Clinical and Radiological Features of Atypical Adrenal Masses—A Multicenter Retrospective Study
Authors' conclusion
AAMs carry significant malignant potential, and long-term follow-up is warranted when surgery is not pursued. Contrast washout is not reliable in predicting malignant potential of AAMs.
Study context
- Population
- Patients ≥18 years with atypical adrenal masses (AAMs) (diameter 10–39 mm on first imaging and pre-contrast attenuation >10 Hounsfield units (HU) on CT); excluded adrenal metastasis, pheochromocytoma, sarcoma, lymphoma, infiltrative lesions, adrenal hemorrhage and genetic predisposition to adrenal neoplasms224 adrenal masses
- Participants
- 217 patients
- Exposure
- Adenoma vs adrenocortical carcinoma (ACC)
- Adenoman = 38
- ACCn = 25
- Outcome
- Radiological characteristics and growth of AAMs
Methodological detailsmulticenter
- Multicenter
Main finding
As reported in the abstract
- Women
- 61.3%
- Median age
- 58 years (IQR 49-65 years)
- Median size
- 20.5 mm (IQR 15-27 mm)
- Median precontrast attenuation
- 23.5 HU (IQR 17-30 HU)
- Median AAM growth rate
- 0.3 mm/year (IQR 0-1.8 mm/year)
- Masses with pathological evaluation
- 71 (31.7%)
Observational data: associations, not effects.
Further findings
| Outcome | ACC |
|---|---|
| Most common pathological diagnoses and growth rate by diagnosis | 11.2% |
| Growth rate | 12.9 mm/year (IQR 3.5-22 mm/year) |
- Absolute contrast washout >60% in ACC
- 71.4% · 5
- Most common pathological diagnoses and growth rate by diagnosis: Adrenal adenoma 17% · growth rate 0.3 mm/year (IQR 0-2.3 mm/year)
- Absolute contrast washout >60% in ACC: 5 out of 7 ACC cases
Growth rate cutoff for predicting malignancy
- Best growth rate cutoff
- 2.68 mm/year
- AUC
- 0.939
- Sensitivity
- 87.5%
- Specificity
- 88.8%
Original publication
Clinical and Radiological Features of Atypical Adrenal Masses—A Multicenter Retrospective Study. J Clin Endocrinol Metab. Published 6 November 2024. doi:10.
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