title: Clinical characteristics and follow-up of Korean patients with adrenal incidentalomas.
abstract: OBJECTIVE
  We investigated the clinical characteristics and follow-up findings of subjects with adrenal incidentalomas in a single, tertiary-care hospital in South Korea.
  
  
  METHODS
  The study consisted of a retrospective analysis of 282 adrenal incidentaloma patients who underwent radiographic and endocrinological evaluations at Samsung Medical Center in Seoul, South Korea, between January 2004 and July 2011.
  
  
  RESULTS
  Most (86.2%) of the subjects were found to have nonfunctioning tumors. Functioning tumors were seen in 39 patients (13.8%). Among them, 28 (9.9%) had subclinical Cushing syndrome (SCS), six (2.1%) had pheochromocytoma, and five (1.8%) had primary hyperaldosteronism. Malignant adrenal tumors were discovered in three cases: two (0.7%) were primary adrenal cancers, and one (0.4%) was a secondary metastasis from a lung cancer. Significant risk factors for functional tumors were female gender (odds ratio [OR], 3.386; 95% confidence interval [CI], 1.611 to 7.117; p = 0.0013) and a noncontrast attenuation value of > 10 Hounsfield units (OR, 2.806; 95% CI, 1.231 to 6.397; p = 0.0141). During follow-up (mean, 22.5 months) of 72 of the patients, three (4.2%) developed hormonal changes due to functional tumors. One was confirmed as pheochromocytoma by histopathology, and the others were diagnosed with SCS and followed routinely without surgical intervention. No malignant transformation was found in these patients.
  
  
  CONCLUSIONS
  Based on these findings, initial hormonal and radiographic evaluations for adrenal incidentalomas appear to be more important than follow-up tests because functional or malignant changes are rare.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yoon Young
authors.initials: YY
authors.lastname: Cho
authors.forename: Sunghwan
authors.initials: S
authors.lastname: Suh
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Joung
authors.forename: Hyemin
authors.initials: H
authors.lastname: Jeong
authors.forename: Dongmo
authors.initials: D
authors.lastname: Je
authors.forename: Hongseok
authors.initials: H
authors.lastname: Yoo
authors.forename: Taek Kyu
authors.initials: TK
authors.lastname: Park
authors.forename: Yong-Ki
authors.initials: YK
authors.lastname: Min
authors.forename: Kwang-Won
authors.initials: KW
authors.lastname: Kim
authors.forename: Jae Hyeon
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D003480:Cushing Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010673:Pheochromocytoma / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D006728:Hormones
keywords: Adrenal gland neoplasms; Aldosterone; Cushing syndrome; Pheochromocytoma