[Diagnosis and treatment of primary pigmented nodular adrenocortical disease report of 4 cases].
OBJECTIVE
To study the diagnosis and treatment of primary pigmented nodular adrenocortical disease (PPNAD).


METHODS
The clinical data including symptom, endocrinal examination, surgical operation and prognosis of 4 cases of PPNAD hospitalized from 2000 to 2007 were analyzed respectively, relative literature were reviewed.


RESULTS
1 case received total adrenalectomy needed adrenocortical hormone postoperatively, 3 cases responded favorably to subtotal adrenalectomy and did not need adrenocortical hormone, however, 1 case was diagnosed of thyroid carcinoma 2 years after subtotal adrenalectomy.


CONCLUSIONS
PPNAD is a rare subtype of ACTH-independent Cushing's syndrome, the diagnosis is depend on symptom, endocrinal examination and pathology. Total adrenalectomy is suitable to the patients with obvious symptom; subtotal adrenalectomy to the patients with mild symptom, the lesion of other endocrinal organ must be followed up postoperatively.
Liu
Guang-Hua
GH
Department of Urology, Peking Union Medical Collage Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
Li
Han-Zhong
HZ
Mao
Quan-Zong
QZ
Ji
Zhi-Gang
ZG
Xia
Ming
M
Xie
Yi
Y
Hu
Ming-Ming
MM
Liu
Yue-Wu
YW
D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000175:diagnosis* / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D055815:Young Adult