title: Evaluation of functional and malignant adrenal incidentalomas.
abstract: BACKGROUND
  Adrenal incidentalomas are adrenal masses discovered inadvertently. We undertook this study to review the clinical characteristics of patients with adrenal incidentalomas who presented to a tertiary endocrine center in Hong Kong.
  
  
  METHODS
  Retrospective review of all 139 cases of adrenal incidentalomas that were referred to the Endocrine Centre of the Prince of Wales Hospital between June 1, 2000, and May 31, 2007. We reviewed detailed patient history, physical examination findings, and symptoms and signs related to hormonal hypersecretion or malignant neoplasm and recorded clinical indications for performing diagnostic radiological imaging.
  
  
  RESULTS
  Sixty-one patients (43.9%) had nonfunctional benign adrenal adenomas, 52 (37.4%) had functional lesions, 15 (10.8%) had malignant adrenal lesions, and the remaining 11 (7.9%) had varying adrenal disease. Among those with functional lesions, 27 (19.4%) had lesions that secreted excess cortisol; 12 (8.6%), lesions that secreted aldosterone; 12 (8.6%), lesions that secreted excess catecholamines; and 1 (0.7%), a lesion that demonstrated excess secretion of cortisol and aldosterone. Only 5 of the 27 patients with cortisol-secreting adrenal incidentalomas had symptoms or signs of excess cortisol levels at presentation.
  
  
  CONCLUSIONS
  Adrenal incidentaloma is a commonly encountered clinical problem. Functional or primary malignant adrenal incidentalomas can be detected at an earlier stage during hormonal and radiological evaluations, which provides an opportunity for further management.
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Vanessa W S
authors.initials: VW
authors.lastname: Ng
authors.forename: Ronald C W
authors.initials: RC
authors.lastname: Ma
authors.forename: Wing-Yee
authors.initials: WY
authors.lastname: So
authors.forename: Kai Chow
authors.initials: KC
authors.lastname: Choi
authors.forename: Alice P S
authors.initials: AP
authors.lastname: Kong
authors.forename: Clive S
authors.initials: CS
authors.lastname: Cockram
authors.forename: Chun-Chung
authors.initials: CC
authors.lastname: Chow
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D018246:Adrenocortical Adenoma / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood / Q000378:metabolism*; D002395:Catecholamines / Q000097:blood / Q000378:metabolism*; D003346:Corticotropin-Releasing Hormone / Q000097:blood; D055088:Early Detection of Cancer; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D002395:Catecholamines; D000450:Aldosterone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone