{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T08:54:27Z","timestamp":1778057667153,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T00:00:00Z","timestamp":1583366400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The international guidelines for management of adrenal incidentalomas (AI) are becoming more conservative. These changes are based on the growing body of evidence suggesting that non\u2010functioning adenomas have a low likelihood of becoming functional or malignant over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To follow up at least 100 patients for 3 years who were originally found to have benign adrenal adenomas which were non\u2010functional or had subclinical Cushing syndrome (SCS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study prospectively evaluated consecutive patients aged 18 years or older with benign adrenal incidentalomas (AI), not treated with adrenalectomy, which were non\u2010functioning or had SCS. The initial and follow\u2010up evaluation, including clinical assessment, hormonal investigations and imaging were coordinated via a standardised nurse\u2010led AI clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 233 patients referred to the AI clinic, 101 patients met the inclusion criteria and completed 3\u2010year follow up. Most of those excluded were due to incomplete initial or follow\u2010up evaluation or were not true AI. Most AI either remained stable or decreased in size on repeat imaging, while 5% of patients had AI enlargement of &gt;5 mm diameter. No patient developed features suggesting adrenal carcinoma. Ninety\u2010two patients had an initial diagnosis of non\u2010functioning adenoma and nine patients had SCS. After 3 years (range 2.9\u20134.7 years), five of the nine patients with SCS showed normalisation of cortisol parameters (44%), and five of the 92 non\u2010functional AI patients developed SCS (5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>After 3 years of follow up, approximately half of patients with SCS normalised, while 5% of patients with initially non\u2010functioning adenomas developed biochemical evidence of SCS. This study found a low likelihood of progressive hormonal excess with no evidence of malignancy developing on follow\u2010up evaluation, providing support for the shift towards the more conservative approach to management of AI recommended in recent guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14332","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T21:00:20Z","timestamp":1557176420000},"page":"350-356","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Three\u2010year follow up of adrenal incidentalomas in a New Zealand centre"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2601-924X","authenticated-orcid":false,"given":"Ziwei","family":"Goh","sequence":"first","affiliation":[{"name":"Department of Endocrinology Christchurch Hospital  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Phillips","sequence":"additional","affiliation":[{"name":"Endocrine and Steroid Laboratory Canterbury Health Laboratories  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Penny J.","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Christchurch Hospital  Christchurch New Zealand"},{"name":"Department of Medicine University of Otago  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Soule","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Christchurch Hospital  Christchurch New Zealand"},{"name":"Department of Medicine University of Otago  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom J.","family":"Cawood","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Christchurch Hospital  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-16-0467"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2002-0031"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-09-0234"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP.15.5.450"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-5-200303040-00013"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3007"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(13)70211-0"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-017-1400-8"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13651"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/000456328802500318"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-128X(96)00189-4"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-4731(85)90217-1"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0039-128X(92)90034-7"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0009-8981(86)90053-7"},{"key":"e_1_2_7_16_1","first-page":"637","article-title":"A survey on adrenal incidentaloma in Italy","volume":"85","author":"Mantero F","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2004.01.001"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.14310\/horm.2002.1506"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-39-5-816"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/29.2.268"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2008.008180"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.85.4.1440"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-10-1147"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.11135"},{"key":"e_1_2_7_26_1","unstructured":"Statistics New Zealand. 2013 Census. 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