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Adrenal morpho-functional alterations in patients with acromegaly

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Abstract

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

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, Endocrinology Unit, University of Padova, via Ospedale 105, 35128, Padova, Italy

    C. Scaroni MD, R. Selice, S. Benedini, N. Albiger & F. Mantero

  2. Internal Medicine, Endocrinology Unit, Ospedale Treviso, Treviso

    E. De Menis

  3. Department of Medical Sciences, Ospedale San Giuseppe AfaR, University of Milan, Italy

    M. Arosio

  4. Fondazione Ospedale Maggiore IRCCS Milano, Milan

    M. Arosio & C. Ronchi

  5. University of Molise, Campobasso

    M. Gasperi (Endocrinology Chair)

  6. Department of Endocrinology and Metabolism, University of Pisa, Pisa

    L. Manetti & E. Martino

  7. Department of Internal Medicine, Endocrinology Unit, Polytechnic University of the Marche Region, Ancona, Italy

    G. Arnaldi, B. Polenta & M. Boscaro

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  1. C. Scaroni MD
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  2. R. Selice
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  3. S. Benedini
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  4. E. De Menis
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  6. C. Ronchi
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  7. M. Gasperi
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  8. L. Manetti
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  9. G. Arnaldi
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Correspondence to C. Scaroni MD.

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Scaroni, C., Selice, R., Benedini, S. et al. Adrenal morpho-functional alterations in patients with acromegaly. J Endocrinol Invest 31, 602–606 (2008). https://doi.org/10.1007/BF03345609

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  • DOI: https://doi.org/10.1007/BF03345609

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