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Adrenal incidentaloma - experience of a standardized diagnostic programme in the Swedish prospective study.

Bülow, B and Ahrén, Bo LU (2002) In Journal of Internal Medicine1989-01-01+01:00 252(3). p.239-246
Abstract
Bülow B, Ahrén B (Lund University, Lund, Sweden) on behalf of the Swedish Research Council Study Group of Endocrine Abdominal Tumours. Adrenal incidentaloma - experience of a standardized diagnostic programme in the Swedish prospective study. J Intern Med 2002; 252: 239-246. OBJECTIVE: To report the 5-year experience of a diagnostic programme for adrenal incidentaloma with special emphasis to diagnose hormonally active and malignant lesions. DESIGN: A prospective study in which new cases of adrenal incidentalomas in Sweden have been evaluated by a standardized diagnostic protocol between January 1996 and July 2001. SETTING: Thirty-three different Swedish hospitals have contributed with cases. SUBJECTS: A total of 381 patients (217 females,... (More)
Bülow B, Ahrén B (Lund University, Lund, Sweden) on behalf of the Swedish Research Council Study Group of Endocrine Abdominal Tumours. Adrenal incidentaloma - experience of a standardized diagnostic programme in the Swedish prospective study. J Intern Med 2002; 252: 239-246. OBJECTIVE: To report the 5-year experience of a diagnostic programme for adrenal incidentaloma with special emphasis to diagnose hormonally active and malignant lesions. DESIGN: A prospective study in which new cases of adrenal incidentalomas in Sweden have been evaluated by a standardized diagnostic protocol between January 1996 and July 2001. SETTING: Thirty-three different Swedish hospitals have contributed with cases. SUBJECTS: A total of 381 patients (217 females, 164 males) with adrenal incidentalomas were studied. INTERVENTIONS: Diagnostic procedures were undertaken according to a standardized programme. Operation was recommended if the incidentaloma had a size of more than 3-4 cm or if there was a suspicion of a hypersecreting tumour. MAIN OUTCOME MEASURES: The size of the incidentaloma, clinical characteristics of the patients and results of biochemical diagnostic tests were registered. RESULTS: The median age of the patients was 64 years (18-84 years), and the median size of the incidentalomas was 3 cm (1-20 cm). A total of 85(22%) patients were operated. Twenty of thesepatients were diagnosed with a benign hypersecreting tumour and 14 with a malignant tumour. Fourteen of 15 operated patients with diagnosed pheochromocytoma had elevated 24-h urinary noradrenaline and all of the patients operated because of a biochemical suspicion of aldosterone or cortisol hypersecretion (n = 6) were found to have adrenal adenomas. Of the 14 operated patients with malignant diseases, 10 were adrenal carcinomas (median size 10 cm; range 4-16 cm). In a multiple logistic regression model, incidentaloma size was significantly associated with the risk of a malignant tumour (P = 0.009), and there was a tendency of an association between age/male sex and the risk of a malignancy (both, P = 0.07). CONCLUSION: In this Swedish multicentre study of 381 cases with adrenal incidentalomas, 5% had benign hypersecreting tumours and nearly 4% had malignant tumours. The results of the biochemical diagnostic tests used had a high compatibility with the histological diagnosis found at operation in the patients with hypersecreting tumours. Tumour size, male gender and high age were predictive for the risk of a malignant tumour. A follow-up of the patients is warranted in order to establish whether there are undiscovered cases of malignant or hypersecreting tumours amongst the nonoperated patients. (Less)
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Contribution to journal
publication status
published
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in
Journal of Internal Medicine1989-01-01+01:00
volume
252
issue
3
pages
239 - 246
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • wos:000178028100006
  • pmid:12270004
  • scopus:0036378401
ISSN
1365-2796
DOI
10.1046/j.1365-2796.2002.01028.x
language
English
LU publication?
yes
id
59de5979-73bf-4b26-afa1-e3e181aa2eb0 (old id 110221)
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12270004&dopt=Abstract
date added to LUP
2007-06-27 14:17:01
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2017-11-05 04:29:41
@article{59de5979-73bf-4b26-afa1-e3e181aa2eb0,
  abstract     = {Bülow B, Ahrén B (Lund University, Lund, Sweden) on behalf of the Swedish Research Council Study Group of Endocrine Abdominal Tumours. Adrenal incidentaloma - experience of a standardized diagnostic programme in the Swedish prospective study. J Intern Med 2002; 252: 239-246. OBJECTIVE: To report the 5-year experience of a diagnostic programme for adrenal incidentaloma with special emphasis to diagnose hormonally active and malignant lesions. DESIGN: A prospective study in which new cases of adrenal incidentalomas in Sweden have been evaluated by a standardized diagnostic protocol between January 1996 and July 2001. SETTING: Thirty-three different Swedish hospitals have contributed with cases. SUBJECTS: A total of 381 patients (217 females, 164 males) with adrenal incidentalomas were studied. INTERVENTIONS: Diagnostic procedures were undertaken according to a standardized programme. Operation was recommended if the incidentaloma had a size of more than 3-4 cm or if there was a suspicion of a hypersecreting tumour. MAIN OUTCOME MEASURES: The size of the incidentaloma, clinical characteristics of the patients and results of biochemical diagnostic tests were registered. RESULTS: The median age of the patients was 64 years (18-84 years), and the median size of the incidentalomas was 3 cm (1-20 cm). A total of 85(22%) patients were operated. Twenty of thesepatients were diagnosed with a benign hypersecreting tumour and 14 with a malignant tumour. Fourteen of 15 operated patients with diagnosed pheochromocytoma had elevated 24-h urinary noradrenaline and all of the patients operated because of a biochemical suspicion of aldosterone or cortisol hypersecretion (n = 6) were found to have adrenal adenomas. Of the 14 operated patients with malignant diseases, 10 were adrenal carcinomas (median size 10 cm; range 4-16 cm). In a multiple logistic regression model, incidentaloma size was significantly associated with the risk of a malignant tumour (P = 0.009), and there was a tendency of an association between age/male sex and the risk of a malignancy (both, P = 0.07). CONCLUSION: In this Swedish multicentre study of 381 cases with adrenal incidentalomas, 5% had benign hypersecreting tumours and nearly 4% had malignant tumours. The results of the biochemical diagnostic tests used had a high compatibility with the histological diagnosis found at operation in the patients with hypersecreting tumours. Tumour size, male gender and high age were predictive for the risk of a malignant tumour. A follow-up of the patients is warranted in order to establish whether there are undiscovered cases of malignant or hypersecreting tumours amongst the nonoperated patients.},
  author       = {Bülow, B and Ahrén, Bo},
  issn         = {1365-2796},
  language     = {eng},
  number       = {3},
  pages        = {239--246},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Journal of Internal Medicine1989-01-01+01:00},
  title        = {Adrenal incidentaloma - experience of a standardized diagnostic programme in the Swedish prospective study.},
  url          = {http://dx.doi.org/10.1046/j.1365-2796.2002.01028.x},
  volume       = {252},
  year         = {2002},
}