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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
"blood pressure"
symptom
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
cadasil
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cushing syndrome
fabry disease
familial mediterranean fever
lymphangioleiomyomatosis
pendred syndrome
proteus syndrome
scrub typhus
systemic capillary leak syndrome
thoracic outlet syndrome
typhoid
von hippel-lindau disease
werner syndrome
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