Treatment of Cushing's Syndrome in Cortisol-Producing Adrenal Adenoma and Benign Unilateral Adrenal Disease
This protocol addresses Cushing's syndrome arising from a benign unilateral source — specifically a cortisol-producing adrenal adenoma or other form of benign unilateral adrenal disease — where a well-defined, surgically approachable lesion accounts for autonomous cortisol excess.
Endogenous hypercortisolism confirmed to originate from a benign unilateral adrenal lesion — cortisol-producing adrenal adenoma. No prior treatment line; this is the first-line intervention.
The established intervention for this scenario involves surgical removal of the affected adrenal gland — performed by a surgeon with dedicated adrenal experience. A minimally invasive approach is generally the preferred route, though the complete structured regimen, including perioperative considerations, is available via the full protocol.
We recommend unilateral resection by an experienced adrenal surgeon for all cases of benign unilateral disease.
In experienced hands, unilateral adrenalectomy is curative in nearly 100% of adults and children with cortisol-producing adrenal adenomas; the complication rate is higher when performed by surgeons with less experience.
Adrenalectomy is generally performed via either trans or retroperitoneal laparoscopy unless other factors preclude this.
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