title: Adrenocorticotropin-independent bilateral macronodular adrenocortical hyperplasia presenting as pre-Cushing's syndrome.
abstract: We report a man with pre-Cushing's syndrome due to ACTH-independent bilateral macronodular adrenocortical hyperplasia. Plasma ACTH was low and urinary 17-OHCS was not suppressed by a high dose of dexamethasone (8 mg), but plasma cortisol was responsive to exogenous ACTH. The adrenal glands were enlarged and contained multiple nodules composed of large clear cells and small compact cells. The steroid levels in the adrenal glands were lower than those in overt Cushing's syndrome due to the adrenocortical adenoma. This suggests that the tumor produces insufficient amounts of active hormones to have a clinical effect.
authors.affiliation: Department of Urology, Yamagata University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Izumi
authors.forename: I
authors.initials: I
authors.lastname: Sasagawa
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.forename: Y
authors.initials: Y
authors.lastname: Kubota
authors.forename: T
authors.initials: T
authors.lastname: Nakada
authors.forename: T
authors.initials: T
authors.lastname: Nishikawa
mesh_terms: D015065:17-Hydroxycorticosteroids / Q000652:urine; D000311:Adrenal Glands / Q000473:pathology*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D003480:Cushing Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged
chemical_list: D015065:17-Hydroxycorticosteroids; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone