Cushing's syndrome
ICD-10 E24.9 · ICD-11 5A70.Z

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.

Clinical Scenario

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.

Approach (partial overview)

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.

References
DOI: 10.1210/jc.2015-1818

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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