title: Should the diagnostic and therapeutic protocols for adrenal incidentalomas be changed?
abstract: BACKGROUND
  The prevalence of adrenal incidentalomas is increasing with the aging of the population and the use of high resolution imaging technics. Current protocols propose a comprehensive monitoring of their functional and morphological state, but with no conclusive clinical evidence that endorses it.
  
  
  METHODS
  Retrospective study of 96 patients diagnosed with adrenal incidentaloma between 2008 and 2012. We evaluated clinical, functional and imaging at baseline and during follow-up.
  
  
  RESULTS
  Initially, 9 cases were surgically removed: 4 due to hyperfunction (2 Cushing syndromes and 2 pheochromocytomas) and 5 due to size larger than 4cm. During follow-up one case of pheochromocytoma was diagnosed and another grew more than 1cm, needing surgery. In 98.86% of nonfunctional and benign lesions, there was no functional and/or morphological changes in the final evaluation.
  
  
  CONCLUSIONS
  The results of our study challenge the validity of current diagnostic-therapeutic protocols of incidentalomas, which should be reassessed in prospective studies taking into account efficiency characteristics.
authors: Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España. Electronic address: isamateogavira@gmail.com.
authors: Isabel
authors: I
authors: Mateo-Gavira
authors: Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España.
authors: Francisco Javier
authors: FJ
authors: Vilchez-López
authors: Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España.
authors: Laura
authors: L
authors: Larrán-Escandón
authors: Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España.
authors: María Belén
authors: MB
authors: Ojeda-Schuldt
authors: Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España.
authors: Cristina López
authors: CL
authors: Tinoco
authors: Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España.
authors: Manuel
authors: M
authors: Aguilar-Diosdado
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D002985:Clinical Protocols / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Adrenal incidentaloma; Adrenalectomy; Adrenalectomía; Cushing syndrome; Feocromocitoma; Incidentaloma suprarrenal; Pheochromocytoma; Síndrome de Cushing