학술논문
The Hormonal Status Comparison of Unilateral and Bilateral Adrenal Adenomas: Are They the Same?
Original Research
Original Research
Document Type
Report
Source
European Journal of Therapeutics. September 2023, Vol. 29 Issue 3, p499, 9 p.
Subject
Language
English
ISSN
2564-7784
Abstract
INTRODUCTION Adrenal incidentalomas are tumors of the adrenal gland, mostly found incidentally in imaging modalities of unrelated purposes and greater than 1 cm. The more frequent use of imaging methods [...]
Objective: It is not yet clear whether unilateral/bilateral adenomas are different in terms of both functionality and etiology. We investigated whether there were differences in hormonal profiles and evaluate the Cortisol secretion profiles of unilateral and bilateral adenomas. Material&Methods: Hormonal secretory profiles and clinical features of patients with adenomas were collected. Detailed evaluation was made in terms of hypercortisolemia. Results: Of the 184 patients examined, 140 had unilateral and 44 had bilateral adenomas. 73% of the patients were female and the mean body mass index was 34[+ or -]8.1kg/[m.sup.2]. The mean age was 57.1[+ or -]9.8 years. The average size of the adrenal masses was 23.3[+ or -]10.5mm. While 83% of the evaluated adenomas were nonfunctional, ACS was found in 11% (n:20), hyperaldosteronism in 4% (n:8), and pheochromocytoma (PCC) in 2% (n:3) of the patients. The prevalence of ACS in bilateral/unilateral adenomas was 20.5%/7.9%, respectively. While serum adrenocorticotropic hormone level (25.6[+ or -]16.6vs19.3[+ or -]15[micro]g/dL), urinary free Cortisol level (162.3[+ or -]108.3vs243.3[+ or -]234.2[micro]g/day), and low-dose-dexamethasone-suppression-test results (1.6[+ or -]1.9vsl.73[+ or -]1.7[micro]g/dL) were not statistically different, the only difference between unilateral and bilateral adenomas was in serum DHEA-S level (141.4[+ or -]85vs77.7[+ or -]73.8 [micro]g/dL, p:0.003). Conclusion: Although there is no significant difference between the two groups in terms of clinical findings, it is clear that ACS is more prevalent in bilateral adenomas than unilateral. Because of the negative effects of long-term hypercortisolism, precise management of ACS is noteworthy. The evaluation of ACS should be done more carefully in bilateral adenomas considering that ACS is more in bilateral adenomas than unilateral. According to our findings, we also suggest that DHEA-S may be an indicator for ACS. Keywords: autonomous Cortisol secretion, bilateral adrenal adenomas, Dehydroepiandrosterone Sulfate
Objective: It is not yet clear whether unilateral/bilateral adenomas are different in terms of both functionality and etiology. We investigated whether there were differences in hormonal profiles and evaluate the Cortisol secretion profiles of unilateral and bilateral adenomas. Material&Methods: Hormonal secretory profiles and clinical features of patients with adenomas were collected. Detailed evaluation was made in terms of hypercortisolemia. Results: Of the 184 patients examined, 140 had unilateral and 44 had bilateral adenomas. 73% of the patients were female and the mean body mass index was 34[+ or -]8.1kg/[m.sup.2]. The mean age was 57.1[+ or -]9.8 years. The average size of the adrenal masses was 23.3[+ or -]10.5mm. While 83% of the evaluated adenomas were nonfunctional, ACS was found in 11% (n:20), hyperaldosteronism in 4% (n:8), and pheochromocytoma (PCC) in 2% (n:3) of the patients. The prevalence of ACS in bilateral/unilateral adenomas was 20.5%/7.9%, respectively. While serum adrenocorticotropic hormone level (25.6[+ or -]16.6vs19.3[+ or -]15[micro]g/dL), urinary free Cortisol level (162.3[+ or -]108.3vs243.3[+ or -]234.2[micro]g/day), and low-dose-dexamethasone-suppression-test results (1.6[+ or -]1.9vsl.73[+ or -]1.7[micro]g/dL) were not statistically different, the only difference between unilateral and bilateral adenomas was in serum DHEA-S level (141.4[+ or -]85vs77.7[+ or -]73.8 [micro]g/dL, p:0.003). Conclusion: Although there is no significant difference between the two groups in terms of clinical findings, it is clear that ACS is more prevalent in bilateral adenomas than unilateral. Because of the negative effects of long-term hypercortisolism, precise management of ACS is noteworthy. The evaluation of ACS should be done more carefully in bilateral adenomas considering that ACS is more in bilateral adenomas than unilateral. According to our findings, we also suggest that DHEA-S may be an indicator for ACS. Keywords: autonomous Cortisol secretion, bilateral adrenal adenomas, Dehydroepiandrosterone Sulfate