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[Adrenocortical "incidentalomas" as a diagnostic and therapeutic problem]
Srpski Arhiv Za Celokupno Lekarstvo
|January 1, 1990
Summary
Adrenal incidentalomas, incidentally discovered adrenal masses, are often linked to long-lasting arterial hypertension. Elevated urinary pregnanediol suggests altered cortisol biosynthesis in these patients.
Area of Science:
- Endocrinology
- Oncology
- Radiology
Background:
- Adrenal incidentalomas are adrenal masses discovered incidentally, often during abdominal imaging like CT scans.
- Historically, these were frequent autopsy findings, but advances in imaging have increased their detection.
Observation:
- A study examined 5 patients (4 male, 1 female, aged 37-66) with incidentally discovered adrenal masses.
- All patients presented with long-lasting arterial hypertension; one also had impaired glucose tolerance progressing to diabetes.
Findings:
- Excessive secretion of glucocorticoids, mineralocorticoids, androgens, or catecholamines was ruled out.
- Markedly elevated urinary pregnanediol in all patients indicated potential early-stage cortisol biosynthesis preservation (pregnenolone synthesis).
- Histological analysis revealed adrenocortical adenoma or hyperplasia in operated patients, with persistent elevated steroid precursors post-surgery.
Implications:
- Adrenal incidentalomas may be non-essential findings associated with chronic arterial hypertension and aging.
- Further investigation into steroid precursor metabolism is warranted for incidentally discovered adrenal masses.