Adrenal morpho-functional alterations in patients with acromegaly

• Published in: Journal of endocrinological investigation Vol. 31; no. 7; pp. 602 - 606
• Main Authors: Scaroni, C., Selice, R., Benedini, S., De Menis, E., Arosio, M., Ronchi, C., Gasperi, M., Manetti, L., Arnaldi, G., Polenta, B., Boscaro, M., Albiger, N., Martino, E., Mantero, F.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.07.2008
• Subjects: Acromegaly - blood; Acromegaly - pathology; Acromegaly - physiopathology; Adrenal Glands - metabolism; Adrenal Glands - pathology; Adrenal Glands - physiopathology; Adult; Aged; Endocrinology; Female; Human Growth Hormone - blood; Humans; Insulin-Like Growth Factor I - metabolism; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Original Articles; Acromegaly; adrenal mass; Cushing’s syndrome
• ISSN: 0391-4097; 1720-8386
• DOI: 10.1007/BF03345609

Acromegaly is associated with a greater morbidity and higher incidence of tumors, possibly due to the permissive role of elevated GH and IGF-I levels. In the general population, adrenal masses are frequently discovered (prevalence 1–5%) at computed tomography (CT). We evaluated the prevalence of adrenal lesions in patients with acromegaly. We studied 94 acromegalic patients, 54 females (mean age 55.0±16.0 yr) and 40 males (mean age 50±14 yr) referred to 5 Endocrinology Units between 2001–2003; 49 had active disease and 45 had been treated with surgery and/or were controlled with medical therapy. Abdominal CT showed adrenal lesions in 27 patients; 9 of them had unilateral masses (10%) with benign features (diameter 0.5–3 cm) and 18 had hyperplasia (14 monolateral and 4 bilateral), with no significant differences between patients with active vs controlled disease, and with no correlation between prevalence of masses and duration of disease, GH and IGF-I levels. Hormone study (urinary free cortisol, catecholamines/metanephrines, upright plasma renin activity and aldosterone, morning plasma ACTH and low-dose dexamethasone suppression test) disclosed no major endocrine alterations. During a 1-yr follow-up, the adrenal masses increased in size in 3 cases and 1 patient also developed subclinical Cushing’s syndrome. Adrenal lesions seem more frequent in acromegaly than in the general population, but no single factor (GH/IGF-I levels or disease duration) predicts them. The masses appear to be benign and non-hypersecreting, but a longer follow-up is recommended to disclose any changes in their morphofunctional state