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N Am J Med Sci. 2015 May;7(5):212-9. doi: 10.4103/1947-2714.157482.

Adrenal Mass in Patients who Underwent Abdominal Computed Tomography Examination.

North American journal of medical sciences

Hassan Al-Thani, Ayman El-Menyar, Marym Al-Sulaiti, Hesham ElGohary, Ahmed Al-Malki, Mohammad Asim, AbdelHakem Tabeb

Affiliations

  1. Department of General Surgery, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar.
  2. Department of Clinical Research, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar ; Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.
  3. Department of Clinical Research, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar.

PMID: 26110133 PMCID: PMC4462817 DOI: 10.4103/1947-2714.157482

Abstract

BACKGROUND: Adrenal masses are usually discovered incidentally (IAM) during abdominal computed tomography (CT).

AIMS: We aimed to describe the prevalence, management, and outcome of incidentally discovered adrenal mass on radiological investigation.

MATERIALS AND METHODS: A retrospective analysis was conducted to look for IAM identified by abdominal CT performed for other reasons between 2004 and 2008 and were followed for 4 years. IAM patients with known malignancy or clinically evident adrenal disease or overt disease originally missed due to insufficient clinical examination were excluded.

RESULTS: A total of 13,115 patients underwent abdominal CT, of which 136 were identified with adrenal mass (69 males and 67 females). Overall, 84 patients had benign IAM and six had primary adrenal carcinoma (all had tumor size ≥4 cm and five were males). Hormonal evaluation was performed in 80 cases, which revealed hypersecretion in 10 cases (six had Conn's syndrome and four had pheochromocytoma). Males had higher frequency of right-sided IAMs; whereas, left-sided IAM swere more common among females (P = 0.02). Seven patients underwent surgery and all were males (one Conn's syndrome, one pheochromocytoma, three primary adrenal adenocarcinoma, one benign nonfunctional adenoma, and one metastatic tumor). Only one patient died due to brain metastasis.

CONCLUSION: The overall prevalence of adrenal incidentaloma is 1% in Qatar. Unfortunately, hormonal evaluation, surgical referral, and follow-up are not appropriate in this study. Moreover, screening of IAM warrants more attention to rule out malignancy. This work could be of value as a local auditing for the current management.

Keywords: Adrenal mass; Computed tomography; Incidentaloma; Malignancy

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