Dominic I Maher1, Evan Williams2, Simon Grodski3, Jonathan W Serpell3, James C Lee3. 1. Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia. Electronic address: James.Lee@monash.edu. 2. Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia. 3. Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia; Department of Surgery, Monash University, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: The majority of adrenal incidentalomas are benign, although some are large, functional, or malignant and may require surgery. Therefore all require follow-up. This study aimed to determine the pattern of adrenal incidentaloma follow-up in a level 1 trauma center, focusing on the factors that influence whether follow-up is facilitated. METHODS: Patients with computed tomography-detected adrenal incidentalomas between January 2010 and September 2015 were included. A keyword search identified case files, which were reviewed for demographic characteristics, managing unit, computed tomography indication and findings, and follow-up arrangements. Statistical analysis was performed using Stata SE Version 14. RESULTS: A total of 38,848 chest and abdominal computed tomographic scans were performed in the study period, revealing 804 patients with adrenal incidentalomas who met inclusion criteria (mean age 65, 58% male). The mean size of adrenal incidentaloma was 23 mm. Follow-up was organized in 30% of cases and was more likely to occur in younger patients (mean age 62 vs 66, P < .001); in larger lesions (mean size 26 mm vs 21 mm, P < .001); if the computed tomographic scan suggested follow-up (P < .001); or if the computed tomography report suggested a diagnosis (P < .001). Follow-up arrangements were most likely to be made by the trauma unit (39%, P = .01). CONCLUSION: This study highlights that adrenal incidentalomas follow-up is often overlooked, and that follow-up is influenced by patient, radiologic, and medical provider factors. An adrenal lesion follow-up protocol may improve follow-up rates but requires further analysis.
BACKGROUND: The majority of adrenal incidentalomas are benign, although some are large, functional, or malignant and may require surgery. Therefore all require follow-up. This study aimed to determine the pattern of adrenal incidentaloma follow-up in a level 1 trauma center, focusing on the factors that influence whether follow-up is facilitated. METHODS:Patients with computed tomography-detected adrenal incidentalomas between January 2010 and September 2015 were included. A keyword search identified case files, which were reviewed for demographic characteristics, managing unit, computed tomography indication and findings, and follow-up arrangements. Statistical analysis was performed using Stata SE Version 14. RESULTS: A total of 38,848 chest and abdominal computed tomographic scans were performed in the study period, revealing 804 patients with adrenal incidentalomas who met inclusion criteria (mean age 65, 58% male). The mean size of adrenal incidentaloma was 23 mm. Follow-up was organized in 30% of cases and was more likely to occur in younger patients (mean age 62 vs 66, P < .001); in larger lesions (mean size 26 mm vs 21 mm, P < .001); if the computed tomographic scan suggested follow-up (P < .001); or if the computed tomography report suggested a diagnosis (P < .001). Follow-up arrangements were most likely to be made by the trauma unit (39%, P = .01). CONCLUSION: This study highlights that adrenal incidentalomas follow-up is often overlooked, and that follow-up is influenced by patient, radiologic, and medical provider factors. An adrenal lesion follow-up protocol may improve follow-up rates but requires further analysis.
Authors: Mark Sherlock; Andrew Scarsbrook; Afroze Abbas; Sheila Fraser; Padiporn Limumpornpetch; Rosemary Dineen; Paul M Stewart Journal: Endocr Rev Date: 2020-12-01 Impact factor: 19.871
Authors: Christoph F Dietrich; Jean Michel Correas; Yi Dong; Christian Nolsoe; Susan Campbell Westerway; Christian Jenssen Journal: Ultrasonography Date: 2019-07-09