Presentation and management of patients with adrenal masses: a large tertiary centre experience
Authors' conclusion
Implementing the 2016 guidelines positively impacted clinical practice, reducing unnecessary surgeries and increasing the discharge rate for benign adrenal masses, thereby preserving healthcare resources and patient burden.
Study context
- Population
- Patients with adrenal masses referred to a tertiary care centre, 1998–2022; 55.7% women; median age 60 years (IQR 49–70)
- Participants
- 1,397 patients
- Exposure
- Post-2016 vs pre-2016 European adrenal incidentaloma guidelines
- Outcome
- Final diagnosis
Methodological detailssingle tertiary centre, sub-analysis before vs after 2016 guidelines
- Single tertiary centre
- Sub-analysis before vs after 2016 guidelines
Main finding
As reported in the abstract
Adrenocortical adenoma
56.0%
Phaeochromocytoma
12.7%
Adrenocortical carcinoma
10.6%
Metastases
5.7%
Observational data: associations, not effects.
Further findings
Adrenalectomies, benign non-functioning adrenal masses
Patients discharged, benign non-functioning adrenal masses
Presentation and imaging
- Incidental discovery (most frequent presentation)
- 63.7%
- Masses ≥ 4 cm
- 30.6%
- Median mass size
- 2.9 cm (IQR 1.9-4.7)
- Heterogeneous or >20 Hounsfield units (HU), among 763 with unenhanced CT HU
- 32.9%
Predictors of malignancy (multivariable analysis)
- >20 HU or heterogeneous density, OR
- 28.40
- Androgen excess, OR
- 27.67
- Detection during cancer surveillance, OR
- 11.34
- Size ≥ 4 cm, OR
- 6.11
- Male sex, OR
- 3.06
Original publication
Presentation and management of patients with adrenal masses: a large tertiary centre experience. Eur J Endocrinol. Published 19 October 2024. doi:10.
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