Clinical radiological assesment in patients with adrenal incidentaloma

Clinical radiological assesment in patients with adrenal incidentaloma. Van Yüzüncü Yıl Üniversity Dursun Odabaşı Medikal Faculty, Department of Internal Diseases Speciality in Medicine Thesis / Van / 2018. PURPOSE: To analysis and detect clinic and radiological features of insidental adrenal masses which is detect as a result of abdominal imaging methods that is practiced for same leasons. METHOD: In the research, 139 adrenal incidentaloma patient who apply to Van Yüzüncü Yıl Üniversity Dursun Odabaşı Medikal Faculty Department of Endocrinology and Metabolism policlinic between 01.01.2015 and 01.01.2017 are considered as retrospective. %69 of the patient are woman and %31 of the patient are men. Of tehese patients, 99 patients were evaluated whit CT, 38 patients with MRG and 2 patients with PET. CONCLUSİON: It is abserverd that %39,6 are right adrenal involvement, %67,6 left adrenal involvement and %7,2 bilateral adrenal involvement in abdominal imaging methods. The mass diameter of adrenal incidentalomas was between 1-90 mm. %23 (n:32) of patients with adrenal insidentaloma were operated. According to pathology results incidentaloma patients are considered as 22 (%68,25) adrenal cortical adenom, 4 (%12,5) bilateral cortical adrenal hyperplasia, 2 (%6,25) adrenal cortical carcinoma, 1 (%3,12) lipoma, 1 (%3,12) maturity cystic teratom, 1 (%3,12) ganglioneuroma, 1 (%3,12) collision tumor. %77 The patient who is not operated is being contiuned to follow. With the result of functional adrenal cortical adenoma, 9 of 20 patient is detected to have Cushing syndrome, 3 have Conn syndrome and 8 have pheochromocytoma. With the result of functional adrenal cortical adenoma lesion diameter of 18 patient was less than 40 mm and diameter average was 23,1 mm. Others lesion diameter was 44 mm and 60 mm. %85,7 Adrenal cortical adenom patients were acctive as hormonal. 11 mm lesion in imaging which is delected Conn syndrome, it was detected as calcific. The diameters of 2 nonfunctional cortical adenomas which is operated was 40 mm and 90 mm. Lesion diameter average (the least diameter is 25 mm, the highest diamater is 90 mm) of the patients who are detected with pheochromocytoma in imaging was 49,25 mm an done of them had necrosis. Lesion diameter average of the patients who are detected with bilateral cortical adrenal hyperplasia was 21 mm, lesion diameter of the patients who are detected with adrenal cortical carcinoma was 35 mm, 60 mm anda re was calcific. Lesion diameter of the patient who are detected with lipoma was 23 mm, lesion diameter of the patient who are detected with maturity cystic teratom was 75 mm, lesion diameter of the patient who are detected with ganglioneuroma was 70 mm, lesion diameter of the patient who are detected with collision tumor was 45 mm. The size of the lipoma was found to increase rapidly from 15 mm to 28 mm in the follow-up. In the result of pathology, 2 of 4 patients who were resulted with cortical adrenal hyperplasia had Cushing syndrome, 1 had Conn syndrome outside Primer hyperaldosteronism. Other patient was operated because of 43 mm lesion diameter. %75 of the patients were acctive as hormonal. It is delected that 4 have Primer hyperaldosteronism and 8 Subclinical Cushing syndrome. 5 of 8 patients, who were detected with Primer hyperaldosteronism, were detected with hypokalemia. 4 patients had calcification in imaging, 2 of them were opereted. According to pathology one was adenom and other adrenal carcinom. 5 patients of adrenal incidentaloma who were operated (%15,6) were continued to be used steroid. 4 of 5 patients were continued about 18 months with steroid. They all had Cushing syndrome. 5 of 11 Cushing syndrome patients needed to have cortisol in long term. When we thouht that all adrenal incidentaloma patients, hypertension was %33,1, Diabetes mellitus was %12,9, Cushing syndrome was %11,5, Conn syndrome outside Primer hyperaldosteronism was %3,5, Conn syndrome was %2,1 and pheochromocytoma was %5,75. 12 of operated had HT (%37,5) and 5 had DM (15,6).