الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Adrenal incidentaloma is one of the common accidental findings in abdominal imaging. Its incidence now is higher due to improvement of imaging studies. The aim of the present work was to assess the clinical significance and metabolic effect of adrenal incidentalomas.
The present prospective study was conducted on 96 patients who were diagnosed as adrenal incidentaloma in Alexandria Main University Hospital from August 2016 to August 2017. All patients are subjected to through history taking, complete clinical examination, adequate hormonal profile (1 mg overnight dexamethasone suppression test, 24 urinary metanephrines, renin/aldosterone ratio if indicated) and further imaging when needed.
Most of the patients were diagnosed as non-functioning incidentalomas (84.4%), and only 33.3% of them required surgery (size more than 4 cm). Nonfunctioning incidentalomas which required surgery showed a significant improvement in the metabolism (HDL, TG, BP, BMI, and HBA 1c). The nonfunctioning patients which were followed up showed non-significant change in the metabolism.
Only 5.2% of the patients diagnosed as pheochromocytoma, adrenalectomy were done to all the patients. They showed a significant improvement of the BP after excision.
Only 5.2% of the patients were diagnosed as subclinical Cushing, adrenalectomy was done to all the patients. They experienced a significant improvement in BMI, HBA1c and lipid profile.
Larger studies with a longer duration of follow up are required to precisely determine the role of adrenalectomy in small adrenal incidentalomas in improving the metabolic effects.