Long term follow-up in patients with incidentally discovered adrenal adenomas tumor diameter, hormonal status and metabolic parameters

Prevalence of incidentally discovered adrenal masses has been increasing. In those individuals the first step of management is the estimation of tumor?s nature and hormonal status. In the literature, current data regarding general characteristics and follow-up data of subjects with incidentally discovered adrenal tumors is not satisfactory. In this study we evaluated the data of 376 subjects who have been registered in our adrenal tumors database. General characteristics and follow-up data were evaluated. Adrenal incidentaloma was dominantly seen in females and especially in middle ages and elderly subjects. The most frequent type of incidentally discovered adrenal adenomas was found to be non-functioning adrenal adenoma. The most frequent type of hormone hypersecretion was subclinical Cushing Syndrome. Adrenal adenomas tended to be stable in terms of tumor diameter; however, in long term follow-up increase in tumor diameter might be seen. The increase in diameter was usually below 10mm. Development of a clinically overt hormone hypersecretion syndrome in subjects with non-functioning adenomas was quite, while development of subclinical Cushing Syndrome might be observed. In our series, development of subclinical Cushing Syndrome was more common in subjects with larger initial tumor diameter and in subjects whom were followed-up for longer duration. Metabolic problems were common and also could be developed during follow-up even in subjects with non-functioning adrenal adenomas. Subtle and continuous cortisol secretion (cortisol autonomy) of the mass seemed to be responsible for those disturbances.