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Two-year follow-up of thirty-two non-functional benign adrenal incidentalomas.
MedLine Citation:
PMID:  19605976     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the risk of developing endocrine hyperactivity and carcinoma during a period of up to 5 yr in patients with apparently benign and non-functioning adrenal incidentalomas. PATIENTS AND METHODS: Thirty-two patients (mean age: 57.0+/-8.3 yr) were investigated in a prospective follow-up study for a median time of 24 months. Twenty-eight patients had unilateral and 4 had bilateral masses. Initial average mass diameter was 17.47+/-6.60 mm. All patients were followed up yearly by physical examination, metabolic parameters, hormonal evaluation [morning cortisol after 3-mg dexamethasone suppression, urinary metanephrines, and upright aldosterone/ plasma renin activity (PRA)]. RESULTS: Among the clinical characteristics, 48% of patients were obese, 20% were hypertensive, 13 had Type 2 diabetes and impaired glucose tolerance. During follow-up period no significant change in the functional status was observed and nomalignant transformation occurred. Only 1 patient developed subclinical Cushing's syndrome at the end of the 1st year and referred to surgery. Change in mass size was correlated with homeostasis model assessment of insulin resistance (p=0.002), upright aldosterone/ PRA (p=0.041), cortisol after dexamethasone suppression (p=0.048) and 24-h urinary normetanephrine (p=0.005) levels. Gender, body mass index, glucose metabolism, and blood pressure were not found to be correlated with change in mass size and functional status. CONCLUSIONS: Due to the extremely low risk of developing malignancy during up to 5 yr of follow-up, conservative approach for the management of adrenal incidentalomas is thought to be appropriate. However, possibility of evolution to hormonal hypersecretion makes long-term follow-up of 2-to-5 yr seems to be obligatory.
H Yilmaz; N B T?t?nc?; M Sahin
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Publication Detail:
Type:  Journal Article     Date:  2009-07-14
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  32     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-02-05     Completed Date:  2010-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  913-6     Citation Subset:  IM    
Baskent University Faculty of Medicine, Department of Endocrinology, Bah?elievler, Ankara, Turkey.
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MeSH Terms
Adrenal Gland Neoplasms / etiology,  pathology,  physiopathology*
Adrenal Glands / pathology*,  physiopathology
Aldosterone / diagnostic use
Cushing Syndrome / etiology
Dexamethasone / diagnostic use
Follow-Up Studies
Hydrocortisone / blood
Incidental Findings
Insulin Resistance
Middle Aged
Obesity / physiopathology
Renin / blood
Reg. No./Substance:
50-02-2/Dexamethasone; 50-23-7/Hydrocortisone; 52-39-1/Aldosterone; EC

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