title: A case of renin-producing adrenocortical cancer.
abstract: Here we report a case of a renin-producing adrenocortical carcinoma. A 57-year-old woman was referred to our hospital complaining of thirst and generalized muscle weakness. She was diagnosed as being hypertensive and diabetic with associated hypokalemia and she had a hard elastic mass with a diameter of 10 cm on the left side of her neck. An abdominal computed tomography scan revealed a suprarenal mass on the left side (8.5 x 8 x 6.5 cm). Endocrinological examination demonstrated a marked elevation in the patient's serum glucocorticoid and sex steroid hormones as well as plasma renin activity. Histological examination of a sample taken from the neck mass revealed a metastasis from an adrenal carcinoma, which was stained positively with antibodies against cytochrome P450 and renin, establishing the diagnosis of a renin-producing adrenocortical carcinoma. Trilostane was effective in reducing serum cortisol levels, but mitotane was ineffective.
authors.affiliation: The Fourth Department of Medicine, Saitama Medical School, Irumagun, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yamanaka
authors.forename: M
authors.initials: M
authors.lastname: Iitaka
authors.forename: M
authors.initials: M
authors.lastname: Inaba
authors.forename: T
authors.initials: T
authors.lastname: Morita
authors.forename: H
authors.initials: H
authors.lastname: Sasano
authors.forename: S
authors.initials: S
authors.lastname: Katayama
mesh_terms: D015065:17-Hydroxycorticosteroids / Q000652:urine; D015068:17-Ketosteroids / Q000652:urine; D015096:3-Hydroxysteroid Dehydrogenases / Q000037:antagonists & inhibitors; D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D001707:Biopsy, Needle; D002395:Catecholamines / Q000097:blood; D003577:Cytochrome P-450 Enzyme System / Q000032:analysis; D013196:Dihydrotestosterone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000097:blood; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006973:Hypertension; D007008:Hypokalemia; D008875:Middle Aged; D008939:Mitotane / Q000627:therapeutic use; D018908:Muscle Weakness; D009362:Neoplasm Metastasis; D012083:Renin / Q000096:biosynthesis* / Q000097:blood; D013894:Thirst; D014057:Tomography, X-Ray Computed
chemical_list: D015065:17-Hydroxycorticosteroids; D015068:17-Ketosteroids; D002395:Catecholamines; D004791:Enzyme Inhibitors; D005938:Glucocorticoids; D012739:Gonadal Steroid Hormones; D013196:Dihydrotestosterone; D008939:Mitotane; D003577:Cytochrome P-450 Enzyme System; D015096:3-Hydroxysteroid Dehydrogenases; D012083:Renin; C009954:trilostane; D006854:Hydrocortisone