Published in Cancer Detection and Prevention 1998; 22(Supplement 1).

Adrenal incidentaloma - analysis of 25 cases dis-covered by ultrasound

E Goncalvesova MD PhD ¹, J Breza MD PhD ², P Hnilica MD PhD ¹, F Goncalves MD ¹ , Z Motovska MD ¹

Incidentaloma is defined as a surprising unexpected mass discovered by chance at the examination performed for any reason. AIM: To evaluate contribution of ultrasonography (USG) in management of adrenal incidentalomas. METHODS: 25 consecutive inpatients (11 males) aged 32 - 80 years with adrenal masses incidentally discovered by ultrasound were studied retrospectively. Diagnosis was established surgically in 14 pts, using combination of imaging technique (CT, MRI and scintigraphy ) and long-term follow up in remaining 11 pts. In all patients screening for hormonal activity was performed. RESULTS: In four out of 25 patients UGS were false positive (all on the left side) and 4 cases were identified as pseudoadrenal masses. Hormonal activity was proved in 4 out of 17 true adrenal masses (2 pheochromocytoma, 2 aldosteronoma). Seven out of 13 hormonally inactive tumors were benign adenomas , 2 myelolipomas, 2 simple cyst, 1 metastasis of bronchogenic carcinoma and 1 tuberculotic involvement. The smallest tumor was andosteronoma (2 cm), the largest myelolipoma (more then 10cm). Size of benign adenoma ranged between 2.5-4.8 cm. No adrenocortical carcinoma has been discovered. Three main ultrasonic patterns of adrenal tumors were recognized. Typical anechogenic of cysts, complex but predominantly hyperechogenic of myelolipomas. All remaining tumors e.g. adenomas and metastasis were homogeneously hypoechogenic. CONCLUSION: Ultrasonographic finding of adrenal mass is relatively unspecific (high incidence of false positive and pseudoadrenal masses), namely for the left side. USG appear as an unsuitable for causal diagnosis of adrenal incidentaloma but is considered optimal for regular follow up of patient with tumor of unknown significance.

KEY WORDS: adrenal incidentalona, diagnosis, ultrasonography, ultrasonography, .

Paper presented at the International Symposium on the Impact of Biotechnology on Prediction, Prevention and Treatment of Cancer; Nice, France; October 24 - 27, 1998; in the section on Diagnostic Techniques.

http://www.cancerprev.org/Journal/Issues/22/101/12/2686