Adrenal Lesions in a Large Kindred With Multiple Endocrine Neoplasia Type 1
John R. Burgess, MBBS;
Robin A. Harle, MBBS;
Paul Tucker, MD, FRCPA;
Venkateswaran Parameswaran, PhD;
Peter Davies, FRACR;
Tim M. Greenaway, PhD, FRACP;
Joseph J. Shepherd, MD
Arch Surg. 1996;131(7):699-702.
Abstract
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Objective
To review the prevalence and natural history of adrenal lesions occurring in patients from a single kindred with multiple endocrine neoplasia type 1 (MEN-1).
Design
Case series.
Setting
Tertiary referral center.
Patients
Medical records of 33 patients from the Tasman 1 MEN-1 kindred who had undergone abdominal computed tomographic (CT) scanning were reviewed. In 30 patients, the results of abdominal ultrasonographic examinations were available for correlation with CT scans. Computed tomographic and ultrasound scans of 18 patients were reviewed by a radiologist blinded to the patients' clinical details. Three patients underwent adrenalectomy, and the histopathologic material was reviewed.
Main Outcome Measures
Computed tomographic and ultrasound scans.
Results
Adrenal lesions were detected in 12 patients (36%) by CT scan examination. Ultrasound imaged 58% of these lesions. Pancreatic lesions were present in all cases of adrenal disease. Follow-up was available for 8 patients with adrenal disease. Over 5.5 years, 6 patients (75%) had stable disease, 1 patient had an adrenal lesion that enlarged by 5 mm, and I patient had a lesion that enlarged by 50 mm. Adrenal histopathologic material was available in 3 patients. Macronodular cortical hyperplasia was present in 2 patients and a cortical adenoma present in 1 patient. Another kindred had bilateral macronodular cortical hyperplasia at autopsy.
Conclusions
Adrenal lesions are common in MEN-1 and occur in association with pancreatic disease. Abdominal CT scan is more sensitive than ultrasonographic examination in detecting adrenal disease. Primary hypersecretory syndromes of the adrenal glands appear to be rare, and the majority of lesions follow an indolent clinical course.
Arch Surg. 1996;131:699-702
Author Affiliations
From the Departments of Diabetes and Endocrine Services (Dr Burgess), Medical Imaging (Drs Harle and Davies), Anatomical Pathology (Dr Tucker), and Diabetes and Endocrine Services (Drs Parameswaran and Greenaway), Royal Hobart Hospital; and Department of Surgery, University of Tasmania (Dr Shepherd), Hobart, Australia.
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