title: Hidden diagnosis of multiple endocrine neoplasia-1 unraveled during workup of virilization caused by adrenocortical carcinoma.
abstract: Multiple endocrine neoplasia-1 (MEN1) is an autosomal dominant syndrome with classic triad of parathyroid hyperplasia, pancreatic neuroendocrine tumors, and pituitary adenomas. Other recognized manifestations include carcinoid, cutaneous or adrenocortical tumors. It is commonly presented with clinical features related to parathyroid, pancreas or pituitary lesions. Here, we have presented a case that had virilization and biochemical Cushing's syndrome due to adrenocortical carcinoma as presenting feature of MEN1. Cushing's syndrome in MEN1 is an extremely rare and usually late manifestation and most cases are due to corticotropin-producing pituitary adenomas. Although Cushing's syndrome generally develops years after the more typical manifestations of MEN1 appear, it may be the primary manifestation of MEN1 syndrome particularly when related to adrenal adenoma or carcinoma.
authors.affiliation: Department of Endocrinology, Army Hospital (Research and Referral), Delhi Cantt, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kharb
authors.forename: Aditi
authors.initials: A
authors.lastname: Pandit
authors.forename: Abhay
authors.initials: A
authors.lastname: Gundgurthi
authors.forename: M K
authors.initials: MK
authors.lastname: Garg
authors.forename: K S
authors.initials: KS
authors.lastname: Brar
authors.forename: N
authors.initials: N
authors.lastname: Kannan
authors.forename: Reena
authors.initials: R
authors.lastname: Bharwaj
keywords: Adrenocortical carcinoma; Cushing's syndrome; multiple endocrine neoplasia-1; virilizing syndrome