CoChat
Sign Up
Cited by 14Adrenal and Paraganglionic TumorsPituitary Gland Disorders and TreatmentsAdrenal Hormones and Disorders

Three-year follow up of adrenal incidentalomas in a New Zealand centre

Goh, Ziwei, Phillips, Ian, Hunt, Penny J., Soule, Steven, Cawood, Tom J.·2020·Internal Medicine Journal
DOI 10.1111/imj.14332
Open this paper in CoChat — free account

Abstract

BACKGROUND: The international guidelines for management of adrenal incidentalomas (AI) are becoming more conservative. These changes are based on the growing body of evidence suggesting that non-functioning adenomas have a low likelihood of becoming functional or malignant over time. AIMS: To follow up at least 100 patients for 3 years who were originally found to have benign adrenal adenomas which were non-functional or had subclinical Cushing syndrome (SCS). METHODS: This study prospectively evaluated consecutive patients aged 18 years or older with benign adrenal incidentalomas (AI), not treated with adrenalectomy, which were non-functioning or had SCS. The initial and follow-up evaluation, including clinical assessment, hormonal investigations and imaging were coordinated via a standardised nurse-led AI clinic. RESULTS: Of 233 patients referred to the AI clinic, 101 patients met the inclusion criteria and completed 3-year follow up. Most of those excluded were due to incomplete initial or follow-up evaluation or were not true AI. Most AI either remained stable or decreased in size on repeat imaging, while 5% of patients had AI enlargement of >5 mm diameter. No patient developed features suggesting adrenal carcinoma. Ninety-two patients had an initial diagnosis of non-functioning adenoma and nine patients had SCS. After 3 years (range 2.9-4.7 years), five of the nine patients with SCS showed normalisation of cortisol parameters (44%), and five of the 92 non-functional AI patients developed SCS (5%). CONCLUSION: After 3 years of follow up, approximately half of patients with SCS normalised, while 5% of patients with initially non-functioning adenomas developed biochemical evidence of SCS. This study found a low likelihood of progressive hormonal excess with no evidence of malignancy developing on follow-up evaluation, providing support for the shift towards the more conservative approach to management of AI recommended in recent guidelines.

Integrity signals

Registry

Crossref · 10.1111/imj.14332

Cites

24 of 24 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In a New Zealand prospective study of 101 patients with benign adrenal adenomas over 3 years, 9 had ACS at diagnosis and 92 had nonfunctioning AI.

    “A recent New Zealand study, prospectively evaluated 101 patients with benign adrenal adenomas over a 3-year follow up period. Nine patients had evidence of ACS at diagnosis (defined as an elevated 24-hour UFC and a 1mg-DST), while the remaining 92 patients were diagnosed with a nonfunctioning AI.”

    From Adrenal incidentaloma (2020) · cites this paper as [268]

  • At 3 years, 5 of 9 (44%) patients with ACS at diagnosis showed normalization of cortisol parameters.

    “At 3 years, 5 of the 9 patients with ACS at diagnosis (44%) showed normalization of cortisol parameters”

    From Adrenal incidentaloma (2020) · cites this paper as [268]

  • At 3 years, 5 of 92 (5%) patients with nonfunctional AI developed ACS.

    “while 5 of the 92 patients with a nonfunctional AI developed ACS (5%) (268).”

    From Adrenal incidentaloma (2020) · cites this paper as [268]

Cites

Flagged first, then by citations

1 of the 25 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Goh, Z., Phillips, I., Hunt, P. J., Soule, S., & Cawood, T. J.
Affiliations
  • Christchurch Hospital (NZ)
  • Canterbury Health Laboratories (NZ)
Corresponding author
Cawood, Tom J.
ORCID
Venue
Internal Medicine Journal
Publisher
Wiley
Published
2020-03
Volume
50
Issue
3
Pages
350-356
ISSN
  • 1444-0903 (ISSN-L)
  • 1445-5994
DOI
10.1111/imj.14332
OpenAlex
W2944221326
Cited by
14
References
25
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 3
FWCI
2.15
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 4 d)
Locations
  • Internal Medicine Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
adrenal incidentaloma, non-functioning adrenal adenoma, subclinical Cushing's syndrome, adrenocortical carcinoma, conservative treatment, long-term follow-up, cortisol, nurse-led clinics
MeSH terms
Adolescent, Adrenal Gland Neoplasms, Cushing Syndrome, Follow-Up Studies, Humans, New Zealand

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review