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Hormonal activity in clinically silent adrenal incidentalomas.
[adrenal incidentaloma]
The
rapid
development
of
modern
imaging
techniques
,
has
led
to
an
increase
in
accidentally
discovered
adrenal
masses
without
clinically
apparent
hormonal
abnormalities
.
Such
tumours
have
been
termed
"
incidentalomas
"
.
The
diagnostic
work-up
in
patients
with
adrenal
incidentalomas
is
aimed
at
the
determination
of
hormonal
activity
of
the
tumour
and
identification
of
patients
with
potentially
malignant
tumours
.
The
aim
of
our
study
was
a
retrospective
analysis
of
selected
clinical
characteristics
and
hormonal
studies
in
accidentally
discovered
adrenal
tumours
.
Fourty
hundred
sixty-
three
patients
with
serendipitously
discovered
adrenal
masses
,
diagnosed
and
treated
in
the
Department
of
Endocrinology
and
Internal
Diseases
,
Medical
University
of
Gdansk
as
well
as
in
the
affiliated
Endocrinology
Clinic
between
1993
and
October
of
2009
were
included
in
the
analysis
.
Out
of
all
patients
,
245
were
referred
for
adrenalectomy
.
We
found
that
clinically
"
silent
"
tumours
often
demonstrate
subclinical
hormonal
activity
.
In
our
report
,
increased
24
-
h
urinary
excretion
of
cortisol
correlated
positively
with
tumour
size
(
p
<
0
.
001
)
.
Moreover
,
a
statistical
relationship
was
demonstrated
between
tumour
size
and
serum
cortisol
concentration
assessed
in
the
1
mg
dexamethasone
suppression
test
(
p
<
0
.
001
)
.
Increased
values
of
dehydroepiandrosterone
/
dehydroepiandrosterone
sulphate
were
more
often
found
in
malignant
than
in
benign
tumours
(
p
<
0
.
01
)
.
Urinary
concentrations
of
17
-
ketosteroids
correlate
positively
with
diagnosis
of
adrenocortical
cancer
(
p
=
0
.
02
)
.
We
found
that
clinically
"
silent
"
tumours
often
demonstrate
subclinical
hormonal
activity
(
subclinical
Cushing
syndrome
,
subclinical
pheochromocytoma
,
low
-symptomatic
adrenocortical
cancer
)
.
Diseases
Validation
Diseases presenting
"diagnosed and treated in the department of endocrinology and internal diseases"
symptom
adrenal incidentaloma
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