Table 1.
Pat no | Age (year) | Sex | BMI (kg/m2) | Clinical presentation | Hypercortisolism | Main clinical features | Radiological findings | S- cortisol (nmol/L) after ONDST | ACTH (pmol/L) | UFC (times the ULN) | S-cortisol (nmol/L) at midnight | S-cortisol (nmol/L) after LDDST |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 55 | F | 26.0 | Bilateral adrenal incidentaloma | MACS | Muscle weakness Hypertension | Bilateral adenomas: Right 32 × 18 mm | 840 | 1.7 | 0.8 | 340 | 630 |
Left 14 × 8 mm | ||||||||||||
2 | 60 | F | 23.9 | Bilateral adrenal incidentaloma | MACS | Hypertension Type 2 DM Muscle weakness | Bilateral adenomas: Right 28 × 22 mm | 110 | 1.9 | 1.0 | 93 | 100 |
Left 15 × 10 mm | ||||||||||||
3 | 54 | M | 22.4 | Bilateral adrenal incidentaloma | MACS | Hypertension Weight gain Decreased libido Impaired memory | Bilateral adenomas: Right 19 × 14 mm | 190 | 3.2 | 0.8 | 140 | 120 |
Left 28 × 25 mm | ||||||||||||
4 | 61 | F | 33.0 | Bilateral adrenal incidentaloma | MACS | Hypertension Obesity | Multiple adenomas, two in right adrenal and three in left, largest adenomas: Right 32 × 22 mm | 563 | <0.2 | 0.6 | 250 | 420 |
Left 19 × 18 mm | ||||||||||||
5 | 62 | M | 24.1 | Bilateral adrenal incidentaloma | MACS | Hypertension Muscle weakness Impaired memory | Bilateral adenomas: Right 23 × 16 mm | 120 | 3,6 | 0.9 | 120 | 120 |
Left 34 × 36 mm | ||||||||||||
6 | 60 | F | 30.5 | Bilateral adrenal incidentaloma | MACS | Mild Cushingoid features Hypertension Type 2 DM | Bilateral adenomas: Right 23 × 15 mm | 150 | 2.6 | 0.8 | 170 | 120 |
Left 10 × 10 mm | ||||||||||||
7 | 59 | F | 34.6 | Bilateral adrenal incidentaloma | Moderate CS | Cushingoid features Hypertension Type 2 DM Fatigue Depression | Bilateral adenomas: Right 22 × 15 mm | 610 | 1.1 | 1.3 | 420 | 560 |
Left 64 × 50 mm | ||||||||||||
8 | 57 | M | 34.9 | Bilateral adrenal incidentaloma | Moderate CS | Cushingoid features Hypertension Osteoporosis Fatigue Depression | Bilaterally enlarged adrenal glands: Right 50 × 47 mm | 550 | 0.9 | 4.7 | 570 | 250 |
Left 41 × 32 mm | ||||||||||||
9 | 39 | F | 23.6 | CS | Moderate CS | Cushingoid features Depression Amenorrhea Osteoporosis Fatigue | Normal adrenal glands | 677 | 1.3 | 1.6 | 560 | 747 |
10 | 11 | F | 40.8 | CS | Severe CS | Cushingoid features Weight gain Decreased growth rate Hypertension | Normal adrenal glands | 830 | 1.7 | 3.9 | 680 | 340 |
11 | 51 | F | 30.1 | CS | Severe CS | Cushingoid features Weight gain Hypertension Type 2 DM Fatigue Muscle weakness | Mildly enlarged adrenal glands bilaterally with suspected 9 mm adenoma in the right adrenal gland | 730 | 2.4/4.0/5.7 | 10.2 | 900 | – |
F female, M male, AVS adrenal venous sampling, MACS mild autonomous cortisol secretion, BMI body mass index, CS Cushing’s syndrome, ACTH adrenocorticotropic hormone at 8 a.m. (ref. 2.0–11 pmol/L), UFC 24-h urinary free cortisol, ULN upper limit of the normal range, ONDST 1 mg overnight dexamethasone suppression test, LDDST low-dose dexamethasone suppression test, DM diabetes mellitus type 2