Department of Pathophysiology, Endocrine Unit, University of Athens Medical School, Athens, Greece.
Clin Endocrinol (Oxf). 2013 Jun;78(6):950-6. doi: 10.1111/cen.12046. Epub 2013 Apr 1.
The widespread application of abdominal computerized tomography (CT) imaging has revealed that 0.98-4.0% of individuals harbour adrenal lesions (incidentalomas). There is, however, paucity of information regarding the prevalence of adrenal lesions in patients with gastroenteropancreatic neuroendocrine tumours (GEP-NETS). Purpose of this study was to estimate the prevalence of adrenal lesions in patients with GEP-NETS and identify their radiological features and clinical significance.
The prevalence of adrenal lesions was estimated retrospectively in 438 patients with GEP-NETS who underwent abdominal imaging. Secretory status and changes in size were documented during subsequent follow-up. MEN-1 patients and ectopic ACTH-secreting tumours were excluded.
Adrenal lesions were detected in 32 (8.4%) of 383 patients included. The majority (22 patients - 69%) were located at the left adrenal gland and the mean size was 23.6 mm. In two patients, one with a well and another with a poorly differentiated tumour, clinicopathological features suggested adrenal metastases. During a mean follow-up period of 69.5 months, no subsequent growth of any adrenal lesion was observed. Endocrine evaluation documented subclinical glucocorticoid hypersecretion in 4 cases (14%). The presence of adrenal lesions did not correlate to distant metastases, however, they were observed more frequently in patients with G3 tumours.
The prevalence of adrenal lesions in patients with GEP-NETs was found to be higher than the general population and mostly represent benign adrenal adenomas (except patients with G3 tumours). Nevertheless, individualized assessment of imaging characteristics should be still considered.
腹部计算机断层扫描（CT）成像的广泛应用显示，0.98-4.0%的个体存在肾上腺病变（偶发瘤）。然而，关于胃肠胰神经内分泌肿瘤（GEP-NETs）患者中肾上腺病变的患病率知之甚少。本研究旨在评估 GEP-NETs 患者中肾上腺病变的患病率，并确定其影像学特征和临床意义。
回顾性估计了 438 例接受腹部影像学检查的 GEP-NETs 患者中肾上腺病变的患病率。在随后的随访中记录了分泌状态和大小变化。排除 MEN-1 患者和异位 ACTH 分泌肿瘤。
在纳入的 383 例患者中，32 例（8.4%）检测到肾上腺病变。大多数（22 例，69%）位于左肾上腺，平均大小为 23.6mm。在 2 例患者中，1 例为高分化肿瘤，1 例为低分化肿瘤，临床病理特征提示肾上腺转移。在平均 69.5 个月的随访期间，未观察到任何肾上腺病变的进一步生长。内分泌评估记录了 4 例（14%）亚临床糖皮质激素分泌过多。肾上腺病变的存在与远处转移无关，但在 G3 肿瘤患者中更为常见。
GEP-NETs 患者中肾上腺病变的患病率高于一般人群，且大多为良性肾上腺腺瘤（除 G3 肿瘤患者外）。然而，仍应考虑对影像学特征进行个体化评估。
