Prevalence of adrenal incidentaloma in patients performed thorax computed tomography for suspected COVID-19 infection
Abstract
Aims: The primary purpose of this study is to make a retrospective evaluation of adrenal incidentaloma (AI) prevalence in patients performed thorax computed tomography (TCT), along with determining whether the diagnosed AIs were assessed functionally for adrenal gland hyperfunction and to detect the rate of hyperfunctional AI.
Methods: The patients who applied to with the suspected COVID-19 and performed TCT between January 2020 and December 2021, were included in the present study. However, the patients who were followed-up due to a known adrenal mass and a malignant tumor were excluded.
Results: TCT imaging, including adrenal glands, was performed on 2580 patients. The mean age for these patients was 54±16.8. However, when the patients were separated into groups in terms of adrenal pathology (AP), the mean age for the patients with and without AP was 61.4±11 and 53.8±16.9, respectively (p<0.001). The number of patients detected with AP, AI, and adrenal hyperplasia was 68 (2.6%), 60 (88.2%), and 7 (10.3%), respectively. The mean mass diameter was 17 (11-41). Bilateral adrenal hyperplasia was not observed in any patients; however, 13 of the patients (18.1%) detected with AI and adrenal hyperplasia were evaluated functionally. Hyperfunction was not observed in any of the assessed patients.
Conclusion: The prevalence of AI found in our study was similar to other studies in the literature; however, functional evaluations of AIs detected via TCT performed due to suspected COVID-19 remained low. Although they are rare, it is important to define whether AIs are functional or malignant due to the comorbid conditions they create. For this reason, we believe patients with AI should be directed to an endocrinology clinic for a practical examination and follow-up plan.
References
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- Wickramarachchi BN, Meyer-Rochow GY, McAnulty K, Conaglen JV, Elston MS. Adherence to adrenal incidentaloma guidelines is influenced by radiology report recommendations. ANZ J Surg. 2016;86(6):483-486.
- Barzon L, Sonino N, Fallo F, Palu G, Boscaro M. Prevalence and natural history of adrenal incidentalomas. Eur J Endocrinol. 2003;149(4):273-285.
- Bovio S, Cataldi A, Reimondo G, Sperone P, Novello S, Berruti A, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest. 2006;29(4):298-302.
- Davenport C, Liew A, Doherty B, et al. The prevalence of adrenal incidentaloma in routine clinical practice. Endocrine. 2011;40(1):80-83.
- NIH state-of-the-science statement on management of the clinically inapparent adrenal mass (“incidentaloma”). NIH Consens State Sci Statements. 2002;19(2):1-25.
- Sherlock M, Scarsbrook A, Abbas A, et al. Adrenal incidentaloma. Endocr Rev. 2020;41:008.
- Glazer HS, Weyman PJ, Sagel SS, Levitt RG, McClennan BL. Nonfunctioning adrenal masses: incidental discovery on computed tomography. AJR Am J Roentgenol. 1982;139(1):81-85.
- Taya M, Paroder V, Bellin E, Haramati LB. The relationship between adrenal incidentalomas and mortality risk. Eur Radiol. 2019;29(11):6245-6255.
- Maher DI, Williams E, Grodski S, Serpell JW, Lee JC. Adrenal incidentaloma follow-up is influenced by patient, radiologic, and medical provider factors: A review of 804 cases. Surgery. 2018;164(6):1360-1365.
- Song JH, Chaudhry FS, Mayo-Smith WW. The incidental adrenal mass on CT: prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known malignancy. AJR Am J Roentgenol. 2008;190(5):1163-1168.
- Hammarstedt L, Muth A, Wängberg B, et al. Adrenal lesion frequency: A prospective, cross-sectional CT study in a defined region, including systematic re-evaluation. Acta Radiol. 2010;51(10):1149-1156.
- Mantero F, Terzolo M, Arnaldi G, et al. A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. J Clin Endocrinol Metab. 2000;85(2):637-644.
- Kasperlik-Załuska AA, Otto M, Cichocki A, et al. Incidentally discovered adrenal tumors: a lesson from observation of 1,444 patients. Horm Metab Res. 2008;40(5):338-341.
- Reimondo G, Castellano E, Grosso M, et al. Adrenal incidentalomas are tied to increased risk of diabetes: findings from a prospective study. J Clin Endocrinol Metab. 2020;105(4):dgz284.
- Hong AR, Kim JH, Park KS, 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(6):475-483.
- Ahn SH, Kim JH, Baek SH, et al. Characteristics of adrenal incidentalomas in a large, prospective computed tomography-based multicenter study: the COAR study in Korea. Yonsei Med J. 2018;59(4):501-510.
- Akkuş G, Evran M, Sert M, Ok F, Tetiker T. Multidisciplinary approach for patients with functional and non-functional adrenal masses and review of the literature. Health Sci Rep. 2018;1(3):e22.
- Sangwaiya MJ, Boland GWL, Cronin CG, Blake MA, Halpern EF, Hahn PF. Incidental adrenal lesions: accuracy of characterization with contrast-enhanced washout multidetector CT--10-minute delayed imaging protocol revisited in a large patient cohort. Radiology. 2010;256(2):504-510.
- Cawood TJ, Hunt PJ, O’Shea D, Cole D, Soule S. Recommended evaluation of adrenal incidentalomas is costly, has high false-positive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant; time for a rethink? Eur J Endocrinol. 2009;161(4):513-527.
- Comlekci A, Yener S, Ertilav S, et al.Adrenal incidentaloma, clinical, metabolic, follow-up aspects: single centre experience. Endocrine. 2010;37(1):40-46.
- Davenport E, Lang Ping Nam P, Wilson M, Reid A, Aspinall S. Adrenal incidentalomas: management in British district general hospitals. Postgrad Med J. 2014;90(1065):365-369.
Abstract
References
- Young WF. Clinical practice. The incidentally discovered adrenal mass. N Engl J Med. 2007;356(6):601-610.
- Wickramarachchi BN, Meyer-Rochow GY, McAnulty K, Conaglen JV, Elston MS. Adherence to adrenal incidentaloma guidelines is influenced by radiology report recommendations. ANZ J Surg. 2016;86(6):483-486.
- Barzon L, Sonino N, Fallo F, Palu G, Boscaro M. Prevalence and natural history of adrenal incidentalomas. Eur J Endocrinol. 2003;149(4):273-285.
- Bovio S, Cataldi A, Reimondo G, Sperone P, Novello S, Berruti A, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest. 2006;29(4):298-302.
- Davenport C, Liew A, Doherty B, et al. The prevalence of adrenal incidentaloma in routine clinical practice. Endocrine. 2011;40(1):80-83.
- NIH state-of-the-science statement on management of the clinically inapparent adrenal mass (“incidentaloma”). NIH Consens State Sci Statements. 2002;19(2):1-25.
- Sherlock M, Scarsbrook A, Abbas A, et al. Adrenal incidentaloma. Endocr Rev. 2020;41:008.
- Glazer HS, Weyman PJ, Sagel SS, Levitt RG, McClennan BL. Nonfunctioning adrenal masses: incidental discovery on computed tomography. AJR Am J Roentgenol. 1982;139(1):81-85.
- Taya M, Paroder V, Bellin E, Haramati LB. The relationship between adrenal incidentalomas and mortality risk. Eur Radiol. 2019;29(11):6245-6255.
- Maher DI, Williams E, Grodski S, Serpell JW, Lee JC. Adrenal incidentaloma follow-up is influenced by patient, radiologic, and medical provider factors: A review of 804 cases. Surgery. 2018;164(6):1360-1365.
- Song JH, Chaudhry FS, Mayo-Smith WW. The incidental adrenal mass on CT: prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known malignancy. AJR Am J Roentgenol. 2008;190(5):1163-1168.
- Hammarstedt L, Muth A, Wängberg B, et al. Adrenal lesion frequency: A prospective, cross-sectional CT study in a defined region, including systematic re-evaluation. Acta Radiol. 2010;51(10):1149-1156.
- Mantero F, Terzolo M, Arnaldi G, et al. A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. J Clin Endocrinol Metab. 2000;85(2):637-644.
- Kasperlik-Załuska AA, Otto M, Cichocki A, et al. Incidentally discovered adrenal tumors: a lesson from observation of 1,444 patients. Horm Metab Res. 2008;40(5):338-341.
- Reimondo G, Castellano E, Grosso M, et al. Adrenal incidentalomas are tied to increased risk of diabetes: findings from a prospective study. J Clin Endocrinol Metab. 2020;105(4):dgz284.
- Hong AR, Kim JH, Park KS, 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(6):475-483.
- Ahn SH, Kim JH, Baek SH, et al. Characteristics of adrenal incidentalomas in a large, prospective computed tomography-based multicenter study: the COAR study in Korea. Yonsei Med J. 2018;59(4):501-510.
- Akkuş G, Evran M, Sert M, Ok F, Tetiker T. Multidisciplinary approach for patients with functional and non-functional adrenal masses and review of the literature. Health Sci Rep. 2018;1(3):e22.
- Sangwaiya MJ, Boland GWL, Cronin CG, Blake MA, Halpern EF, Hahn PF. Incidental adrenal lesions: accuracy of characterization with contrast-enhanced washout multidetector CT--10-minute delayed imaging protocol revisited in a large patient cohort. Radiology. 2010;256(2):504-510.
- Cawood TJ, Hunt PJ, O’Shea D, Cole D, Soule S. Recommended evaluation of adrenal incidentalomas is costly, has high false-positive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant; time for a rethink? Eur J Endocrinol. 2009;161(4):513-527.
- Comlekci A, Yener S, Ertilav S, et al.Adrenal incidentaloma, clinical, metabolic, follow-up aspects: single centre experience. Endocrine. 2010;37(1):40-46.
- Davenport E, Lang Ping Nam P, Wilson M, Reid A, Aspinall S. Adrenal incidentalomas: management in British district general hospitals. Postgrad Med J. 2014;90(1065):365-369.
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