Assessment of mild autonomous cortisol secretion among incidentally discovered adrenal masses. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Yozamp, Nicholas; Vaidya, Anand
• Is Part Of: Best practice & research. Volume 35:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: Cushing syndrome -- hypercortisolism -- adrenocortical adenoma -- adrenal incidentaloma; Endocrine glands -- Diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; Endocrinology -- Periodicals; Metabolism -- Periodicals; 616.4
• DOI: 10.1016/j.beem.2021.101491
• Languages: English
• ISSNs: 1521-690X

Abstract

Abstract : Incidentally discovered adrenal masses are common and mostly benign and non-functioning adenomas. However, evolving evidence suggests that a notable proportion of these adrenal adenomas may demonstrate mild autonomous cortisol secretion (MACS), which has been associated with an increased risk for hypertension, hyperglycemia, obesity, dyslipidemia, vertebral fractures, adverse cardiovascular events, and mortality. Therefore, it is advised that all patients with an incidentally discovered adrenal mass be tested for MACS. When there is convincing evidence for MACS, surgical adrenalectomy has been associated with an improvement in certain metabolic parameters and a reduction in vertebral fractures; however, conclusive evidence demonstrating decreased cardiovascular outcomes or mortality are not yet available. Future studies with adequate randomization and follow-up to assess adverse clinical endpoints are needed to determine the optimal management and follow-up of patients with MACS.