A case report of subclinical hypercortisolism due to adrenal incidentaloma complicated by myasthenia gravis after adrenalectomy.
A 62-year-old woman was admitted for evaluation of an incidentally discovered adrenal mass and hypertension. CT scan revealed a 7 cm mass in the right adrenal gland. After careful examination, the patient was diagnosed with subclinical hypercortisolism (SH). Adrenalectomy was performed. Histopathological examination showed an adrenocortical adenoma. Symptoms and signs of myasthenia gravis appeared 5 months later. CT of the chest showed a solid tissue mass in the mediastinum. The patient underwent a sternotomy with excision of the tumor, which histologically proved to be a type 2B thymoma. We describe a rare case of SH due to an incidentally discovered adrenocortical adenoma in a patient who manifested myasthenia gravis after surgical remission of the cortisol excess.
Department of Internal Medicine and Medical Specialties, La Sapienza University, Rome - Italy.
Luigi
L
Petramala
Department of Internal Medicine and Medical Specialties, La Sapienza University, Rome - Italy.
Cristiano
C
Marinelli
Department of Neurological Sciences, La Sapienza University, Rome - Italy.
Anna Teresa
AT
Giallonardo
Department of Internal Medicine and Medical Specialties, La Sapienza University, Rome - Italy.
Antonio
A
Concistrè
Department of Internal Medicine and Medical Specialties, La Sapienza University, Rome - Italy.
Piernatale
P
Lucia
Department of Thoracic Surgery, Policlinico Umberto I, La Sapienza University, Rome - Italy.
Federico
F
Venuta
Department of Surgery "Pietro Valdoni", La Sapienza University, Rome - Italy.
Bruna
B
Cerbelli
Department of Surgery "Pietro Valdoni", La Sapienza University, Rome - Italy.
Antonio
A
Ciardi
Department of Surgery "Pietro Valdoni", La Sapienza University, Rome - Italy.
Giorgio
G
De Toma
Department of Internal Medicine and Medical Specialties, La Sapienza University, Rome - Italy.
Claudio
C
Letizia
D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D000315:Adrenalectomy / Q000009:adverse effects; D015415:Biomarkers; D001706:Biopsy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011729:Pyridostigmine Bromide / Q000008:administration & dosage / Q000627:therapeutic use; D013945:Thymoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D015415:Biomarkers; D011729:Pyridostigmine Bromide