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Adrenocorticotropic hormone-independent cushing syndrome with bilateral cortisol-secreting adenomas.
[cushing syndrome]
A
48
-
year
-old
woman
was
incidentally
found
to
have
bilateral
adrenal
masses
,
2
.
8
cm
in
diameter
on
the
right
,
and
2
.
3
cm
and
1
.
7
cm
in
diameter
on
the
left
,
by
abdominal
computed
tomography
.
The
patient
had
a
medical
history
of
hypertension
,
which
was
not
being
controlled
by
carvedilol
,
at
a
dose
of
25
mg
daily
.
She
presented
with
signs
and
symptoms
that
suggested
Cushing
Syndrome
.
We
diagnosed
adrenocorticotropic
hormone
(
ACTH
)
-
independent
Cushing
Syndrome
based
on
the
results
of
basal
and
dynamic
hormone
tests
.
Adrenal
vein
sampling
(
AVS
)
was
performed
to
localize
a
functioning
adrenal
cortical
mass
.
AVS
results
were
consistent
with
hypersecretion
of
cortisol
from
both
adrenal
glands
,
with
a
cortisol
lateralization
ratio
of
1
.
1
.
Upon
bilateral
laparoscopic
adrenalectomy
,
bilateral
ACTH-independent
adrenal
adenomas
were
found
.
The
patient
's
signs
and
symptoms
of
Cushing
Syndrome
improved
after
surgery
just
as
the
blood
pressure
was
normalized
.
After
surgery
,
the
patient
was
started
on
glucocorticoid
and
mineralocorticoid
replacement
therapy
.
Diseases
Validation
Diseases presenting
"bilateral acth-independent adrenal adenomas were found"
symptom
cushing syndrome
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