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

doi:10.2169/internalmedicine.51.7547

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

MED - Medical Sciences

Research output: Contribution to journal › Article › peer-review

19 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 language	English
Pages (from-to)	2181-2187
Number of pages	7
Journal	Internal Medicine
Volume	51
Issue number	16
DOIs	https://doi.org/10.2169/internalmedicine.51.7547
Publication status	Published - 2012

Keywords

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

ASJC Scopus subject areas

Internal Medicine

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A rare case of adrenocorticotropic hormone (ACTH)-independent macroadrenal hyperplasia showing ectopic production of ACTH. / Iwata, Minoru; Oki, Yutaka; Okazawa, Teruyo; Ishizawa, Shin; Taka, Chihiro; Yamazaki, Katsuya; Tobe, Kazuyuki; Fukuoka, Junya; Sasano, Hironobu; Nishikawa, Tetsuo.

In: Internal Medicine, Vol. 51, No. 16, 2012, p. 2181-2187.

Research output: Contribution to journal › Article › peer-review

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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.",

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AU - Iwata, Minoru

AU - Oki, Yutaka

AU - Okazawa, Teruyo

AU - Ishizawa, Shin

AU - Taka, Chihiro

AU - Yamazaki, Katsuya

AU - Tobe, Kazuyuki

AU - Fukuoka, Junya

AU - Sasano, Hironobu

AU - Nishikawa, Tetsuo

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AB - 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.

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

Abstract

Keywords

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