Clinical study of adrenal incidentaloma in Korea.
BACKGROUND
This study was designed to evaluate the clinical, endocrinological and histological characteristics of adrenal incidentalomas.


METHODS
Eighty patients (41, males; 38, females; age range 17-80 years) who were diagnosed with adrenal incidentaloma at Korea University Hospital from 1992 to 2003 were studied retrospectively.


RESULTS
Endocrinological investigation revealed 16 pheochromocytomas (20%), nine Cushing's syndromes (11%), eight primary aldosteronism (10%) and 46 non-functioning tumors (58%). Forty-four patients received operations, and biopsies were performed on two patients. Pathologic examination revealed 16 adrenocortical adenomas (20%), five carcinomas (6%), 13 pheochromocytomas (16%), three metastatic cancers (4%), and other tumors (10%). The diameter of the carcinomas (mean: 10.8 cm, range: 5-19 cm) were significantly larger than the diameter of benign adenomas (mean: 2.84 cm, range: 1-6 cm) (p=0.002). According to the receiver operating charactenstic (ROC) curve analysis, the cut-off value of tumor size for discriminate malignant tumor was 4.75 cm (sensitivity 90%, specificity 58%). Twenty-four patients with non-functioning tumors were followed up for a period of 3 to 72 months. During the follow up period, two patients showed an increase in tumor size of more than 1 cm, and one patient developed Cushing's syndrome. Changes in mass size and function were observed only between 10 and 26 months after the initial diagnosis.


CONCLUSIONS
These data show that an endocrine evaluation should be performed in all adrenal incidentalomas, and an adrenalectomy is recommended for tumors 5 cm or greater or tumors with adrenocortical hyperfunction. In addition, these tumors should be monitored for changes in mass size and function for a follow up period of approximately 26 months.
Department of Internal Medicine, Korea University College of Medicine, Seoul.
Hee Young
HY
Kim
Sin Gon
SG
Kim
Kye Won
KW
Lee
Ji A
JA
Seo
Nan Hee
NH
Kim
Kyung Mook
KM
Choi
Sei Hyun
SH
Baik
Dong Seop
DS
Choi
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis*; D018246:Adrenocortical Adenoma / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007723:Korea; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000175:diagnosis; D012189:Retrospective Studies