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Cited by 112Adrenal and Paraganglionic TumorsAdrenal Hormones and DisordersPituitary Gland Disorders and Treatments

Hormonal activity of adrenal incidentalomas: results from a long-term follow-up study

Vassilatou, E., Vryonidou, A., Michalopoulou, S., Manolis, J., Caratzas, J., Phenekos, C., Tzavara, I.·2009·Clinical Endocrinology
DOI 10.1111/j.1365-2265.2008.03492.x
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Abstract

OBJECTIVE: To investigate the natural course of apparently benign adrenal incidentalomas with no overt hyperfunction at diagnosis, as their clinical significance and appropriate management are still controversial. DESIGN: Prospective long-term follow-up study of patients with adrenal incidentalomas with periodic hormonal and morphological evaluation. PATIENTS AND METHODS: A total of 77 patients with incidental adrenal masses, diameter 1.0-6.0 cm (median 2.5 cm), were submitted to a hormonal assessment of adrenal function at diagnosis. This was repeated, together with an adrenal CT scan, 12 months later and then every 12-24 months, for a period of 12-154 months (mean 62.7 +/- 31.9, median 60.0). RESULTS: At diagnosis, 57 patients had normal adrenal function and 20 had subclinical Cushing's syndrome. During follow-up, adrenal function remained normal in 49 patients, subclinical Cushing's syndrome was confirmed in 12, whilst intermittent subclinical autonomous cortisol hypersecretion was found in 12 patients. Overt endocrine disease was diagnosed in 4 patients (Cushing's syndrome in 2 and phaeochromocytoma in 2). A change in mass size (> or = 0.5 cm) was observed in 26 patients (enlargement in 20--including patients who developed overt hyperfunction--with no signs of malignancy and reduction in size in 6). CONCLUSIONS: Subclinical autonomous cortisol hypersecretion is the most frequent hormonal abnormality in patients with adrenal incidentalomas, and may be intermittent in a significant percentage of cases. Few patients develop overt endocrine disease. A growth tendency is observed in some adrenal incidentalomas without evidence of malignant transformation and occasionally can be related to development of overt hyperfunction. These findings indicate the need for periodic hormonal and morphological evaluation for several years.

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  • Autonomous cortisol secretion has emerged as the commonest functional abnormality in patients with adrenal incidentaloma, with prevalence rates of up to 20%.

    “ACS has emerged as the commonest functional abnormality in patients with AI with prevalence rates of up to 20% (64,65,72).”

    From Adrenal incidentaloma (2020) · cites this paper as [72]

  • 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 [215]

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Authors
Vassilatou, E., Vryonidou, A., Michalopoulou, S., Manolis, J., Caratzas, J., Phenekos, C., & Tzavara, I.
Affiliations
  • Simanogleio-Amalia Fleming General Hospital (GR)
  • Hellenic Red Cross (GR)
Corresponding author
Vassilatou, E.
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2009-03-31
Volume
70
Issue
5
Pages
674-679
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.2008.03492.x
OpenAlex
W2035478948
Cited by
112
References
31
Citations by year
2026: 1 · 2025: 5 · 2024: 3 · 2023: 11 · 2022: 5 · 2021: 11 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 9 · 2015: 10 · 2014: 8 · 2013: 6 · 2012: 8
FWCI
6.34
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
Keywords
adrenal incidentaloma, subclinical Cushing's syndrome, adrenal function, pheochromocytoma, long-term follow-up
MeSH terms
Adrenal Cortex Hormones, Adrenal Gland Neoplasms, Adult, Aged, Cushing Syndrome, Female, Follow-Up Studies, Humans, Hydrocortisone, Male, Middle Aged, Pheochromocytoma, Prospective Studies, Tomography, X-Ray Computed, Incidental Findings

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