Clinical and imaging presentations are associated with function in incidental adrenocortical adenomas: a retrospective cohort study
Authors' conclusion
Age, sex, tumor size, and laterality were associated with ACA hormonal subtype and can guide diagnosis and management. Tumor growth was more common with younger age and longer follow-up. Unenhanced HU did not predict hormonal subtype or growth. Adrenalectomy for MACS and NFA was mainly performed in younger patients with larger tumor size, growth, and elevated postdexamethasone cortisol.
Study context
- Population
- Consecutive adults with incidental adrenal cortical adenomas diagnosed 2000–2016; median age 59 years, 62% womenconsecutive incidental ACA
- Participants
- 699 / 482 / 62 / 39 / 18 / 226
- Exposure
- NFA vs mild autonomous cortisol secretion (MACS) vs primary aldosteronism (PA) vs Cushing syndrome vs PA and MACS vs Incomplete work-up
- NFAn = 699
- MACSn = 482
- PAn = 62
- Cushing syndromen = 39
- PA and MACSn = 18
- Incomplete work-upn = 226
- Outcome
- Association of clinical and imaging characteristics with hormonal subtype, growth and adrenalectomy
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Hormonal subtype, growth and adrenalectomy
- ≥1 cm growth: younger age (multivariable), per 5-year increase
- OR = 0.8, P = .0047
- ≥1 cm growth: longer imaging follow-up (multivariable), per year
- OR = 1.2, P < .0001
- Adrenalectomy performed
- 355 (23%)
- Adrenalectomy in MACS
- 38%
- Adrenalectomy in NFA
- 15%
- Adrenalectomy for NFA and MACS: younger age, per 5-year increase
- OR = 0.79, P = .002
- Adrenalectomy for NFA and MACS: larger initial tumor size, per 1 cm increase
- OR = 2.3, P < .0001
- Adrenalectomy for NFA and MACS: ≥1 cm growth
- OR = 15.3, P < .0001
- Adrenalectomy for NFA and MACS: higher postdexamethasone cortisol, >5 vs <1.8 μg/dL
- OR = 6.6, P = .002
Observational data: associations, not effects.
Original publication
Clinical and imaging presentations are associated with function in incidental adrenocortical adenomas: a retrospective cohort study. Eur J Endocrinol. Published 28 June 2024. doi:10.
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