{"doi":"10.1093/ejendo/lvae078","title":"Clinical and imaging presentations are associated with function in incidental adrenocortical adenomas: a retrospective cohort study","abstract":"OBJECTIVE: The aim of this study is to assess whether clinical and imaging characteristics are associated with the hormonal subtype, growth, and adrenalectomy for incidental adrenal cortical adenomas (ACAs). DESIGN: This is a single-center cohort study. METHODS: Consecutive adult patients with incidental ACA were diagnosed between 2000 and 2016. RESULTS: Of the 1516 patients with incidental ACA (median age 59 years, 62% women), 699 (46%) had nonfunctioning adenomas (NFAs), 482 (31%) had mild autonomous cortisol secretion (MACS), 62 (4%) had primary aldosteronism (PA), 39 (3%) had Cushing syndrome, 18 (1%) had PA and MACS, and 226 (15%) had incomplete work-up. Age, sex, tumor size, and tumor laterality, but not unenhanced computed tomography Hounsfield units (HU), were associated with hormonal subtypes. In a multivariable analysis, ≥1 cm growth was associated with younger age (odds ratio [OR] = 0.8 per 5-year increase, P = .0047) and longer imaging follow-up (OR = 1.2 per year, P < .0001). Adrenalectomy was performed in 355 (23%) patients, including 38% of MACS and 15% of NFA. Adrenalectomy for NFA and MACS was more common in younger patients (OR = 0.79 per 5-year increase, P = .002), larger initial tumor size (OR = 2.3 per 1 cm increase, P < .0001), ≥1 cm growth (OR = 15.3, P < .0001), and higher postdexamethasone cortisol (OR = 6.6 for >5 vs <1.8 μg/dL, P = .002). CONCLUSIONS: Age, sex, tumor size, and laterality were associated with ACA hormonal subtype and can guide diagnosis and management. Tumor growth was more common with younger age and longer follow-up. Unenhanced HU did not predict hormonal subtype or growth. Adrenalectomy for MACS and NFA was mainly performed in younger patients with larger tumor size, growth, and elevated postdexamethasone cortisol.","journal":"European Journal of Endocrinology","year":2024,"id":442741,"datarank":0.4340526004512123,"base_score":2.1972245773362196,"endowment":2.1972245773362196,"self_citation_contribution":0.32958368660043297,"citation_network_contribution":0.10446891385077933,"self_endowment_contribution":0.32958368660043297,"citer_contribution":0.10446891385077933,"corpus_percentile":57.07434052757794,"corpus_rank":5550,"citation_count":8,"citer_count":6,"citers_with_citation_signal":4,"citers_with_endowment":4,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5419,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1256488,"name":"Muhammad Shahmeer Ullah Shah","orcid":"0009-0005-6898-9286","position":1,"is_corresponding":false},{"id":686625,"name":"Catherine D Zhang","orcid":"0000-0003-2784-2673","position":2,"is_corresponding":false},{"id":1256941,"name":"Natalia Lazik","orcid":null,"position":3,"is_corresponding":false},{"id":337140,"name":"Dingfeng Li","orcid":"0000-0001-5795-0419","position":4,"is_corresponding":false},{"id":467964,"name":"Sumitabh Singh","orcid":"0000-0001-6203-6955","position":5,"is_corresponding":false},{"id":311934,"name":"Nicole M. Iñiguez‐Ariza","orcid":"0000-0002-8614-7163","position":6,"is_corresponding":false},{"id":1256942,"name":"Ram Raman","orcid":null,"position":7,"is_corresponding":false},{"id":650361,"name":"Maria D. Hurtado","orcid":"0000-0002-2322-7334","position":8,"is_corresponding":false},{"id":1256489,"name":"Lindsay Carafone","orcid":"0000-0001-7129-6441","position":9,"is_corresponding":false},{"id":1256943,"name":"Aakanksha Khanna","orcid":null,"position":10,"is_corresponding":false},{"id":681889,"name":"Qi Yan","orcid":"0000-0002-8565-1018","position":11,"is_corresponding":false},{"id":667129,"name":"Neena Natt","orcid":null,"position":12,"is_corresponding":false},{"id":1056185,"name":"Robert P. Hartman","orcid":"0000-0003-1994-6237","position":13,"is_corresponding":false},{"id":253558,"name":"Travis J. McKenzie","orcid":"0000-0002-1343-6941","position":14,"is_corresponding":false},{"id":239619,"name":"William F. 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