AI Article Synopsis
- Adrenal cortical carcinoma (ACC) is a rare and aggressive cancer that often leads to hormone overproduction, with 60% of cases exhibiting this symptom.
- A unique case is shared of a previously healthy individual diagnosed with dual-secreting ACC, resulting in high blood pressure and low potassium levels due to excess aldosterone and cortisol.
- The patient underwent surgery to remove the tumor, which led to a resolution of symptoms and highlights the need for regular screening of cortisol levels in patients with adrenal masses to prevent complications post-surgery.
Article Abstract
Adrenal cortical carcinoma (ACC) is a rare cancer (1-2/million) that presents with hormone overproduction in 60% of cases. Presentation of ACC with multiple hormone syndromes from different adrenal zones is rare. We present a case of dual-secreting ACC with hyperaldosteronism and cortisol excess. The previously healthy patient was noted to have new-onset hypertension and hypokalemia during a primary care visit. On hormonal evaluation, he was found to have evidence of hyperaldosteronism and adrenocorticotropic hormone (ACTH)-independent cortisol excess. Imaging revealed a 2.7 × 3.1 × 3.5 cm left adrenal mass with indeterminant computed tomography characteristics. He underwent laparoscopic adrenalectomy and required glucocorticoid replacement for adrenal insufficiency postoperatively. Pathology revealed stage T2N0M0 ACC. His hypokalemia resolved and glucocorticoids were stopped within a month. This case stresses the importance of routine screening for cortisol excess in all adrenal masses detected on imaging. Avoidance of postoperative adrenal insufficiency in patients with cortisol excess without overt Cushing syndrome is paramount.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580411 | PMC |
| http://dx.doi.org/10.1210/jcemcr/luad073 | DOI Listing |
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