Impact of Adrenal IncidenTalomas and Possible Autonomous Cortisol Secretion on Cardiovascular and Metabolic Alterations

  • End date
    Mar 31, 2025
  • participants needed
  • sponsor
    University of Roma La Sapienza
Updated on 23 January 2021


The investigators hypothesize that cardiovascular and metabolic alterations can occur in patients with adrenal adenomas and possible Autonomous Cortisol Secretion (pACS). Investigators hypothesize that adrenalectomy in selected patients, following the 2016 ECE guidelines, can improve metabolic parameters and cardiovascular risks and features.


Adrenal incidentalomas are clinically silent masses discovered inadvertently during diagnostic imaging procedures performed for unrelated reasons. Depending on the criteria applied, up to 50% of patients with adrenal incidentalomas may have biochemical evidence of cortisol excess. Possible autonomous cortisol secretion (pACS), as defined in the 2016 European Society of Endocrinology Guidelines, is characterized by a partial, incomplete suppression of the hypothalamic-pituitary-adrenal (HPA) axis without the typical signs of overt cortisol hypersecretion.

Investigators will perform a prospective longitudinal study in patients with adrenal incidentalomas associated with possible autonomous cortisol secretion, aiming to assess the effect of surgical and conservative management on cardiovascular and metabolic features.

Data will be detected at baseline, at 1 and at 5 years follow-up to quantitatively identify the different cardiovascular and metabolic alterations in: (1) patients with non-functioning adrenal adenoma; (2) patients with possible autonomous cortisol secretion receiving conservative management; (3) patients with possible autonomous cortisol secretion receiving adrenalectomy according to the 2016 European Society of Endocrinology guidelines; (4) patients without adrenal masses.

Condition Hyperadrenocorticism, Cushing's Syndrome, Malignant neoplasm of adrenal gland, Adrenal Cancer, Adrenal Incidentaloma, Adrenal Cancer, hypercortisolism, hypercortisolemia, adrenal tumour, adrenal neoplasm, adrenal tumor, adrenal gland tumor, cushing
Treatment Adrenalectomy
Clinical Study IdentifierNCT04127552
SponsorUniversity of Roma La Sapienza
Last Modified on23 January 2021


Yes No Not Sure

Inclusion Criteria

Incidentally detected adrenal mass

Exclusion Criteria

Patients with overt Cushing's syndrome, pheocromocytoma, Conn syndrome, adrenocortical carcinoma, late-onset congenital adrenal hyperplasia, adrenal metastasis and adrenal hemorrhage
Patients taking medications influencing glucocorticoid production or metabolism
Patients with psychiatric diseases or alcohol abuse
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