[Adrenal incidentalomas: clinical experience in the hospitals of Castilla-La Mancha (Spain)].
OBJECTIVE
The management of incidentally discovered adrenal masses (incidentalomas) remains controversial. Our objective was to describe the demographic and clinical characteristics of a series of patients with adrenal incidentalomas attended in several hospitals of Castilla-La Mancha, and their diagnostic and therapeutic management.


METHODS
Data were obtained by reviewing the patients' medical charts.


RESULTS
A total of 270 patients were included (28.1% from Toledo, 25.9% from Albacete, 24.1% from Ciudad Real, 15.9% from Cuenca and 5.9% from Guadalajara). The mean age was 60.3 +/- 12 and 53.3% were women. Overweight or obesity were found in 80.6%, hypertension in 55.8%, diabetes mellitus in 25.6%, impaired fasting glucose or impaired glucose tolerance in 15.6%, osteopenia in 31.5% and osteoporosis in 20.4%. These percentages were similar in patients with subclinical Cushing's syndrome. Diameter was less than 3 cm in 66% of the tumors, and more than 4 cm in 14.3%. Eighty-five percent of the tumors were detected by computed tomography. After a median follow-up of 28.8 months, 6% of nonfunctioning adenomas progressed to subclinical Cushing's syndrome, tumoral enlargement of more than 1 cm was found in 9.4% and a contralateral mass developed in 8.9%. Surgical adrenalectomy was performed in 14.4% of the patients.


CONCLUSIONS
Our study confirms the favorable outcome in most patients with adrenal incidentalomas and contributes to a better understanding of this clinical entity.
Lamas
Cristina
C
Sección de Endocrinología y Nutrición, Complejo Hospitalario Universitario de Albacete, Albacete, España. clamaso@sescam.jccm.es
Palma
Mercedes
M
Martín
David
D
de Frutos
Visitación Alvarez
VA
López
María
M
Marco
Amparo
A
D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000453:epidemiology / Q000378:metabolism / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000150:complications / Q000453:epidemiology / Q000378:metabolism / Q000601:surgery; D018268:Adrenocortical Carcinoma / Q000150:complications / Q000453:epidemiology / Q000378:metabolism / Q000601:surgery; D000368:Aged; D002277:Carcinoma / Q000453:epidemiology* / Q000601:surgery; D015897:Comorbidity; D003480:Cushing Syndrome / Q000209:etiology; D005260:Female; D044882:Glucose Metabolism Disorders / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D006929:Hyperaldosteronism / Q000453:epidemiology / Q000209:etiology; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology; D050177:Overweight / Q000453:epidemiology; D010673:Pheochromocytoma / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D013030:Spain / Q000453:epidemiology
D006854:Hydrocortisone