RT Journal Article
T1 Predictors of Tumour Growth and Autonomous Cortisol Secretion Development during Follow-Up in Non-Functioning Adrenal Incidentalomas
A1 Araujo-Castro, Marta
A1 Parra Ramirez, Paola
A1 Robles Lazaro, Cristina
A1 Garcia Centeno, Rogelio
A1 Gracia Gimeno, Paola
A1 Fernandez-Ladreda, Mariana Tome
A1 Sampedro Nunez, Miguel Antonio
A1 Marazuela, Monica
A1 Escobar-Morreale, Hector F.
A1 Valderrabano, Pablo
K1 adrenal incidentalomas
K1 autonomous cortisol secretion
K1 non-functioning adrenal incidentalomas
K1 dexamethasone suppression test
K1 Cardiovascular outcomes
K1 European-society
K1 Endocrinology
K1 Management
K1 Risk
K1 Association
K1 Guidelines
AB Purpose: To assess the risk of developing autonomous cortisol secretion (ACS) and tumour growth in non-functioning adrenal incidentalomas (NFAIs). Methods: Multicentre retrospective observational study of patients with NFAIs. ACS was defined as serum cortisol >1.8 mu g/dL after 1 mg-dexamethasone suppression test (DST) without specific data on Cushing's syndrome. Tumour growth was defined as an increase in maximum tumour diameter >20% from baseline; and of at least 5 mm. Results: Of 654 subjects with NFAIs included in the study, both tumour diameter and DST were re-evaluated during a follow-up longer than 12 months in 305 patients. After a median follow-up of 41.3 (IQR 24.7-63.1) months, 10.5% of NFAIs developed ACS. The risk for developing ACS was higher in patients with higher serum cortisol post-DST levels (HR 6.45 for each mu g/dL, p = 0.001) at diagnosis. Significant tumour growth was observed in 5.2% of cases. The risk of tumour growth was higher in females (HR 10.7, p = 0.004). Conclusions: The frequency of re-evaluation with DST in NFAIs during the initial 5 years from diagnosis can probably be tailored to the serum cortisol post-DST level at presentation. Re-evaluation of NFAIs with imaging studies, on the other hand, seems unnecessary in most cases, particularly if the initial imaging demonstrates features specific to typical adenoma, given the low rate of significant tumour growth.
PB Mdpi
YR 2021
FD 2021-12-01
LK https://hdl.handle.net/10668/25158
UL https://hdl.handle.net/10668/25158
LA en
DS RISalud
RD Apr 17, 2025