To investigate age-specific characteristics of adrenal tumors in older adults and to identify predictors for adrenal malignancy.
Approach:
Study Design: Retrospective analysis of inpatients ≥60 years old with adrenal tumors evaluated at a large medical center from January 2011 to December 2023.
Patient Population: 559 patients (21.2% of 2,633 inpatients) were eligible for analysis, with a median age of 64 years.
Data Collection: Demographic data, tumor size, and CT attenuation were recorded, along with hormonal evaluations.
Key Findings:
58.7% of patients were incidentally diagnosed.
Median tumor size was 29 mm, and median CT attenuation was 15.0 HU.
19.0% of cases were malignant, with adrenal metastases being the most common (59.4% of malignant cases).
Predictors for adrenal malignancy included incidental discovery, male gender, bilateral tumors, older age, higher HU, and lower weight.
The optimal cutoff values for predicting malignancy were age=67.5 years, size=42.5 mm, and CT attenuation=20.5 HU.
Interpretation:
Limitations:
The study is retrospective, which may limit the ability to draw causal inferences.
Multidisciplinary decision-making processes for surgical indications were not systematically retrieved.
