[Adrenal adenoma as a cause of Cushing's syndrome: twenty years' experience in a referral center in Mexico].
BACKGROUND
Cushing's syndrome (CS) includes a wide range of clinical and laboratory abnormalities and is the final outcome of chronic glucocorticoid exposure. Adrenal adenomas are an uncommon cause of adult CS.


OBJECTIVE
To describe the characteristics and outcome of patients with CS caused by adrenal adenomas in a referral center.


METHODS
We performed a retrospective cross-sectional observational study of patients with a diagnosis of CS caused by adrenal adenomas managed in our center over a 20-year period. Our clinical experience in the diagnosis and treatment of this entity was analyzed.


RESULTS
There were a total of 20 patients, 19 women and one man. The mean age was 25.9 years (14 to 52). The most frequently recorded clinical data were hirsutism and moon face. The mean morning cortisol level was 26.9±10.7 mcg/dl, the mean afternoon level was 24.4±8.5 mcg/dl and the mean corticotropin (ACTH) concentration was 24±19.4 pg/ml. Only four patients (20%) had ACTH levels below 5 pg/ml. The results of dynamic testing with dexamethasone suggested adrenal adenoma in 100% of the patients. Seventy percent of adenomas were found in the left gland. The mean size of the lesion was 2.8±0.47 cm.


CONCLUSIONS
In dynamic testing, the criteria of non-suppression with high doses of dexamethasone were evident in almost all patients. ACTH measurement in our center was not reliable in identifying adrenal adenoma as a cause of CS.
Garduno-García
José de Jesús
Jde J
Servicio de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zurbirán, México Distrito Federal, México. jjgg1977@hotmail.com
Reza-Albarrán
Alfredo
A
Márquez
Marco Antonio Escamilla
MA
Pérez
Francisco Javier Gómez
FJ
D000236:Adenoma / Q000150:complications*; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000150:complications*; D000328:Adult; D003430:Cross-Sectional Studies; D003480:Cushing Syndrome / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult