Adrenocorticotropic hormone (ACTH) independent Cushing´s syndrome due to unilateral adrenocortical hyperplasia: two case reports

Adrenal unilateral macronodular hyperplasia is a rare cause of Cushing´s syndrome. We discuss the case of two patients who present Cushing syndrome due to unilateral adrenal hyperplasia. They presented the signs of clinical hypercorticism as well as metabolic, cardiovascular and osteoporotic complic...

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Bibliographic Details
Published in:The Pan African medical journal 2021-04, Vol.38 (367)
Main Authors: Yousra Aouinati, Amal Mjabber, Nassim Essabah Haraj, Siham El Aziz, Asmaa Chadli
Format: Article
Language:English
Subjects:
acth-independent cushing syndrome
case report
cortisol
macronodular hyperplasia
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Summary:Adrenal unilateral macronodular hyperplasia is a rare cause of Cushing´s syndrome. We discuss the case of two patients who present Cushing syndrome due to unilateral adrenal hyperplasia. They presented the signs of clinical hypercorticism as well as metabolic, cardiovascular and osteoporotic complications. Both patients presented clinical and laboratory signs of adrenocorticotropic hormone (ACTH)-independent Cushing syndrome with elevated urinary free cortisol (UFC) levels, adrenal computed tomography (CT) scan revealed the appearance of unilateral adrenal adenoma and normal contralateral adrenal gland. Adrenalectomy was performed under laparoscopic surgery; the resected mass was pathologically diagnosed as unilateral nodular adrenal hyperplasia. Unilateral adrenal hyperplasia is a very rare etiology of ACTH-independent Cushing syndrome, often mistaken for adenoma on CT and only pathological examination can confirm the diagnosis.
ISSN:1937-8688
1937-8688
DOI:10.11604/pamj.2021.38.367.26040