Evolution of computed tomography-detectable adrenal nodules in patients with bilateral primary aldosteronism

Idiopathic hyperaldosteronism due to bilateral autonomous production of aldosterone is the most common subtype of primary hyperaldosteronism and is diagnosed by adrenal venous sampling. The aim of our study was to assess the over time evolution of computed tomography (CT)-detectable adrenal nodule(s) in patients with idiopathic hyperaldosteronism. Thirty-two patients (23 males and 9 females; age 50\ub19 years) diagnosed as bilateral PA and having nodular adrenal lesions (median diameter 12 mm, range 8 to 28 mm; 28 unilateral and 4 bilateral), were studied. Adrenal was described as nodular when unilateral or bilateral nodule(s) of at least 8 mm in diameter were detected using CT with contrast and fine cuts. The diagnosis of a benign adrenal nodule rested on the following CT criteria: size <4 cm, regular shape with well-defined margins, homogeneous and hypodense content. All patients had CT imaging re-evaluated 3 to 6 years (median 45 months) after diagnosis. A unilateral nodular lesion enlargement 6525% was detected in 2 cases; a slight increase (