Subclinical Cushing's syndrome: current concepts and trends.

摘要: Clinically inapparent adrenal masses which are incidentally detected have become a common problem in everyday practice. Approximately 5-20% of incidentalomas present subclinical cortisol hypersecretion is characterized by subtle alterations the hypothalamic-pituitary-adrenal axis due to autonomy. This disorder has been described as Cushing's syndrome, since there no typical clinical phenotype. The diagnosis syndrome based on biochemical evaluation; however, still consensus for diagnostic criteria. An abnormal 1mg dexamethasone suppression test (DST) initial screening combination with at least one other advocated most experts syndrome. DST main method establishing diagnosis, while inhomogeneity information that tests provide. Arterial hypertension, diabetes mellitus type 2 or impaired glucose tolerance, central obesity, osteoporosis/vertebral fractures and dyslipidemia considered detrimental effects chronic excess, although proven causal relationship between these morbidities. Therapeutic strategies include careful observation along medical treatment morbidities potentially related versus laparoscopic adrenalectomy. optimal management patients not yet defined. conservative approach appropriate majority patients; duration follow-up frequency periodical evaluation remain open issues. Surgical resection may be beneficial tolerance obesity.