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Cited by 96Adrenal and Paraganglionic TumorsHormonal Regulation and HypertensionPituitary Gland Disorders and Treatments

Adrenal incidentaloma, clinical, metabolic, follow-up aspects: single centre experience

Comlekci, Abdurrahman, Yener, Serkan, Ertilav, Senem, Secil, Mustafa, Akinci, Baris, Demir, Tevfik, Kebapcilar, Levent, Bayraktar, Firat +2 more·2010·Endocrine
DOI 10.1007/s12020-009-9260-5
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Abstract

To investigate clinical characteristics, metabolic parameters and follow-up findings of subjects with incidentally discovered adrenal tumors. 376 consecutive subjects who have been evaluated since 2002 were included. Initial radiological examination was CT. Hormonal evaluation included 8.00 a.m. cortisol, DHEA-S, ACTH and in hypertensive subjects, plasma renin activity, and serum aldosterone. Urinary free cortisol (UFC), urinary normetanephrine, and metanephrine were measured. Overnight 1 mg dexamethasone suppression test was performed. Radiological evaluation was performed at 6th and 12th months and annually in subsequent visits. Hormonal evaluation was performed 6 months after the initial visit and annually in subsequent visits. Additionally, patients were evaluated for the development of Type 2 diabetes mellitus, hypertension, hyperlipidemia, and metabolic syndrome in 6-month intervals. Mean age of the participants was 54.7 ± 13.1. Female subjects were more commonly affected (70%). CT was the most frequent radiological intervention that discovered adrenal masses (57%). The vast majority of the participants (85.6%) had benign adrenal adenomas. Primary adrenocortical malignancy was detected in 4 subjects (1.1%). Subjects with adrenal adenomas had significantly smaller tumor diameters (P ≤ 0.001 vs. other tumors). Sensitivity and specificity of 40 mm as a cut-off value in the differentiation of adrenal gland malignancies from benign tumors was 73.3 and 54.8%, respectively. Most of the adrenal adenomas were non-functioning (73.5%). Subclinical Cushing syndrome (sCS) was detected in 12.5%. The overall prevalence of Type 2 diabetes mellitus, hypertension, hyperlipidemia, and metabolic syndrome was 18.4, 54.9, 59.6, and 48.1%, respectively. They were significantly more common in middle-aged and elderly subjects. During 24 months follow-up 10.2% of adenomas featured increase in tumor diameter and 2.06% developed sCS. Young subjects featured more stable tumor diameter and hormonal status. Most of the incidentally discovered adrenal tumors were non-functioning adrenal adenomas. Clinically overt hormone hypersecretion syndromes were mainly shown in young subjects, while adrenal gland malignancies and sCS were more common in older ages. Mass enlargement and development of subclinical cortisol secretion were not rare and observed especially in middle-aged and elderly subjects. Metabolic derangements were common; however, a possible independent association between adrenal adenoma and metabolic problems need to be elucidated with prospective studies.

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  • Previous imaging studies have reported that AIs are more common in females; however, this has not been observed in autopsy studies.

    “Previous imaging studies have reported that AIs are more common in females (66,71,73); however, this has not been observed in autopsy studies (11,85).”

    From Adrenal incidentaloma (2020) · cites this paper as [73]

  • Chronic mild cortisol secretion abnormality may be associated with classic metabolic and cardiovascular complications of hypercortisolism.

    “A chronic mild cortisol secretion abnormality may be associated with classic metabolic and cardiovascular complications of hypercortisolism (, -).”

    From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [217]

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Authors
Comlekci, A., Yener, S., Ertilav, S., Secil, M., Akinci, B., Demir, T., Kebapcilar, L., Bayraktar, F., Yesil, S., & Eraslan, S.
Affiliations
Dokuz Eylül University (TR)
ORCID
Venue
Endocrine
Publisher
Springer Science and Business Media LLC
Published
2009-10-30
Volume
37
Issue
1
Pages
40-46
ISSN
  • 0969-711X (ISSN-L)
  • 1355-008X
  • 1559-0100
DOI
10.1007/s12020-009-9260-5
OpenAlex
W1990327817
Cited by
96
References
20
Citations by year
2026: 2 · 2025: 4 · 2024: 6 · 2023: 8 · 2022: 5 · 2021: 8 · 2020: 8 · 2019: 5 · 2018: 8 · 2017: 5 · 2016: 6 · 2015: 7 · 2014: 5 · 2013: 6 · 2012: 6
FWCI
4.05
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Endocrine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
Keywords
adrenal incidentaloma, adrenal adenoma, adrenal tumors, subclinical Cushing's syndrome, tumor growth, metabolic syndrome, type 2 diabetes, hypertension, hyperlipidemia, dexamethasone suppression test, urinary free cortisol, metanephrine, follow-up outcomes, age differences, benign versus malignant differentiation
MeSH terms
Adenoma, Adolescent, Adrenal Cortex Hormones, Adrenal Gland Neoplasms, Adrenocorticotropic Hormone, Adult, Aged, Aging, Cushing Syndrome, Female, Follow-Up Studies, Humans, Hypertension, Male, Metabolic Diseases, Metanephrine, Middle Aged, Normetanephrine, Retrospective Studies, Turkey, Prevalence, Young Adult

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