Clinical Benefits of Unilateral Adrenalectomy in Patients with Subclinical Hypercortisolism Due to Adrenal Incidentaloma: Results from a Single Center

Introduction This study was designed to evaluate the results of unilateral laparoscopic adrenalectomy in patients with subclinical hypercortisolism (SH) due to adrenal incidentaloma (AI) concerning the main cardiometabolic disorders. Methods We have studied between January 2000 to December 2015, 645 patients with AI (283 males and 362 females; mean age 61.9 +/- 10 years) and we found 70 patients with SH (27 males and 43 females; mean age 61.9 +/- 8.4 years). Twenty-six (37%) SH patients (6 males and 20 females; mean age 58.7 +/- 7.1 years) underwent unilateral laparoscopic adrenalectomy, whereas 44 SH patients (21 males and 23 females; mean age 63.9 +/- 9.9 years) performed a conservative treatment. All SH patients were evaluated at diagnosis and after follow-up (mean 12 months; range 9-15 months). Results In only SH patients undergoing unilateral adrenalectomy we found a statistical significant reduction of the arterial hypertension and metabolic syndrome (p < 0.05, respectively). In particular we observed a reduction of 24-h systolic blood pressure and non-dipper'' pattern (p < 0.05, respectively) evaluated with ambulatory blood pressure monitoring (ABPM). Conclusions Our study confirm the high prevalence of SH in AI, and the unilateral laparoscopic adrenalectomy seemed to have a beneficial effect on some cardiometabolic disorders.