Incidentaloma epidemiology and demographics: Difference between revisions
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==Overview== | ==Overview== | ||
The [[Prevalence]] of clinically inapparent [[Adrenal gland|adrenal]] masses (≥1 cm in diameter) in adults was estimated to be between 1 and 6%. The vast majority of [[Adrenal incidentaloma|adrenal incidentalomas]] are [[Nonfunctioning adenoma|nonfunctioning]] [[benign tumors]]. The [[prevalence]] of adrenal incidentalomas increases with [[age]] especially in [[Obesity|obese]], [[diabetic]], and [[Hypertension|hypertensive]] patients. There is no [[racial]] or [[Gender, Institutions and Development Data Base|gender]] predilection to [[adrenal incidentaloma]]. | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
===Incidence and Prevalence=== | ===Incidence and Prevalence=== | ||
* | *[[Incidence|The incidence]] and [[prevalence]] of [[adrenal incidentaloma]] can only be [[assessed]] from [[Imaging studies|imaging]] or [[autopsy]] studies. | ||
* | |||
* The | *The [[prevalence]] of [[adrenal incidentaloma]] in adults was estimated to be between 1 and 6%, with a peak [[prevalence]] of (≤7%) reported in the 5th to 7th decades. .<ref name="pmid31786909">{{cite journal| author=Dietrich CF, Correas JM, Dong Y, Nolsoe C, Westerway SC, Jenssen C| title=WFUMB position paper on the management incidental findings: adrenal incidentaloma. | journal=Ultrasonography | year= 2020 | volume= 39 | issue= 1 | pages= 11-21 | pmid=31786909 | doi=10.14366/usg.19029 | pmc=6920619 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31786909 }}</ref><ref name="pmid32266384">{{cite journal| author=Sherlock M, Scarsbrook A, Abbas A, Fraser S, Limumpornpetch P, Dineen R | display-authors=etal| title=Adrenal Incidentaloma. | journal=Endocr Rev | year= 2020 | volume= 41 | issue= 6 | pages= | pmid=32266384 | doi=10.1210/endrev/bnaa008 | pmc=7431180 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32266384 }}</ref> | ||
*The recent development in [[imaging]] and [[diagnostic]] modalities has been associated with an increase in the [[prevalence]] of [[adrenal incidentaloma]]. | |||
*The vast majority of adrenal incidentalomas are [[Nonfunctioning adenoma|nonfunctioning]] [[benign tumors]]; of which the nonfunctioning cortical adenomas are constituting about 75%.<ref name="pmid145143412">{{cite journal| author=Barzon L, Sonino N, Fallo F, Palu G, Boscaro M| title=Prevalence and natural history of adrenal incidentalomas. | journal=Eur J Endocrinol | year= 2003 | volume= 149 | issue= 4 | pages= 273-85 | pmid=14514341 | doi=10.1530/eje.0.1490273 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14514341 }}</ref><ref name="pmid106908692">{{cite journal| author=Mantero F, Terzolo M, Arnaldi G, Osella G, Masini AM, Alì A | display-authors=etal| title=A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. | journal=J Clin Endocrinol Metab | year= 2000 | volume= 85 | issue= 2 | pages= 637-44 | pmid=10690869 | doi=10.1210/jcem.85.2.6372 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10690869 }}</ref><ref name="pmid11849252">{{cite journal| author=Lam KY, Lo CY| title=Metastatic tumours of the adrenal glands: a 30-year experience in a teaching hospital. | journal=Clin Endocrinol (Oxf) | year= 2002 | volume= 56 | issue= 1 | pages= 95-101 | pmid=11849252 | doi=10.1046/j.0300-0664.2001.01435.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11849252 }}</ref> | |||
*The [[functional tumors]] represent about 14% of [[Adrenal incidentaloma|adrenal incidentalomas]] which may release [[cortisol]], [[aldosterone]], or both in rare occasions. | |||
*[[Prevalence]] of [[pheochromocytoma]] is 4–7% of incidentalomas.<ref name="pmid9167966">{{cite journal| author=Mantero F, Masini AM, Opocher G, Giovagnetti M, Arnaldi G| title=Adrenal incidentaloma: an overview of hormonal data from the National Italian Study Group. | journal=Horm Res | year= 1997 | volume= 47 | issue= 4-6 | pages= 284-9 | pmid=9167966 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9167966 }}</ref> | |||
*[[Prevalence]] of [[hyperaldosteronism]] is 1.1 to 10%.<ref name="pmid26934393">{{cite journal| author=Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H et al.| title=The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. | journal=J Clin Endocrinol Metab | year= 2016 | volume= 101 | issue= 5 | pages= 1889-916 | pmid=26934393 | doi=10.1210/jc.2015-4061 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26934393 }}</ref> | |||
*The [[incidence]] of primary adrenal [[carcinoma]] or [[Metastasis|metastases]] in patients with [[Adrenal gland|adrenal]] incidentaloma is approximately 4%.<ref name="pmid27390021">{{cite journal| author=Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A | display-authors=etal| title=Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. | journal=Eur J Endocrinol | year= 2016 | volume= 175 | issue= 2 | pages= G1-G34 | pmid=27390021 | doi=10.1530/EJE-16-0467 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27390021 }}</ref> | |||
*The risk of [[malignancy]] over time for [[Mass|masses]] defined as [[benign]] at diagnosis is estimated at about 1/1000, even though 5-25% of masses increase in size during follow-up.<ref name="pmid14514341">{{cite journal| author=Barzon L, Sonino N, Fallo F, Palu G, Boscaro M| title=Prevalence and natural history of adrenal incidentalomas. | journal=Eur J Endocrinol | year= 2003 | volume= 149 | issue= 4 | pages= 273-85 | pmid=14514341 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14514341 }}</ref> | |||
*[[Hyperfunction]] develops in about 1.7% of cases and the risk is higher in patients with lesions larger than 3 cm.<ref name="pmid14514341" /> | |||
*The [[prevalence]] is higher in [[Obesity|obese]], [[diabetic]], and [[Hypertension|hypertensive]] patients.<ref name="pmid12614096">{{cite journal| author=Grumbach MM, Biller BM, Braunstein GD, Campbell KK, Carney JA, Godley PA et al.| title=Management of the clinically inapparent adrenal mass ("incidentaloma"). | journal=Ann Intern Med | year= 2003 | volume= 138 | issue= 5 | pages= 424-9 | pmid=12614096 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12614096 }}</ref> | |||
===Age=== | ===Age=== | ||
*The [[prevalence]] of adrenal incidentalomas increases with [[Ageing|age]]. It is less than 1% in patients younger than 30 yr of age and up to 7% in patients over age 70.<ref name="pmid12614096" /><ref name="pmid15082524">{{cite journal| author=Mansmann G, Lau J, Balk E, Rothberg M, Miyachi Y, Bornstein SR| title=The clinically inapparent adrenal mass: update in diagnosis and management. | journal=Endocr Rev | year= 2004 | volume= 25 | issue= 2 | pages= 309-40 | pmid=15082524 | doi=10.1210/er.2002-0031 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15082524 }}</ref> | |||
*The prevalence of adrenal incidentalomas increases with age | *In childhood, [[Adrenal gland|adrenal]] incidentalomas are extremely rare. | ||
*[[Adrenal incidentaloma]] is more common in older patients. | |||
* | |||
===Race=== | ===Race=== | ||
*There is no racial predilection to incidentaloma. | |||
*There is no [[racial]] predilection to [[adrenal incidentaloma]]. | |||
===Gender=== | ===Gender=== | ||
* | |||
*There is no [[Gender-neutral|gender]] predilection to [[adrenal incidentaloma]]. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 06:31, 8 May 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
The Prevalence of clinically inapparent adrenal masses (≥1 cm in diameter) in adults was estimated to be between 1 and 6%. The vast majority of adrenal incidentalomas are nonfunctioning benign tumors. The prevalence of adrenal incidentalomas increases with age especially in obese, diabetic, and hypertensive patients. There is no racial or gender predilection to adrenal incidentaloma.
Epidemiology and Demographics
Incidence and Prevalence
- The incidence and prevalence of adrenal incidentaloma can only be assessed from imaging or autopsy studies.
- The prevalence of adrenal incidentaloma in adults was estimated to be between 1 and 6%, with a peak prevalence of (≤7%) reported in the 5th to 7th decades. .[1][2]
- The recent development in imaging and diagnostic modalities has been associated with an increase in the prevalence of adrenal incidentaloma.
- The vast majority of adrenal incidentalomas are nonfunctioning benign tumors; of which the nonfunctioning cortical adenomas are constituting about 75%.[3][4][5]
- The functional tumors represent about 14% of adrenal incidentalomas which may release cortisol, aldosterone, or both in rare occasions.
- Prevalence of pheochromocytoma is 4–7% of incidentalomas.[6]
- Prevalence of hyperaldosteronism is 1.1 to 10%.[7]
- The incidence of primary adrenal carcinoma or metastases in patients with adrenal incidentaloma is approximately 4%.[8]
- The risk of malignancy over time for masses defined as benign at diagnosis is estimated at about 1/1000, even though 5-25% of masses increase in size during follow-up.[9]
- Hyperfunction develops in about 1.7% of cases and the risk is higher in patients with lesions larger than 3 cm.[9]
- The prevalence is higher in obese, diabetic, and hypertensive patients.[10]
Age
- The prevalence of adrenal incidentalomas increases with age. It is less than 1% in patients younger than 30 yr of age and up to 7% in patients over age 70.[10][11]
- In childhood, adrenal incidentalomas are extremely rare.
- Adrenal incidentaloma is more common in older patients.
Race
- There is no racial predilection to adrenal incidentaloma.
Gender
- There is no gender predilection to adrenal incidentaloma.
References
- ↑ Dietrich CF, Correas JM, Dong Y, Nolsoe C, Westerway SC, Jenssen C (2020). "WFUMB position paper on the management incidental findings: adrenal incidentaloma". Ultrasonography. 39 (1): 11–21. doi:10.14366/usg.19029. PMC 6920619 Check
|pmc=value (help). PMID 31786909. - ↑ Sherlock M, Scarsbrook A, Abbas A, Fraser S, Limumpornpetch P, Dineen R; et al. (2020). "Adrenal Incidentaloma". Endocr Rev. 41 (6). doi:10.1210/endrev/bnaa008. PMC 7431180 Check
|pmc=value (help). PMID 32266384 Check|pmid=value (help). - ↑ Barzon L, Sonino N, Fallo F, Palu G, Boscaro M (2003). "Prevalence and natural history of adrenal incidentalomas". Eur J Endocrinol. 149 (4): 273–85. doi:10.1530/eje.0.1490273. PMID 14514341.
- ↑ Mantero F, Terzolo M, Arnaldi G, Osella G, Masini AM, Alì A; et al. (2000). "A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology". J Clin Endocrinol Metab. 85 (2): 637–44. doi:10.1210/jcem.85.2.6372. PMID 10690869.
- ↑ Lam KY, Lo CY (2002). "Metastatic tumours of the adrenal glands: a 30-year experience in a teaching hospital". Clin Endocrinol (Oxf). 56 (1): 95–101. doi:10.1046/j.0300-0664.2001.01435.x. PMID 11849252.
- ↑ Mantero F, Masini AM, Opocher G, Giovagnetti M, Arnaldi G (1997). "Adrenal incidentaloma: an overview of hormonal data from the National Italian Study Group". Horm Res. 47 (4–6): 284–9. PMID 9167966.
- ↑ Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H; et al. (2016). "The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline". J Clin Endocrinol Metab. 101 (5): 1889–916. doi:10.1210/jc.2015-4061. PMID 26934393.
- ↑ Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A; et al. (2016). "Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors". Eur J Endocrinol. 175 (2): G1–G34. doi:10.1530/EJE-16-0467. PMID 27390021.
- ↑ 9.0 9.1 Barzon L, Sonino N, Fallo F, Palu G, Boscaro M (2003). "Prevalence and natural history of adrenal incidentalomas". Eur J Endocrinol. 149 (4): 273–85. PMID 14514341.
- ↑ 10.0 10.1 Grumbach MM, Biller BM, Braunstein GD, Campbell KK, Carney JA, Godley PA; et al. (2003). "Management of the clinically inapparent adrenal mass ("incidentaloma")". Ann Intern Med. 138 (5): 424–9. PMID 12614096.
- ↑ Mansmann G, Lau J, Balk E, Rothberg M, Miyachi Y, Bornstein SR (2004). "The clinically inapparent adrenal mass: update in diagnosis and management". Endocr Rev. 25 (2): 309–40. doi:10.1210/er.2002-0031. PMID 15082524.