AI Article Synopsis
- The study focused on 70 patients with bilateral adrenal masses to understand their clinical, biochemical, and radiological features from a single endocrine center in western India.
- The most common causes identified were pheochromocytoma (40%) and tuberculosis (27.1%), with significant variations in age of onset and presenting symptoms among the different aetiologies.
- Key findings indicated that biochemical results, lesion size, and patient age can aid in distinguishing the underlying causes of bilateral adrenal masses.
Article Abstract
Background: Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited.
Aims: To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses.
Methods: Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002-2015).
Results: The most common aetiology was pheochromocytoma (40%), followed by tuberculosis (27.1%), primary adrenal lymphoma (PAL) (10%), metastases (5.7%), non-functioning adenomas (4.3%), primary bilateral macronodular adrenal hyperplasia (4.3%), and others (8.6%). Age at presentation was less in patients with pheochromocytoma (33 years) and tuberculosis (41 years) compared with PAL (48 years) and metastases (61 years) (P<0.001). The presenting symptoms for pheochromocytoma were hyperadrenergic spells (54%) and abdominal pain (29%), whereas tuberculosis presented with adrenal insufficiency (AI) (95%). The presenting symptoms for PAL were AI (57%) and abdominal pain (43%), whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm) followed by pheochromocytoma (4.8cm), metastasis (4cm) and tuberculosis (2.1cm) (P<0.001). Biochemically, most patients with pheochromocytoma (92.8%) had catecholamine excess. Hypocortisolism was common in tuberculosis (100%) and PAL (71.4%) and absent with metastases (P<0.001).
Conclusion: In evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5002952 | PMC |
| http://dx.doi.org/10.1530/EC-16-0015 | DOI Listing |
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