A rare case of adrenocorticotropic hormone (ACTH)-independent macroadrenal hyperplasia showing ectopic production of ACTH

Minoru Iwata, Yutaka Oki, Teruyo Okazawa, Shin Ishizawa, Chihiro Taka, Katsuya Yamazaki, Kazuyuki Tobe, Junya Fukuoka, Hironobu Sasano, Tetsuo Nishikawa

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17 Citations (Scopus)

Abstract

A 57-year-old Japanese man presented with drug-resistant hypertension without Cushingoid features. Endocrinological tests revealed autonomous secretion of cortisol with suppressed plasma adrenocorticotropic hormone (ACTH). Imaging examinations showed multiple macronodules in the bilateral adrenal gland. These findings were consistent with subclinical Cushing's syndrome caused by ACTH-independent macronodular adrenal hyperplasia (AIMAH). Left adrenalectomy was performed and the resected adrenal lesion was consistent with the pathological diagnosis of AIMAH. Furthermore, in resected tissue, we demonstrated intraadrenal production of ACTH by immunohistochemical analysis and RIA. This is a very rare case of AIMAH showing ectopic production of ACTH, which may be associated with autonomous cortisol secretion.

Original languageEnglish
Pages (from-to)2181-2187
Number of pages7
JournalInternal Medicine
Volume51
Issue number16
DOIs
Publication statusPublished - 2012

Keywords

  • ACTH-independent macroadrenal hyperplasia
  • Autocrine/paracrine regulatory mechanism
  • Ectopic ACTH production

ASJC Scopus subject areas

  • Internal Medicine

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    Iwata, M., Oki, Y., Okazawa, T., Ishizawa, S., Taka, C., Yamazaki, K., Tobe, K., Fukuoka, J., Sasano, H., & Nishikawa, T. (2012). A rare case of adrenocorticotropic hormone (ACTH)-independent macroadrenal hyperplasia showing ectopic production of ACTH. Internal Medicine, 51(16), 2181-2187. https://doi.org/10.2169/internalmedicine.51.7547