[Mild autonomic cortisol secretion: comorbidities and surgical treatment outcomes]

"Mild autonomous cortisol secretion" is present in up to one-third of patients with adrenal incidentalomas and is characterized by excessive cortisol production without the typical clinical signs of Cushing's syndrome. Due to the lack of typical symptoms, biochemical evaluation is essential for diagnosis, as chronic cortisol secretion has been linked to multiple comorbidities (hypertension, diabetes, metabolic syndrome, dyslipidemia and osteoporosis) as well as increased mortality. While numerous studies address the comorbidities associated with autonomous cortisol secretion and its clinical impact, the indication for surgery remains uncertain and controversial; currently, no guidelines provide precise recommendations for surgical treatment in these patients. However, the few studies reported in the literature suggest an improvement in the cardiometabolic profile after adrenalectomy.