To evaluate the prevalence, clinical implications, and perioperative outcomes of autonomous cortisol secretion in patients with pheochromocytomas and paragangliomas (PPGLs).
Key Findings:
24.5% of patients exhibited nonsuppressive cortisol concentrations post-DST.
Nonsuppressive group was older (median age: 66 vs 56 years) and predominantly female (84.6% vs 48.8%).
Larger tumors were found in the nonsuppressive group (5.2 vs 4.0 cm).
Higher prevalence of diabetes in the nonsuppressive group both pre- and post-surgery.
Increased perioperative complications in the nonsuppressive group, including blood loss and prolonged hospital stays.
Interpretation:
One-quarter of patients with PPGLs exhibit autonomous cortisol secretion, which is associated with larger tumors, higher diabetes prevalence, and increased perioperative risks, suggesting that routine DST screening could enhance preoperative management.
Limitations:
Retrospective design may introduce selection bias.
Limited generalizability due to the study being conducted at two specific centers.
Conclusion:
Routine DST screening may improve preoperative management and provide insights into the impact of cortisol on outcomes in patients with PPGLs.
