title: A case of ACTH-independent bilateral macronodular adrenal hyperplasia successfully treated by subtotal resection of the adrenal glands: four-year follow-up.
abstract: We report ACTH-independent bilateral macronodular adrenal hyperplasia (AIMAH) seen in a 48-year-old male with a history of rectal and skin cancer. Bilateral multiple adrenal nodular lesions on abdominal CT scans, elevated early morning plasma cortisol levels with undetectable plasma ACTH, increased 24-hour urinary free cortisol excretion, and loss of the normal circadian rhythm in cortisol secretion established the diagnosis of AIMAH. Subtotal resection of the adrenal glands preserving lower one third of the left side was performed, considering the unfavorable effects of total adrenalectomy on future treatment of his malignancies. He has been doing well for four years with normal plasma ACTH and cortisol levels. This case suggests that subtotal resection of the adrenal glands may be applicable to selected patients.
authors.affiliation: Department of Urology and Reproductive Medicine, Graduate School Tokyo Medical and Dental University, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kageyama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishizaka
authors.forename: Masatora
authors.initials: M
authors.lastname: Iwashina
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kihara
mesh_terms: D000311:Adrenal Glands / Q000473:pathology* / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D006965:Hyperplasia / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone