Subclinical hypercortisolism and CT appearance in adrenal incidentalomas: a multicenter study from Southern Sweden
Abstract
Evaluation of subclinical hypercortisolism (SH) in patients with adrenal incidentaloma (AI) including its correlation to size, attenuation at unenhanced computed tomography (CT) and unilateral or bilateral adrenal disease. Nine hospitals in Southern Sweden investigated during 2005-2007 consecutively patients with AI with hormonal and CT examinations according a regional protocol. Two hundred and twenty-eight patients with AI with median size 2.0 cm were included. One mg overnight dexamethasone suppression test (DST) was performed in 223 patients and basal P-ACTH measured in 146 patients. SH was defined as cortisol ≥ 50 nmol/l at DST in combination with basal ACTH <2 pmol/l. In patients with unilateral AI 42% (76/180) had inadequate suppression at DST and 23% (27/115) had SH. The probability for SH and inadequate suppression at DST correlated positively to size and inversely to attenuation at CT. Bilateral AI were found in 43 patients and of these 70% (30/43) had inadequate suppression at DST and 42% (13/31) SH. The patients with SH or inadequate suppression at DST had increased frequency of hypertension which increased further in patients with post-DST cortisol ≥ 140 nmol/l. The applied criterion for SH is useful for initial evaluation of patients with AI. SH is common in patients with AI, particular in bilateral disease. In patients with unilateral AI the probability for SH correlated positively to size and inversely to attenuation at CT. Furthermore, SH and the post-DST cortisol concentration was associated with hypertension.
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ACS is more frequently encountered in patients with bilateral AI than in those with unilateral lesions.
“ACS is more frequently encountered in patients with bilateral AI than in those with unilateral lesions (317-319).”
From Adrenal incidentaloma (2020) · cites this paper as [317]
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Adrenal incidentaloma: management of patients with functionally autonomous cortisol synthesis
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Predicting Biochemical Activity in Incidentally Discovered Adrenal Masses
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- Authors
- Olsen, H., Nordenström, E., Bergenfelz, A., Nyman, U., Valdemarsson, S., & Palmqvist, E.
- Affiliations
- Helsingborgs lasarett (SE)
- Skåne University Hospital (SE)
- Trelleborg (Sweden) (SE)
- Hallands sjukhus Halmstad (SE)
- Corresponding author
- Olsen, Henrik
- Venue
- Endocrine
- Published
- 2012-02-17
- Volume
- 42
- Issue
- 1
- Pages
- 164-173
- ISSN
- 0969-711X (ISSN-L)
- 1355-008X
- 1559-0100
- OpenAlex
- W2017402278
- Cited by
- 60
- References
- 37
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 1 · 2018: 4 · 2017: 7 · 2016: 4 · 2015: 11 · 2014: 4 · 2013: 2 · 2012: 1
- FWCI
- 5.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Endocrine (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Department of Science and Technology, Ministry of Science and Technology, India
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Keywords
- subclinical hypercortisolism, adrenal incidentaloma, dexamethasone suppression test, ACTH, CT attenuation, tumor size, hypertension, cortisol, Cushing's disease
- MeSH terms
- Adrenal Gland Neoplasms, Adrenocorticotropic Hormone, Adult, Aged, Aged, 80 and over, Cushing Syndrome, Female, Humans, Hydrocortisone, Hypertension, Male, Middle Aged, Sweden, Tomography, X-Ray Computed, Dehydroepiandrosterone Sulfate, Asymptomatic Diseases
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