title: [Diagnosis and treatment of primary pigmented nodular adrenocortical disease report of 4 cases].
abstract: 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.
authors.affiliation: Department of Urology, Peking Union Medical Collage Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
authors.forename: Guang-Hua
authors.initials: GH
authors.lastname: Liu
authors.forename: Han-Zhong
authors.initials: HZ
authors.lastname: Li
authors.forename: Quan-Zong
authors.initials: QZ
authors.lastname: Mao
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Ji
authors.forename: Ming
authors.initials: M
authors.lastname: Xia
authors.forename: Yi
authors.initials: Y
authors.lastname: Xie
authors.forename: Ming-Ming
authors.initials: MM
authors.lastname: Hu
authors.forename: Yue-Wu
authors.initials: YW
authors.lastname: Liu
mesh_terms: 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