AI Article Synopsis
- A 38-year-old transgender man was admitted for severe hypercortisolemia caused by suspected ectopic ACTH production from a metastatic pancreatic neuroendocrine neoplasm (PanNEN) gastrinoma.
- Following preoperative treatment, he underwent a left adrenal gland tumor resection, resulting in significant decreases in ACTH and cortisol levels, leading to clinical improvement.
- The pathology confirmed an adrenal adenoma with positive ACTH staining and found a metastatic NEN G2 in the liver, while exploring the relationship between gender-affirming hormone therapy and disease onset.
Article Abstract
A 38-year-old transgender man with advanced metastatic functional pancreatic neuroendocrine neoplasm (PanNEN) gastrinoma was admitted to the Department of Endocrinology due to severe ACTH-dependent hypercortisolemia. An ectopic production of ACTH by PanNEN was suspected. The patient qualified for bilateral adrenalectomy after preoperative treatment with metyrapone. Finally, the patient underwent resection of the left adrenal gland with the tumor only, which surprisingly resulted in a significant decrease in ACTH and cortisol levels, leading to clinical improvement. Pathology report revealed an adenoma of the adrenal cortex with positive ACTH staining. The result of the simultaneous liver lesion biopsy confirmed a metastatic NEN G2 with positive ACTH immunostaining as well. We looked for a correlation between gender-affirming hormone treatment and the onset of the disease and its rapid progression. This may be the first case describing the coexistence of gastrinoma and ectopic Cushing disease in a transsexual patient.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10061007 | PMC |
| http://dx.doi.org/10.3389/fendo.2023.1135016 | DOI Listing |
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