Adrenal incidentaloma - follow-up results from a Swedish prospective study.
OBJECTIVE
To examine the risk of developing adrenal carcinomas and clinically overt hypersecreting tumours during short-term follow-up in patients with adrenal incidentalomas.


METHODS
229 (98 males and 131 females) patients with adrenal incidentalomas were investigated in a prospective follow-up study (median time 25 months; range 3-108 months). The patients were registered between January 1996 and July 2001 and followed until December 2004. Twenty-seven Swedish hospitals contributed with follow-up results.


METHODS
Diagnostic procedures were undertaken according to a protocol including reinvestigation with computed tomography scans after 3-6 months, 15-18 months and 27-30 months, as well as hormonal evaluation at baseline and after 27-30 months of follow-up. Operation was recommended when the incidentaloma size increased or if there was a suspicion of a hypersecreting tumour.


RESULTS
The median age at diagnosis of the 229 patients included in the follow-up study was 64 years (range 28-84 years) and the median size of the adrenal incidentalomas when discovered was 2.5 cm (range 1-8 cm). During the follow-up period, an increase in incidentaloma size of > or =0.5 cm was reported in 17 (7.4%) and of > or =1.0 cm was reported in 12 (5.2%) of the 229 patients. A decrease in size was seen in 12 patients (5.2%). A hypersecreting tumour was found in 2% of the hormonally investigated patients: Cushing's syndrome (n = 2) and phaeochromocytoma (n = 1). Eleven patients underwent adrenalectomy, but no cases of primary adrenal malignancy were observed.


CONCLUSIONS
Patients with adrenal incidentaloma had a low risk of developing malignancy or hormonal hypersecretion during a short-term follow-up period.
Department of Medicine, Ryhov Hospital, Jönköping, Sweden. b.bulow@telia.com
Birgitta
B
Bülow
Svante
S
Jansson
Claes
C
Juhlin
Lars
L
Steen
Marja
M
Thorén
Hans
H
Wahrenberg
Stig
S
Valdemarsson
Bo
B
Wängberg
Bo
B
Ahrén
D000305:Adrenal Cortex Hormones / Q000097:blood; D000310:Adrenal Gland Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D013548:Sweden / Q000453:epidemiology; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones