Journal of Korean Endocrine Society 2004;19(4):446-451.
Published online August 1, 2004.
A Case of Adrenocortical Carcinoma with Concurrent Cushing's Syndrome and Primary Aldosteronism.
Chang Won Lee, Hyun Ju Yoon, Won Min Hwang, Jung Kyu Kim, Hoon Sup Koo, Dong Mee Lim, Eu Gene Choi, Moon Jun Na, Do Yeun Cho, Bum Kyeong Kim, In Seok Choi, Keun Young Park
1Department of Internal Medicine, Konyang University College of Medicine, Daejon, Korea.
2Department of Pathology, Konyang University College of Medicine, Daejon, Korea.
3Department of Surgery, Konyang University College of Medicine, Daejon, Korea.
Abstract
An adrenocortical carcinoma is a rare malignancy, which is associated with a poor prognosis. Eighty percent of adrenal tumors are functional, and commonly secrete glucocorticoids alone (45%), glucocorticoids and androgens (45%) or androgen alone (10%). Less than 1% of all cases secrete aldosterone. A case of a 75 year old female patient was experienced, presenting with anadrenocortical carcinoma and associated concurrent Cushing's syndrome and primary aldosteronism. She had complained of left flank pain for 5 months, and also showed clinical features of Cushing's syndrome, hypertension, hypokalemia and a left abdominal mass. An abdominal CT* demonstrated a large left adrenal mass, with necrosis, and a hemorrhage in the left upper abdomen. The plasma renin activity was 0.51 ng/ml/hr, and the serum aldosterone level was increased by 46.4 ng/dL. A low and high dose dexamethasone suppression test revealed no suppression. Histologically, the tumor was diagnosed as a adrenocortical carcinoma. After complete removal of the mass, she received mitotan and prednisolone as adjuvant therapies. Liver and bone metastasis occurred after 6 months of treatment, so was treated with palliative radiotherapy for the bone metastasis
Key Words: Cushing's syndrome, Primary aldosteronism, Adrenocortical carcinoma


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