Value of Biochemical Follow-up in Adrenal Incidentalomas
Value of Biochemical Follow-up in Adrenal Incidentalomas
An adrenal incidentaloma is a tumour in the adrenal gland accidentally discovered when a patient undergoes radiological investigation for other reasons than suspected adrenal disease. The mean prevalence is 2.3% and increases with age to 6.9% in patients above 70 years. The prevalent occurrence together with the increased use of radiological investigation has resulted in the frequent incidental discovery of asymptomatic adrenal masses. Even though the majority of incidentalomas are benign and non-hyperfunctioning, careful radiological and hormonal investigations are needed in order to identify malignant and hormone producing tumours. The management often includes biochemical hormonal surveillance maintained for several years which may be associated with significant emotional distress and financial costs in a group of patients where the vast majority turn out to be healthy. The prevailing view that advocates long-term hormonal follow-up has therefore recently been challenged. However, the evidence remains scarce. The present study examined all adrenal incidentalomas presented to a single centre between 2006 and 2010. We hypothesized that long-term biochemical follow-up in patients with an initial normal biochemical screening would fail to increase the sensitivity in finding hormone-producing tumours.
Background
An adrenal incidentaloma is a tumour in the adrenal gland accidentally discovered when a patient undergoes radiological investigation for other reasons than suspected adrenal disease. The mean prevalence is 2.3% and increases with age to 6.9% in patients above 70 years. The prevalent occurrence together with the increased use of radiological investigation has resulted in the frequent incidental discovery of asymptomatic adrenal masses. Even though the majority of incidentalomas are benign and non-hyperfunctioning, careful radiological and hormonal investigations are needed in order to identify malignant and hormone producing tumours. The management often includes biochemical hormonal surveillance maintained for several years which may be associated with significant emotional distress and financial costs in a group of patients where the vast majority turn out to be healthy. The prevailing view that advocates long-term hormonal follow-up has therefore recently been challenged. However, the evidence remains scarce. The present study examined all adrenal incidentalomas presented to a single centre between 2006 and 2010. We hypothesized that long-term biochemical follow-up in patients with an initial normal biochemical screening would fail to increase the sensitivity in finding hormone-producing tumours.