期刊
CLINICAL ENDOCRINOLOGY
卷 93, 期 1, 页码 11-18出版社
WILEY
DOI: 10.1111/cen.14188
关键词
adrenal adenoma; adrenal function; adrenal incidentaloma; adrenal mass; adrenal tumour; adrenalectomy; congenital adrenal hyperplasia; lipomatous adrenal tumours
资金
- James A. Ruppe Career Development Award in Endocrinology
- Catalyst Award for Advancing in Academics from Mayo Clinic
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) USA [K23DK121888]
Objective We aimed to describe clinical course of myelolipoma and to identify predictors of tumour growth and need for surgery. Design A retrospective study. Patients Consecutive patients with myelolipoma. Results A total of 321 myelolipomas (median size, 2.3 cm) were diagnosed in 305 patients at median age of 63 years (range, 25-87). Median follow-up was 54 months. Most myelolipomas were incidentally detected (86%), whereas 9% were discovered during cancer staging and 5% during workup of mass effect symptoms. Thirty-seven (12%) patients underwent adrenalectomy. Compared to myelolipomas <6 cm, tumours >= 6 cm were more likely to be bilateral (21% vs 3%, P < .0001), cause mass effect symptoms (32% vs 0%, P < .0001), have haemorrhagic changes (14% vs 1%, P < .0001) and undergo adrenalectomy (52% vs 5%, P < .0001). Among patients with >= 6 months of imaging follow-up, median size change was 0 mm (-10, 115) and median growth rate was 0 mm/y (-6, 14). Compared to <1 cm growth, >= 1 cm growth correlated with larger initial size (3.6 vs 2.3 cm, P = .02), haemorrhagic changes (12% vs 2%, P = .007) and adrenalectomy (35% vs 8%, P < .0001). Conclusions Most myelolipomas are incidentally discovered on cross-sectional imaging. Myelolipomas >= 6 are more likely to cause mass effect symptoms, have haemorrhagic changes and undergo resection. Tumour growth >= 1 cm is associated with larger myelolipoma and haemorrhagic changes. Adrenalectomy should be considered in symptomatic patients with large tumours and when there is evidence of haemorrhage or tumour growth.
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