Evaluation of characteristic features of incidental adrenal masses

Adrenal incidentaloma is a general name given to masses larger than 10 mm, detected incidentally by imaging methods performed by various clinics and for various reasons, without any finding suggestive of any disease originating from the adrenal gland. As a result of the widespread use of radiological examinations the incidence of adrenal incidentaloma has increased significantly. When the literature studies are examined, it is noteworthy that there are uncertainties in follow-up and treatment due to the heterogeneity in the findings, the inclusion of a small number of patients, and the disruptions in long-term follow-up. We aimed to retrospectively analyze the demographic and clinical characteristics, hormonal status, findings obtained by radiological imaging methods, treatments and histological diagnoses of patients diagnosed with adrenal incidentaloma in our study. A total of 199 patients, 139 (69,8%) women and 60 (30,2%) men were included in our the study. The mean age was 59.42 ± 12,087/years. There was no significant difference between the sexes in terms of mean age. Right-sided adenoma was detected in 78 (39,2%) and left-sided adenomas in 96 (48,2%) patients. Bilateral adenoma was present in 25 (12,6%). There was no significant difference between unilateral and bilateral adenomas in terms of mean age and tumor size. 56 (28.14%) of the patients were hormonally active, 18 (32.14%) patients had subclinical hypercortisolism, 9 (16.07%) Cushing's Syndrome, and 29 (51.79%) primary hyperaldosteronism. We did not have a patient diagnosed with pheochromocytoma. There were 42 (75%) female and 14 (25%) male patients with functional adenoma. Although female gender was more than male, it was seen that there was no statistically significant difference. The mean age of the patients with functional adenoma was 56.60±11.96/year, t with nonfunctional adenoma 60.59±11.99 years, and there was a significant difference between the groups. When unilateral and bilateral adenomas were evaluated in terms of functionality, there was no significant difference between the groups. The mean size of functional adenomas was 26.02±9.95mm, and the mean size of nonfunctional adenomas was 22.47 ±15.65mm. Mean size of functional adenomas was found to be significantly larger than nonfunctional adenomas. In addition, a homogeneous distribution of additional diseases such as type 2 diabetes mellitus, hypertension, hyperlipidemia and coronary artery disease was observed between the groups with functional and nonfunctional adenomas. Of 199 patients included, 11 (5.52%) were operated. Pathology results were reported as adenoma in 7 (63.6%), hyperplasia in 1 (9.1%), adrenocortical carcinoma in 1 (9.1%), angiomyolipoma in 1 (9.1%) and metastasis in 1 (9.1%). In conclusion, all cases of adrenal incidentaloma should be evaluated by considering functionality and possibility of malignancy. It should be considered that large sized adenomas may be functional. Key words: Adrenal incidentaloma, Cushing Syndrome,