Etiology Distribution And Clinical Manifestation Of Bilateral Adrenal Lesions

Objective To investigate the etiologies and clinical characteristics of bilateral adrenal lesions.Methods This study enrolled 143 patients with bilateral adrenal lesions hospitalized in the First Affiliated Hospital of Chongqing Medical University between January 2013 and March 2018,whose clinical data was collected and analyzed.Results 140 patients were retained for final analysis.Patients were 79 males and 61 females.The mean age was(51.53±13.93)years.Regarding the etiologies of bilateral adrenal lesions,there are primary aldosteronism(n=44,31.43%),Cushing’s syndrome(n=27,19.29%),non-functional lesions(n=23,16.43%),adrenal tuberculosis(n=17,12.14%),pheochromocytoma(n=11,7.86%),congenital adrenal hyperplasia(n=5,3.57%),adrenal metastases(n=5,3.57%),adrenal lymphoma(n=4,2.86).These patients were classified into the following groups according to the mass size: ≤2 cm,2-4 cm and >4 cm.The highest proportion of primary aldosteronism(62.79%),Cushing’s syndrome(46.15%)and pheochromocytoma(31.25%)was observed in the ≤2 cm,2-4 cm and >4cm groups,respectively.The mass sizes of primary aldosteronism,Cushing’s syndrome and pheochromocytoma were compared.Pheochromocytoma is the largest,followed by Cushing’s syndrome,non-functional lesions and primary aldosteronism(P<0.001).Conclusion For patients with bilateral adrenal lesions in our hospital,primary aldosteronism and Cushing’s syndrome are more common than non-functional lesions.Mass size is of great value in the evaluation of endocrinological etiology,as well as distinguishing malignant tumors from the benign ones.The imaging phenotype is helpful to determine tumor types.