Long Term Follow-up of Patients with Adrenal Incidentalomas- A Single Center Experience and Review of the Literature

Anagnostis, Panagiotis; Efstathiadou, Zoe; Polyzos, Stergios A.; Tsolakidou, Konstantina; Litsas, I.; Panagiotou, Athanasios; Kita, Marina

doi:10.1055/s-0029-1237704

Cited by 17 publications

(9 citation statements)

References 26 publications

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“…Even in patients in whom a significantly increasing mass (≥1 cm/year) was observed, the final pathological diagnosis was confirmed as benign after surgical resection. The majority of previous cohort studies, which comprised sample sizes of 24-187 patients and had median follow-up periods of 1.8-7.5 years, similarly revealed no malignant transformation in typical benign nonfunctional AIs (20,21,22,23,24,25,26). One systematic review including data from 1081 patients reported an incidence of adrenal malignancy of 0.2% (only 1 case) (4).…”

Section: :6 481 Clinical Studymentioning

confidence: 95%

Optimal follow-up strategies for adrenal incidentalomas: reappraisal of the 2016 ESE-ENSAT guidelines in real clinical practice

Hong

Kim

Park

et al. 2017

European Journal of Endocrinology

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Section: :6 481 Clinical Studymentioning

confidence: 95%

Optimal follow-up strategies for adrenal incidentalomas: reappraisal of the 2016 ESE-ENSAT guidelines in real clinical practice

Hong

Kim

Park

et al. 2017

European Journal of Endocrinology

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“…13,61 Moreover, the so-called "clear cell variant" (lipid degeneration) of pheochromocytoma may show significant morphologic overlap with metastatic CC-RCC. 13,61 Moreover, the so-called "clear cell variant" (lipid degeneration) of pheochromocytoma may show significant morphologic overlap with metastatic CC-RCC.…”

Section: Pheochromocytomamentioning

confidence: 99%

The Use of Immunohistochemistry in the Diagnosis of Metastatic Clear Cell Renal Cell Carcinoma

Sangoi

Karamchandani

Kim

et al. 2010

Advances in Anatomic Pathology

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The diagnosis of metastatic clear cell renal cell carcinoma may be difficult in some cases, particularly in the small image-guided biopsies that are becoming more common. As targeted therapies for renal cell carcinoma are now standard treatment, the recognition and diagnosis of renal cell carcinoma has become even more critical. Many adjunctive immunohistochemical markers of renal epithelial lineage such as CD10 and RCCma have been proposed as aids in the diagnosis of metastatic renal cell carcinoma, but low specificities often limit their utility. More recently described markers (PAX-2, PAX-8, human kidney injury molecule-1, hepatocyte nuclear factor-1-β, and carbonic anhydrase-IX) offer the potential for greater sensitivity and specificity in this diagnostic setting; however, knowledge of their expected staining in other neoplasms and tissues is critical for appropriate use. In this review, we discuss the most widely used immunohistochemical markers of renal lineage with an emphasis on their sensitivity and specificity for metastatic clear cell renal cell carcinoma. Subsequently, we present a variety of organ-specific differential diagnostic scenarios in which metastatic clear cell renal cell carcinoma might be considered and we propose immunopanels for use in each situation.

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“…By contrast, the 2016 ESE guidelines recommend that adrenal masses <40 mm with clear benign features do not require follow‐up imaging, irrespective of their history of extra‐adrenal malignancy . The majority of previous cohort studies, which comprised sample sizes of 24‐637 patients and had median follow‐up periods of 1.8‐7.5 years, similarly revealed no malignant transformation in typical benign nonfunctional AIs . One systematic review including data from 1081 patients reported an incidence of adrenal malignancy of 0.2% …”

Section: Discussionmentioning

confidence: 99%

“…12 The majority of previous cohort studies, which comprised sample sizes of 24-637 patients and had median follow-up periods of 1.8-7.5 years, similarly revealed no malignant transformation in typical benign nonfunctional AIs. 20,21,24,27,[30][31][32][33][34] One systematic review including data from 1081 patients reported an incidence of adrenal malignancy of 0.2%. 35 In the present study, most nonfunctional adrenal masses remained stable in size during the long-term follow-up period, and no malignancy was diagnosed.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of new recommendations for adrenal incidentalomas in the evaluation of excessive cortisol secretion and follow‐up

Ruiz

Michalopoulou

Megía

et al. 2018

Eur J Clin Investigation

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Objective To evaluate whether the 2016 European Society of Endocrinology (ESE) recommendations for the management of adrenal incidentalomas accurately classifies those patients who do not require further follow‐up. Design and Methods Single centre retrospective study. From 2010 to 2015, 130 patients with adrenal incidentaloma were evaluated and followed‐up. Clinical, analytical and radiological data were recorded and the presence of comorbidities was assessed. Patients were grouped as nonfunctional or subclinical Cushing syndrome according to American guidelines; and nonfunctional, possible autonomous cortisol secretion and autonomous cortisol secretion, according to ESE guidelines. Results Based on American guidelines, 94% of patients had nonfunctional adrenal incidentalomas and 6% had subclinical Cushing syndrome. Based on ESE guidelines, patients were classified into nonfunctional (54%), possible autonomous cortisol secretion (40%) and autonomous cortisol secretion (6%) groups. No differences were observed in demographic characteristics and comorbidities between groups in either classification. Following ESE guidelines, no patient in the nonfunctional group was reclassified into the possible autonomous or autonomous cortisol secretion groups during follow‐up, but one patient in the possible autonomous cortisol secretion group was reclassified into the autonomous cortisol secretion group. Also, 30 patients included in the groups of possible autonomous or autonomous cortisol secretion experienced progression of a comorbidity associated with cortisol excess, with diabetes mellitus as the most frequent comorbidity observed. Conclusion Although adrenal incidentalomas with an excess of cortisol secretion were more frequently diagnosed with the new ESE recommendations, patients who did not require longer follow‐up after first evaluation were accurately classified.

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Long Term Follow-up of Patients with Adrenal Incidentalomas- A Single Center Experience and Review of the Literature

Abstract: AIs present usually as benign, non-secretory lesions. Criteria for surgical intervention were met at initial assessment for the majority of AIs. Size alterations during follow-up are uncommon and functional evolution is rare.

Cited by 17 publications

References 26 publications

Optimal follow-up strategies for adrenal incidentalomas: reappraisal of the 2016 ESE-ENSAT guidelines in real clinical practice

Optimal follow-up strategies for adrenal incidentalomas: reappraisal of the 2016 ESE-ENSAT guidelines in real clinical practice

The Use of Immunohistochemistry in the Diagnosis of Metastatic Clear Cell Renal Cell Carcinoma

Accuracy of new recommendations for adrenal incidentalomas in the evaluation of excessive cortisol secretion and follow‐up

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