Table 1.
Clinical presentation, imaging characteristics, management and outcomes of patients with benign adrenal cysts overall and based on initial cyst size. Data are presented as n (%) or as median (range).
| Data available for, n | All patients (n=92) | Initial Cyst Size |
P-value* | ||
|---|---|---|---|---|---|
| <50 mm (n=51) | ≥50 mm (n=41) | ||||
|
| |||||
| Clinical Characteristics | |||||
| Women | 52 (56.5%) | 28 (54.9%) | 24 (58.5%) | 0.8331 | |
| Age at diagnosis, years, median (range) | 45 (14.4–83.1) | 51.2 (14.4–83.1) | 37.1 (15.5–76) | 0.0030 | |
| Race | 0.0316 | ||||
| Caucasian | 80 (87.0%) | 42 (82.4%) | 38 (92.7%) | ||
| African American | 4 (4.5%) | 3 (5.9%) | 1 (2.4%) | ||
| Hispanic | 3 (3.3%) | 2 (3.9%) | 1 (2.4%) | ||
| Native American | 2 (2.2%) | 2 (3.9%) | 0 (0.0%) | ||
| Other or unknown | 3 (3.3%) | 2 (3.9%) | 1 (2.4%) | ||
| Mode of discovery, n/N (%) | 0.0095 | ||||
| Incidental | 81 (88.0%) | 49 (96.0%) | 32 (76.2%) | ||
| Mass effect | 9 (9.8%) | 1 (2.0%) | 8 (19.5%) | ||
| Cancer staging | 2 (2.2%) | 1 (2.0%) | 1 (2.4%) | ||
| Evaluated by endocrinologist | 75 (81.5%) | 39 (75%) | 36 (87.8%) | 0.1877 | |
| Year of diagnosis | 0.0209 | ||||
| < 2012 | 44 (47.8%) | 19 (37.3%) | 25/41 (61.0%) | ||
| ≥ 2012 | 48 (52.2%) | 32 (62.8%) | 16/41 (39.0%) | ||
| Imaging Characteristics | |||||
| Site | 0.3740 | ||||
| Right | 45 (48.9%) | 28 (54.9%) | 17 (41.5%) | ||
| Left | 44 (47.8%) | 22 (43.1%) | 22 (53.7%) | ||
| Bilateral | 3 (3.3%) | 1 (2.0%) | 2 (4.9%) | ||
| Shape | 89 | 0.5959 | |||
| Round/oval | 76 (85.4%) | 42 (84.0%) | 34 (87.2%) | ||
| Lobulated | 13 (14.6%) | 8 (16.0%) | 5 (12.8%) | ||
| Well defined borders | 89 | 87 (97.8%) | 49 (98.0%) | 38 (97.4%) | 0.8553 |
| Homogenous | 89 | 74/89 (83.2%) | 42 (84.0%) | 32 (82.1%) | 0.7975 |
| Vascular enhancement (excluding rim) | 86 | 2 (2.3%) | 2 (4.1%) | 0 (0.0%) | 0.2151 |
| Rim enhancement | 83 | 1.9 (0–71) | 2.1 (0–7) | 1.8 (0–7) | 0.9149 |
| Calcification | 86 | 55 (64.0%) | 26 (55.3%) | 29 (74.4%) | 0.0676 |
| Calcification pattern | |||||
| Peripheral | 49 (89.1%) | 26 (100.0%) | 23 (79.3%) | ||
| Septal | 10 (18.2%) | 5 (19.2%) | 5 (17.2%) | ||
| Scattered | 12 (21.8%) | 6 (23.1%) | 6 (20.7%) | ||
| Unenhanced CT attenuation, HU | 76 | 19 (0–83) | 19.6 (0–83) | 18 (8.9–70) | 0.8014 |
| Cyst growth rate, mm per year | 59 | +2 (−8.9 to 27.4) | +2.3 (−5.9 to 20.7) | +0.22 (−8.9 to 27.4) | 0.3613 |
| Change in cyst size$, mm | 59 | +6 (−60 to 111) | +8.5 (−37.6 to 111) | +3.0 (−60 to 100) | 0.2827 |
| Maximum cyst size, mm | 57.5 (5–200) | 42 (5–159) | 82.8 (51–200) | <0.0001 | |
| Hormonal Assessment | |||||
| Hormonal testing done | 78 (84.8%) | 41 (78.4%) | 37 (90.2%) | 0.1934 | |
| Catecholamine excess | 76 | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | |
| Cortisol secretory autonomy | 50 | 5 (10%) | 3 (10.7%) | 2 (9.5%) | |
| Aldosterone excess | 42 | 4 (9.5%) | 2 (8.3%) | 2 (11.1%) | |
| Management | |||||
| No surgical intervention | 46 (50.0%) | 29 (56.9%) | 17 (41.5%) | 0.2080 | |
| Laparoscopic adrenalectomy | 35 (38.0%) | 18 (35.3%) | 17 (41.5%) | 1.000 | |
| Open adrenalectomy | 7 (7.6%) | 2 (3.9%) | 5 (12.2%) | ||
| Cystectomy | 4 (4.4%) | 2 (3.9%) | 2 (4.9%) | ||
| Follow-up | |||||
| Imaging follow-up, months | 59 | 65 (7–288) | 71 (12–233) | 46 (7–288) | 0.4206 |
| Clinical follow-up, months | 88 | 58 (1–292) | 79 (1–259) | 50 (1–292) | 0.2800 |
| Appearance of new cyst | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | ||
Abbreviations used: CT = computed tomography; HU = Hounsfield unit
*
Comparison between initial cyst size < 50 mm and ≥ 50 mm. P value < 0.05 is significant
$
Difference between cyst size on last and the first imaging studies