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Thyroid and adrenal incidentalomas on chest CT: Prevalence, diagnostic work-up and outcomes in a cohort of COVID-19 suspected patients.
Willems, Jeresa I A; Tummers-de Lind van Wijngaarden, Roderick F A; Dubelaar, Ivo J M; De Kruif, Martijn D; Leers, Math P G; Luu, Inge H Y; Peeters, Robin P; van Twist, Daan J L.
Afiliación
  • Willems JIA; Department of Internal Medicine, Zuyd Thyroid Center, Zuyderland Medical Center, Sittard, Heerlen, the Netherlands.
  • Tummers-de Lind van Wijngaarden RFA; Department of Internal Medicine, Zuyd Thyroid Center, Zuyderland Medical Center, Sittard, Heerlen, the Netherlands.
  • Dubelaar IJM; Department of Radiology, Zuyderland Medical Center, Sittard, Heerlen, the Netherlands.
  • De Kruif MD; Department of Pulmonology, Zuyderland Medical Center, Sittard, Heerlen, the Netherlands.
  • Leers MPG; Department of Clinical Chemistry and Hematology, Zuyderland Medical Center, Sittard, Heerlen, the Netherlands.
  • Luu IHY; Department of Internal Medicine, Zuyd Thyroid Center, Zuyderland Medical Center, Sittard, Heerlen, the Netherlands.
  • Peeters RP; Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, the Netherlands.
  • van Twist DJL; Department of Internal Medicine, Zuyd Thyroid Center, Zuyderland Medical Center, Sittard, Heerlen, the Netherlands. Electronic address: d.vantwist@zuyderland.nl.
Eur J Intern Med ; 123: 114-119, 2024 May.
Article en En | MEDLINE | ID: mdl-38123419
ABSTRACT

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Tiroides / Tomografía Computarizada por Rayos X / Neoplasias de las Glándulas Suprarrenales / Hallazgos Incidentales / COVID-19 Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Tiroides / Tomografía Computarizada por Rayos X / Neoplasias de las Glándulas Suprarrenales / Hallazgos Incidentales / COVID-19 Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Países Bajos