scholarly journals Subclinical Cushing's syndrome

2007 ◽  
Vol 51 (8) ◽  
pp. 1272-1279 ◽  
Author(s):  
Massimo Terzolo ◽  
Silvia Bovio ◽  
Anna Pia ◽  
Giangiacomo Osella ◽  
Giorgio Borretta ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Adrenal Mass ◽  
Treatment Options ◽  
Adrenal Incidentaloma ◽  
Cushing's Syndrome ◽  
Subclinical Cushing’S Syndrome ◽  
The Metabolic Syndrome ◽  
Study Protocols ◽  
Frequent Event

Subclinical Cushing's syndrome (CS) is attracting increasing interest since the serendipitous discovery of an adrenal mass has become a rather frequent event owing to the routine use of sophisticated radiologic techniques. Cortical adenoma is the most frequent type of adrenal incidentaloma accounting for approximately 50% of cases in surgical series and even greater shares in medical series. Incidentally discovered adrenal adenomas may secrete cortisol in an autonomous manner that is not fully restrained by pituitary feedback, in 5 to 20% of cases depending on study protocols and diagnostic criteria. The criteria for qualifying subclinical cortisol excess are controversial and presently there is no consensus on a gold standard for the diagnosis of this condition. An increased frequency of hypertension, central obesity, impaired glucose tolerance, diabetes and hyperlipemia has been described in patients with subclinical CS; however, there is still no clear demonstration of the long-term complications of this condition whose management remains largely empirical. Either adrenalectomy or careful observation associated with treatment of the metabolic syndrome have been suggested as treatment options.

Subclinical Cushing's syndrome in adrenal incidentaloma

1998 ◽  
Vol 48 (1) ◽  
pp. 89-97 ◽  
Author(s):  
Terzolo ◽  
Osella ◽  
Alì ◽  
Borretta ◽  
Cesario ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Adrenal Incidentaloma ◽  
Cushing's Syndrome ◽  
Subclinical Cushing’S Syndrome

Adrenal Incidentaloma and Subclinical Cushing’s Syndrome: A Longitudinal Follow-Up Study by Endoscopic Ultrasound

2015 ◽  
Vol 38 (04) ◽  
pp. 411-419 ◽  
Author(s):  
Maike Collienne ◽  
Nina Timmesfeld ◽  
Simona Bergmann ◽  
Joachim Goebel ◽  
Peter Kann
Keyword(s):  
Growth Rate ◽  
Cushing’S Syndrome ◽  
Endoscopic Ultrasound ◽  
Adrenal Incidentaloma ◽  
Cushing's Syndrome ◽  
Endocrine Function ◽  
Maximum Diameter ◽  
Subclinical Cushing’S Syndrome ◽  
The Mean

Abstract Purpose Adrenal incidentaloma (AI) and adrenal masses in cases of subclinical Cushing’s syndrome (SCS) initially require follow-up imaging. In this study we used endoscopic ultrasound (EUS) as a method for high-resolution imaging. The aim was to evaluate the growth rate of AI and SCS by EUS. Materials and Methods This retrospective analysis included 93 out of 229 patients with AI or SCS who were investigated longitudinally by EUS in our university hospital between 1997 and 2013. The longitudinal follow-up required at least two investigations by EUS and evaluation of endocrine function. Plasma renin, serum aldosterone, 24 h urinary catecholamines and 2 mg dexamethasone suppression test were performed. EUS was performed at baseline and during follow-up. Each time, the maximum diameter was measured. Three groups were defined: non-functioning adenomas (NFA), non-functioning nodular hyperplasias (NFH) and SCS. Results 86 patients had non-functioning masses [NFM] (59 NFA, 48 NFH) and 7 patients had SCS (10 masses). At baseline the mean diameter was 19.4 (± 9.3) mm (NFM) and 19.6 (± 9.2) mm (SCS). The mean follow-up period was 31.6 ± 28.7 months. The estimated mean growth rates per year were low: They were 0.35 mm/yr [NFA], 0.02 mm/yr [NFH] and 0.53 mm/yr [SCS]. Furthermore, there was no malignant progression of any mass. Conclusion The growth rate as determined by EUS was low for all tumor entities observed in this study. There was no difference in tumor growth between the groups.

scholarly journals An Uncommon Presentation of Adrenal Cyst with Subclinical Cushing’s Syndrome: A Diagnosis Dilemma

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
A. Tahri ◽  
W. Abdellaoui ◽  
S. Benyakhlef ◽  
K. Boujtat ◽  
I. Mahroug ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Adrenal Incidentaloma ◽  
Cushing's Syndrome ◽  
Adrenocortical Adenoma ◽  
Subclinical Cushing’S Syndrome ◽  
Unique Case ◽  
Partial Adrenalectomy ◽  
Adrenal Cyst ◽  
Uncommon Presentation ◽  
Tomography Scan

Adrenal cysts are a rare entity that is usually nonfunctional and asymptomatic. Their association with adrenal neoplasms was rarely described in the literature. We report a unique case of a 40 -year-old woman who was referred for evaluation of a left adrenal incidentaloma with subclinical Cushing’s syndrome. The tumor was suspicious for malignancy regarding computed tomography scan (CT scan) features. Therefore, a laparoscopic left partial adrenalectomy was performed. Pathology examination showed multilocular spaces lined by endothelial cells which are compatible with endothelial adrenal cyst, associated to an adrenocortical adenoma. We further discuss the management of adrenal cyst with review of the literature.

Resistant hypertension after shockwave lithotripsy: the rude awakening of an adrenal incidentaloma

2020 ◽  
Vol 13 (8) ◽  
pp. e235261
Author(s):  
Ramon Jr Bagaporo Larrazabal ◽  
Harold Henrison Chang Chiu ◽  
Mark Anthony Santiago Sandoval
Keyword(s):  
Blood Pressure ◽  
Cushing’S Syndrome ◽  
Adrenal Mass ◽  
Adrenal Incidentaloma ◽  
Signs And Symptoms ◽  
Cushing's Syndrome ◽  
Flank Pain ◽  
Shockwave Lithotripsy ◽  
Left Flank ◽  
Left Flank Pain

A 41-year-old woman presented to the hospital because of left flank pain. CT scan of the kidneys revealed left-sided calculi and an incidental right adrenal mass, no other symptoms noted. She then underwent shockwave lithotripsy (SWL). However, immediately postoperatively, she had elevated blood pressure and remained hypertensive despite having four different medications. How SWL could have increased blood pressure could not be identified. On endocrine consult 16 months after SWL, she was found to now exhibit signs and symptoms of Cushing’s syndrome. Further workup revealed the adrenal incidentaloma to be cortisol-secreting. After undergoing right laparoscopic adrenalectomy, her blood pressure normalised, cortisol levels decreased and signs of Cushing’s syndrome gradually improved. We hypothesise that the performance of the SWL could have triggered the adenoma to ‘awaken’ from being non-functioning to cortisol-producing since this was the only intervening event. Observations of other patients are needed to validate our hypothesis.

scholarly journals Serum Adiponectin Level as a Predictor of Subclinical Cushing’s Syndrome in Patients with Adrenal Incidentaloma

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Asli Dogruk Unal ◽  
Semra Ayturk ◽  
Derya Aldemir ◽  
Neslihan Bascil Tutuncu
Keyword(s):  
Cushing’S Syndrome ◽  
Adiponectin Level ◽  
Adrenal Incidentaloma ◽  
Signs And Symptoms ◽  
Urinary Free Cortisol ◽  
Cushing's Syndrome ◽  
Subclinical Cushing’S Syndrome ◽  
Free Cortisol ◽  
Detailed Medical History ◽  
And Control

Subclinical Cushing’s syndrome (SCS) is a condition of slight but chronic cortisol excess in patients with adrenal incidentaloma (AI) without typical signs and symptoms of Cushing’s syndrome. Adiponectin has potent roles in modulating energy balance and metabolic homeostasis and acts in opposition to glucocorticoids. This study aimed to evaluate adiponectin level in SCS and nonfunctional AI (NAI) patients and its relation with metabolic parameters. Patients with AI (n=40) and metabolically healthy controls (n=30) were included. In AI patients and controls, detailed medical history assessment, physical examinations, anthropometric measurements, and laboratory measurements were performed. Age, body mass index, waist circumference, and lipid profiles were significantly higher and waist-to-hip ratio and adiponectin level were significantly lower in the AI patients than in the controls. The midnight cortisol and urinary free cortisol levels were significantly higher in the SCS patients (n=8) than in the NAI patients (n=32). Adiponectin level of the SCS group was significantly lower than those of the NAI and control groups. The sensitivity and specificity for an adiponectin level of ≤13.00 ng/mL in predicting the presence of SCS were 87.5% and 77.4%, respectively. In conclusion, adiponectin is valuable in predicting the presence of SCS in AI patients.

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