Faculty Collaboration Database

Change in adrenal mass size as a predictor of a malignant tumor. Endocr Pract 2010;16(4):577-87

Date

02/13/2010

Pubmed ID

20150023

DOI

10.4158/EP09351.OR

Scopus ID

2-s2.0-79952010763 (requires institutional sign-in at Scopus site)   50 Citations

Abstract

OBJECTIVE: To assess the value of adrenal mass absolute growth, growth rate, and percentage growth rate on serial imaging for distinguishing benign from malignant adrenal masses.

METHODS: We retrospectively reviewed the Cleveland Clinic medical record data on 136 adrenalectomies or biopsies in 132 patients with 2 imaging studies performed more than 2 months apart (during 1997 to 2008).

RESULTS: There were 111 benign (81.6%) and 25 malignant (18.4%) adrenal masses. With use of receiver operating characteristic curve analysis, all 3 aforementioned growth measures showed similar levels of discrimination for the entire study group as well as for the subgroups with 3 to 12 months of follow-up (n = 75 masses) and noncontrast computed tomography Hounsfield units >10 or not reported (n = 111 masses). After adjustment for other factors, the 3 growth measures remained statistically significant predictors of a malignant tumor. The absolute growth cutoff value of 0.8 cm had the highest sum of sensitivity and specificity of 72% and 81.1%, respectively. We could not identify an adrenal mass growth cutoff value to provide 100% sensitivity or specificity to confirm or exclude the presence of a malignant lesion. In 3 patients with metastatic lesions, no growth or a decrease in mass size during a period of 4 to 36 months was observed.

CONCLUSION: In this study, the largest with surgical histopathology findings as the "gold standard" for diagnosis, change in adrenal mass size was a significant predictor of a malignant tumor. Nevertheless, we could not identify an adrenal mass growth cutoff value for reliable confirmation or exclusion of a malignant lesion. Change in adrenal mass size should be used in conjunction with other imaging and clinical characteristics when surgical resection is being considered.

Author List

Pantalone KM, Gopan T, Remer EM, Faiman C, Ioachimescu AG, Levin HS, Siperstein A, Berber E, Shepardson LB, Bravo EL, Hamrahian AH

Author

Adriana G. Ioachimescu MD, PhD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adrenal Gland Neoplasms
Adrenal Glands
Adult
Aged
Diagnosis, Differential
Female
Humans
Male
Medical Records
Middle Aged
Organ Size
Retrospective Studies
Sensitivity and Specificity
Time Factors
Tomography, X-Ray Computed
Tumor Burden