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
Affiliations
- Department of General Surgery, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar.
- Department of Clinical Research, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar ; Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.
- 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
References
- J Clin Endocrinol Metab. 1998 Jan;83(1):55-62 - PubMed
- BMJ Case Rep. 2011 Nov 08;2011:null - PubMed
- Endocrine. 2010 Feb;37(1):40-6 - PubMed
- Surgery. 2007 Oct;142(4):497-502; discussion 502-4 - PubMed
- J Endocrinol Invest. 2007 Sep;30(8):647-52 - PubMed
- Eur J Endocrinol. 2010 Apr;162(4):779-85 - PubMed
- Endocrine. 2015 May;49(1):6-26 - PubMed
- NIH Consens State Sci Statements. 2002 Feb 4-6;19(2):1-25 - PubMed
- Eur J Endocrinol. 2002 Jan;146(1):61-6 - PubMed
- Surgery. 2004 Dec;136(6):1289-96 - PubMed
- Eur J Endocrinol. 2002 Oct;147(4):489-94 - PubMed
- Ann Intern Med. 2003 Mar 4;138(5):424-9 - PubMed
- Chang Gung Med J. 2003 Jan;26(1):34-40 - PubMed
- Clin Med (Lond). 2008 Apr;8(2):201-4 - PubMed
- Korean J Intern Med. 2005 Dec;20(4):303-9 - PubMed
- Eur J Endocrinol. 2005 Oct;153(4):477-87 - PubMed
- Nat Rev Urol. 2009 Jul;6(7):363-73 - PubMed
- J Endocrinol Invest. 2006 Apr;29(4):298-302 - PubMed
- Clin Endocrinol (Oxf). 2007 Jun;66(6):778-88 - PubMed
- Endocr J. 2003 Aug;50(4):399-408 - PubMed
- Br J Cancer. 2005 Mar 28;92(6):1104-9 - PubMed
- J Clin Endocrinol Metab. 2000 Feb;85(2):637-44 - PubMed
- JAMA. 1982 Aug 13;248(6):701-4 - PubMed
- J Intern Med. 2002 Sep;252(3):239-46 - PubMed
- Eur J Endocrinol. 2009 Feb;160(2):257-64 - PubMed
- Clin Endocrinol (Oxf). 2009 May;70(5):674-9 - PubMed
- N Engl J Med. 2007 Feb 8;356(6):601-10 - PubMed
- Surgery. 2014 Oct;156(4):959-65 - PubMed
- Cancer Imaging. 2007 Oct 01;7 Spec No A:S100-9 - PubMed
- Proc (Bayl Univ Med Cent). 2003 Jan;16(1):7-12 - PubMed
- Korean J Intern Med. 2013 Sep;28(5):557-64 - PubMed
- AJR Am J Roentgenol. 2008 May;190(5):1163-8 - PubMed
- Endocr Rev. 2004 Apr;25(2):309-40 - PubMed
- Radiology. 1984 Oct;153(1):217-8 - PubMed
- Eur J Endocrinol. 2006 Mar;154(3):419-23 - PubMed
- Can Urol Assoc J. 2011 Aug;5(4):241-7 - PubMed
- World J Surg. 2001 Jul;25(7):905-13 - PubMed
- J Clin Endocrinol Metab. 2011 Jul;96(7):2004-15 - PubMed
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