open access

Vol 58, No 5 (2007)
Original papers
Published online: 2007-10-16
Submitted: 2013-02-15
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Diagnostic difficulties in adrenal incidentaloma - analysis of 125 cases

Janusz Myśliwiec, Agnieszka Rudy, Katarzyna Siewko, Piotr Myśliwiec, Mariusz Pułka, Maria Górska
Endokrynologia Polska 2007;58(5):417-421.

open access

Vol 58, No 5 (2007)
Original papers
Published online: 2007-10-16
Submitted: 2013-02-15

Abstract

Introduction: Therapeutic approach to incidentaloma, in spite of existing algorithms, is not always obvious due to diagnostic difficulties. The aim of the study was to assess the validity of the initial diagnoses of incidentaloma which determined the qualification for the operation.
Material and methods: 125 patients hospitalised in the Endocrinology Dept. of the Medical University of Bialystok in the years 2003-2005 and in the Endocrinology dept. of Voivodeship Hospital of Bialystok. The patients were clinically and hormonally examined (metanephrines in daily urine collection, daily cortisol rhythm, short dexamethasone test, aldosterone, and renin plasma activity, Na, K levels in the serum) as well as computer tomography of the adrenal glands were performed.
Results: 42 patients were qualified for adrenalectomy. Adenoma was confirmed in 25 patients (in 7 subclinical Cushing syndrome was diagnosed, in 2 Conn disease, in 16 inactive changes), phaeochromocytoma in 6 patients, cysts in 3, lipoma in 2, carcinoma in one, in 4 patients metastases (in 2 of kidney carcinoma, in 1 of malignant melanoma and in 1 of planocellular carcinoma) and in one oncocytoma. Metanephrines urine measurements showed 33% of false positive results.
Conclusions: Qualification for adrenalectomy requires an assessment of tumor’s enlargement, its tissue density, morphology and growth dynamics. To reduce the percentage of false positive results of metanephrine measurement there is to eliminate an influence of some drugs, victuals, beverages and nicotine and eventually to carry out additional tests. The decision as to proceeding with adrenal incidentaloma should be individualized based on clinical symptoms, hormonal tests and tumor morphology.
(Pol J Endocrinol 2007; 58 (5): 417-421)

Abstract

Introduction: Therapeutic approach to incidentaloma, in spite of existing algorithms, is not always obvious due to diagnostic difficulties. The aim of the study was to assess the validity of the initial diagnoses of incidentaloma which determined the qualification for the operation.
Material and methods: 125 patients hospitalised in the Endocrinology Dept. of the Medical University of Bialystok in the years 2003-2005 and in the Endocrinology dept. of Voivodeship Hospital of Bialystok. The patients were clinically and hormonally examined (metanephrines in daily urine collection, daily cortisol rhythm, short dexamethasone test, aldosterone, and renin plasma activity, Na, K levels in the serum) as well as computer tomography of the adrenal glands were performed.
Results: 42 patients were qualified for adrenalectomy. Adenoma was confirmed in 25 patients (in 7 subclinical Cushing syndrome was diagnosed, in 2 Conn disease, in 16 inactive changes), phaeochromocytoma in 6 patients, cysts in 3, lipoma in 2, carcinoma in one, in 4 patients metastases (in 2 of kidney carcinoma, in 1 of malignant melanoma and in 1 of planocellular carcinoma) and in one oncocytoma. Metanephrines urine measurements showed 33% of false positive results.
Conclusions: Qualification for adrenalectomy requires an assessment of tumor’s enlargement, its tissue density, morphology and growth dynamics. To reduce the percentage of false positive results of metanephrine measurement there is to eliminate an influence of some drugs, victuals, beverages and nicotine and eventually to carry out additional tests. The decision as to proceeding with adrenal incidentaloma should be individualized based on clinical symptoms, hormonal tests and tumor morphology.
(Pol J Endocrinol 2007; 58 (5): 417-421)
Get Citation

Keywords

phaeochromocytoma; Conn syndrom; Cushing syndrom; adrenal carcinoma

About this article
Title

Diagnostic difficulties in adrenal incidentaloma - analysis of 125 cases

Journal

Endokrynologia Polska

Issue

Vol 58, No 5 (2007)

Pages

417-421

Published online

2007-10-16

Bibliographic record

Endokrynologia Polska 2007;58(5):417-421.

Keywords

phaeochromocytoma
Conn syndrom
Cushing syndrom
adrenal carcinoma

Authors

Janusz Myśliwiec
Agnieszka Rudy
Katarzyna Siewko
Piotr Myśliwiec
Mariusz Pułka
Maria Górska

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