Evaluation of hormonal function in a series of incidentally discovered adrenal masses

被引:56
作者
Bondanelli, M [1 ]
Campo, M [1 ]
Trasforini, G [1 ]
Ambrosio, MR [1 ]
Zatelli, MC [1 ]
Franceschetti, P [1 ]
Valentini, A [1 ]
Pansini, R [1 ]
Uberti, ECD [1 ]
机构
[1] UNIV FERRARA, CHAIR ENDOCRINOL, DEPT ENDOCRINOL, I-44100 FERRARA, ITALY
来源
METABOLISM-CLINICAL AND EXPERIMENTAL | 1997年 / 46卷 / 01期
关键词
D O I
10.1016/S0026-0495(97)90176-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The discovery of an asymptomatic adrenal mass (incidentaloma) during the investigation of an unrelated condition is relatively common. In this study, we report the clinical, radiologic, and endocrine evaluation of 38 patients (22 women and 16 men aged 24 to 84 years) with adrenal incidentaloma (size, 1 to 12 cm). The patients underwent basal and dynamic evaluation of the hypothalamic-pituitary-adrenal (HPA) axis, renin-angiotensin-aldosterone system, and adrenomedullary function. Moreover, computed tomography (CT) scan and I-131-6 beta-iodomethyl-19-norcholest-5(10)-en-3 beta-ol (NP-59) and/or I-131-metaiodobenzylguanidine (MIBG) scintigraphy were performed. The endocrine evaluation indicated two cases of pheochromocytoma and four cases of preclinical Cushing's syndrome, three of which underwent surgery with histologic diagnosis of two adrenocortical adenomas and one carcinoma. Low levels of serum dehydroepiandrosterone sulfate (DHEA-S), associated with a markedly increased 17-hydroxyprogesterone (17-OHP) response to a corticotropin (ACTH) test, were found in patients with incidentaloma. On the basis of endocrine and morphologic data, 13 patients underwent surgical treatment: five adrenocortical adenomas (two functioning), two pheochromocytomas, two ganglioneuromas, one cortisol-secreting adrenal carcinoma, one lymphangiomatous cyst, one myelolipoma, and one hemorrhage were found. Careful diagnostic assessment of incidentally discovered adrenal masses must be performed to exclude the presence of malignant and/or functioning lesions and to verify the possibility that patients with incidentaloma have a genetic or acquired deficit of adrenal steroidogenic activity. Copyright (C) 1997 by W.B. Saunders Company
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页码:107 / 113
页数:7
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