[Multiple adenoma of the adrenal cortex with the clinical picture of Cushing's syndrome].
The paper sums up the experience of the clinic in diagnosing and therapy of the Cushing syndrome due to multiple autonomous adrenal cortical adenomas. The observation was carried out in a group of 5 women between 15-44 years of age (31.7 on an average). In the clinical material including 225 cases of the Cushing syndrome, they amounted to 2.2 per cent. All the five patients had typical somatic symptoms, myasthenia, ++amenorrhea. In hormonal examinations the content of 17-OHCS in the 24-hour urine was only periodically increased, 17-KS was within the normal range. There was no inhibiting action of dexamethasone on the excretion of cortisol, even when the initial values of corticosteroids++ were normal. The concentration of ACTH in the blood (determined in 3 cases) was around low normal range. Three patients underwent computer tomography; in one case adrenal glands were of normal size, in the second case--the two glands were enlarged, in the third case--the right gland was much larger than the left one. Microscopic examinations showed the atrophy of adrenal cortex beyond the adenomas. In case of multiple adenomas of the left gland surgery was confined to unilateral adrenalectomy. Among the remaining 4 patients, 3 underwent simultaneous resection of the two glands. All the patients showed the regression of symptoms of the disease, except for the changes in bones. One patient did not turn up for further therapy after unilateral adrenalectomy because of partial improvement.
Kasperlik-Załuska
A A
AA
Klinika Endokrynologii Centrum Medycznego Kształcenia Podyplomowego w Warszawie.
Szamowska
R
R
Migdalska
B
B
Słowińska-Srzednicka
J
J
Załuska
J
J
Nowakowski
J
J
D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism; D000293:Adolescent; D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D000328:Adult; D003480:Cushing Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000378:metabolism
Mnogie gruczolaki kory nadnerczy z klinicznym obrazem zespołu Cushinga.