Bilateral Adrenal Incidentalomas

Abstract

Introduction: Bilateral adrenal incidentaloma presents a unique diagnostic challenge. Besides the risk of hormonal hypersecretion, bilateral adrenal lesion carries an additional risk of being metastatic from another primary carcinoma or part of a genetic syndrome. The discovery of a bilateral adrenal incidentaloma requires special attention and a broad diagnostic approach. This study is focused on the clinical, biological, etiological, therapeutic and progressive characteristics of bilateral adrenal incidentalomas. Patients and Methods: Descriptive retrospective study of 9 patients with bilateral adrenal incidentaloma from 2015 to 2020. Results: The mean age was 45±20 years with a predominance of male 77% (n=7). Adrenal masses were discovered during abdominal computed tomography in 77% of cases, abdominal ultrasound in 22% of cases. The reason for performing the radiological assessment was abdominal pain in 55% of patients (n=5), exploration of the hypertension in 33% (n=3), other causes were found in 11% of cases. Hormonal and biological exploration found a bilateral pheochromocytoma in 77%. The treatment was bilateral adrenalectomy in 44%, unilateral in 33%. Other treatments were offered for the rest of patient. Conclusion: The fortuitous radiological discovery of a bilateral adrenal incidentaloma should lead to additional explorations to clarify its nature, which will guide the treatment. Keywords: Bilateral, adrenal, incidentaloma, pheochromocytoma, metastases. Read more →