1.A Case of Cushing's Syndrome in Pregnancy Secondary to an Adrenal Cortical Adenoma.
Hwi Gon KIM ; Kwang Hyun LEE ; Goo Hwa JE ; Myoung Seok HAN
Journal of Korean Medical Science 2003;18(3):444-446
Cushing's syndrome in pregnant women is rare and difficult to be diagnosed because of the syndrome's association with oligomenorrhea or amenorrhea and the changes in cortisol metabolism during normal pregnancy. Cushing syndrome in pregnancy is usually confused with complicated pregnancy, such as preeclampsia or gestational diabetes, and its rarity leads to a low degree of clinical suspicion, often delaying diagnosis. We experienced a case of Cushing's syndrome in pregnancy, which had been considered as the severe preeclampsia and gestational diabetes due to uncontrolled hypertension and hyperglycemia. The pregnancy was terminated with an emergency cesarean operation at 30 weeks of gestation because of severe preeclampsia. In consequence of the evaluation about the Cushing's syndrome after delivery, the adrenal cortical adenoma of right adrenal gland was diagnosed and laparoscopic adrenalectomy was performed.
Adenoma, Adrenal Cortical/*complications/radiography/surgery
;
Adrenal Cortex Neoplasms/*complications/radiography/surgery
;
Adrenalectomy
;
Adult
;
Cushing Syndrome/*etiology/radiography/surgery
;
Female
;
Human
;
Pregnancy
;
Pregnancy Complications, Neoplastic/*radiography
;
Pregnancy Outcome
2.Bilateral primary pigmented nodular adrenocortical disease: a case of report describing a rare cause of Cushing's syndrome.
Yong Koo PARK ; Youn Wha KIM ; Jin Woo KIM ; Young Kil CHOI ; Young Tae KO ; Seok Whan KO ; Moon Ho YANG
Journal of Korean Medical Science 1994;9(6):450-457
A case of Cushing's syndrome due to bilateral pigmented nodular adrenal disease in a 35-year-old male is presented. The adrenals showed multiple, black, variable sized nodules. Histologically the cells contained lipofuscin and either had a clear cytoplasm or an eosinophilic cytoplasm with a prominent nucleus. Lymphocytic infiltration and fatty metaplasia within the nodules are two of the prominent histological features. There is extreme internodular atrophy which suggests that primary pigmented nodular adrenocortical disease is a non-adrenocorticotropic hormone dependent condition. Since the disorder appears to involve primarily the cortex of both adrenals, the treatment of choice is bilateral adrenalectomy followed by steroid replacement. The characteristic clinicopathological manifestations that separate this diagnosis from other types of adrenal disease are also discussed. This is the first reported case in Korea to be documented with the pertinent clinicopathological findings.
Adipose Tissue/pathology
;
Adrenal Cortex/chemistry/*pathology/radiography/secretion/ultrasonography
;
Adrenalectomy
;
Adult
;
Atrophy
;
Case Report
;
Cushing Syndrome/*etiology/surgery
;
Dexamethasone/diagnostic use
;
Furosemide/diagnostic use
;
Human
;
Hydrocortisone/secretion
;
Inflammation
;
Lipofuscin/*analysis
;
Male
;
Metaplasia
;
Organelles/ultrastructure