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Ruptured triple hormone-secreting adrenal cortical carcinoma with hyperaldosteronism, hypercortisolism, and elevated normetanephrine: a case report.
Woo, Sin Yung; Park, Seongji; Kwon, Kun Young; Lim, Dong-Mee; Park, Keun-Young; Kim, Jong-Dai.
Afiliação
  • Woo SY; Division of Endocrinology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
  • Park S; Division of Endocrinology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
  • Kwon KY; Division of Endocrinology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
  • Lim DM; Division of Endocrinology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
  • Park KY; Division of Endocrinology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
  • Kim JD; Division of Endocrinology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
J Yeungnam Med Sci ; 41(4): 306-311, 2024 Oct.
Article em En | MEDLINE | ID: mdl-39238157
ABSTRACT
We report a case of a ruptured triple hormone-secreting adrenal mass with hyperaldosteronism, hypercortisolism, and elevated normetanephrine levels, diagnosed as adrenal cortical carcinoma (ACC) by histology. A 53-year-old male patient who initially presented with abdominal pain was referred to our hospital for angiocoagulation of an adrenal mass rupture. Abdominal computed tomography revealed a heterogeneous 19×11×15 cm right adrenal mass with invasion into the right lobe of the liver, inferior vena cava, retrocaval lymph nodes, and aortocaval lymph nodes. Angiocoagulation was performed. Laboratory evaluation revealed excess cortisol via a positive 1-mg overnight dexamethasone suppression test, primary hyperaldosteronism via a positive saline infusion test, and plasma normetanephrine levels three times higher than normal. An adrenal mass biopsy was performed for pathological confirmation to commence palliative chemotherapy because surgical management was not deemed appropriate considering the extent of the tumor. Pathological examination revealed stage T4N1M1 ACC. The patient started the first cycle of adjuvant mitotane therapy along with adjuvant treatment with doxorubicin, cisplatin, and etoposide, and was discharged. Clinical cases of dual cortisol- and aldosterone-secreting ACCs or ACCs presenting as pheochromocytomas have occasionally been reported; however, both are rare. Moreover, to the best of our knowledge, a triple hormone-secreting ACC has not yet been reported. Here, we report a rare case and its management. This case report underscores the necessity of performing comprehensive clinical and biochemical hormone evaluations in patients with adrenal masses because ACC can present with multiple hormone elevations.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Yeungnam Med Sci Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Yeungnam Med Sci Ano de publicação: 2024 Tipo de documento: Article