TY - JOUR
T1 - A rare case of cushing’s syndrome due to bilateral adrenocortical adenomas
AU - Yasuda, Atsushi
AU - Seki, Toshiro
AU - Ito, Kazuko
AU - Takagi, Atsushi
AU - Watanabe, Daisuke
AU - Nakamura, Naoya
AU - Hanai, Kazuya
AU - Terachi, Toshiro
AU - Maekawa, Takashi
AU - Sasano, Hironobu
AU - Fukagawa, Masafumi
PY - 2014/12
Y1 - 2014/12
N2 - We report a rare case of Cushing’s syndrome caused by bilateral cortisol-secreting adenomas in a 63-year-old man. Our preoperative diagnosis was based on endocrinological results and imaging findings. Laparoscopic adrenalectomy has become a standard technique for adrenal tumors; however, bilateral adrenalectomy results in postoperative adrenal insufficiency, necessitating lifelong steroid replacement. To preserve adrenal function, the left adrenal gland was completely resected, whereas the right adrenal gland was partially resected laparoscopically. Hydrocortisone supplementation was initiated at a dose of 30 mg/day and was slowly tapered. However, symptoms of adrenal insufficiency developed, and adrenal steroid secretion did not respond to exogenous adrenocorticotropic hormone. Bilateral cortisol-secreting tumors rarely cause Cushing’s syndrome. The present study comprised few patients, and the utilized surgical procedures (i.e., total/partial adrenalectomy or bilateral total adrenalectomy) were not uniform. Few cases of bilateral adrenal-preserving surgery have been reported. However, our patient developed adrenal insufficiency after the oral cortisone supplementation was tapered. This report demonstrates that partial adrenalectomy does not necessarily preserve normal adrenocortical function. Therefore, careful postoperative observation is necessary for patients undergoing a partial adrenalectomy.
AB - We report a rare case of Cushing’s syndrome caused by bilateral cortisol-secreting adenomas in a 63-year-old man. Our preoperative diagnosis was based on endocrinological results and imaging findings. Laparoscopic adrenalectomy has become a standard technique for adrenal tumors; however, bilateral adrenalectomy results in postoperative adrenal insufficiency, necessitating lifelong steroid replacement. To preserve adrenal function, the left adrenal gland was completely resected, whereas the right adrenal gland was partially resected laparoscopically. Hydrocortisone supplementation was initiated at a dose of 30 mg/day and was slowly tapered. However, symptoms of adrenal insufficiency developed, and adrenal steroid secretion did not respond to exogenous adrenocorticotropic hormone. Bilateral cortisol-secreting tumors rarely cause Cushing’s syndrome. The present study comprised few patients, and the utilized surgical procedures (i.e., total/partial adrenalectomy or bilateral total adrenalectomy) were not uniform. Few cases of bilateral adrenal-preserving surgery have been reported. However, our patient developed adrenal insufficiency after the oral cortisone supplementation was tapered. This report demonstrates that partial adrenalectomy does not necessarily preserve normal adrenocortical function. Therefore, careful postoperative observation is necessary for patients undergoing a partial adrenalectomy.
KW - Adrenal insufficiency
KW - Bilateral adrenocortical adenoma
KW - Cushing’s syndrome
KW - Laparoscopic adrenalectomy
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M3 - Article
C2 - 25504201
AN - SCOPUS:84948977830
VL - 39
SP - 158
EP - 165
JO - Tokai Journal of Experimental and Clinical Medicine
JF - Tokai Journal of Experimental and Clinical Medicine
SN - 0385-0005
IS - 4
ER -