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Molecular pathology of primary aldosteronism and hypercortisolism: Impact on adrenal surgery

Year: 2026

Type: article

Abstract: in hypercortisolism. These insights are increasingly guiding precise, function-preserving surgery, such as mini back scope adrenalectomy (MBSA) at high-volume centers with reduced morbidity and risk of adrenal insufficiency, even in complex bilateral cases. Postoperative pathological analysis assessing hormone secretion and genetics provides prognostic information and directs further therapy, whether medical or surgical. A modern approach to PA and hypercortisolism, influenced by an enhanced understanding of the molecular pathophysiology, is likely to improve outcomes and expand adrenalectomy usage and indications as the morbidity and mortality associated with these endocrinopathies are increasingly recognized.

Source: iScience

DOI: 10.1016/j.isci.2026.114910

Authors: Tobias Carling, Constantine A. Stratakis, Fabio R. Faucz, C. Christofer Juhlin