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Published on: January 17, 2018
Endocrine incidentalomas--challenges imposed by incidentally discovered lesions
Dimitra A Vassiliadi1, Stylianos Tsagarakis
12nd Department of Internal Medicine, Attikon University Hospital, Athens, Greece.
Nature Reviews. Endocrinology
|June 29, 2011
Summary
Endocrine incidentalomas, including pituitary, thyroid, parathyroid, and adrenal lesions, are common. Key concerns include malignancy risk and hormonal hypersecretion, particularly subtle cortisol excess from adrenal tumors.
Area of Science:
- Endocrinology
- Oncology
- Diagnostic Imaging
Background:
- Incidentalomas in endocrine glands (pituitary, thyroid, parathyroid, adrenal) are frequently discovered.
- Major concerns include malignancy potential and hormonal hypersecretion, often from subclinical tumors.
- Adrenal incidentalomas present unique challenges with hormonal alterations, notably subtle cortisol excess.
Purpose of the Study:
- To review the prevalence, clinical impact, and management of endocrine incidentalomas.
- To focus on diagnostic and therapeutic challenges of incidentally discovered adrenal lesions.
- To discuss the implications of subclinical hypercortisolism and surgical interventions.
Main Methods:
- Literature review of endocrine incidentalomas.
- Analysis of diagnostic criteria for hormonal hypersecretion.
- Evaluation of management strategies, including surgery.
Main Results:
- Pituitary incidentalomas are often benign microadenomas; larger lesions need careful evaluation.
- Thyroid incidentalomas require malignancy exclusion.
- Parathyroid adenomas are often missed; adrenal incidentalomas carry malignancy risk and potential for subtle cortisol excess.
Conclusions:
- Subtle cortisol excess from adrenal incidentalomas may have adverse effects, though criteria remain debated.
- Surgical intervention shows promise in select cases but requires further research.
- Comprehensive management strategies are needed for endocrine incidentalomas, especially adrenal lesions.
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