A Case of Adrenocortical Carcinoma with Concurrent Cushing's Syndrome and Primary Aldosteronism.
- Author:
Chang Won LEE
1
;
Hyun Ju YOON
;
Won Min HWANG
;
Jung Kyu KIM
;
Hoon Sup KOO
;
Dong Mee LIM
;
Eu Gene CHOI
;
Moon Jun NA
;
Do Yeun CHO
;
Bum Kyeong KIM
;
In Seok CHOI
;
Keun Young PARK
Author Information
1. Department of Internal Medicine, Konyang University College of Medicine, Daejon, Korea.
- Publication Type:Case Report
- Keywords:
Cushing's syndrome;
Primary aldosteronism;
Adrenocortical carcinoma
- MeSH:
Abdomen;
Adrenocortical Carcinoma*;
Aged;
Aldosterone;
Androgens;
Cushing Syndrome*;
Dexamethasone;
Female;
Flank Pain;
Glucocorticoids;
Hemorrhage;
Humans;
Hyperaldosteronism*;
Hypertension;
Hypokalemia;
Liver;
Necrosis;
Neoplasm Metastasis;
Plasma;
Prednisolone;
Prognosis;
Radiotherapy;
Renin
- From:Journal of Korean Society of Endocrinology
2004;19(4):446-451
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
An adrenocortical carcinoma is a rare malignancy, which is associated with a poor prognosis. Eighty percent of adrenal tumors are functional, and commonly secrete glucocorticoids alone (45%), glucocorticoids and androgens (45%) or androgen alone (10%). Less than 1% of all cases secrete aldosterone. A case of a 75 year old female patient was experienced, presenting with anadrenocortical carcinoma and associated concurrent Cushing's syndrome and primary aldosteronism. She had complained of left flank pain for 5 months, and also showed clinical features of Cushing's syndrome, hypertension, hypokalemia and a left abdominal mass. An abdominal CT* demonstrated a large left adrenal mass, with necrosis, and a hemorrhage in the left upper abdomen. The plasma renin activity was 0.51 ng/ml/hr, and the serum aldosterone level was increased by 46.4 ng/dL. A low and high dose dexamethasone suppression test revealed no suppression. Histologically, the tumor was diagnosed as a adrenocortical carcinoma. After complete removal of the mass, she received mitotan and prednisolone as adjuvant therapies. Liver and bone metastasis occurred after 6 months of treatment, so was treated with palliative radiotherapy for the bone metastasis