Adrenal incidentaloma: clinical characteristics and comparison between patients with and without extraadrenal malignancy.
Adrenal incidentaloma (AI) is frequently found in patients with a history of malignancy and, as such, is not always considered a true incidental finding.


OBJECTIVE
To compare the short-term clinical and biochemical behavior of adrenal incidentalomas between oncology and non-oncology patients.


METHODS
Retrospective comparative case series of 100 consecutive patients with adrenal incidentaloma, followed from 1995 to 2005 in the endocrinology clinic of a tertiary university medical center.


RESULTS
A history of malignancy was present in 32 patients. Median follow-up was 24 months. Mean tumor size was 24+/-10 mm. Endocrine evaluation yielded functional abnormalities in 12.2% (subclinical Cushing's 7.4%, Cushing's syndrome 1.1%, hyperaldosteronism 1.3%, pheochromocytoma 3.6%). During follow-up, adrenal function remained unchanged in all patients, but tumor growth was seen in 12.5%. Compared to the non-oncology patients, the oncology group had a higher mean age (67.5+/-9.6 vs 59.4+/-1.3 yr, p=0.001) and greater tumor growth (23.3% vs 7%, p=0.035), with no significant differences for tumor size, functional abnormalities, and extent of change in tumor size. Surgery was performed in 9 patients (3 oncologic) and revealed metastasis in one. None of the other patients had clinical or radiological findings suggesting adrenal malignancy.


CONCLUSIONS
Our study suggests a similar clinical behavior of adrenal incidentaloma in oncology and non-oncology patients. More studies are needed to assist clinicians in selecting oncology patients with AI for whom a more conservative approach can be recommended.
Tsvetov
G
G
Endocrine Institute, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel 49100.
Shimon
I
I
Benbassat
C
C
D000310:Adrenal Gland Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D000328:Adult; D000368:Aged; D003480:Cushing Syndrome / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006929:Hyperaldosteronism / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000473:pathology*; D009765:Obesity / Q000453:epidemiology; D010673:Pheochromocytoma / Q000453:epidemiology* / Q000473:pathology*; D015995:Prevalence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed