A case of preclinical Cushing's syndrome associated with diurnal rhythms of ACTH and cortisol in blood: correlation with histological findings.

Abstract

We describe a case of adrenocortical adenoma with preclinical Cushing's syndrome demonstrating diurnal rhythms of ACTH and cortisol in blood. A 50-year-old man was admitted to the hospital for the evaluation of incidental right adrenal mass with hyperglycemia and hypertension. On admission, there were no signs of clinical manifestation of hypercortisolism. The basal levels of cortisol (9.3 microg/dl) and ACTH (9.4 pg/ml) at 0800 h were not elevated and these diurnal rhythms were maintained. One or 8 mg of dexamethasone given orally overnight suppressed the plasma ACTH but not serum cortisol. Ultrasonogram, CT and scintiscan of (131)I adosterol all demonstrated an enlarged adrenal mass in the right adrenal gland. The right adrenal gland was subsequently resected by laparoscopic surgery. Histopathological findings of resected adrenal tumor were consistent with adrenocortical adenoma. Adjacent non-neoplastic adrenal tissue demonstrated adrenocortical atrophy but DHEA-sulfotransferase immunoreactivity in the zona reticularis was detected.

• Authors: Tomoo Ikarashi, Kyuzi Kamoi, Katsuaki Asakawa, Midori Tanaka, Masashi Miyakoshi, Takeshi Komeyama, Hideo Morishita, Hiroyuki Usuda, Iwao Emura, Hironobu Sasano
• Journal: Endocrine journal (Endocr J) Vol. 53 Issue 5 Pg. 609-13 (Oct 2006) ISSN: 0918-8959 [Print] Japan
• PMID: 16896266 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenocorticotropic Hormone
• Hydrocortisone

Topics

• Adrenal Cortex Neoplasms (blood, diagnosis, pathology)
• Adrenal Glands (pathology)
• Adrenocortical Adenoma (blood, diagnosis, pathology)
• Adrenocorticotropic Hormone (blood)
• Circadian Rhythm
• Cushing Syndrome (blood, diagnosis, pathology)
• Humans
• Hydrocortisone (blood)
• Male
• Middle Aged