{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:23:55Z","timestamp":1761006235738,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T00:00:00Z","timestamp":1760832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Over the last few decades, due to improvement in imaging techniques, the increased detection of adrenal incidentalomas is observed. Non-aldosterone producing adrenal adenomas (NAPACAs) often co-exist with second benign or malignant lesions. In the present study, we aimed to assess the presence of second neoplasms, both benign and malignant, in patients with NAPACAs, and to investigate possible correlations with clinical parameters, hormonal characteristics and the emergence of comorbidities. A total of 130 NAPACA patients were included in this single-center retrospective study. In this cohort, 35.4% of NAPACA patients carried any second neoplasm (either benign or malignant) whereas, 26.9% had a second malignant neoplasm. Cortisol levels after 1 mg overnight dexamethasone suppression test (F-ODS) were significantly higher in patients without a second neoplasm (p = 0.02), and this finding was consistent even when categorizing patients with and without malignancies (p = 0.02). In line with this observation, ACTH\/F-ODS levels were significantly higher in patients with second malignancies (p &lt; 0.05). Interestingly, the presence of mild autonomous cortisol secretion tended to be lower in patients with second malignancies (p = 0.08). No remarkable differences in the comorbidities of NAPACA patients with and without a second neoplasm were documented. Further prospective studies will be needed to elucidate the role of mild hypercortisolemia on the development of these second tumors in NAPACA patients.<\/jats:p>","DOI":"10.3390\/ijms262010167","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T08:18:54Z","timestamp":1760948334000},"page":"10167","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Prevalence of Second Neoplasms in Patients with Non-Aldosterone Producing Adrenocortical Lesions"],"prefix":"10.3390","volume":"26","author":[{"given":"Paraskevi","family":"Tripolitsioti","sequence":"first","affiliation":[{"name":"Intensive Care Unit, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9525-2275","authenticated-orcid":false,"given":"Ariadni","family":"Spyroglou","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, Aretaieio Athens Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Odysseas","family":"Violetis","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, Aretaieio Athens Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiota","family":"Konstantakou","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, Aretaieio Athens Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleni","family":"Chouliara","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, Aretaieio Athens Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grigoria","family":"Betsi","sequence":"additional","affiliation":[{"name":"Endocrinology & Diabetes Clinic, University Hospital of Heraklion, University of Crete, School of Medicine, 71500 Crete, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2527-7087","authenticated-orcid":false,"given":"Konstantinos","family":"Iliakopoulos","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, Aretaieio Athens Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4119-3051","authenticated-orcid":false,"given":"Eleni","family":"Memi","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, Aretaieio Athens Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2744-3042","authenticated-orcid":false,"given":"Konstantinos","family":"Bramis","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, Aretaieio Athens Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Kolomodi","sequence":"additional","affiliation":[{"name":"European Neuroendocrine Tumor Society (ENETS) Center of Excellence, Ekpa-Laiko Center, 11527 Athens, Greece"},{"name":"IATROPOLIS Private Medical Center, 11521 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paraskevi","family":"Xekouki","sequence":"additional","affiliation":[{"name":"Endocrinology & Diabetes Clinic, University Hospital of Heraklion, University of Crete, School of Medicine, 71500 Crete, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manousos","family":"Konstadoulakis","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, Aretaieio Athens Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1929-3275","authenticated-orcid":false,"given":"George","family":"Mastorakos","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, Aretaieio Athens Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"},{"name":"Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2398-6768","authenticated-orcid":false,"given":"Krystallenia I","family":"Alexandraki","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery, Aretaieio Athens Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1007\/BF03344099","article-title":"Prevalence of adrenal incidentaloma in a contemporary computerized tomography series","volume":"29","author":"Bovio","year":"2006","journal-title":"J. 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