• Eur. J. Intern. Med. · May 2024

    Observational Study

    Thyroid and adrenal incidentalomas on chest CT: Prevalence, diagnostic work-up and outcomes in a cohort of COVID-19 suspected patients.

    • Jeresa I A Willems, Roderick F A Tummers-de Lind van Wijngaarden, Ivo J M Dubelaar, Martijn D De Kruif, Math P G Leers, Inge H Y Luu, Robin P Peeters, and Daan J L van Twist.
    • Department of Internal Medicine, Zuyd Thyroid Center, Zuyderland Medical Center, Sittard, Heerlen, the Netherlands.
    • Eur. J. Intern. Med. 2024 May 1; 123: 114119114-119.

    ObjectiveDue 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.DesignA retrospective, observational cohort study.MethodsWe 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.ResultsA 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.ConclusionPrevalence 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.Copyright © 2023 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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