İn patients with adrenal incidentaloma using adenoma dimensions to prediction of subclinic hypercortisolemia

OBJECTİVE : Adrenal incidentalomas are adrenal masses detected by radiological imaging performed for reasons unrelated to adrenal gland pathologies. Our work purpose; the aim is to detect the size of adenoma, which can create a threshold value in the prediction of cortisol hypersecretion in patients with a diagnosis of adrenal incidentaloma. METHODS : 741 patients followed for adrenal adenoma at Dokuz Eylul University Faculty of Medicine Endocrinology Science were included in this study. Patients analyzed as retrospective. RESULTS : Of the patients, 204 were male and 537 were female. The mean age at diagnosis 57.73 ± 10.53. The mean size of adrenal incidentalomas was 25.07 cm ± 10.89 cm. 464 of 741 patients were bilateral adenoma. Progression to cortisol hypersecretion is quite high in patients with AI and an increase in cortisol values measured after 1 mg of DST. When all patients are evaluated, a significiant and positive moderate correlation was found between the cortisol level measured after 1 mg of DST and size of the adenoma ( r = 0.449 ; p < 0.01 ). A positive and significant correlation was found between cortisol level and adenoma size after 1 mg DST in patients with NFA and SCS ( r = .413 , p < .01 ). In our study, 21.5 mm adenoma size was determined as the threshold value in predicting the diagnosis of SCS. CONCLUSION : Thanks to our study, it was concluded that the evaluation of HPA axis in Aİ patients may be limited to female gender and adenoma size values of 21 mm and above. KEY WORDS : Adrenal size, Adenoma incidentaloma, Nonfunctional adenoma, Subclinical Cushing's Syndrome , Female gender