Adrenal Incidentalomas with Supraphysiologic Response to ACTH Stimulus : A Case Report
Joint Authors
Perelstein, Asya
Antonopoulou, Marianna
Source
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2012-10-14
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
We present the diagnostic approach of a patient with adrenal incidentalomas.
A 72-year-old African American male had a CT scan of the abdomen showing right and left adrenal masses measuring 5×3.5 cm and 3.7×2.9 cm, respectively.
The patient had negative hormonal workup.
The radiologist insisted that the CT findings are consistent with adrenal hyperplasia, and therefore he underwent ACTH stimulation to rule out late-onset congenital adrenal hyperplasia (CAH).
The stimulation test revealed that 17-hydroxyprogesterone and 11-deoxycortisol increased to levels high enough to confirm CAH, but cortisol had exaggerated response as well, thus making the diagnosis of CAH unlikely where metabolism is shifted to precursors.
Subsequently, the patient underwent screening for Cushing's syndrome (CS) with a dexamethasone suppression test.
Patient failed the suppresion test, raising the issue for subclinical CS (SCS), likely due to ACTH-independent macronodular adrenal hyperplasia.
Our patient had been diagnosed with MGUS and so far there are only 3 case reports of extramedullary plasmacytoma arising from the adrenals.
One was bilateral and one had functional abnormalities.
Our differential diagnosis includes subclinical CS with aberrant receptors versus a functioning extramedullary plasmacytoma.
American Psychological Association (APA)
Antonopoulou, Marianna& Perelstein, Asya. 2012. Adrenal Incidentalomas with Supraphysiologic Response to ACTH Stimulus : A Case Report. Case Reports in Endocrinology،Vol. 2012, no. 2012, pp.1-4.
https://search.emarefa.net/detail/BIM-476779
Modern Language Association (MLA)
Antonopoulou, Marianna& Perelstein, Asya. Adrenal Incidentalomas with Supraphysiologic Response to ACTH Stimulus : A Case Report. Case Reports in Endocrinology No. 2012 (2012), pp.1-4.
https://search.emarefa.net/detail/BIM-476779
American Medical Association (AMA)
Antonopoulou, Marianna& Perelstein, Asya. Adrenal Incidentalomas with Supraphysiologic Response to ACTH Stimulus : A Case Report. Case Reports in Endocrinology. 2012. Vol. 2012, no. 2012, pp.1-4.
https://search.emarefa.net/detail/BIM-476779
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-476779