Clinical Characteristics Of4049Hospitalized Patients With Adrenal Lesions

ObjectiveTo summarize the characteristics of the disease distribution in hospitalized patientswith adrenal lesions during the past20years,analyze the changes of the diseasespectrum.And to summarize the characteristics of the etiology distribution in patients withadrenal incidentalomas（AI）.Methods1. All data of patients with adrenal lesions admitted to Chinese PLA general hospitalbetween1993and2013were collected.The sex ratio of patients, visiting ages,finaldiagnosis,the year of hospitalization were retrospectively analyzed.2. Among all included cases,we futher analyzed those which were incidentally detected.Patients’ demographics data,final functional diagnosis,adrenal imaging features,andconcomitant diseases were retrospectively analyzed.Results1.①During the past20years,4049patients with adrenal lesions were admitted to theChinese PLA General Hospital,of which,2004males and2045females.The overallmean age was46.82+13.36years old.②The number of cases was gradually increasedyear by year, the visiting ages was about30-60years old. The proportion of adrenalincidentaloma in total adrenal lesions was gradually increased year by yeaer,and alsoincreased along with the age increased.③In total4049patients,3014were undergoneendocrine function assessment,of which,1503(49.88%) cases were non-functionallesions which topped the list,259cases (8.60%) were adrenal Cushing syndrome,665cases (22.06%) were primary aldosteronism,235cases (7.80%) werepheochromocytoma.④During the past20years, the proportion of non-functional lesionsrose from20.97%to54.11%(P＜0.05). The proportion of primary aldsteronismdeclined from29.84%to20.43%(P＜0.05). The proportion of pheochromocytomadeclined from18.55%to6.99%(P＜0.05). The proportion of adrenal Cushing syndromechanged slightly (P＞0.05).2.①Of4049patients suffering from adrenal lesions,1173patients with adrenalincidentalomas were undergone functional assessment. Of which,629(53.62%) males and544(46.38%) females. The overall mean age was50.84+12.13years old. Therewere669(57.03%) cases combined with hypertension.622(53.03%) cases wereundergone adrenalectomy.②Routine medical checkup was the most clinicalpresentations leading to discovery of adrenal incidentalomas, and then abdominal pain.③As to the etiologies, non-functional tumors accounted for68.97%, pheochromocytoma11.68%, primary aldosteronism7.16%, adrenal Cushing syndrome5.54%,the proportionof adrenal cortical carcinomas and metastases were1.70%and1.36%, respectively.④Compared with normotension group, the proportion of non-functional lesions inhypertension group was significant lower (73.81%VS.65.32%, P＜0.05), theproportion of primary aldosteronism and adrenal Cushing syndrome were higher,(11.96%VS.0.79%，5.83%VS.5.18%，both P＜0.05).Conclusion1. The number of patients with adrenal lesions was gradually increased during the past20years, the proportion of adrenal incidentalomas was increased, too. The disease spectrumof adrenal lesions has been changed. The proportion of non-functional lesions hadincreased, while, the proportion of functional lesions was in decline.2. Adrenal incidentaloma patients concomitant with hypentension were very common. Inrespect of etiology, non-functional tumor topped the list, and then pheochromocytoma,primary aldosteronism, Cushing syndrome.