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Mild autonomous cortisol secretion — SCE Endocrinology MCQ

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HardAdrenalMild autonomous cortisol secretionSCE Endocrinology

A 58-year-old man has an adrenal incidentaloma and mild autonomous cortisol secretion after dexamethasone suppression. He has poorly controlled diabetes, hypertension and osteoporosis. What is the most appropriate management principle?

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Correct answer: B — Assess cortisol-related comorbidities and discuss individualised adrenalectomy versus conservative care

Mild autonomous cortisol secretion can worsen cardiometabolic and skeletal comorbidities even without classic Cushingoid appearance. Management is individualised based on comorbidity burden and surgical risk. Fludrocortisone treats mineralocorticoid deficiency, not cortisol excess.

Reference: European Society of Endocrinology Adrenal Incidentaloma Guideline