[Adrenal incidentalomas: clinical experience in the hospitals of Castilla-La Mancha (Spain)].

OBJECTIVE

The management of incidentally discovered adrenal masses (incidentalomas) remains controversial. Our objective was to describe the demographic and clinical characteristics of a series of patients with adrenal incidentalomas attended in several hospitals of Castilla-La Mancha, and their diagnostic and therapeutic management.

MATERIAL AND METHODS

Data were obtained by reviewing the patients' medical charts.

RESULTS

A total of 270 patients were included (28.1% from Toledo, 25.9% from Albacete, 24.1% from Ciudad Real, 15.9% from Cuenca and 5.9% from Guadalajara). The mean age was 60.3 +/- 12 and 53.3% were women. Overweight or obesity were found in 80.6%, hypertension in 55.8%, diabetes mellitus in 25.6%, impaired fasting glucose or impaired glucose tolerance in 15.6%, osteopenia in 31.5% and osteoporosis in 20.4%. These percentages were similar in patients with subclinical Cushing's syndrome. Diameter was less than 3 cm in 66% of the tumors, and more than 4 cm in 14.3%. Eighty-five percent of the tumors were detected by computed tomography. After a median follow-up of 28.8 months, 6% of nonfunctioning adenomas progressed to subclinical Cushing's syndrome, tumoral enlargement of more than 1 cm was found in 9.4% and a contralateral mass developed in 8.9%. Surgical adrenalectomy was performed in 14.4% of the patients.

CONCLUSIONS

Our study confirms the favorable outcome in most patients with adrenal incidentalomas and contributes to a better understanding of this clinical entity.