{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:34:44Z","timestamp":1783478084778,"version":"3.55.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The treatment of subclinical hypercortisolism in patients with bilateral adrenal incidentalomas (AI) is debatable. We aimed to compare the biochemical and clinical outcome of unilateral adrenalectomy vs a conservative approach in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included 33 patients with bilateral AI; 14 patients underwent unilateral adrenalectomy of the largest lesion (surgical group), whereas 19 patients were followed up (follow-up group). At baseline and at each follow-up visit, we measured 0800\u200ah plasma ACTH, midnight serum cortisol (MSF), 24-h urinary-free cortisol (UFC) and serum cortisol following a standard 2-day low-dose-dexamethasone-suppression test (LDDST). We evaluated the following comorbidities: arterial hypertension, impaired glucose tolerance or diabetes mellitus, dyslipidemia and osteoporosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline demographic, clinical characteristics and the duration of follow-up (53.9\u00b121.3 vs 51.8\u00b120.1 months, for the surgical vs the follow-up group) were similar between groups. At the last follow-up visit the surgical group had a significant reduction in post-LDDST cortisol (2.4\u00b11.6 vs 6.7\u00b13.9\u200a\u03bcg\/dl,<jats:italic>P<\/jats:italic>=0.002), MSF (4.3\u00b12 vs 8.8\u00b14.6\u200a\u03bcg\/dl,<jats:italic>P<\/jats:italic>=0.006) and 24-h UFC (50.1\u00b121.1 vs 117.9\u00b142.4\u200a\u03bcg\/24\u200ah,<jats:italic>P<\/jats:italic>=0.0007) and a significant rise in mean\u00b1<jats:sc>s.d.<\/jats:sc>morning plasma ACTH levels (22.2\u00b19.6 vs 6.9\u00b14.8\u200apg\/ml,<jats:italic>P<\/jats:italic>=0.002). Improvement in co-morbidities was seen only in the surgical group, whereas no changes were noted in the follow-up group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our early results show that removal of the largest lesion offers significant improvement both to cortisol excess and its metabolic consequences, without the debilitating effects of bilateral adrenalectomy. A larger number of patients, as well as a longer follow-up, are required before drawing solid conclusions.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-15-0566","type":"journal-article","created":{"date-parts":[[2015,9,2]],"date-time":"2015-09-02T02:18:46Z","timestamp":1441160326000},"page":"719-725","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":52,"title":["Biochemical and clinical benefits of unilateral adrenalectomy in patients with subclinical hypercortisolism and bilateral adrenal incidentalomas"],"prefix":"10.1093","volume":"173","author":[{"given":"I","family":"Perogamvros","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D A","family":"Vassiliadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O","family":"Karapanou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Botoula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Tzanela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Tsagarakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2015102318231813000_173.6.719.1","doi-asserted-by":"publisher","DOI":"10.1210\/edrv-16-4-460"},{"key":"2015102318231813000_173.6.719.2","doi-asserted-by":"crossref","unstructured":"Tsagarakis S Vassiliadi D Thalassinos N . 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