The incidence of SCS is much higher than initially appreciated, and can be present in up to 20% of patients with adrenal incidentalomas. The postoperative course of patients with SCS helps to demonstrate the fact that these tumors are not truly asymptomatic. Although these tumors do not secrete enough cortisol to lead to the development of overt Cushing's syndrome, they are likely playing a contributory role in the development of hypertension, diabetes, osteoporosis, and obesity. Studies suggest that many of these problems can be reversed with the surgical treatment of SCS. Additionally, if this diagnosis is not sought out before pursuing an adrenalectomy for an incidentaloma, the patient can develop profound postoperative adrenal insufficiency.