{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:15:12Z","timestamp":1789985712916,"version":"4.0.1"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>It is recommended that adrenal incidentaloma patients should be monitored for radiological changes, increase in size and new functionality that may occur in the future, even if they are benign and nonfunctional at the initial evaluation. Our aim is to evaluate the key clinical characteristics of adrenal incidentaloma patients focusing on changes during follow-up and associated clinical outcomes. A total of 755 patients (median age: 56 years), with an adrenal incidentaloma &gt;\u20091\u2009cm and underwent functionality tests, were included in the study. Clinical characteristics, functionality status and follow-up durations were recorded. During the course of follow-up, any changes in size and development of new functionality, and clinical consequences thereof were evaluated. In 71.8% of patients, incidentalomas were non-functional. Most frequent functionality (15.8%, n=119) was subclinical hypercortisolemia (SH) [10.9% (n=82) possible autonomous cortisol secretion (PACS) and 4.9% (n=37) autonomous cortisol secretion (ACS)] of all incidentalomas. Frequencies of Cushing\u2019s syndrome (CS), pheochromacytoma and primary hyperaldosteronism were 4.9% (n=37), 3.8% (n=29) and 3.7% (n=28), respectively. Adrenocortical carcinoma frequency was 1.5% (n=11). Of 755 patients, 43% (n=325) were followed up regularly more than 6 months. Median follow-up duration was 24 months (6\u2013120). A total of 17 (5.2%) patients, which had non-functional incidentalomas at baseline had developed new functionality during follow-up, of which 15 (4.6%) were SH [13 patients (4%) PACS and 2 patients (0.6%) ACS] and 2 (0.6%) were CS. During follow-up, 24% (n=78) of the patients had an increase in mass size between 5\u20139\u2009mm, while 11.7% (n=38) of the patients had an increase of \u226510\u2009mm. During follow-up, 4% (n=13) of the patients developed a new lesion with a diameter \u226510\u2009mm on the opposite side. In patients with a follow-up duration of more than 2 years, frequencies of size increase and new lesion emerging at the opposite adrenal gland were higher. 14 patients (4.3% of the patients with regular follow-up) underwent surgery due to increase in size or development of new functionality during follow-up. Our study demonstrated that a necessity for surgery may arise due to increase in size and development of functionality during follow-up period in adrenal incidentaloma patients, and thus continuing patient follow-up, even with wider intervals, will be appropriate.<\/jats:p>","DOI":"10.1055\/a-1079-4915","type":"journal-article","created":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T23:52:57Z","timestamp":1579564377000},"page":"349-356","source":"Crossref","is-referenced-by-count":30,"title":["Clinical Characteristics and Follow-Up Results of Adrenal Incidentaloma"],"prefix":"10.1055","volume":"129","author":[{"given":"Nusret","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Akdeniz University, School of Medicine, Department ofInternal Medicine, Division of Endocrinology andMetabolism, Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esin","family":"Avsar","sequence":"additional","affiliation":[{"name":"Akdeniz University, School of Medicine, Department ofInternal Medicine, Division of Endocrinology andMetabolism, Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokhan","family":"Tazegul","sequence":"additional","affiliation":[{"name":"Akdeniz University, School of Medicine, Department ofInternal Medicine, Division of Endocrinology andMetabolism, Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramazan","family":"Sari","sequence":"additional","affiliation":[{"name":"Akdeniz University, School of Medicine, Department ofInternal Medicine, Division of Endocrinology andMetabolism, Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan","family":"Altunbas","sequence":"additional","affiliation":[{"name":"Akdeniz University, School of Medicine, Department ofInternal Medicine, Division of Endocrinology andMetabolism, Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa Kemal","family":"Balci","sequence":"additional","affiliation":[{"name":"Akdeniz University, School of Medicine, Department ofInternal Medicine, Division of Endocrinology andMetabolism, Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,1,20]]},"reference":[{"key":"ref1","first-page":"460","article-title":"Incidentally discovered adrenal masses","volume":"16","author":"R T Kloos","year":"1995","journal-title":"Endocr Rev"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1530\/eje.0.1490273","article-title":"Prevalence and natural history of adrenal incidentalomas","volume":"149","author":"L Barzon","year":"2003","journal-title":"Eur J Endocrinol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1016\/S0022-5347(17)37601-2","article-title":"A survey on incidental adrenal tumors in Japan","volume":"147","author":"Y Aso","year":"1992","journal-title":"J Urol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1056\/NEJMcp065470","article-title":"Clinical practice. 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Metab"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1530\/EJE-13-0848","article-title":"Bilateral adrenal incidentalomas differ from unilateral adrenal incidentalomas in subclinical cortisol hypersecretion but not in potential clinical implications","volume":"171","author":"E Vassilatou","year":"2014","journal-title":"Eur J Endocrinol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1007\/BF03346546","article-title":"Prospective evaluation of tumor size and hormonal status in adrenal incidentalomas","volume":"33","author":"S Yener","year":"2010","journal-title":"J Endocrinol Invest"},{"key":"ref36","first-page":"55","article-title":"Incidentally discovered adrenal tumors: Endocrine and scintigraphic correlates","volume":"83","author":"L Barzon","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.surg.2018.07.011","article-title":"Adrenal 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Endocrinol (Oxf)"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s12893-016-0154-1","article-title":"Management of adrenal incidentaloma: The role of adrenalectomy may be underestimated","volume":"16","author":"Y L Ye","year":"2016","journal-title":"BMC Surg"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1530\/EJE-09-0957","article-title":"Long-term morphological, hormonal, and clinical follow-up in a single unit on 118 patients with adrenal incidentalomas","volume":"162","author":"R Giordano","year":"2010","journal-title":"Eur J Endocrinol"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1530\/eje.0.1470489","article-title":"Long-term follow-up study of patients with adrenal incidentalomas","volume":"147","author":"R Libe","year":"2002","journal-title":"Eur J Endocrinol"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"736","DOI":"10.4158\/EP151085.RA","article-title":"Congenital adrenal hyperplasia due to 21-Hydroxylase deficiency presenting as adrenal incidentaloma: A systematic review and meta-analysis","volume":"22","author":"H Falhammar","year":"2016","journal-title":"Endocr Pract"}],"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1079-4915.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T22:41:51Z","timestamp":1620168111000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1079-4915"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,20]]},"references-count":44,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2021,5,4]]},"published-print":{"date-parts":[[2021,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1079-4915","relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"value":"0947-7349","type":"print"},{"value":"1439-3646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,20]]}}}