Idiopathic hyperaldosteronism due to bilateral autonomous production of aldosterone is the most common subtype of primary hyperaldosteronism and is diagnosed by adrenal venous sampling. The aim of our study was to assess the over time evolution of computed tomography (CT)-detectable adrenal nodule(s) in patients with idiopathic hyperaldosteronism. Thirty-two patients (23 males and 9 females; age 50±9 years) diagnosed as bilateral PA and having nodular adrenal lesions (median diameter 12 mm, range 8 to 28 mm; 28 unilateral and 4 bilateral), were studied. Adrenal was described as nodular when unilateral or bilateral nodule(s) of at least 8 mm in diameter were detected using CT with contrast and fine cuts. The diagnosis of a benign adrenal nodule rested on the following CT criteria: size <4 cm, regular shape with well-defined margins, homogeneous and hypodense content. All patients had CT imaging re-evaluated 3 to 6 years (median 45 months) after diagnosis. A unilateral nodular lesion enlargement ≥25% was detected in 2 cases; a slight increase (<25%) or no variations or a decrease of nodule size occurred in the remaining 30 cases. No patients showed appearance of radiological picture of malignancy or new masses in the ipsilateral/contralateral glands. At follow-up all patients reported compliance to medications, and 29/32 patients had a persistent clinical/biochemical control of the disease. Three patients showed hypertension resistant to a combination of four different antihypertensive drugs. Over time CT variations of adrenal nodules are uncommon and without apparent signs of malignancy in patients with AVS-confirmed bilateral PA. A diagnostic

Evolution of computed tomography-detectable adrenal nodules in patients with bilateral primary aldosteronism

BATTOCCHIO, MARIALBERTA;FALLO, FRANCESCO
2016

Abstract

Idiopathic hyperaldosteronism due to bilateral autonomous production of aldosterone is the most common subtype of primary hyperaldosteronism and is diagnosed by adrenal venous sampling. The aim of our study was to assess the over time evolution of computed tomography (CT)-detectable adrenal nodule(s) in patients with idiopathic hyperaldosteronism. Thirty-two patients (23 males and 9 females; age 50±9 years) diagnosed as bilateral PA and having nodular adrenal lesions (median diameter 12 mm, range 8 to 28 mm; 28 unilateral and 4 bilateral), were studied. Adrenal was described as nodular when unilateral or bilateral nodule(s) of at least 8 mm in diameter were detected using CT with contrast and fine cuts. The diagnosis of a benign adrenal nodule rested on the following CT criteria: size <4 cm, regular shape with well-defined margins, homogeneous and hypodense content. All patients had CT imaging re-evaluated 3 to 6 years (median 45 months) after diagnosis. A unilateral nodular lesion enlargement ≥25% was detected in 2 cases; a slight increase (<25%) or no variations or a decrease of nodule size occurred in the remaining 30 cases. No patients showed appearance of radiological picture of malignancy or new masses in the ipsilateral/contralateral glands. At follow-up all patients reported compliance to medications, and 29/32 patients had a persistent clinical/biochemical control of the disease. Three patients showed hypertension resistant to a combination of four different antihypertensive drugs. Over time CT variations of adrenal nodules are uncommon and without apparent signs of malignancy in patients with AVS-confirmed bilateral PA. A diagnostic
2016
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/3216459
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