title: Aldosterone and cortisol co-secreting bifunctional adrenal cortical carcinoma: A rare event.
abstract: Adrenocortical carcinoma (ACC) co-secreting aldosterone and cortisol is extremely rare. We report the case of a 37-yearold female who presented with paresis and facial puffiness. Evaluation revealed hypertension, hyperglycemia, severe hypokalemia and hyperaldosteronemia with elevated plasma aldosterone to renin ratio (ARR). Urinary free cortisol estimation showed elevated levels. Computed tomography scan revealed a right adrenal mass. Radical adrenalectomy specimen revealed ACC (T3N1). Post-operatively, the patient became normotensive and euglycemic with normalization of urinary cortisol and ARR. This case highlights the need for a complete evaluation in patients of hyperaldosteronism if overlapping symptoms of hypercortisolism are encountered, to avoid post-operative adrenal crisis.
authors.affiliation: Department of Urology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
authors.forename: Puskar Shyam
authors.initials: PS
authors.lastname: Chowdhury
authors.affiliation: Department of Urology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
authors.forename: Prasant
authors.initials: P
authors.lastname: Nayak
authors.affiliation: Department of Urology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Gurumurthy
authors.affiliation: Department of Urology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: David
keywords: Adrenal cortical carcinoma; bi-functional tumor; co-secretion
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