Are small adrenal incidentalomas solely a radiological finding?

Area of Science:

• Endocrinology
• Oncology
• Radiology

Background:

• Adrenal incidentalomas (AI) are adrenal masses >1cm.
• Data on smaller AI (≤1cm) is limited.
• Understanding the function of small AI is crucial.

Purpose of the Study:

• To evaluate the function of adrenal masses ≤1cm.
• To compare these findings with larger adrenal masses (>1cm).

Main Methods:

• Included 130 patients with AI (38 ≤1cm, 92 >1cm).
• Evaluated demographic and hormonal characteristics.
• Compared functional and non-functional AI between size groups.

Main Results:

• Subclinical Cushing's syndrome (SCS) prevalence was 5.3% in AI ≤1cm and 12% in AI >1cm.
• Hyperaldosteronism occurred only in AI >1cm.
• Diabetes and hypertension were common in non-functional AI of both sizes.

Conclusions:

• AI ≤1cm can exhibit subclinical Cushing's syndrome.
• Non-functional AI ≤1cm share high rates of diabetes and hypertension with larger AI.
• This study is the first to characterize smaller adrenal incidentalomas.