ECE2016 Eposter Presentations Adrenal cortex (to include Cushing's) (85 abstracts)
Asynchronous bilateral adrenal masses: from surgery to endocrine follow-up
Ana Valea 1, , Irina Ciocan 2 , Dan Dumitru Pop 4 , Mara Carsote 3 , Iulia Muntean 2 , Cristina Ghervan 1, & Carmen Emanuela Georgescu 1,
1Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; 2Endocrinology Clinic, Cluj-Napoca, Romania; 3Carol Davila University of Medicine and Pharmacy, Bucharest and C.I. Parhon National Institute of Endocrinology, Bucharest, Romania; 4Department of Radiotherapy, Prof. Dr Ion Chiricuta Oncology Institute Cluj-Napoca, Cluj-Napoca, Romania.
Introduction: Cushing’s syndrome (CS) is correlated with prolonged exposure to high levels of glucocorticoid hormones. Although the most common cause is exogenous adrenal tumors incidentally discovered (incidentaloma) may underline CS.
Material and method: This is a case presentation of an adult patient. Specific tests for CS have been used: morning plasma cortisol and circadian rhythm, plasma ACTH, testosterone, dexamethasone (DXM) suppression test.
Case presentation: A 50-year male associating diabetes mellitus and hypertension, was admitted for very high blood pressure and centripet obesity. Clinical examination revealed: moon face, plethora, telangiectasia. Normal thyroid tests were found, a morning plasma cortisol of 145.4 ng/ml (N:70–225 ng/ml) with normal circadian rhythm, ACTH of 10.6 pg/ml (N:7–46 pg/ml) and a total plasma testosterone of 2.46 ng/ml (N:0.2–0.75 ng/ml). Lack of suppression at 1 mg DXM overnight test established CS diagnosis of adrenal etiology (a right adrenal tumor of 39 mm was identified at CT scan). The tumor was removed and after surgery clinical improvement was associated with a morning cortisol of 18.99 ng/ml 18 days after surgery and a level of 12.55 ng/ml 3 months later. 9 months after surgery, endocrine evaluation indicated a raise of morning plasma cortisol with normal ACTH and suppression at DXM test. CT detected a left adrenal mass of 24/20/13 mm. Given the results of endocrine evaluation suggesting an incidentaloma, follow-up was recommended.
Conclusions: Adrenal incidentaloma management varies on symptoms, size, lateralization, etc. The pathogenic traits in asynchronous bilateral adrenal masses are still incompletely understood.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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