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Adrenalectomy may improve cardiovascular and metabolic impairment and ameliorate quality of life in patients with adrenal incidentalomas and subclinical Cushing's syndrome.
[adrenal incidentaloma]
Adrenalectomy
represents
the
definitive
treatment
in
clinically
evident
Cushing
's
syndrome
;
however
,
the
most
appropriate
treatment
for
patients
with
subclinical
Cushing
's
syndrome
(
SCS
)
with
an
adrenal
incidentaloma
remains
controversial
.
This
study
was
aimed
to
assess
whether
adrenalectomy
may
improve
cardiovascular
and
metabolic
impairment
and
quality
of
life
compared
with
conservative
management
.
Twenty
patients
with
adrenal
incidentaloma
underwent
laparoscopic
adrenalectomy
for
SCS
,
whereas
15
were
managed
conservatively
.
Hormonal
laboratory
parameters
of
corticosteroid
secretion
,
arterial
blood
pressure
(
BP
)
,
glycometabolic
profile
,
and
quality
of
life
(
by
the
SF-
36
questionnaire
)
were
compared
at
baseline
and
the
end
of
follow-up
.
The
2
groups
were
equivalent
concerning
all
the
examined
parameters
at
baseline
.
In
the
operative
group
,
laboratory
corticosteroid
parameters
normalized
in
all
patients
but
not
in
the
conservative-management
group
(
P
<
.
001
)
.
In
operated
patients
,
a
decrease
in
BP
occurred
in
53
%
of
patients
,
glycometabolic
control
improved
in
50
%
,
and
body
mass
index
decreased
;
in
contrast
,
no
improvement
or
some
worsening
occurred
in
the
conservative-management
group
(
P
<
.
01
)
.
SF-
36
evaluation
improved
in
the
operative
group
(
P
<
.
05
)
.
Adrenalectomy
can
be
more
beneficial
than
conservative
management
in
SCS
and
may
achieve
remission
of
laboratory
hormonal
abnormalities
and
improve
BP
,
glycemic
control
,
body
mass
index
,
and
quality
of
life
.
Diseases
Validation
Diseases presenting
"blood pressure"
symptom
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
cadasil
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cushing syndrome
fabry disease
familial mediterranean fever
lymphangioleiomyomatosis
pendred syndrome
proteus syndrome
scrub typhus
systemic capillary leak syndrome
thoracic outlet syndrome
typhoid
von hippel-lindau disease
werner syndrome
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