A Case of Cushing's Syndrome Presenting as Endometrial Hyperplasia
The Korean Journal of Internal Medicine
; : 49-52, 2008.
Article
de En
| WPRIM
| ID: wpr-114570
Bibliothèque responsable:
WPRO
ABSTRACT
We describe here the case of a 39-year-old woman with a cortisol-producing adrenal adenoma and she presented with endometrial hyperplasia and hypertension without the specific characteristics of Cushing's syndrome. The patient had consulted a gynecologist for menometrorrhagia 2 years prior to her referral and she was diagnosed with endometrial hyperplasia and hypertension. Her blood pressure and the endometrial lesion were refractory despite taking multiple antihypertensives and repetitive dilation and curettage and progestin treatment. On admission, the clinical examination revealed mild central obesity (a body mass index of 22.9 kg/m2, a waist circumference of 85 cm and a hip circumference of 94cm), but there was no hirsutism and myopathy. She showed impaired glucose tolerance on an oral glucose tolerance test. The biochemical hypercortisolemia together with the prolactin and androgen levels were evaluated to explore the cause of her anovulation. Adrenal Cushing's syndrome was confirmed on the basis of the elevated urinary free cortisol (454 microgram/24h, normal range: 20-70) with a suppressed ACTH level (2.0 pg/mL, normal range: 6.0-76.0) and the loss of circadian cortisol secretion. A CT scan revealed a 3.1 cm, hyperechoic, well-marginated mass in the left adrenal gland. Ten months post-adrenalectomy, the patient had unintentionally lost 9 kg of body weight, had regained a regular menstrual cycle and had normal thickness of her endometrium.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Hydrocortisone
/
Rythme circadien
/
Tumeurs corticosurrénaliennes
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Adénome corticosurrénalien
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Hormone corticotrope
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Surrénalectomie
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Syndrome de Cushing
/
Diagnostic différentiel
/
Hyperplasie endométriale
Type d'étude:
Diagnostic_studies
Limites du sujet:
Adult
/
Female
/
Humans
langue:
En
Texte intégral:
The Korean Journal of Internal Medicine
Année:
2008
Type:
Article