Objective. To study the clinical picture, malignancy potential of hormone-inactive adrenal tumors (HIAT) by the results of computed tomography (CT) to identify the most significant clinical and diagnostic signs. Materials and methods. Case histories of 65 patients operated for HIAT (group 1) and 52 ambulatory records of HIAT patients (group 2) observed in the polyclinic were retrospectively studied. All patients underwent survey, antropometry, biochemical blood analysis, adrenal hormone level, CT of adrenal glands. Results. The operated patients in 81.6 % of cases were under sixty, nonoperated in 73 % of cases over sixty. The size of tumor in patients of group 1 in 84.7 % exceeded 4 cm, in group 2 in 98.1 % was less than 4 cm. HIAT size, CT-density in NF were significantly lower (р = 0,000 and р = 0,000, respectively), but the level of morning cortisol, observation period and age were significantly higher in the group of nonoperated patients. (р = 0,013, р = 0,000 and р = 0,000, respectively). According to the results of comparative analysis of the clinical manifestations of the autonomous cortisol secretion (arterial hypertension, obesity) in the groups of nonoperated and operated patients with HIAT, statistically significant differences were established (р = 0,000, р = 0,002 respectively). In group 1, stage 2 AH was diagnosed more often and obesity rarely. No statistically significant differences were detected in the analysis of carbohydrate metabolism disorders, osteoporosis, dyslipidemia (р = 0,531, р р = 0,322, р = 0,105). Correlation analysis of HIAT size with the period of dynamic observation and CT-density in NF showed a negative notable (р = -0,606, р = 0,000) and a positive moderate (р = 0,391, р = 0,036) (respectively) tightness of links by Chaddock scale. In case of a 1 cm increase in HIAT size, CT-density in NF is expected to rise by 1,857 HU. Conclusions. 1. To determine the indications to adrenalectomy, it is necessary to take into account the size and native density of the adrenal tumor by the results of computed tomography as well as clinical and laboratory data. With the values of HIAT size 4.0 cm in combination with CT-density in NF 12 HU, adrenalectomy is recommended. 2. In case of a 1 cm increase in HIAT size, rise in CT-density by 1,857 HU is expected. It is worthwhile to control CT-phenotype of HIAT in nonoperated ambulatory patients to determine the malignancy potential of HIAT and up-to-date surgical treatment.

Introduction. The choice of tactics for patients with adrenal masses (AM) with functionally autonomous cortisol secretion (FASC) remains controversial.The aim of the study was to determine the most significant clinical manifestations of FASC in unoperated AM patients.Materials and methods Thirty unoperated AM patients aged 67.0 [59.25 to 71.0] years with a disease duration of 92.0 [46.75 to 112.0] months were included in the study.Results. We defined thresholds for morning blood cortisol levels to predict clinical manifestations of FASC: for obesity ≥ 300.7 nmol/L, (p = 0.02), DM2 ≥ 508.0 nmol/L, (p < 0.001), dyslipidemia ≥ 450.0 nmol/L, (p = 0.02). Increases in AM size were determined: at 36 months − by 0.146 cm, at 60 months − by 0.169 cm, its positive marked direct correlation with the initial AM size.Discussion. According to the literature, FASC is diagnosed in 30−50 % of patients with AM. Our data are comparable with scientific sources: AH was observed in 86.7% (n = 26) of patients, obesity − 73.3 % (n = 22), T2DM − 36.7 % (n = 11), dyslipidemia − 60 % (n = 17), osteoporosis − 43.3 % (n = 13).Conclusion In unoperated outpatients with AM, obesity, DM2, and dyslipidemia are the most significant clinical manifestations of FASC. In patients over 60 years of age with a benign CT-phenotype of adrenal masses and controlled clinical manifestations of FASC, the treatment tactic is observation.

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