title: Adrenal morpho-functional alterations in patients with acromegaly.
abstract: Acromegaly is associated with a greater morbidity and higher incidence of tumors, possibly due to the permissive role of elevated GH and IGF-I levels. In the general population, adrenal masses are frequently discovered (prevalence 1-5%) at computed tomography (CT). We evaluated the prevalence of adrenal lesions in patients with acromegaly. We studied 94 acromegalic patients, 54 females (mean age 55.0+/-16.0 yr) and 40 males (mean age 50+/-14 yr) referred to 5 Endocrinology Units between 2001-2003; 49 had active disease and 45 had been treated with surgery and/or were controlled with medical therapy. Abdominal CT showed adrenal lesions in 27 patients; 9 of them had unilateral masses (10%) with benign features (diameter 0.5-3 cm) and 18 had hyperplasia (14 monolateral and 4 bilateral), with no significant differences between patients with active vs controlled disease, and with no correlation between prevalence of masses and duration of disease, GH and IGF-I levels. Hormone study (urinary free cortisol, catecholamines/metanephrines, upright plasma renin activity and aldosterone, morning plasma ACTH and low-dose dexamethasone suppression test) disclosed no major endocrine alterations. During a 1-yr follow-up, the adrenal masses increased in size in 3 cases and 1 patient also developed subclinical Cushing's syndrome. Adrenal lesions seem more frequent in acromegaly than in the general population, but no single factor (GH/IGF-I levels or disease duration) predicts them. The masses appear to be benign and nonhypersecreting, but a longer follow-up is recommended to disclose any changes in their morphofunctional state.
authors.affiliation: Department of Medical and Surgical Sciences, Endocrinology Unit, University of Padua, 35128 Padua, Italy. carla.scaroni@unipd.it
authors.forename: C
authors.initials: C
authors.lastname: Scaroni
authors.forename: R
authors.initials: R
authors.lastname: Selice
authors.forename: S
authors.initials: S
authors.lastname: Benedini
authors.forename: E
authors.initials: E
authors.lastname: De Menis
authors.forename: M
authors.initials: M
authors.lastname: Arosio
authors.forename: C
authors.initials: C
authors.lastname: Ronchi
authors.forename: M
authors.initials: M
authors.lastname: Gasperi
authors.forename: L
authors.initials: L
authors.lastname: Manetti
authors.forename: G
authors.initials: G
authors.lastname: Arnaldi
authors.forename: B
authors.initials: B
authors.lastname: Polenta
authors.forename: M
authors.initials: M
authors.lastname: Boscaro
authors.forename: N
authors.initials: N
authors.lastname: Albiger
authors.forename: E
authors.initials: E
authors.lastname: Martino
authors.forename: F
authors.initials: F
authors.lastname: Mantero
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000473:pathology* / Q000503:physiopathology*; D000311:Adrenal Glands / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I
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