Long-term study of subclinical Cushing’s syndrome shows high prevalence of extra-adrenal malignancy in patients with functioning bilateral adrenal tumors

Endocrine Journal

Toshihiko Yanase³  Keizo Ohnaka¹  Ryoichi Takayanagi²  Hisaya Kawate²  Masatoshi Nomura²  Yayoi Matsuda²  Makito Tanabe³  Toshihiro Horiuchi²  Yuko Akehi³  Michiko Kohno² 

[1] Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan;Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan;Department of Endocrinology and Diabetes Mellitus, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan

关键词: Subclinical Cushing’s syndrome;    Adrenal tumor;    Cortisol;    Extra-adrenal cancer;   

DOI  :  10.1507/endocrj.EJ14-0155

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(41)Cited-By(4)Subclinical Cushing’s syndrome (SCS) is characterized by subtle autonomous cortisol secretion from adrenal tumors without specific signs and symptoms of hypercortisolism.Patients with SCS have a high prevalence of “lifestyle-related diseases,” such as hypertension, diabetes mellitus, dyslipidemia, and osteoporosis.Long-term follow-up of SCS patients is reportedly indispensable for establishing indications for surgical treatment of SCS.We performed a follow-up survey of 27 patients with SCS (median: 5.3 years) and compared those who had undergone surgical treatment (n=15) with those who had not (n=12).The mean diameter of tumors was 31 mm; 16 (59%) patients had unilateral lesions and 11 (41%) carried bilateral ones.In 67% and 60% of the treatment group, respectively, hypertension and diabetes mellitus improved.We also noticed that eight of 11 (73%) SCS patients with bilateral adrenal tumors had extra-adrenal malignancies in various tissues.Interestingly, among nine SCS patients who had malignancies, eight showed bilateral adrenal uptake in 131I-aldosterol scintigraphy.The results imply that surgical treatment can reduce cardiovascular risks in SCS patients.Screening for malignancy may be necessary in patients with bilateral adrenal tumors suspected of autonomous hypersecretion of cortisol from both sides.

【 授权许可】

Unknown