TY - JOUR
T1 - Thyroid and adrenal incidentalomas on chest CT
T2 - Prevalence, diagnostic work-up and outcomes in a cohort of COVID-19 suspected patients
AU - Willems, Jeresa I.A.
AU - Tummers-de Lind van Wijngaarden, Roderick F.A.
AU - Dubelaar, Ivo J.M.
AU - De Kruif, Martijn D.
AU - Leers, Math P.G.
AU - Luu, Inge H.Y.
AU - Peeters, Robin P.
AU - van Twist, Daan J.L.
N1 - Publisher Copyright:
© 2023 European Federation of Internal Medicine
PY - 2024/5
Y1 - 2024/5
N2 - Objective: Due to increased use of computed tomography (CT), prevalence of thyroid and adrenal incidentalomas is rising. Yet, previous studies on the outcomes of diagnostic work-up of incidentalomas are subjected to inclusion bias. Therefore, we aimed to investigate prevalence and outcomes of diagnostic work-up of thyroid and adrenal incidentalomas detected on chest CT in a less selected population of COVID-19 suspected patients. Design: A retrospective, observational cohort study. Methods: We included all COVID-19 suspected patients who underwent chest CT between March 2020 and March 2021. Radiology reports and medical records were reviewed for the presence and subsequent diagnostic work-up of thyroid and adrenal incidentalomas. Results: A total of 1,992 consecutive COVID-19 patients were included (59.4% male, median age 71 years [IQR: 71–80]). Thyroid and adrenal incidentalomas were identified in 95 (4.8%) and 133 (6.7%) patients, respectively. Higher prevalence was observed with increasing age, among female patients and in patients with malignancy. Forty-four incidentalomas were further analyzed, but no malignancies were found. Only three lesions were hormonally active (1 thyrotoxicosis and 2 mild autonomous cortisol secretion). Diagnostic work-up did not lead to any change in clinical management in 97.7% of the analyzed patients. Conclusion: Prevalence rates of thyroid and adrenal incidentalomas on chest CT in a less selected COVID-19 cohort were 4.8% and 6.7%, respectively. Yet, as all incidentalomas turned out to be benign and only three lesions were (mildly) hormonally active, this raises the question whether intensive diagnostic work-up of incidentalomas is necessary in all patients.
AB - Objective: Due to increased use of computed tomography (CT), prevalence of thyroid and adrenal incidentalomas is rising. Yet, previous studies on the outcomes of diagnostic work-up of incidentalomas are subjected to inclusion bias. Therefore, we aimed to investigate prevalence and outcomes of diagnostic work-up of thyroid and adrenal incidentalomas detected on chest CT in a less selected population of COVID-19 suspected patients. Design: A retrospective, observational cohort study. Methods: We included all COVID-19 suspected patients who underwent chest CT between March 2020 and March 2021. Radiology reports and medical records were reviewed for the presence and subsequent diagnostic work-up of thyroid and adrenal incidentalomas. Results: A total of 1,992 consecutive COVID-19 patients were included (59.4% male, median age 71 years [IQR: 71–80]). Thyroid and adrenal incidentalomas were identified in 95 (4.8%) and 133 (6.7%) patients, respectively. Higher prevalence was observed with increasing age, among female patients and in patients with malignancy. Forty-four incidentalomas were further analyzed, but no malignancies were found. Only three lesions were hormonally active (1 thyrotoxicosis and 2 mild autonomous cortisol secretion). Diagnostic work-up did not lead to any change in clinical management in 97.7% of the analyzed patients. Conclusion: Prevalence rates of thyroid and adrenal incidentalomas on chest CT in a less selected COVID-19 cohort were 4.8% and 6.7%, respectively. Yet, as all incidentalomas turned out to be benign and only three lesions were (mildly) hormonally active, this raises the question whether intensive diagnostic work-up of incidentalomas is necessary in all patients.
UR - http://www.scopus.com/inward/record.url?scp=85180563344&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2023.12.008
DO - 10.1016/j.ejim.2023.12.008
M3 - Article
C2 - 38123419
AN - SCOPUS:85180563344
SN - 0953-6205
VL - 123
SP - 114
EP - 119
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
ER -