ADRENAL INCIDENTALOMA - AN OVERVIEW OF CLINICAL AND EPIDEMIOLOGIC DATA FROM THE NATIONAL ITALIAN STUDY-GROUP

Background: The incidental discovery of an adrenal mass raises the pro blem of distinguishing the frequent benign masses from the infrequent malignant ones that require surgery. At present, univocal guidelines t o approach this problem are not available. The aim of the present stud y was to perform a multicentric retrospective analysis of adrenal mass es incidentally discovered (adrenal incidentalomas). Patients and Meth ods: Hospital records of adrenal incidentalomas diagnosed over a 15-ye ar period in 29 surgical and medical centers in Italy were scrutinized . Collected cases were 1,013, and 887 were analyzed. Results: The majo rity of patients were in the 5th and 6th decade and females were predo minantly affected. The frequency of adrenocortical cancer was 12% amon g operated patients (316 cases). The tumor diameter was highly correla ted with the risk of malignancy, as well as the CT characteristics suc h as density, shape and margins. The frequency of pheochromocytoma was 10% among operated patients. Conclusions: The occurrence of incidenta lly discovered adrenocortical carcinomas and pheochromocytomas is not rare. Evaluation of the mass size and CT characteristics are simple an d effective methods to differentiate malignant lesions. Biochemical sc reening for pheochromocytoma is mandatory before surgery.