Adrenal incidentaloma follow-up is influenced by patient, radiologic, and medical provider factors: A review of 804 cases

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Background: The majority of adrenal incidentalomas are benign, although some are large, functional, or malignant and may require surgery. Therefore all require follow-up. This study aimed to determine the pattern of adrenal incidentaloma follow-up in a level 1 trauma center, focusing on the factors that influence whether follow-up is facilitated. Methods: Patients with computed tomography–detected adrenal incidentalomas between January 2010 and September 2015 were included. A keyword search identified case files, which were reviewed for demographic characteristics, managing unit, computed tomography indication and findings, and follow-up arrangements. Statistical analysis was performed using Stata SE Version 14. Results: A total of 38,848 chest and abdominal computed tomographic scans were performed in the study period, revealing 804 patients with adrenal incidentalomas who met inclusion criteria (mean age 65, 58% male). The mean size of adrenal incidentaloma was 23 mm. Follow-up was organized in 30% of cases and was more likely to occur in younger patients (mean age 62 vs 66, P < .001); in larger lesions (mean size 26 mm vs 21 mm, P < .001); if the computed tomographic scan suggested follow-up (P < .001); or if the computed tomography report suggested a diagnosis (P < .001). Follow-up arrangements were most likely to be made by the trauma unit (39%, P = .01). Conclusion: This study highlights that adrenal incidentalomas follow-up is often overlooked, and that follow-up is influenced by patient, radiologic, and medical provider factors. An adrenal lesion follow-up protocol may improve follow-up rates but requires further analysis.

Original languageEnglish
Pages (from-to)1360-1365
Number of pages6
JournalSurgery (United States)
Issue number6
Publication statusPublished - Dec 2018
EventAcademic Surgical Congress 2018 - Jacksonville, United States of America
Duration: 30 Jan 20181 Feb 2018

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