非機能性副腎偶発腫瘍の臨床像とステロイド生合成系に関する検討

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CT or MRI scan has revealed unexpected adrenal masses during examinations for unrelated disease with the frequency ranging from 0.4 to 1.3%. Most of these incidentalomas were adenomas that had lost the ability to secrete biological potent hormones, i.e., nonfunctioning adenoma. The present study was to clarify the clinical characteristics and steroidogenesis of these incidentalomas. The frequency of adrenal incidentaloma on CT scan examined in 1,116 subjects in a general hospital increased after age 60, i.e., 0.49% between 40 and 49 years, 0.43% between 50 and 59 years, 0.87% between 60 and 69 years, and 0.82% between 70 and 79 years. Forty-four patients have been diagnosed to have a nonfunctioning adenoma(s) in our department. They were frequently suffered from hypertension, impaired glucose intolerance, and/or hyper-lipidemia. These findings suggest that nonfunctioning adenomas may be an aging-related phenomenon. Nonfunctioning adenomas were small and grew very slowly. No difference in frequency was seen between men and women. Rapid ACTH tests was conducted in 8 patients with nonfunctioning adenoma. Plasma 17-hydroxyprogesterone (17-OHP) increased excessively in one patient and increased fairly in two. A hyperresponder of 17-OHP in rapid ACTH test was thus present, although its frequency was lower than that reported in Caucasians. Thus, the impairment of steroidogenesis at or proximal to 21-hydroxylation may occur in most of non-functioning adenomas.
1998-03-25

非機能性副腎偶発腫瘍の臨床像とステロイド生合成系に関する検討

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