ArticleThe Journal of clinical endocrinology and metabolism2026
The Role of Cortisol Secretion in Pheochromocytomas and Paragangliomas: Clinical and Perioperative Implications.
Article in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Ectopic ACTH syndrome caused by pheochromocytoma: diagnostic challenges and surgical outcomes in two cases.BMC endocrine disorders · 2026Article
- Coexistence of primary aldosteronism and micro-pheochromocytoma: a case report with pathological analysis and literature review.Frontiers in medicine · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundPheochromocytomas and paragangliomas (PPGLs) are tumors marked by excessive catecholamine secretion. Patients with pheochromocytomas may have elevated plasma glucocorticosteroid concentrations. This study aimed to evaluate the prevalence, clinical implications, and perioperative outcomes of autonomous cortisol secretion in patients with PPGLs.
designThis was a retrospective cohort study conducted across 2 tertiary endocrinology centers, including patients with PPGLs who underwent adrenalectomy or extra-adrenal surgery for paragangliomas.
methodsPatients were divided based on the 1-mg dexamethasone suppression test (DST) results into suppressive and nonsuppressive groups (above or below 1.8 µg/dL [50 nmol/L]). Data on clinical characteristics, biochemical markers, tumor features, perioperative outcomes, and follow-up were analyzed.
resultsAmong 106 patients, 24.5% exhibited nonsuppressive cortisol concentrations post-DST. These patients were older (median age: 66 vs 56 years, P < .001), predominantly female (84.6% vs 48.8%, P = .001), and presented with larger tumors (5.2 vs 4.0 cm, P < .05). Diabetes was more common in the nonsuppressive group both before adrenalectomy/surgery (50.0% vs 26.8%, P < .05) and after (33.3% vs 12.7%, P < .05). The nonsuppressive group had higher urinary and plasma metanephrine concentrations, lower DHEAS concentrations, and more cardiovascular diseases. Perioperative complications, including blood loss, conversion to open surgery, and prolonged hospital stays, were more frequent in the nonsuppressive group (P < .05).
conclusionOne-quarter of patients with PPGLs exhibit autonomous cortisol secretion, associated with larger tumors, higher diabetes prevalence, and increased perioperative risks. Routine DST screening may improve preoperative management and offer insights into the impact of cortisol on PPGLs outcomes.
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