A case of ACTH-independent bilateral macronodular adrenal hyperplasia successfully treated by subtotal resection of the adrenal glands: four-year follow-up.
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.
Kageyama
Yukio
Y
Department of Urology and Reproductive Medicine, Graduate School Tokyo Medical and Dental University, Japan.
Ishizaka
Kazuhiro
K
Iwashina
Masatora
M
Sasano
Hironobu
H
Kihara
Kazunori
K
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
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone