Purpose: Adrenalectomy represents the definitive treatment in
clinically evident Cushing's Syndrome, while the most
appropriate treatment in case of subclinical Cushing's Syndrome
(SCS) in adrenal incidentalomas remains controversial. This
study was aimed to compare the outcome of adrenalectomy or
conservative management in adrenal incidentalomas with SCS.
Methods: Twenty patients underwent laparoscopic adrenalectomy
for SCS in adrenal incidentaloma, while 15 were
managed conservatively. Hormonal laboratory parameters
of corticosteroidal secretion, arterial blood pressure (BP),
glycometabolic control parameters, and quality of life (by the
SF-36 questionnaire) were assessed pre and postoperatively.
Results: The 2 groups were equivalent concerning demographics,
preoperative laboratory data, BP levels. In the surgical
group, no postoperative morbidity occurred; laboratory corticosteroidal
parameters normalized in all patientswhile never in the
conservative group (p<0.01). In operated patients, a normalization
or significant amelioration of BP was achieved in 53% and
glucose intolerance recovered in 54% of cases; while in the
conservative group no significant ameliorations or some worsening
occurred (p<0.01). SF-36 physical and mental components
significantly ameliorated in the surgical group (p<0.01).
Conclusions: Adrenalectomy can be more beneficial than
conservative management in SCS. Surgery may achieve
remission of laboratory hormonal abnormalities, improve
BP values, glycemic control, and quality of life
