FRI174 Spectrum Of Presentation Of Adrenal Incidentalomas : Is The Distribution Changing? Experience From A Tertiary Care Centre Of Eastern India

Abstract

Abstract Disclosure: I. Mishra: None. M.V. Vivek: None. A.K. Baliarsinha: None. Spectrum of presentation of adrenal incidentalomas : Is the distribution changing? Experience from a tertiary care centre of Eastern India Abstract: Incidentally discovered adrenal masses have become a common clinical problem. An adrenal mass is uncovered in up to 4% -10% of patients imaged for non-adrenal disease. Incidentalomas are uncommon in patients younger than 30 years of age but increase in frequency with age; more frequently in females, especially in the sixth and seventh decades. Functioning tumors with a clear clinical phenotype (pheochromocytomas and those secreting cortisol, aldosterone, or sex steroids) and carcinomas account for around 28%- 32% of all adrenal incidentalomas. We reviewed last three year records of all the patients with the diagnosis of adrenal incidentaloma presenting to our institute and data regarding the clinical profile and outcomes of all the patients were analysed. The data obtained was entered into Microsoft Excel Worksheet and analysed using Statistical Package for Social Sciences (SPSS, IBM Corp. Released 2020.IBM SPSS Statistics for Windows, Version 20.0.Armonk,NY: IBM Corp.).Total 44 patients of adrenal incidentalomas were reviewed. In our case series, incidentalomas frequency were found to be increasing with age, most common in the 5th and 6th decades with equal frequency between male and females. Functioning tumours accounted for 54.5%(n=24), non functioning in 38.6%(n=17) and adrenal deficiciency in 6.8%(n=3)respectively. Most commonly encountered tumour was Pheochromocytoma(n=14,31.8%)followed by benign adenoma(n=10, 22.7%), adrenalcarcinoma (n=7,15.9%), myelolipoma(n=5,11.3%), aldosterone producing adenoma (n=3,6.8%), adrenal haemorrhage (n=1,2.2%), angiomyolipoma (n=1,2.2%), adrenal cyst (n=1,2.2%), and adrenal granuloma (n=2,4.5%) respectively. Amongst benign adenomas 40%(n=4) were functional( cortisol excess) and 60%(n=6) were non functional.Amongst adrenal carcinomas 42.8% (n=3) were functional and 57.2%(n=4) were non functional. Adrenal haemorrhage and adrenal granulomas had features of adrenal deficiency. The present work demonstrates that the distribution of adrenal incidentalomas is equal in both males and females, with functioning tumour Pheochromocytoma being more common than other variants. Hence the importance of complete biochemical investigation of adrenal incidentalomas is warranted. The probable changing pattern in the distribution of etiologies of adrenal incidentolomas can be further elucidated by analyzing data of a large cohort of patients with adrenal incidentolomas. Reference: Mansmann G, Lau J, Balk E, Rothberg M, Miyachi Y, Bornstein SR. The clinically inapparent adrenal mass: update in diagnosis and management. Endocr Rev. 2004 Apr;25(2):309-40. doi: 10.1210/er.2002-0031. PMID: 15082524. Presentation: Friday, June 16, 2023