ADRENAL CORTEX AND MEDULLA: Edited by Anand VaidyaUpdate on subclinical Cushing's syndromeNieman, Lynnette K.Author Information Eunice Kennedy Shriver Institute of Child Health and Human Development, Bethesda, Maryland, USA Correspondence to Lynnette K. Nieman, Eunice Kennedy Shriver Institute of Child Health and Human Development, Building 10, CRC, 1 East, Room 1-3140, 10 Center Dr, MSC 1109, Bethesda, MD 20892, USA. Tel: +1 301 496 8935; fax: +1 301 402 0884; e-mail: [email protected] Current Opinion in Endocrinology, Diabetes and Obesity: June 2015 - Volume 22 - Issue 3 - p 180-184 doi: 10.1097/MED.0000000000000159 Buy Metrics Abstract Purpose of review The present review summarizes recent findings in the diagnosis and treatment of subclinical Cushing's syndrome, a condition of subtle cortisol dysregulation with a spectrum of clinical and biochemical abnormalities. Recent findings The diagnosis of subclinical Cushing's syndrome is suggested by abnormal suppression to dexamethasone in a patient with an adrenal mass. The natural history of this disorder includes progression in a minority of cases, and increased cardiovascular disease in patients with more severe and progressive disease, much as is found in overt Cushing's syndrome. In patients with an abnormal response to dexamethasone, additional biochemical and metabolic features increase confidence in the ability of adrenalectomy to reverse clinical abnormalities. In addition, bilateral masses and larger masses are more likely to be associated with hypercortisolism. Summary We review the recent literature on subclinical cortisol secretion and suggest that additional studies are needed to define optimal diagnostic and therapeutic approaches. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.