Spontaneous rupture of adrenal incidentaloma in a patient with subclinical Cushing’s syndrome, whose clinical expression is metabolic syndrome

Abstract Purpose Adrenal incidentaloma (AI) and adrenal masses in cases of subclinical Cushing’s syndrome (SCS) initially require follow-up imaging. In this study we used endoscopic ultrasound (EUS) as a method for high-resolution imaging. The aim was to evaluate the growth rate of AI and SCS by EUS. Materials and Methods This retrospective analysis included 93 out of 229 patients with AI or SCS who were investigated longitudinally by EUS in our university hospital between 1997 and 2013. The longitudinal follow-up required at least two investigations by EUS and evaluation of endocrine function. Plasma renin, serum aldosterone, 24 h urinary catecholamines and 2 mg dexamethasone suppression test were performed. EUS was performed at baseline and during follow-up. Each time, the maximum diameter was measured. Three groups were defined: non-functioning adenomas (NFA), non-functioning nodular hyperplasias (NFH) and SCS. Results 86 patients had non-functioning masses [NFM] (59 NFA, 48 NFH) and 7 patients had SCS (10 masses). At baseline the mean diameter was 19.4 (± 9.3) mm (NFM) and 19.6 (± 9.2) mm (SCS). The mean follow-up period was 31.6 ± 28.7 months. The estimated mean growth rates per year were low: They were 0.35 mm/yr [NFA], 0.02 mm/yr [NFH] and 0.53 mm/yr [SCS]. Furthermore, there was no malignant progression of any mass. Conclusion The growth rate as determined by EUS was low for all tumor entities observed in this study. There was no difference in tumor growth between the groups.

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An Uncommon Presentation of Adrenal Cyst with Subclinical Cushing’s Syndrome: A Diagnosis Dilemma

Case Reports in Endocrinology ◽

10.1155/2021/6662492 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

A. Tahri ◽

W. Abdellaoui ◽

S. Benyakhlef ◽

K. Boujtat ◽

I. Mahroug ◽

...

Keyword(s):

Cushing’S Syndrome ◽

Adrenal Incidentaloma ◽

Cushing's Syndrome ◽

Adrenocortical Adenoma ◽

Subclinical Cushing’S Syndrome ◽

Unique Case ◽

Partial Adrenalectomy ◽

Adrenal Cyst ◽

Uncommon Presentation ◽

Tomography Scan

Adrenal cysts are a rare entity that is usually nonfunctional and asymptomatic. Their association with adrenal neoplasms was rarely described in the literature. We report a unique case of a 40 -year-old woman who was referred for evaluation of a left adrenal incidentaloma with subclinical Cushing’s syndrome. The tumor was suspicious for malignancy regarding computed tomography scan (CT scan) features. Therefore, a laparoscopic left partial adrenalectomy was performed. Pathology examination showed multilocular spaces lined by endothelial cells which are compatible with endothelial adrenal cyst, associated to an adrenocortical adenoma. We further discuss the management of adrenal cyst with review of the literature.

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ACTH-independent subclinical Cushing's syndrome in patient with acromegaly and adrenal incidentaloma

Endocrine Abstracts ◽

10.1530/endoabs.49.ep831 ◽

2017 ◽

Author(s):

Maria Kurowska ◽

Joanna Malicka ◽

Jerzy Tarach

Keyword(s):

Cushing’S Syndrome ◽

Adrenal Incidentaloma ◽

Cushing's Syndrome ◽

Subclinical Cushing’S Syndrome

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Serum Adiponectin Level as a Predictor of Subclinical Cushing’s Syndrome in Patients with Adrenal Incidentaloma

International Journal of Endocrinology ◽

10.1155/2016/8519362 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Asli Dogruk Unal ◽

Semra Ayturk ◽

Derya Aldemir ◽

Neslihan Bascil Tutuncu

Keyword(s):

Cushing’S Syndrome ◽

Adiponectin Level ◽

Adrenal Incidentaloma ◽

Signs And Symptoms ◽

Urinary Free Cortisol ◽

Cushing's Syndrome ◽

Subclinical Cushing’S Syndrome ◽

Free Cortisol ◽

Detailed Medical History ◽

And Control

Subclinical Cushing’s syndrome (SCS) is a condition of slight but chronic cortisol excess in patients with adrenal incidentaloma (AI) without typical signs and symptoms of Cushing’s syndrome. Adiponectin has potent roles in modulating energy balance and metabolic homeostasis and acts in opposition to glucocorticoids. This study aimed to evaluate adiponectin level in SCS and nonfunctional AI (NAI) patients and its relation with metabolic parameters. Patients with AI (n=40) and metabolically healthy controls (n=30) were included. In AI patients and controls, detailed medical history assessment, physical examinations, anthropometric measurements, and laboratory measurements were performed. Age, body mass index, waist circumference, and lipid profiles were significantly higher and waist-to-hip ratio and adiponectin level were significantly lower in the AI patients than in the controls. The midnight cortisol and urinary free cortisol levels were significantly higher in the SCS patients (n=8) than in the NAI patients (n=32). Adiponectin level of the SCS group was significantly lower than those of the NAI and control groups. The sensitivity and specificity for an adiponectin level of ≤13.00 ng/mL in predicting the presence of SCS were 87.5% and 77.4%, respectively. In conclusion, adiponectin is valuable in predicting the presence of SCS in AI patients.

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