were hypertensive, 8 were diabetic and 5 six had dyslipidemia. Metabolic syndrome was present in 11 patients and 4 patients had history of extra-adrenal neoplasma. Adrenal CT scans were performed in 26 patients and MRI in tox others. AIs in Size was greater than 4 cm in 2 cases. Adrenal insufficiency was found in 6 patients with bilateral AIs. Hormonal exploration revealed a secreting mass in 7 cases concluding to MACS in 5 patients and primary hyperaldosteronism in tow cases. in a single case, the presence of large bilateral masses was associated with 11 beta hydroxylase deficiency in a 27-year-old patient in whom the diagnosis has been confirmed genetically. Myelolipomas were diagnosed in two cases and a bilateral acute adrenal hemmoragia during covid 19 infection in another case. hydrocortisone has been prescribed in patients with adrenal insufficiency as a replacement therapy and as a suppressant treatment in patients with congenital adrenal hyperplasia. Aldactone treatment has been prescribed for the case of primary hyperaldosteronism. Therapeutic monitoring or abstention have been decided in other patients

Conclusion: Hormonal exploration and radiologic imaging generally makes it possible to link AIs to its etiology and to establish the therapeutic strategies adapted for each patients. investigation of adrenal insufficiency is the rule in order to avoid acute decompensation.