The Prospect And Progress Of Diagnoses And Management Study In Subclinical Cushing’s Syndrome Of Adrenal Incidentaloma

The morbidity incidence of adrenal incidentaloma is increasingly increased in the wake of imaging technology development. Adrenal incidentaloma(AI) is a term, which is an accidentally discovered adrenal mass on imaging examination for unadrenal diseases. It can be categorized into non-functioning adenomas(NA), Subclinical Cushing’s syndrome(SCS), Pheochromocytoma(PHEO), Primary hyperaldosteronism(PHA) and so on according to its secretory function, and can be categorized into primary adrenocortical carcinoma, metastatic cancer and so on according to the pathologic type of the tumor. Once AI is find, it is necessary to identify its pathologic type and whether it has secretory function by entire medical history, careful physical examination and hormone and radiologic evaluation, which would help us select the optimal treatment, perioperative management and develop the plan of follow-up to improve the long-term survival rate. Many studies have indicated that SCS is the most common endocrinic syndrome of AI. It has no typical clinical manifestations so that it is often misdiagnosed or missed diagnosis. However, due to the increased secretion of endogenous glucocorticoids caused by this syndrome, SCS is closely associated with glucose and lipid metabolism disorder, osteoporosis, vertebral fractures, cardiovascular disease and so on. In recent years, SCS has become a popular research topic in endocrinology, and there is no gold standard of diagnosis and preferred treatment prescription until now. This review summarized and expounded the diagnosis, complications and therapies of SCS, which arouses medical workers attention to SCS and making patients get early diagnosis and early treatment.