Bilateral macronodular adrenocortical disease: a single centre experience
Background: Data on bilateral macronodular adrenocortical disease (BMAD) with respect to computed tomography (CT) scan characteristics (attenuation and washout) and long-term follow-up are limited. This study aims to describe BMAD patients managed in a single centre. Methods: BMAD was defined by the...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2025-02-01
|
| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | https://ec.bioscientifica.com/view/journals/ec/14/3/EC-24-0664.xml |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849724256940720128 |
|---|---|
| author | Anuj Ban Rohit Barnabas Manjiri Karlekar Anurag Ranjan Lila Chethan Yami Channaiah Saba Samad Memon Virendra A Patil Vijaya Sarathi Gwendolyn Fernandes Hemangini Thakkar Sameer Rege Nalini S Shah Tushar Bandgar |
| author_facet | Anuj Ban Rohit Barnabas Manjiri Karlekar Anurag Ranjan Lila Chethan Yami Channaiah Saba Samad Memon Virendra A Patil Vijaya Sarathi Gwendolyn Fernandes Hemangini Thakkar Sameer Rege Nalini S Shah Tushar Bandgar |
| author_sort | Anuj Ban |
| collection | DOAJ |
| description | Background: Data on bilateral macronodular adrenocortical disease (BMAD) with respect to computed tomography (CT) scan characteristics (attenuation and washout) and long-term follow-up are limited. This study aims to describe BMAD patients managed in a single centre. Methods: BMAD was defined by the presence of bilateral adrenal macronodules (>1 cm) on CT. Clinical, biochemical, radiological, genetic characteristics, management and follow-up of 22 BMAD patients were studied retrospectively. Results: The median age (range) at presentation was 49.5 (23–83) years, predominantly observed in females (16/22). Eighteen (82%) patients were incidentally diagnosed (11 with mild autonomous cortisol secretion (MACS) and seven non-secretory), three (13.7%) presented with overt Cushing’s syndrome (CS), and one (4.5%) had androgen excess (without CS features). On CT, the dominant nodule’s median (range) size was 2.6(1.6–9.5) cm. 77.8% (14/18) of adrenal nodules were lipid-rich, and 93.3% (14/15) of the nodules exhibited good washout. Genetic analysis was available for eight patients; one had a novel germline ARMC5 variant, and two had MEN-1 gene mutations. Three overt CS and one androgen-secreting patient underwent total bilateral adrenalectomy; histopathology showed macronodular hyperplasia with internodular hypertrophy. Only one (1/8) patient from the MACS group developed a new comorbidity (diabetes mellitus) after a median follow-up of 6.4 (0.5–12.4) years, while none of the non-secretory group patients developed new comorbidities after a median follow-up of 1.4 (0.8–12.2) years. Conclusion: Most BMAD patients presented without overt hormonal excess, and none developed overt CS on follow-up. Detailed CT characteristics of BMAD nodules may help in radiological diagnosis in bilateral adrenal incidentalomas. |
| format | Article |
| id | doaj-art-e2328a72e6b84c599fbe53a390d7ff82 |
| institution | DOAJ |
| issn | 2049-3614 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj-art-e2328a72e6b84c599fbe53a390d7ff822025-08-20T03:10:47ZengBioscientificaEndocrine Connections2049-36142025-02-0114310.1530/EC-24-06641Bilateral macronodular adrenocortical disease: a single centre experienceAnuj Ban0Rohit Barnabas1Manjiri Karlekar2Anurag Ranjan Lila3Chethan Yami Channaiah4Saba Samad Memon5Virendra A Patil6Vijaya Sarathi7Gwendolyn Fernandes8Hemangini Thakkar9Sameer Rege10Nalini S Shah11Tushar Bandgar12Department of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, IndiaDepartment of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, IndiaDepartment of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, IndiaDepartment of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, IndiaDepartment of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, IndiaDepartment of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, IndiaDepartment of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, IndiaDepartment of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IndiaDepartment of Pathology, Seth GSMC and KEMH, Mumbai, IndiaDepartment of Radiology, Seth GSMC and KEMH, Mumbai, IndiaDepartment of General Surgery, Seth GSMC and KEMH, Mumbai, IndiaDepartment of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, IndiaDepartment of Endocrinology and Metabolism, Seth G S Medical College and KEM Hospital, Mumbai, IndiaBackground: Data on bilateral macronodular adrenocortical disease (BMAD) with respect to computed tomography (CT) scan characteristics (attenuation and washout) and long-term follow-up are limited. This study aims to describe BMAD patients managed in a single centre. Methods: BMAD was defined by the presence of bilateral adrenal macronodules (>1 cm) on CT. Clinical, biochemical, radiological, genetic characteristics, management and follow-up of 22 BMAD patients were studied retrospectively. Results: The median age (range) at presentation was 49.5 (23–83) years, predominantly observed in females (16/22). Eighteen (82%) patients were incidentally diagnosed (11 with mild autonomous cortisol secretion (MACS) and seven non-secretory), three (13.7%) presented with overt Cushing’s syndrome (CS), and one (4.5%) had androgen excess (without CS features). On CT, the dominant nodule’s median (range) size was 2.6(1.6–9.5) cm. 77.8% (14/18) of adrenal nodules were lipid-rich, and 93.3% (14/15) of the nodules exhibited good washout. Genetic analysis was available for eight patients; one had a novel germline ARMC5 variant, and two had MEN-1 gene mutations. Three overt CS and one androgen-secreting patient underwent total bilateral adrenalectomy; histopathology showed macronodular hyperplasia with internodular hypertrophy. Only one (1/8) patient from the MACS group developed a new comorbidity (diabetes mellitus) after a median follow-up of 6.4 (0.5–12.4) years, while none of the non-secretory group patients developed new comorbidities after a median follow-up of 1.4 (0.8–12.2) years. Conclusion: Most BMAD patients presented without overt hormonal excess, and none developed overt CS on follow-up. Detailed CT characteristics of BMAD nodules may help in radiological diagnosis in bilateral adrenal incidentalomas.https://ec.bioscientifica.com/view/journals/ec/14/3/EC-24-0664.xmlbmadcushing’s syndromect scanaimahadrenal cushing’spbmah |
| spellingShingle | Anuj Ban Rohit Barnabas Manjiri Karlekar Anurag Ranjan Lila Chethan Yami Channaiah Saba Samad Memon Virendra A Patil Vijaya Sarathi Gwendolyn Fernandes Hemangini Thakkar Sameer Rege Nalini S Shah Tushar Bandgar Bilateral macronodular adrenocortical disease: a single centre experience Endocrine Connections bmad cushing’s syndrome ct scan aimah adrenal cushing’s pbmah |
| title | Bilateral macronodular adrenocortical disease: a single centre experience |
| title_full | Bilateral macronodular adrenocortical disease: a single centre experience |
| title_fullStr | Bilateral macronodular adrenocortical disease: a single centre experience |
| title_full_unstemmed | Bilateral macronodular adrenocortical disease: a single centre experience |
| title_short | Bilateral macronodular adrenocortical disease: a single centre experience |
| title_sort | bilateral macronodular adrenocortical disease a single centre experience |
| topic | bmad cushing’s syndrome ct scan aimah adrenal cushing’s pbmah |
| url | https://ec.bioscientifica.com/view/journals/ec/14/3/EC-24-0664.xml |
| work_keys_str_mv | AT anujban bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT rohitbarnabas bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT manjirikarlekar bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT anuragranjanlila bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT chethanyamichannaiah bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT sabasamadmemon bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT virendraapatil bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT vijayasarathi bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT gwendolynfernandes bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT hemanginithakkar bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT sameerrege bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT nalinisshah bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience AT tusharbandgar bilateralmacronodularadrenocorticaldiseaseasinglecentreexperience |