title: A case of cortisol producing adrenal adenoma associated with a latent aldosteronoma: usefulness of the ACTH loading test for the detection of covert aldosteronism in overt Cushing syndrome.
abstract: A 36-year-old woman with Cushing syndrome was evaluated for coexisting hyperaldosteronism, which was suggested by an abnormal response of the aldosterone-to-cortisol ratio in peripheral blood to the ACTH-administration despite a low basal aldosterone-to-renin ratio. Computed tomography revealed two independent tumors in the left adrenal gland, and adrenal venous sampling indicated hyperaldosteronism in addition to hypercortisolism in the same side. Postsurgical study including immunohistochemical analysis of steroidogenic enzymes suggested one adenoma to be cortisol-producing and the other, aldosterone-producing. The comorbidity of these different hormone-producing adenomas is not rare and careful pre-surgical evaluation is necessary to avoid post-surgical exacerbation of latent hyperaldosteronism.
authors.affiliation: Department of Metabolic Medicine, Kumamoto University School of Medicine, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kukidome
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Miyamura
authors.forename: Kourin
authors.initials: K
authors.lastname: Sakakida
authors.forename: Seiya
authors.initials: S
authors.lastname: Shimoda
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Shigematu
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nishi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Eto
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
authors.forename: Eiichi
authors.initials: E
authors.lastname: Araki
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis*; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000150:complications / Q000175:diagnosis*; D000324:Adrenocorticotropic Hormone; D000328:Adult; D000450:Aldosterone / Q000097:blood*; D003480:Cushing Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D006929:Hyperaldosteronism / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed
chemical_list: D000450:Aldosterone; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone