Optimisation of the adrenal incidentaloma patient management pathway University Hospitals of North Midlands NHS Trust

Adrenal incidentalomas (AI) are lesions which are increasingly found while patients are undergoing radiological scans for other conditions. While most are benign and non-functional, around 20% are malignant and/or hormonally active. Malignant lesions require rapid treatment as tumours can be aggressive and life-threatening. Hormonally active tumours may result in the development of a number of endocrine disorders, which can cause significant morbidity and mortality.

The extent and approach to the investigation and follow-up of AIs is variable, and there is no robust evidence for their management. Studies have shown that the majority of patients receive no biochemical investigation or follow-up.

This project will look to manage patients with AIs more effectively, minimise delays in diagnosis and treatment, and reduce patient distress.

The first robust guidelines for managing AIs will be developed, based on the best available evidence from the UK and internationally. These guidelines will inform the development of an electronic AI Management System (eAIMS) that will link the clinical, biochemical and radiological data necessary for assessing and managing AI patients. eAIMS will create a clear management pathway for AI patients, enabling multidisciplinary teams to provide a management plan in a timely and cost effective manner, thereby preventing unnecessary investigations and patient distress.

A key part of the project will be patient partnership. The team will gauge patient experience with the current unstructured approach; incorporate their views in designing clear patient information material, which will facilitate better understanding and reduce anxiety; and engage with patients when designing eAIMS. 

Contact details

If you would like further information about this project, please contact Dr Fahmy Hanna, Consultant Physician and Endocrinologist at Royal Stoke University Hospital.