The use of imaging techniques and their increasing sensitivity have resulted in increased detection of incidentalomas of the endocrine organs. The aim of our study was to review the currently used evaluation schemes and the outcomes of surgical and
conservative management of
adrenal incidentalomas at an Indian center. Fifty-eight cases of
adrenal incidentalomas diagnosed and treated at the Govt. General Hospital, Chennai, and private practice were reviewed. Ultrasonogram of the abdomen was the most frequently used investigation (88%). The common complaint was upper abdominal discomfort. The mean
duration of treatment of symptoms before diagnosis was 3.5 months. Thirty-three cases underwent
adrenalectomy. The cases not subjected to resection were followed every 6 months for 2 years and follow-up ceased if no increase in size was detected. Of these, two patients required subsequent
adrenalectomy. Thirty-six of these
tumors were eventually detected to be nonfunctioning
adenomas, of which 15 underwent resection because of size >3 cm. Cortical
carcinoma was detected in nine patients,
pheochromocytoma in seven,
myelolipoma in one, metastatic
tumor in one, and
cyst,
ganglioneuroma, and
tuberculoma in four. Of these, 20 developed features of hypersecretion during preparation for surgery. In
tumors between 3 and 5 cm, in view of noncompliance of patients to repeated follow-up and cost factors, surgery was considered the most effective treatment option. There is a need for prospective studies to formulate diagnostic and treatment strategy.