title: Cushing syndrome and adrenal carcinoma: a clinical case.
abstract: A 21-year-old girl arrived at our hospital with a short history of hirsutism, facial pletora, amenorrhea, progressive weight gain and hypertension. The clinically suspected Cushing syndrome was then confirmed through chemical pathology. In fact, the results from hemato-chemical exams were: 45.5 Ig/dl cortisol, a DHEA sulphate >8000 ng/ml, 7.2 pg/ml ACTH, 17OH-Progesterone 10.66 ng/ml, Delta-4 Androstenedione 5.2 ng/ml, UFC (Urine Free Cortisol) >1000 mg/24h, FSH 0.8 mUI/ml, LH < 0.1 mUI/ml, Prolactin 13, 17, estradiol 96 pg/ml, and a bonded hypokalaemia, K+ 2,4 mEq/L. The echogram of the complete abdomen reveals, near the superior pole of the left kidney, the presence of a solid mass, not independent from the pole itself about 9.5 centimetres long, diagnosis confirmed to the TC abdomen and pelvis too, with or without mdc. This removed mass resulted, from the histological exam, in an adrenal carcinoma with a general and trabecular structure. Primal adrenal tumours are responsible for about 10% of Cushing syndrome cases. They present an annual incidence of 0.5 - 2.0 cases per million of inhabitants. The prognosis of adrenal ca remains low, with 5 year survival rate for 38% of diagnosed patients.
authors.affiliation: VII Division of General Surgery, Seconda Università degli Studi di Napoli S.U.N, Napoli, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Candela
authors.forename: Sergio
authors.initials: S
authors.lastname: Varriale
authors.forename: Fiorenza
authors.initials: F
authors.lastname: Manetta
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Di Libero
authors.forename: Marco
authors.initials: M
authors.lastname: Giordano
authors.forename: Luigi
authors.initials: L
authors.lastname: Santini
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018268:Adrenocortical Carcinoma / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D000735:Androstenedione / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood* / Q000652:urine; D003480:Cushing Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000601:surgery; D003687:Dehydroepiandrosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006628:Hirsutism / Q000209:etiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D006973:Hypertension / Q000209:etiology; D011188:Potassium / Q000097:blood; D011374:Progesterone / Q000097:blood; D011379:Prognosis; D011388:Prolactin / Q000097:blood; D016896:Treatment Outcome; D015430:Weight Gain
chemical_list: D014408:Biomarkers, Tumor; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D011374:Progesterone; D004958:Estradiol; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D005640:Follicle Stimulating Hormone; D011188:Potassium; D006854:Hydrocortisone