Chulalongkorn Medical Journal


Background : Cross-sectional imaging has been increasingly used. The adrenalincidentaloma was detected and caused problem to diagnose benignor malignant especially unknown primary cases.Objective : To determine the prevalence of malignancy in adrenal incidentalomain patients with unknown primary malignancy.Setting : Department of Radiology, Faculty of Medicine, ChulalongkornUniversity/ King Chulalongkorn Memorial Hospital, Thai Red CrossSocietyResearch design : Retrospective studyMethods : The CT study was retrospectively reviewed from January 2004 to April2010 to identify adrenal incidentaloma in patients without clinicalhistory of malignancy. The diagnosis of benign adrenal lesion wasbased on specific imaging criteria. Imaging diagnosis of benign hadto be confirmed by its attenuation, washout rate study, 1-year stabilityin diameter on follow-up CT or MRI or at least 2-years stability onclinical follow-up.Results : Forty-eight adrenal incidentalomas were included. Histopathology wasconfirmed for 1 lesion, MRI with at least 1-year stability for 3 lesions,more than 1-year follow-up CT studies for 18 lesions and at least2-year clinical stability for 26 lesions. One lesion showed slightlyincreased in diameter but had well-defined margin and low attenuationvalue on unenhanced CT. Most of the incidentalomas were adenomas,followed by myelolipomas, hematomas, adrenal cortical hyperplasiaand disseminated histoplasmosis. No malignant adrenal lesion wasidentified.Conclusions : No malignancy was confirmed in patients with adrenal incidentalomawith unknown primary malignancy.


Faculty of Medicine, Chulalongkorn University



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