{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:29:15Z","timestamp":1791044955584,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T00:00:00Z","timestamp":1719532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23DK121888"],"award-info":[{"award-number":["K23DK121888"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The aim of this study is to assess whether clinical and imaging characteristics are associated with the hormonal subtype, growth, and adrenalectomy for incidental adrenal cortical adenomas (ACAs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This is a single-center cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Consecutive adult patients with incidental ACA were diagnosed between 2000 and 2016.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 1516 patients with incidental ACA (median age 59 years, 62% women), 699 (46%) had nonfunctioning adenomas (NFAs), 482 (31%) had mild autonomous cortisol secretion (MACS), 62 (4%) had primary aldosteronism (PA), 39 (3%) had Cushing syndrome, 18 (1%) had PA and MACS, and 226 (15%) had incomplete work-up. Age, sex, tumor size, and tumor laterality, but not unenhanced computed tomography Hounsfield units (HU), were associated with hormonal subtypes. In a multivariable analysis, \u22651 cm growth was associated with younger age (odds ratio [OR] = 0.8 per 5-year increase, P = .0047) and longer imaging follow-up (OR = 1.2 per year, P &amp;lt; .0001). Adrenalectomy was performed in 355 (23%) patients, including 38% of MACS and 15% of NFA. Adrenalectomy for NFA and MACS was more common in younger patients (OR = 0.79 per 5-year increase, P = .002), larger initial tumor size (OR = 2.3 per 1 cm increase, P &amp;lt; .0001), \u22651 cm growth (OR = 15.3, P &amp;lt; .0001), and higher postdexamethasone cortisol (OR = 6.6 for &amp;gt;5 vs &amp;lt;1.8 \u03bcg\/dL, P = .002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Age, sex, tumor size, and laterality were associated with ACA hormonal subtype and can guide diagnosis and management. Tumor growth was more common with younger age and longer follow-up. Unenhanced HU did not predict hormonal subtype or growth. Adrenalectomy for MACS and NFA was mainly performed in younger patients with larger tumor size, growth, and elevated postdexamethasone cortisol.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejendo\/lvae078","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T18:19:14Z","timestamp":1719598754000},"page":"47-54","source":"Crossref","is-referenced-by-count":11,"title":["Clinical and imaging presentations are associated with function in incidental adrenocortical adenomas: a retrospective cohort study"],"prefix":"10.1093","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7367-3885","authenticated-orcid":false,"given":"Oksana","family":"Hamidi","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, UT Southwestern Medical Center , Dallas, TX 75390 , United 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55905 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumitabh","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, UT Southwestern Medical Center , Dallas, TX 75390 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M","family":"I\u00f1iguez-Ariza","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City, 14080 , Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram","family":"Raman","sequence":"additional","affiliation":[{"name":"Watford General Hospital, West Hertfordshire NHS Trust , Watford, WD18 0HB, England , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria D","family":"Hurtado","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic , Jacksonville, FL 32224 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Carafone","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic , Rochester, MN 55905 , United States"},{"name":"Division of Endocrinology, Diabetes and Metabolism, University of Rochester , Rochester, NY 13627 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aakanksha","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Dartmouth-Hitchcock Medical Center , Lebanon, NH 03756 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8565-1018","authenticated-orcid":false,"given":"Qi","family":"Yan","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic , Rochester, MN 55905 , 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