Adrenal morpho-functional alterations in patients with acromegaly

Carla Scaroni, R. Selice, S. Benedini, E. De Menis, M. Arosio, C. Ronchi, M. Gasperi, L. Manetti, G. Arnaldi, B. Polenta, M. Boscaro, N. Albiger, E. Martino, F. Mantero

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Abstract

Acromegaly is associated with a greater morbidity and higher incidence of tumors, possibly due to the permissive role of elevated GH and IGF-I levels. In the general population, adrenal masses are frequently discovered (prevalence 1-5%) at computed tomography (CT). We evaluated the prevalence of adrenal lesions in patients with acromegaly. We studied 94 acromegalic patients, 54 females (mean age 55.0±16.0 yr) and 40 males (mean age 50±14 yr) referred to 5 Endocrinology Units between 2001-2003; 49 had active disease and 45 had been treated with surgery and/or were controlled with medical therapy. Abdominal CT showed adrenal lesions in 27 patients; 9 of them had unilateral masses (10%) with benign features (diameter 0.5-3 cm) and 18 had hyperplasia (14 monolateral and 4 bilateral), with no significant differences between patients with active vs controlled disease, and with no correlation between prevalence of masses and duration of disease, GH and IGF-I levels. Hormone study (urinary free cortisol, catecholamines/ metanephrines, upright plasma renin activity and aldosterone, morning plasma ACTH and low-dose dexamethasone suppression test) disclosed no major endocrine alterations. During a 1-yr follow-up, the adrenal masses increased in size in 3 cases and 1 patient also developed subclinical Cushing's syndrome. Adrenal lesions seem more frequent in acromegaly than in the general population, but no single factor (GH/IGF-I levels or disease duration) predicts them. The masses appear to be benign and non-hypersecreting, but a longer follow-up is recommended to disclose any changes in their morphofunctional state.

Original languageEnglish
Pages (from-to)602-606
Number of pages5
JournalJournal of Endocrinological Investigation
Volume31
Issue number7
Publication statusPublished - Jul 2008

Keywords

  • Acromegaly
  • Adrenal mass
  • Cushing's syndrome

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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    Scaroni, C., Selice, R., Benedini, S., De Menis, E., Arosio, M., Ronchi, C., Gasperi, M., Manetti, L., Arnaldi, G., Polenta, B., Boscaro, M., Albiger, N., Martino, E., & Mantero, F. (2008). Adrenal morpho-functional alterations in patients with acromegaly. Journal of Endocrinological Investigation, 31(7), 602-606.