title: Adrenal Incidentaloma and Subclinical Cushing's Syndrome: A Longitudinal Follow-Up Study by Endoscopic Ultrasound.
abstract: PurposeAdrenal incidentaloma (AI) and adrenal masses in cases of subclinical Cushing's syndrome (SCS) initially require follow-up imaging. In this study we used endoscopic ultrasound (EUS) as a method for high-resolution imaging. The aim was to evaluate the growth rate of AI and SCS by EUS.Materials and MethodsThis retrospective analysis included 93 out of 229 patients with AI or SCS who were investigated longitudinally by EUS in our university hospital between 1997 and 2013. The longitudinal follow-up required at least two investigations by EUS and evaluation of endocrine function. Plasma renin, serum aldosterone, 24 h urinary catecholamines and 2 mg dexamethasone suppression test were performed. EUS was performed at baseline and during follow-up. Each time, the maximum diameter was measured. Three groups were defined: non-functioning adenomas (NFA), non-functioning nodular hyperplasias (NFH) and SCS.Results86 patients had non-functioning masses [NFM] (59 NFA, 48 NFH) and 7 patients had SCS (10 masses). At baseline the mean diameter was 19.4 (± 9.3) mm (NFM) and 19.6 (± 9.2) mm (SCS). The mean follow-up period was 31.6 ± 28.7 months. The estimated mean growth rates per year were low: They were 0.35 mm/yr [NFA], 0.02 mm/yr [NFH] and 0.53 mm/yr [SCS]. Furthermore, there was no malignant progression of any mass.ConclusionThe growth rate as determined by EUS was low for all tumor entities observed in this study. There was no difference in tumor growth between the groups.
authors.affiliation: Division of Endocrinology & Diabetology, Philipps University Marburg, Faculty of Medicine, University Hospital Marburg, Germany.
authors.forename: Maike
authors.initials: M
authors.lastname: Collienne
authors.affiliation: Institute of Medical Biometry and Epidemiology, Philipps University Marburg, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Timmesfeld
authors.affiliation: Division of Endocrinology & Diabetology, Philipps University Marburg, Faculty of Medicine, University Hospital Marburg, Germany.
authors.forename: Simona Raluca
authors.initials: SR
authors.lastname: Bergmann
authors.affiliation: Division of Endocrinology & Diabetology, Philipps University Marburg, Faculty of Medicine, University Hospital Marburg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Goebel
authors.affiliation: Division of Endocrinology & Diabetology, Philipps University Marburg, Faculty of Medicine, University Hospital Marburg, Germany.
authors.forename: Peter Herbert
authors.initials: PH
authors.lastname: Kann
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging; D003480:Cushing Syndrome / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D012189:Retrospective Studies