{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T08:40:21Z","timestamp":1758703221600,"version":"3.44.0"},"reference-count":22,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>ACTH-independent Cushing syndrome is commonly caused by a unilateral adrenal adenoma. However, in cases with bilateral adrenal nodules, localization of the functional lesion is challenging. We present the case of a 26-year-old woman with ACTH-independent Cushing syndrome and concurrent bilateral adrenal nodules. Using dexamethasone-suppressed adrenal venous sampling (AVS), an adrenal vein to peripheral vein cortisol ratio &amp;gt;6.5, and an aldosterone-corrected cortisol lateralization ratio &amp;gt;2.3, the autonomous cortisol secretion was localized to the right adrenal adenoma. She underwent a right posterior retroperitoneal laparoscopic adrenalectomy resulting in clinical and biochemical resolution of hypercortisolism. Postoperatively, she required hydrocortisone therapy, which was successfully discontinued after 4 years. The use of dexamethasone-suppressed AVS, in conjunction with aldosterone-corrected cortisol lateralization ratio, may enhance the diagnostic accuracy of AVS.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf192","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T08:24:12Z","timestamp":1758702252000},"source":"Crossref","is-referenced-by-count":0,"title":["Addressing the Clinical Conundrum of Localization in ACTH-independent Cushing Syndrome With Bilateral Adrenal Nodules"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6402-2990","authenticated-orcid":false,"given":"Soo Ling","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Medicine, Ng Teng Fong General Hospital , Singapore 609606, 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