Mild Autonomous Cortisol Secretion: Approach to Diagnosis, Evaluation, and Management

Adrenal nodules are increasingly encountered in clinical practice with the advent of widespread cross-sectional imaging over the past 2 decades. Mild autonomous cortisol secretion (MACS) is the most common hormone abnormality diagnosed in 20% to 50% of patients with adrenal nodules and is associated with multisystem morbidity, including increased likelihood of cardiometabolic disease, vertebral fractures, and mortality. While adrenalectomy may improve select comorbidities in patients with MACS, management should be individualized based on patient characteristics.