ECEESPE2025 Poster Presentations Adrenal and Cardiovascular Endocrinology (169 abstracts)
Pediatric adrenal incidentalomas: Insights from a multicenter study on diagnosis and outcomes
Sebla Güneş 1 , Selda Altıncık 2 , Semra Çetinkaya 3 , Nihal Hatipoğlu 4 , Sevinç Odabaşı Güneş 5 , Ayşen Aksoy Genç 6 , Ozge Bayrak Demirel 7 , Ahmet Uçar 8 , Zeynep Şıklar 9 , İsmail Dündar 10 , Selen Hürmüzlü Közler 11 , Buşra Gürpınar Tosun 12 , Gamze Çelmeli 13 , Sercan Öztürk 14 , Göksel Tuzcu 15 & Ahmet Anik 1
1Aydın Adnan Menderes University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Aydın, Türkiye; 2Pamukkale Unıversity, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Denizli, Türkiye; 3Ankara Dr Sami Ulus Child Health and Diseases Training and Research Hospital, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Türkiye; 4Erciyes Unıversity, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Kayseri, Türkiye; 5Gulhane Training and Research Hospital, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Türkiye; 6Eskisehir Osmangazi University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Eskişehir, Türkiye; 7Istanbul Unıversity, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Türkiye; 8Şişli Hamidiye Etfal Training and Research Hospital, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Türkiye; 9Ankara Unıversity, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Türkiye; 10Inonu Unıversity, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Malatya, Türkiye; 11Kocaeli Unıversity, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Kocaeli, Türkiye; 12Marmara Unıversity, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İstanbul, Türkiye; 13Antalya Training and Research Hospital, Department of Pediatrics, Division of Pediatric Endocrinology, Antalya, Türkiye; 14Aydın Adnan Menderes University, Faculty of Medicine, Department of Pediatrics, Aydın, Türkiye; 15Aydın Adnan Menderes University, Faculty of Medicine, Department of Radiology, Aydın, Türkiye
JOINT3959
Objective: Adrenal incidentalomas (AIs) are asymptomatic adrenal masses with a diameter of ≥1 cm that are detected incidentally during imaging without suspicion of adrenal gland disease. Most studies have focused on the characteristics of adult AIs and the recommendations for their diagnosis. However, the clinical characteristics of AIs in childhood differ greatly from those in adulthood. This multicenter study aimed to examine the clinical, laboratory and imaging characteristics of AIs in children to guide the clinical diagnosis and treatment.
Methods: The clinical data of pediatric AI cases admitted to participating hospitals from 2010 to 2024 was collected and analyzed retrospectively. The data analysis included the patient’s sex, age; initial presentation, imaging, composition, size and site of the mass; tumor function; intervention/surgery and pathological/clinical diagnosis. All patients’ radiographic images were reviewed by an experienced radiologist of the coordinating center. The determination of a malignant/benign tumor was primarily based upon histological findings from surgical resections.
Results: Nineteen children (68.4% male) were included, with a mean follow-up of 3.05±2.83 years and mean age of 10.69±4.24 (3.9–17.5) years. Abdominal ultrasound revealed almost all of the AIs (94.7%), while only one mass was detected with abdominal computed tomography. Most masses were <4 cm (68.4%), hormonally non-functional (84.2%) and excised (89.4%) by laparoscopic/laparotomic adrenalectomy. Seventeen cases (89.4%) were biopsy-confirmed, two (hemorrhage sequelae calcification and benign adrenal mass) were diagnosed clinically. These two cases who followed up without adrenalectomy remained clinically stable, with no increase in size. One patient who had adrenalectomy for bilateral pheochromocytoma developed adrenal insufficiency during follow-up. Among all the AIs, ganglioneuroma was the most common (63.2%). The mean age at ganglioneuroma diagnosis was 10±4.64 years, most cases were male patients (75%) and most of them sized<4 cm (66.6%). The other diagnosed conditions were two adrenocortical neoplasia and one case each of pheochromocytoma, hemorrhagic sequela calcification, gastric duplication cyst, benign adrenal mass and adrenocortical-medullary hemorrhage. Both adrenocortical neoplasia cases were evaluated as suspicious for malignancy by the radiologist due to their heterogeneous internal structures, presence of hemorrhagic/calcific components,>4 cm size and heterogeneous contrast enhancement outside of adenoma characteristics.
Conclusion: Generally, most AIs are benign and poorly functional; often do not show any physical signs of excess/insufficient hormone secretion. In our multicenter study, ganglioneuroma was the most common type of pediatric AI. All of these cases were hormonally non-functional. Sixteen patients (84.2%) were regularly followed and all remained stable throughout the surveillance period.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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