Diagnosis of adrenal glands incidentaloma.

Authors

  • O. B. Kutovoy
  • E. V. Zhmurenko
  • L. V. Kunyk

DOI:

https://doi.org/10.26641/2307-0404.2017.3.111925

Keywords:

incidentaloma diagnosis, computed tomography, ultrasound examination of the adrenal glands

Abstract

In this study the results of examination and treatment of 91 patients with adrenal glands incidentaloma were analyzed. According to the results of the morphological study, adenomas were the most common (n=60). Among malignant tumors, ACC was detected in 7 patients, low and undifferentiated cancer – in 3 patients, sarcoma – in 2 patients and metastasis of cancer – in 4 patients. To assess the nature of the tumor, the following criteria were used: size and density according to CT. In 43 patients with neoplasms less than4 cmin 9,3% of cases malignant adrenalomas occurred, at 4-6 cm(n=29) - in 17,2% of cases, more than6 cm(n=19) - in 31,6%. In patients with ACC, 71,4% of tumors exceeded6 cm, 28,5% - were within 4-6 cm, 14,1% - less than4 cm. The frequency of detection of malignant incidentalomas increases in proportion to the growth of tumor size, and with a diameter of more than4 cmit was 27,1%. Adrenal adenomas in 31.6% of cases were from 4 to6 cm, and in 10% - more than6 cm. Thus, the orientation only on the size of tumors did not provide enough convincing grounds for determining its malignant potential. High native density was noted in ACC (33.4±2.8 HU), ganglioneuroma (36.6 НU) and metastases of cancer (43.6±9.0 HU). Low density was found in adenomas (0.4±10.7 HU) and adrenal cysts (6.0±8.2 HU), p<0.05. The most informative method of investigation in adrenal incidentalomas was CT, with sensitivity in adenomas and cancers – 98,3% and 94,4% respectively, specificity – 82,4% and 84,6%.

Author Biographies

O. B. Kutovoy

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of Surgery N 2
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

E. V. Zhmurenko

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine»
Department of Surgery N 2
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

L. V. Kunyk

Dnipropetrovsk Regional Clinical Hospital I.I. Mechnikov
Soborna sq., 14, Dnipro, 49005, Ukraine

References

1. Arablinsky AV. [Computer and magnetic reso­nance tomography in the diagnosis of adrenal diseases]. Sibirskij onkologicheskij zhurnal. 2011;8-9. Russian.

2. Beltsevich DG. [Incidental adrenal gland]. Jen­dokrinnaja hirurgija. 2009;19-23. Russian.

3. Kvachenyuk AN. [Clinical and laboratory cha­racteristics of adrenal insulin-adenomas]. Klіnіchna hіrurgіya. 2011;59-61. Russian.

4. Klyushin DA, Petunin Yu. [Evidence-based me­dicine. Application of statistical methods]. Dialektika. 2007;320. Russian.

5. Kotelnikova LP. [Computer tomography in dif­ferential diagnosis of adrenal incidents]. Sovrem. proble­my nauki i obrazovanija. 2008;129-33. Russian.

6. Lutsenko LA. [Inciydentalomas of the adrenal glands, aspects of diagnosis and choice of tactics for pa­tients]. Jendokrinologija. 2014;19(2):126-129. Ukrainian.

7. Molashenko NV. [Volume formations of adrenal glands (diagnosis and differential diagnosis)]. Problemy endokrinologii. 2010;48-52. Russian.

8. Soldatova ТV. [Differential diagnosis of random­ly detected tumors of the adrenal gland]. Mezhdunarodnyj jendokrinologicheskij zhurnal. 2011;8. Russian.

9. Zeiger MA, Thompson GB, Quan-Yang Duh, et al. American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons Medical Guidelines for the Management of Adrenal Inciden­taloma. Endocrine practice. 2009;15:1-20.

10. Boland GW, Blake MA, Hahn PF, et al. In­ciden­tal adrenal lesions: principles, techniques, and algo­rithms for imaging characterization. Radiology. 2008;756-775.

11. NIH State of the Science Statement of mana­ge­ment of the clinically in apparent adrenal mass (inciden­taloma). NIH Consens. State Sci. Stats. 2002;19(2):1-25.

12. Pacak K, Eisenhofer G, Ahlman H, et al. Pheo­chromocytoma: recommendations for clinical practice from the First International Symposium. Nat. Clin. Pract. Endocrinol. 2007;3:92-102.

13. Bovio S, Cataldi A, Reimondo G, et al. Pre­va­len­ce of adrenal incidentaloma in a contemporary compu­te­rized tomography series. Endocrinol Invest. 2006;29:298–302.

14. El-Hefnawy AS, El Garba M, Osman Y, et al. Surgical management of adrenal cysts: single-institution experience. Endocrinol Invest. 2009;104:847-850.

15. Funder JW, Carey RM, Fardella C, еt al. The Dia­gnosis of Cushing’s Syndrome: аn endocrine society clinical practice guideline. Сlin. Еndocrinol. 2008;5:1526-1540.

Downloads

How to Cite

1.
Kutovoy OB, Zhmurenko EV, Kunyk LV. Diagnosis of adrenal glands incidentaloma. Med. perspekt. [Internet]. 2017Oct.12 [cited 2024Apr.25];22(3):46-51. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/111925

Issue

Vol. 22 No. 3 (2017)

Section

CLINICAL MEDICINE

License

Copyright (c) 2017 Medicni perspektivi (Medical perspectives)

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.

Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.