AD13 Adrenal incidentalomas in a Georgian endocrine cohort: clinical, radiological and biochemical characteristics

Abstract Background/Introduction Data on adrenal incidentalomas from Georgia remain limited. We aimed to characterize the clinical, radiological, and biochemical profile of adults evaluated for adrenal incidentalomas in a Georgian endocrine cohort, with a particular focus on cardiometabolic comorbidities and the completeness of hormonal assessment. Purpose To describe the demographic, radiological, biochemical, and cardiometabolic characteristics of patients with adrenal incidentalomas evaluated at a tertiary endocrine centre in Georgia. Methods We retrospectively analysed a cleaned dataset of adults with computed tomography (CT), magnetic resonance imaging (MRI), or histopathologically confirmed adrenal lesions. Demographic, cardiometabolic, imaging, and hormonal variables were extracted from available medical records. Continuous variables were summarised as mean ± standard deviation (SD) or median with interquartile range (IQR), and categorical variables as counts and percentages. Hormonal abnormalities were reported only among patients who underwent the corresponding investigations. Results Among 37 screened records, 28 patients with confirmed adrenal lesions were included. The mean age was 50.9 ± 12.9 years, and 19 patients (67.9%) were women. Hypertension was documented in 15 patients (53.6%), while diabetes mellitus, prediabetes, insulin resistance, or abnormal fasting glucose/HbA1c were present in 12 patients (42.9%). Body mass index (BMI) was available for 25 patients, with a mean BMI of 29.3 ± 6.6 kg/m²; obesity was present in eight patients (32.0%). Adrenal lesions were predominantly unilateral (27/28, 96.4%), including 15 right-sided and 12 left-sided lesions, while one patient had bilateral disease. Median lesion size was 20.0 mm (IQR 16.0–27.0; n = 27). A 1-mg overnight dexamethasone suppression test was available in eight patients, of whom two (25.0%) had post-dexamethasone cortisol concentrations >1.8 µg/dL, consistent with possible mild autonomous cortisol secretion. The aldosterone-to-renin ratio (ARR) was available in 19 patients, with a positive screening result (ARR ≥20) in nine (47.4%). One patient was diagnosed with pheochromocytoma. Conclusion In this preliminary Georgian cohort, adrenal incidentalomas were predominantly unilateral but frequently coexisted with cardiometabolic abnormalities. The heterogeneous use of hormonal investigations highlights the need for a standardized diagnostic approach to adrenal incidentalomas.