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Mild autonomous cortisol secretion (MACS) occasionally is found in patients with adrenal incidentalomas who don't have clinically obvious Cushing syndrome. To better understand the distinctions and overlap between MACS and Cushing syndrome, researchers at an endocrine referral center in Germany conducted this comparative study.
Patients were classified as having MACS if they had adrenal masses that were incidentally discovered during abdominal imaging, nonsuppressed serum cortisol (>1.8 μg/dL) after overnight low-dose dexamethasone suppression testing, and an initial clinical impression of not being “Cushingoid.” The 48 patients who met this definition were compared with 129 patients who presented clinically with Cushing syndrome (of pituita…