Ectopic adreocortical adenoma——An uncommon etiology of Cushing's syndrome
10.3760/cma.j.issn.1000-6699.2018.12.007
- VernacularTitle:异位肾上腺皮质腺瘤——罕见的皮质醇增多症病因
- Author:
Miaomiao SANG
1
;
Feiyan WU
;
Yilin XU
;
Chenmin WEI
;
Tao YANG
;
Wei HE
;
Min SUN
Author Information
1. 210029,南京医科大学第一附属医院内分泌科
- Keywords:
Ectopic adreocortical adenoma;
Cushing's syndrome;
Retroperitoneum nodule
- From:
Chinese Journal of Endocrinology and Metabolism
2018;34(12):1019-1022
- CountryChina
- Language:Chinese
-
Abstract:
We report a case of cushing's syndrome caused by ectopic adreocortical adenoma. The patient is a 37 years old woman, she was admitted to our hospital for " 2 years history of hypertension and weakness in both lower extremities for 2 months". Physical examination revealed: blood pressure 160/116 mmHg(1 mmHg＝0.133 kPa), body mass index 27.47 kg/m2, moon-face, increased fat in the neck and back, purple marks on abdominal skin, withⅡdegree edema of both lower extremities. Laboratory examination revealed that serum cortisol levels were elevated, loss of normal circadian rhythm, and serum adrenocorticotropic hormone (ACTH) was suppressed, the level of cortisol could not be suppressed in low dose desamethasone suppression test. Adrenal computed tomography ( CT) revealed a nodule in the right retroperitoneum, compression of the renal hilum, no bilateral adrenal adenoma and hyperplasia were found. This patient was diagnosed as corticotropin-independent Cushing's syndrome unequivocally. The clinical symptoms were relieved after successful laparoscopic retroperitoneum resection of the nodule. Pathological exam confirmed adrenocortical adenoma in ectopic adrenal tissue. Thus, we should consider the ectopic corticosteroid-secreting tumor in the context of corticotropin-independent Cushing's syndrome, especially when the imaging studies of adrenal revealed bilateral adrenal glands were normal or atrophic, which helped to make an appropriate strategy treatment.
