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Long term follow-up of non functional adrenal incidentalomas in size: a single center experience

Year 2018, Volume: 10 Issue: 4, 506 - 510, 01.12.2018
https://doi.org/10.21601/ortadogutipdergisi.364582

Abstract

Aim:
Adrenal masses
incidentally detected (adrenal incidentalomas, AI) during imaging studies
performed due to unrelated causes can be benign or malignant in behaviour and
hormonally inactive or active in action. It is important whether change in size
occurs during follow-up of AIs. In this study we aimed to study change in size
of adrenal incidentalomas during follow-up.

Material
and Method:
Electronic
data of 136 patients with AI, who were followed up in endocrinology unit of
Yunus Emre State Hospital, Eskisehir, during 2011-2017 were evaluated
retrospectively. Hormonal activity were studied by 1 mg dexamethasone
suppression test, plasma aldosterone/renin activity ratio, and catecholamines
and vanyl mandelic acid measurement in 24 hour urine samples. The longest
diameter of AIs in the axial plane were measured by using distance cursor on
computed CT images or MRI. Data of 82 patients who met inclusion criteria were
evaluated.

Results:
Thirty-seven
(45%) out 82 patients were male and 45 (55%) were female. 42 (51%) had left
sided and 40 (49%) had right sided AIs. Mean duration of follow-up was 41.5±14.7
(24-72) months. Mean diameter of AIs at the time diagnosis was 23.1±9.6 mm, and
on the last imaging study was 23.4±9.8 mm (p>0.05).







Conclusion:
We did not find
any significant change in size of non-functional AIs during at least 2 years of
follow-up.

References

  • 1. Chidiac RM, Aron DC. Incidentalomas. A disease of modern technology. Endocrinol Metab Clin North Am 1997;26:233-53.
  • 2. Kloos RT, Gross MD, Francis IR, Korobkin M, Shapiro B. Incidentally discovered adrenal masses. Endocr Rev 1995;16:460-84.
  • 3. Schmid H, Mussack T, Wornle M, Pietrzyk MC, Banas B. Clinical management of large adrenal cystic lesions. Int Urol Nephrol 2005;37:767-71.
  • 4. Zeiger MA, Thompson GB, Duh QY, et al. American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons Medical Guidelines for the Management of Adrenal Incidentalomas: executive summary of recommendations. Endocr Pract 2009;15:450-3.
  • 5. NIH state-of-the-science statement on management of the clinically inapparent adrenal mass ("incidentaloma"). NIH Consens State Sci Statements 2002;19:1-25.
  • 6. Schalin-Jantti C, Raade M, Hamalainen E, Sane T. A 5-Year Prospective Follow-Up Study of Lipid-Rich Adrenal Incidentalomas: No Tumor Growth or Development of Hormonal Hypersecretion. Endocrinol Metab (Seoul) 2015;30:481-7.
  • 7. Hong AR, Kim JH, Park KS, Kim KY, Lee JH, Kong SH, et al. Optimal follow-up strategies for adrenal incidentalomas: reappraisal of the 2016 ESE-ENSAT guidelines in real clinical practice. Eur J Endocrinol 2017;177:475-83.
  • 8. Grumbach MM, Biller BM, Braunstein GD, et al. Management of the clinically inapparent adrenal mass ("incidentaloma"). Ann Intern Med 2003;138(5):424-9.
  • 9. Young WF, Jr. Clinical practice. The incidentally discovered adrenal mass. N Engl J Med 2007;356(6):601-10.
  • 10. Zeiger MA, Thompson GB, Duh QY, et al. The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas. Endocr Pract 2009;15 Suppl 1:1-20.
  • 11. Arnaldi G, Boscaro M. Adrenal incidentaloma. Best Pract Res Clin Endocrinol Metab 2012;26:405-19.
  • 12. Türkiye Endokrinoloji ve Metabolizma Derneği, Adrenal ve Gonadal Hastalıklar Kılavuzu 2017 http://www.turkendokrin.org/files/ADRENAL2017_web.pdf
  • 13. Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 2016;175:G1-G34.

Non-fonksiyone adrenal insidentelomalı hastalarda uzun dönem kitle boyut takibi: Tek merkez sonuçları

Year 2018, Volume: 10 Issue: 4, 506 - 510, 01.12.2018
https://doi.org/10.21601/ortadogutipdergisi.364582

Abstract

Amaç:
Adrenal dışı
hastalıklar nedeni ile yapılan görüntüleme tetkikleri sırasında saptanan
adrenal insidentalomalar (Aİ) benign yada malign, hormonal olarak aktif yada
inaktif olabilir. Aİ’ların tanı, tedavi ve takibinde; başlangıçtaki adenom
boyutu ve takip sürecindeki boyut artışının olup olmadığı önemlidir. Bu
çalışmada non-fonksiyone Aİ’ların takip sürecinde boyut artışı olup olmadığı
araştırılmıştır.

Gereç
ve Yöntem:
2011-2017
yılları arasında Yunus Emre Devlet Hastanesi Endokrinoloji polikliniğine
başvuran toplam 136 Aİ hastasının medikal verileri retrospektif olarak tarandı.
Hastaların laboratuvar verilerinden; 1 mg deksametazon supresyon testi, plazma
renin aktivitesi/aldosteron oranı, idrar katekolamin metabolitleri ve vanil
mandelik asit düzeylerine göre fonksiyone olup olmadığına karar verildi.
Adrenal kitlenin en büyük boyutu bilgisayarlı tomografi yada manyetik rezonans
görüntüleme tetkiklerinden, aksiyel planda mesafe imleci ile ölçülerek bulundu.
Çalışmaya dahil edilme kriterlerine uyan 82 hastanın verileri ayrıntılı olarak
analiz edildi.

Bulgular:
82 hastadan 37’si (%45) erkek ve 45’i (%55) kadındı. Hastaların  42’sinde (%51) adenom sol, 40’ında (%49) sağ
tarafta idi. Ortalama takip süresi 41,5±14,7 (24-72) ay olarak bulundu.
Hastaların çalışmaya alındıkları andaki ortalama adenom boyutu 23,1±9,6 mm,
takip sonu adenom boyutu 23,4±9,8 mm olarak bulundu (p>0,05).







Sonuç: Nonfonksiyone Aİ’lı hastalardaki
adenom boyutunun yıllar içerisinde değişip değişmediğini araştırdığımız bu
çalışmada en az iki yıllık takip sonunda adenom boyutunda anlamlı bir artış
olmadığı saptandı.

References

  • 1. Chidiac RM, Aron DC. Incidentalomas. A disease of modern technology. Endocrinol Metab Clin North Am 1997;26:233-53.
  • 2. Kloos RT, Gross MD, Francis IR, Korobkin M, Shapiro B. Incidentally discovered adrenal masses. Endocr Rev 1995;16:460-84.
  • 3. Schmid H, Mussack T, Wornle M, Pietrzyk MC, Banas B. Clinical management of large adrenal cystic lesions. Int Urol Nephrol 2005;37:767-71.
  • 4. Zeiger MA, Thompson GB, Duh QY, et al. American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons Medical Guidelines for the Management of Adrenal Incidentalomas: executive summary of recommendations. Endocr Pract 2009;15:450-3.
  • 5. NIH state-of-the-science statement on management of the clinically inapparent adrenal mass ("incidentaloma"). NIH Consens State Sci Statements 2002;19:1-25.
  • 6. Schalin-Jantti C, Raade M, Hamalainen E, Sane T. A 5-Year Prospective Follow-Up Study of Lipid-Rich Adrenal Incidentalomas: No Tumor Growth or Development of Hormonal Hypersecretion. Endocrinol Metab (Seoul) 2015;30:481-7.
  • 7. Hong AR, Kim JH, Park KS, Kim KY, Lee JH, Kong SH, et al. Optimal follow-up strategies for adrenal incidentalomas: reappraisal of the 2016 ESE-ENSAT guidelines in real clinical practice. Eur J Endocrinol 2017;177:475-83.
  • 8. Grumbach MM, Biller BM, Braunstein GD, et al. Management of the clinically inapparent adrenal mass ("incidentaloma"). Ann Intern Med 2003;138(5):424-9.
  • 9. Young WF, Jr. Clinical practice. The incidentally discovered adrenal mass. N Engl J Med 2007;356(6):601-10.
  • 10. Zeiger MA, Thompson GB, Duh QY, et al. The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas. Endocr Pract 2009;15 Suppl 1:1-20.
  • 11. Arnaldi G, Boscaro M. Adrenal incidentaloma. Best Pract Res Clin Endocrinol Metab 2012;26:405-19.
  • 12. Türkiye Endokrinoloji ve Metabolizma Derneği, Adrenal ve Gonadal Hastalıklar Kılavuzu 2017 http://www.turkendokrin.org/files/ADRENAL2017_web.pdf
  • 13. Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 2016;175:G1-G34.
There are 13 citations in total.

Details

Subjects Health Care Administration
Journal Section Original article
Authors

Güven Barış Cansu

Bengür Taşkıran

Eylem Bahadır This is me

Publication Date December 1, 2018
Published in Issue Year 2018 Volume: 10 Issue: 4

Cite

Vancouver Cansu GB, Taşkıran B, Bahadır E. Non-fonksiyone adrenal insidentelomalı hastalarda uzun dönem kitle boyut takibi: Tek merkez sonuçları. otd. 2018;10(4):506-10.

e-ISSN: 2548-0251

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