Objective: To improve the diagnosis and treatment of adrenal incidentaloma (AI).
Methods: Retrospective analysis of 103 AI patients in PUMC Hospital from 1994 to 2002.
Results: Of the 103 cases (43 men and 60 women), most patients were 40-60 years old. Eighty-five cases (82.5%) were benign masses, of which 36 (35.0%) were non-functional adrenal cortical adenoma, and 12 (11.7%) were pheochromocytoma, 1 (1%) was Cushing's syndrome and 1 for aldosteronomas. Three cases did not show clinical feature and the diagnosis of pheochromocytoma were based on 131I-MIBG. Among 18 (17.5%) malignant tumors, adrenal carcinomas account for the majority (8 cases, 7.8%). Patients with malignant masses were significantly younger than patients with adenomas (P < 0.05), and the adenomas were significantly smaller than malignancy (P < 0.001). A cut-off at 4.0 cm of tumor mass size was set for differentiating benign and malignant tumors.
Conclusions: During the diagnosis of AI, it's essential to evaluate hormonal activity and assess for the risk of malignancy. If the mass size is 4 cm or larger, the risk of malignancy increases. More attention should be paid to subclinical hyperfunctional state.
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