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The Curbsiders Internal Medicine Podcast

#519 Mild Autonomous Cortisol Secretion

1 tim 14 min30 mars 2026

Become a master of cortisol and learn how to identify and treat a common condition in patients with adrenal tumors! Join us as we learn about mild autonomous cortisol secretion (MACS) with Dr. Irina Bancos (@irinabancos), an internationally renowned adrenal expert!

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Show Segments

  • Intro
  • Advice for listeners
  • Adrenal incidentaloma Definition (Case 1)
  • Hormonal workup for adrenal incidentalomas
  • Defining mild autonomous cortisol secretion (MACS)
  • Significance and prevalence of MACS
  • Diagnostic testing for MACS
  • Treatment options for MACS (surgery vs. comorbidity management)
  • Post surgical management of MACS (Case 2)
  • Diagnostic testing for adrenal insufficiency (AI)
  • Glucocorticoid withdrawal syndrome management
  • Deciding when patients are able to come off of steroids after AI
  • Outcomes after adrenalectomy in MACS
  • Take home points


Credits

Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.

  • Producer, writer, show notes, and CME: Mobeen Ahmad MD
  • Cover art and infographic: Kate Grant MBChb, MRCGP
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Mobeen Ahmad MD
  • Reviewer: Emi Okamoto MD
  • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Technical Production: PodPaste
  • Guest: Irina Bancos MD, MSc

Disclosures

Dr. Bancos has the following disclosures:
  • Consulting, advisory board or safety monitoring board (all fees to institution): Recordati, Corcept, Esteve, Spruce, Sparrow, Diurnal, Neurocrine, Lufordi, Adaptyx, Crinetics, Xeris, AstraZeneca, NovoNordisc, Camurus.
  • Research grant for investigator initiated research (to institution): Esteve, Recordati


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