How do you approach treatment of a patient with bilateral adrenal gland thickening & biochemical evidence of ACTH-independent hypercortisolism?  

Treatment options may include removing the larger adrenal mass/hyperplasia and then assessing the HPA axis after surgery or considering medical therapy. The AVS does not have a well-established role in such patients. A nice review on this topic was recently published in Endocrine Practice (Sweeney e...